When It's Not Enough- Jean Bramer, MD

Anyone in healthcare knows the joy & satisfaction of helping others to feel better. But they also know the sorrow & frustration of when it doesn’t work or if there’s nothing you can do. You take it personally. If only… Usually it is a condition that has progressed rapidly or the patient waited too long to seek care. But for the students & physicians at Rain Tree, it is often because of lack of resources & the remoteness that causes them to not be able to heal patients.

Rainy Season Challenges

In the US, I’m used to being able to consult lots of specialists & try multiple treatments before finally realizing that I can’t help them. And by the grace of God, it’s not a common experience that I have in OB. At Rain Tree there are 5 physicians teaching the students & supervising all of the patient care. That means that every difficult case falls on one (& usually several) of them.

They are well trained & often know what is needed, but unable to provide the level of care or transfer to a higher facility in time. That means they are often having to do what they can but without the outcome that they hoped for.

My thought process started from a recent case that led to a maternal mortality. It highlights so many parts of life in Burma that are different from everything I’ve ever known. She delivered her 13th baby at home with a “traditional” midwife (meaning no formal training). It was a difficult delivery that we don’t have a lot of details about. The baby was stillborn. She wasn’t feeling well and was sent to an outside clinic the next day.

"Bambulance" in Action

She was transferred to Rain Tree after getting worse over several days but had to be carried by “bambulance” (bamboo with hammock) for 10 hours over jungle trails because of rainy season. Upon arrival she was immediately taken to surgery. Unfortunately she did not survive.

OR in Middle of Jungle

It’s hard to know if the outcome would’ve been different in the US but there definitely would’ve been many more doctors to share the burden with. And eventually those doctors would be able to go home & rest allowing a new group to take over. At Rain Tree that too is not possible. They rotate call & help one another out but when those really sick patients come, they are all working to save them.

Death is inevitable, but as physicians we work hard to prevent it. The emotional toll is difficult. It’s part of our jobs but that doesn’t make it easier. The PA students and physicians have lived the majority of their lives in a world of conflict. They know death more than they should, but it’s still hard every single time. When I visited Rain Tree I was amazed at the facilities that they have created in the middle of the jungle - especially after the journey to get there - realizing that everything had to arrive via that same route!

Thankfully there is more than life or death; there is the promise of salvation for those who know Jesus. And that is what Rain Tree exists for - to share the gospel with the Karen people by showing them the love of Jesus through healthcare. Please join me in praying for the students & physicians at RainTree as they face challenges each day & allow the Great Physician to give them wisdom & comfort them even on the hardest days..