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carl68

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June 6, 2016

How I inspired my student how to save other’s life over a decade ago

June 6, 2016 | By |

Yesterday was a surreal day in many ways but one thing stood out and made me think about all my years here in Thailand! Why had I stayed here for 16 years!?

As a teacher you always have a little dream tucked away in the back of your head that one day you will make an impact on someone else’s life. I sometimes see my grade one and two students applying something I have taught them in a real life situation and it makes me beam with pride and happiness like a parent must feel when their child takes their first steps or says their first words.

As a medic I have also experienced these feelings when I see fellow rescue workers applying the same techniques or protocols as myself.

The value of keeping my big mouth shut

When I first came to Thailand and joined the rescue service 16 years ago I came with the wrong type of thinking, I came with the idea I would actively go out and tell rescue workers what they were doing wrong and teach them the right way….

Im surprised I lasted as long as I did 🙂 lol

It soon became apparent to me, they thought I was a dick, and so for some time after that I just started doing things my own way, ignoring what others may have been doing wrong and basically keeping my mouth shut.

I had almost given up on trying to teach when one day I began to notice changes in the habits and attitude of the workers around me, and I realized they were actually emulating some of the things I was doing.

It was then that I realized the significance of cultural teaching methodology that I had long forgotten since my days of studying linguistics at university.

Thailand’s attitude adjustment created new chances for me

In the unusual environment of Thai EMS system, there is a lot of active learning as most volunteers start off with only a 2 day training course before embarking on hands on trauma care in real life situations, normally peered with more experienced workers this passive-active environment builds some good EMS workers but sometimes at the expense of patient outcome.

Nevertheless, this is the hand the government has dealt us and so it is one we have to work with.

After some time since my “attitude adjustment” I was even more surprised to have rescue workers actually come to me and ask me questions about how to do things, about equipment, and even about English in the EMS environment.

I had become more of a trusted mentor than teacher and that worked well for me and everyone around me.

bkk-free-ambulance

Over the years I was finally entrusted officially as a teacher at the Ruamkatanyu Foundation’s yearly training sessions which finally solidified my status as a teacher but I think the groundwork I unknowingly did over those long years was the real reason.

Nowadays I am still asked to teach here and there but now I enjoy more just doing my thing in the field and hoping the passive learning method continues to work.

Meeting old friends

And so back to yesterday. I had just delivered a patient to ER and was waiting outside to collect the paperwork when I met another Ruamkatanyu volunteer who had also just delivered a patient.

Recently I had started working in a new area and so did not recognize him but being fellow rescue workers we smiled and nodded. I could see him hesitate as he forced himself shyly to approach me and he called me “Ajarn” (teacher), “I studied at Tepleela high school”.

I thought it was a little strange for a first thing to say to someone but then I remembered that for a short period of my first years in Thailand I was a contract teacher there and so I said “Oh, I used to teach there too! About 14 years ago”, he smiled holding back his laughter and said “I know, I was your student”.

Then the penny dropped, in my defense I had just worked a 12 hour shift!

And so it all came together in a head rush, he began to tell me that he had been impressed as a 14 year old student that a foreigner had come to Thailand and wanted to help people and had followed my life over the years, from TV and other social media, this had prompted him to join Ruamkatanyu as a rescue worker and help people too.

I was overwhelmed with pride, happiness and a sense of worth! But what surprised me most was the fact not even his fellow workers knew his story, he had just quietly embarked on his own odyssey quietly and humbly.

Of all my own perceived achievements this one has stood out among them all, enough to sit down and write about it.

I think he has no idea how he has made me feel but to say contented with my life here in Thailand would be the top of a very long list because of this simple chance meeting 🙂

carl68

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December 27, 2015

2015 A Year of Resolution and Evolution

December 27, 2015 | By |

New Years Eve 2014: I arrived at my condo minutes before midnight after a night out volunteering in the ambulance. I sat out on my balcony with a bottle of Carabao as the skyline began to light up with fireworks and began thinking about life, as people sometimes do, the universe and everything.

In my work I regularly deal with the poor and needy and sometimes it takes a toll on the soul, sometimes when friends invite me out to an expensive restaurant I don’t enjoy the experience as I should because I often have a negative view on consumerism and waste. If the food is impeccable and the company is good I can enjoy myself but there is always the visions of past that haunt me, I always know in many places around Asia tonight children sleep in hot open air houses with little or no food, unhygienic conditions and infested with mosquitoes with diseases that could kill them. I forcibly try and forget the visions otherwise I think I would go mad with grief and sorrow. This lifestyle is harder than anyone can really know unless they have lived it, and I really understand why people suddenly give it up and go back to what I consider relatively “normal” lifestyle. I’ve seen plenty of friends get fucked up by this lifestyle and so I try to handle it the very un-psychological way by just blocking it out. For the most part this works.
Treading the line between first and third worlds is like living in limbo, you never feel comfortable or at home anymore, no matter where you are.

Since “Fight Club” inspired me to become interested in minimalism I think I have grown more, and as Tyler Durdens once said

Fuck off with your sofa units and strine green stripe patterns. I say never be complete, I say stop being perfect, I say let’s evolve—let the chips fall where they may.” I

like to think I have evolved….

As a teacher in Thailand we are supposed to not only teach our subject, science being mine, but also espouse the teachings of Buddha and King. “Self-Sufficiency” has always been the hallmark of the King and one I do like to support, particularly with my middle class kids who, like me as a child, want for nothing. My 6 year olds often have the latest cell-phones and gadgets, and often talk about wanting more. I like to share my stories of children in Thailand and Myanmar who have nothing, and try to balance it with the Buddhist philosophy of walking the middle path. Most of them lap this up and are happy to engage their parent’s questionable expenditures much to the horror of their parents.

As I gazed at the fiery display over Bangkok I decided then I wanted to experience more what it is like to be without and so my 2015 New Year’s Resolution was to not buy anything non-essential for a year.

So my New Year started with an invite from my Japanese friend Koju who was having a Kobe beef and Sake party at his restaurant, he said it would only cost 1500 per person…. I shyly began to explain about my New Year’s resolution and that I could not spend that kind of money for alcohol, although I might be able to explain it away with Kobe beef being a food which is essential to all life… that was pushing it…. but before I had tried to rationalize things he calmly said “well then I need an assistant chef and dishwasher so if you will help out you can come for free”! J

My first hurdle was so easily overcome! I was so happy and thought, this can really work! Could I revert to a life of barter? Was that cheating? I guess it was in a way since if I was to experience being without then I probably should not be using my skills as a teacher, medic, or dishwasher! So I added this to my new list of rules….. to be enforced ‘after’ the party. J

As the weeks rolled on I had to basically make up rules as I went along since I had not planned this at all. It made me think a lot about what I had and how lucky I was and how some more insignificant parts of my life became more significant. Firstly I realized how blessed I was with friends who understood and supported my resolution. They would often offer to pay for things but I did insist I paid my way at least, so “going Dutch” was the norm now (or “American Share” as they say in Thailand, I guess that came from the days when the US army was around and Thai’s first experienced this act).

One day just before the end of term, my belt broke and so was thinking about how to solve this problem without buying a new belt, I had glued it back together but I knew this would not last long. The very next day to my surprise I received a present from my graduating students, of course it was a belt. They had no idea I needed one so it was a kind of Twilight Zone experience. One more hurdle overcome.

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Over the months a very strange thing happened, I noticed I had begun to care more about my belongings, I would check my shirts after they were cleaned and make sure they were ironed to perfection. I hate ironing and it was one of the new chores I had that I normally farmed out to the lady downstairs. Despite trying to be free of attachment I actually became more attached to my belongings knowing they would have to last me for the year at least. Whether it was attachment or desperation did not matter, I felt it was giving me a greater sense of appreciation to the things around me.

Now, we are on the eve of 2016, I have not purchased anything for myself and honestly have not really missed much! I feel glad I have done this and even decided to continue to do without, but not quite to the same extent. I still want some headphones so I can listen to music in my classroom when other teachers are teaching, I would like a new shirt for going out since my Facebook pictures look like they have all been taken on the same day, and a few other non-essentials.
This experience plus my years in Thailand helping the poor and needy have made me feel I cannot go back to a life of unabated consumption but neither can I live a life of destitution, I love my air-conditioned room, my Sunday morning Yum-Cha breakfasts, and my holidays with my brother to foreign lands, these are some of my personal “essentials”.
I could never be a monk, I have tried it and failed but what I do want to do is continue helping people less fortunate, in a way this is part selfishness as I get so much satisfaction from it, fortunately the recipients seem to get more from it so I can live with my own selfish part.

Once or twice a month I see 2 old people walk past my ambulance standby area pushing their giant pile of recyclables they have collected during the day. This gives them their 300 or 400 baht allowance for daily living costs. Once or twice a month I ride over to where they take their rest on Sukumvhit road and ask how they are and offer some money to them suggesting they take a rest for a day or so, Im never sure if they do or not but at least they could if they wanted. The old man always gives me a blessing, and that smile is more than worth the 500baht.

My suggestion to people who want to experience minimalism is first go to your closet and look at all the clothes you have not worn for a year, pack them in a box and donate them to a charity. See how you feel, if you feel good, do it again with other stuff in your house, continue doing this until light and fluffy. My friend Oz in Canada did it after I recommended it to him and he said he felt a load had been lifted from him. It really is enlightening.

Alternatively you could try philanthropy being a way out of minimalism whereby you get to be good but keep all your goods, research and choose wisely who you donate to.

Altruism is probably a step too far unless you are spiritual and believe in Nirvana (not the band) and can also be detrimental to yourself but whatever you decide to do, just do it, I promise you it will lift you mind and spirit to new levels.

Most importantly say no to wanton consumerism and waste and don’t give me that bullshit about if we all stopped buying the universe would come to a standstill. There are millions of articles by economists to debunk that theory (eg: http://www.mrmoneymustache.com/2012/04/09/what-if-everyone-became-frugal/)
Use your time and money more wisely, if not for the world then for yourself. Oh, and one more thing, just for fun, do watch and analyze ‘Fight Club’ as part of your transition.

Evolve and have a Happy New Year everyone J

carl68

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October 8, 2015

Machete attack: Severed limb dressing

October 8, 2015 | By |

WARNING! GRAPHIC CONTENT!
This video is for rescue workers and features some graphic scenes of a machete attack and how we took care of a severed limb. Comments/discussion welcome.

On a Tuesday night in Tong-Lor a teen gang chased down and cut off the hand of a rival. On my motorcycle ambulance I arrived too soon as the gang was just leaving with machetes in hand and walked straight past me, thankfully ignoring me. They are afraid of nothing. It’s a tense moment as I am there to assist their foe. I make my way in past the victim’s shocked friends and shop owner, Two morons are standing in the doorway filming the teen bleed out, I push pass them realizing now I am alone in the back room surrounded by teen thugs with weapons. I try to concentrate on my job as I see a teen on the stairwell holding his stump where his hand used to be. Blood has been sprayed all around the room and a large pool of blood is on the floor around the teen. I only have 2 small hip bags of dressings but luckily have an Israeli bandage which I decide to use to stop the now weak flow of blood coming from the stump. The teen is pale and looks ready to pass out but manages to keep talking with his friend. As i am working I am still keeping an eye behind me in case the gang returns to finish him off, or his friends arrive with guns to retaliate. I work as fast as i can not only for his sake but for mine.
As I finish I see the hand on the floor and pick it up and put it in a plastic bag, just then, to my relief, my friend Yo walks in behind me and without me asking he coolly goes straight to the freezer for a bag of ice. We pack the hand and transport him out to a waiting volunteers ambulance. I’m standing outside coming down from the adrenaline rush when a girl, perhaps the teens friend or family member walks up to me and thanks me, she takes me off guard after such a tense moment.
The police officers face says it all at the end of the video when he inquires about the severed hand.

This should also be a warning to anyone, not to ever get involved in fights in Thailand. Thai justice can be quick and unforgiving.

Blur and music is to hide victims and assailants as this is an ongoing case.

carl68

By

September 5, 2015

Bangkok Bombing 2015

September 5, 2015 | By |

On the 17th August 2015, the largest bombing in Bangkok’s history occurred inside the popular Erawan Shrine at Ratchaprasong Intersection in Pathum Wan, Central Bangkok. 

Initially it was reported as a possible car LPG tank explosion, of which Thailand has many. There were also reports on emergency radio frequencies of many injured, but numbers were not exact.

Although Pathum Wan is not an area I cover in my duties as a Rescue Medic, a friend suggested I attend this incident as reports of the wounded began flooding in. Ratchaprasong intersection is a quick 5-minute ride away from where I am usually stationed – I drive a motorcycle ambulance enabling me to navigate Bangkok’s grid-locked traffic and quickly arrive on scene to assist patients until ambulances arrive.

A few minutes later as I entered the Lumpini area of Bangkok I heard on one of my radios a conflicting report that it was a motorcycle bomb; a type we regularly have in the south of Thailand. Radio chatter was alight with reports of many seriously injured, and even some deaths. I picked up my pace and arrived two minutes later.

As I neared the scene I turned on my bodycam and began filming; the rest of what happened can be viewed in this video.

The initial video was 20 minutes long, but I edited it and pixelated the faces of the victims as well as I could to preserve some dignity for them and their families. I recorded the scene to allow my fellow rescue workers around the world to witness an EMS scene they themselves may one day have to attend. I hope it will assist you in your training courses.

Arrival on Scene

0:00 Because of traffic, I ended up on the wrong side of the road when entering the scene. And so I initially did not see the extent of the carnage opposite me, where the shrine is. In front of me I saw a man lying on the road who looked like he had some serious injuries and was unable to stand. I noticed people all around me being carried away with superficial to serious injuries.

I parked my bike next to a column that supports Bangkok’s BTS sky-train system and dismounted ready to help the man on the road. As I approached him, a fire-rescue worker came to his aid. I turned around looking past the column and finally saw the destruction the blast had wrought. I was quite stunned to see such devastation and made my way over as I spotted a lady lying motionless on the ground with no one assisting her.

At 0:51 I was briefed by a rescue worker that this lady had no pulse. The reason I continue to check her pulse is that I wanted to double check, since in the past rescue workers have made mistakes causing delays in treatment. After checking with my pulse meter and physically checking her carotid artery and eyes, I felt she was already cool to the touch. I pay little attention to a small hole in her cheek which later would probably be the main reason she died – it was made by a ball bearing shooting at high velocity up through her cheek and probably entering her skull. All this time I am surveying the scene and noticing more bodies inside and outside of the shrine area. A rescue worker is telling me a motorcycle bomb caused the explosion. I feel the scene is safe for me to enter, so do so. On my left is a woman that looks in shock, staring eerily into space. She is already on a spinal board and about to be lifted out.

The Shrine

Inside the shrine is chaos. There are more reporters than rescue workers and I have to push past them. There is still no scene control at this time. At 1:55 I arrive to assist a group of ambulance staff removing a patient but then stop and look down to notice I am straddling 3 other bodies with others all around. My head is trying to take in all of this, and make a decision who to help first. I walk around the group and see several fatally injured people, and some body parts. I start checking pulses, but most I do not even need to check as they are obviously deceased. The blood, concrete dust, dirt, and oil from the shrines now damaged oil lamps, is all mixing together and causing volunteers to slip and slide – sometimes losing their footing and ending up covered in this mix.

A breath of life

2:24 I am wondering if there is anything I can do anymore when I notice a lady in a blue top near my feet. I see her eyes open and then close again. I push past a medic next to me and kneel down in the blood. I can’t believe she is alive, as she has some significant injuries to her lower extremities. As I start cutting open her clothing to check for other injuries I am looking around for other signs of life. There are two other people piled on top of her legs, and they look severely disfigured having been left for dead – as was this lady until I noticed her eyes. Someone besides me notices I am helping this lady and calls for people to assist in removal of these bodies but nobody responds so I jump over and move them myself. I feel bad to push aside the bodies as if they are a piece of debris but I am still hoping to get life out of this situation.

3:40 Under the bodies are pieces of other people’s bodies and it is then I notice that both her legs are broken in multiple places – from the femur down to her feet. These injuries alone are life-threatening and I wonder how long she has. I once again notice holes everywhere and finally click that this must have been a ball bearing bomb intended to cause maximum damage and casualties. I automatically think this is not a Thai bomb; I have never encountered this kind of devastation from a bomb in Bangkok before, and I have been to several already, mostly without fatalities. They are normally used to cause panic or political instability but this was different, this had full intentions of death and destruction.

4:26 I look up suddenly to see my partner, Tiger, arrive with a board and vacuum splints. I’m so happy to see him. Moments later other members of our team arrive – Pop, and young Bond. They are unfazed by the devastation and just do their job! I am damn proud of them! As they are preparing to take patients to the ambulance; I am busy applying “combat dressings” to the wounds. It is hard to know what to bandage since there are so many wounds. If I had more time I would have her looking like a mummy before she left, but the boys want to get her out of the scene as I find out later there is now talk of a potential second bomb.

6:00 She is taken from the scene, and I assume off to hospital.

6:10 I’m walking around trying to assist others, stepping over dead bodies to get anywhere.

6:30 the police and army are trying to clear everyone out, I still want to check on the bodies I have been stepping over, but notice they are already shrouded in white cloth.

6:40 I go to assist another EMS group with their patients. I am told the girl is dead, but the man seems to not have life threatening injuries. We finish patching him up and are moving him onto a board when I realize he is expressionless – staring at the girl next to him whom I guess is his girlfriend or wife. Someone tells him she is dead and to release his hand from her so we can board him out. He was either deaf from the blast or in shock, but finally we had to remove his hand and take him away. For me this was the hardest thing to forget that night – I felt so sorry for the guy, and of course his partner.

7:20 I get a good look at the bomb crater.

7:38 I notice our ambulance has still not left scene and is full of doctors and nurses working on our patient. I make my way over to see they are doing CPR, defibrillating and intubating. I make my way in to assist. I didn’t want to lose my patient.

8:00 I take over CPR. The video is cut short, but after another five minutes she is taken to hospital. A few hours later she is pronounced dead from internal bleeding.

8:57 I notice a bird cage and just wish I could find a bird alive in there to release, but once again the reaper wins out this night.

I’m still a bit dazed and trying to take it all in. Now there is only the familiar white shrouded victims we could not help, laying all around us. I work my way back to my bike and behind the column I notice a hidden plastic bin bag hanging head height just 3 meters from me. I feel a cold hand over me as I get off my bike. I walk around the column to tell army and ranking police officers what I found. They quickly clear the area and a bomb disposal officer is brought in. After an hour someone tells me it is diffused – I find out a day later from a reporter friend that it was not a bomb. Lots of misinformation happened during this time but I still feel I did the right thing – Perhaps I could have saved many people had it been a bomb.

EMS Personnel

I want to say I am really proud of the Thai EMS and how they were able to clear 150 injured from the scene in the space of about 30 minutes. Remember that most of these volunteers are First Responders with only a 2-day training course under their belts. The Thai hospitals and government ambulance services coordinated the receiving of patients well, and there were plenty of nurses and doctors on scene within 15-20 minutes of the blast. Thailand’s ‘Secure, scoop, and run’ system works well because of the abundance of hospitals. Western systems are slowly heading back this way, asking advanced paramedics to spend less time on scene and to get patients to hospitals faster. This is a good system for Thailand and it seems to be working well.

The Victims

Finally, to all those that died this day, may you be remembered for the goodness you may have done, the love you may have given, and the way you may have touched someone else’s heart.

carl68

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May 15, 2015

CPR Training (Thailand-Myanmar)

May 15, 2015 | By |

In my last 15 years of working in Thai rescue service I have always been confused and concerned about the fact that CPR (Cardio Pulmonary Resuscitation) was not part of the First Aid, or First Responder (FR) courses here. Read More

carl68

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May 15, 2015

Basic Life Support Action Plan in Burmese

May 15, 2015 | By |

Download our BLS action plan in Burmese and learn how to save life!

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carl68

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May 3, 2015

BFA Motorcy Ambulance

May 3, 2015 | By |

In 2013 I was involved in 2 fatalities due to cardiac arrest because of traffic jams. The traffic in Bangkok central has increased over the years and as a result traffic jams are a daily occurrence. In 2013-14, I tried to find sponsors for a new advanced motorcycle to try to get around this problem. Read More

carl68

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March 24, 2015

Myanmar EMS Brief 2015 by Marko Cunningham

March 24, 2015 | By |

This month I traveled to Myanmar for 1 week on a fact-finding mission into the state of the Myanmar Emergency Medical Services System, in particular, the Pre-Hospital volunteer rescue organizations and their role in the system.

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carl68

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April 22, 2014

Bomb explodes in Bangkok killing 7 people

April 22, 2014 | By |

April 2 2014, Bangkok Thailand an old bomb found by the authorities accidentally exploded during removal killing at least 7 people and injuring 19. Read More

carl68

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January 4, 2014

Kiwi caught up in Bangkok clashes

January 4, 2014 | By | No Comments

Marko talks with one news live from streets of Bangkok clashes during May 2010.  Read More