1. Taylor Veh

2. Huai Malai, Chong Lu Province, Kanchanaburi, Thailand

3. 40 Inpatient Beds (Room for 30 on the floor) Three outpatient “rooms” One delivery suite One operating room (“theatre) Pharmacy Lab Malaria Research Clinic

4. Every morning after devotions we have inpatient rounds. These last 15 minutes to 3 hours depending on the number of patients and how familiar the attendings are with each patient. Monday-Friday has outpatient department from 9:30 until 5:00pm. These are all walk-in appointments, ranging from colds to second opinions on known malignancies. You never know what will walk through those doors.

5. The afternoons, are for the OR All surgical cases are performed under local anesthesia only. Spinal anesthesia takes minutes to set up, but only last a few hours Surgeries were highlight: C-section, nephrolithotomy, D&Cs, hernia repairs, appendectomy, antrectomy with Bilroth II anastomosis

6. I became interested in the KRCH because of their work with refugees, but also because it was a mission of the Presbyterian church (the church I grew up in) You have to wonder how mission hospitals remain open, especially when they serve largely poor, rural patients There are donation boxes in front of the hospital, but how do they take care of everyone else?

7. Kwai River Christian Hospital is a stable, functioning hospital Thai citizens and people with insurance are financially sound for the hospital Displaced persons (Burmese, Mon, Karen, etc.) must be funded by someone (ARC) or pay out of pocket Hospital stays are inexpensive Surgeries and blood are very expensive

8. Most international aid hospitals are not financially stable They have funds for the short term, but don’t have long term plans Many rely on rotating American missionaries to come and provide goods and services before they leave

9. One Singaporian hospital had not paid employees for 4 months After a benefactor left them his money, they paid their employees, and went back in the black Gift would only last about 1.5 years No plans for investment or international fundraising. Will not remain open if they cannot develop a financial plan.

10. Because KRCH has a surgeon on staff at all times, they are able to provide a needed service in a 250km radius People will travel very far to pay for a good surgery, and they do By expanding their services, and investing heavily in OR equipment, KRCH has longevity

11. You have to interpret, instead of literally translate, just like the people helping you Apply international lessons in any unfamiliar situation You cannot remain rigid, you must be flexible

12. You must do the best with what you have. Your patient does not benefit if you know first line American treatments and you don’t know the cost of third line treatment in their homeland. Nobody can hate you if you smile.

13. OR Set-up for Cesarean section Removed antrum of stomach Renal stone removed (2.5 x 3cm)

14. Hypertonic, underweight baby Angioedema in a young girl Burmese boy at outreach clinic

15. First Songkran Attack! Songkran Feast SONGKRAN SELFIE

16. Temple in Mon Village Rubber Tree Grove Nursing Student and Me ED Nurse, Head Nurse, Me, Interpreter

17. Interview Dr. Tzu. 4/13/2016. Murray, Scott. Introduction to Kwai River Christian Hospital. Last update 9/22/2015. Images.google.com Photos: Taylor Veh