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Musings: Blog of the JAAPA Editorial Board


Blog of the JAAPA editorial board.

Monday, December 14, 2015

Physician assistant training in Laos
Alicia Quella, PhD, MPAS, PA-C
This November, I returned from a monthlong training program for 95 first-year physician assistant (PA) students from the College of Health Sciences in the Lao People’s Democratic Republic (Lao PDR).  The didactic curriculum and skill-based training for these Laotian PA students was taught in cooperation with Laotian faculty and with faculty from Health Leadership International (HLI).  HLI is a US-based non-profit organization with volunteer physicians and PAs who have worked in the Lao PDR since 2008.  The President of HLI, Khampho Ohno, PA-C, is a Lao-American who works as a PA in primary care in Guam.
From the start, HLI has worked with the Lao Ministry of Health to improve medical knowledge and clinical skills of PAs who practice in rural district hospitals, particularly the districts affected by unexploded ordnances.  An estimated 2 million tons of bombs were dropped on Laos during the Vietnam War, making it one of the heaviest bombed nations in the world.  Laos’ geography, together with a sizable amount of unexploded ordnance, has hindered the development of its healthcare infrastructure.  A priority of HLI is to train the Laotian physicians and PAs who care for patients when unexploded ordnances explode.  In 2014, an emerging goal was to strengthen the primary healthcare skills of providers in rural communities and to address the high rates of mortality from cardiovascular disease.  The Ministry of Health has asked us to focus on primary care education for PA students and to strengthen their curriculum with a strong focus on hands-on, skill-based learning.
The HLI group in Laos. From left, Alicia Quella; students Justin Shobe, Ellie Andrews, Sarah Kopke, and Portia Kamps; and HLI Executive Director Reba McIntyre, PhD.
In 2015, HLI received the second, 3-year memorandum of understanding from the Laotian government to provide and support PA curriculum. These students are training to work in primary care in the rural areas.  Upon graduation from their program, Laotian PAs typically are assigned to district hospitals and village dispensaries, which have been extremely low-resourced.  These providers will become the country’s frontline of healthcare.
Our training program is supported by a federal grant from the US Department of State’s Office of Weapons Removal and Abatement, which specifically funds ultrasound donations and training in emergency medicine.  The State Department is very interested in building bridges of cooperation in the Lao PDR in order to reverse the damage left by the extensive bombing during the war and the unexploded ordnances that remain.
This year we were awarded a Robert K. Pedersen Global Outreach Grant from the PA Foundation. The grant helped support four American PA students who taught integrated primary care modules to their fellow Laotian PA students.  One of the students, Justin Shobe, developed modules on diabetes and hypertension and led skill-based workshops on measuring BP and checking blood glucose.  The American PA students integrated their teaching curriculum into their master’s projects for graduation. They also gained valuable experience as future PA educators and leaders in global health.
I would like to thank AAPA and the PA Foundation for supporting this unique opportunity to help train Laotian PA students who will be working in primary care.  This year we will continue to build relationships with the Laotian faculty and work with the Ministry of Health on building an innovative and skill-based PA curriculum.
Alicia Quella is a member of HLI and is associate professor and program director of the PA program at Augsburg College in Minneapolis, Minn. The views expressed in this blog post are those of the author and may not reflect AAPA policies.

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