From the Field
Medical Updates
“Whoever dwells in the shelter of the Most High will rest in the shadow of the Almighty. I will say of the Lord, ‘He is my refuge and my fortress, my God, in whom I trust.’”
PSALM 91:1-2
With the Thanksgiving holiday coming soon for our American friends, it is good to stop and remember what God has done. There is much to be thankful for!
Celebrating 10 Years in Asia!
Ten years ago this October, we registered Earth Mission as a nonprofit foundation in Thailand and started our Physician Associate and Engineering Technology training programs. Earth Mission has been registered in the United States as a nonprofit organization since 1982.
It's incredible how these programs have grown over the last decade:
2016: 13 students enrolled
2025: 94 students enrolled
We couldn't be more proud of these young Karen who devote themselves to serving their communities.
Four of our staff were recognized for 10 years of service: Ray Kaw, Nathan, Mhee, and Dhee. Their commitment to use their skills and gifts is inspiring!
Thank you to all of our guests who were able to come and celebrate with us. It was so good to gather together a decade later to thank God for His wisdom, grace, and protection through both good and bad times. We couldn't do this without your support.
International Day of Prayer
One of our donor partners, Barnabas Aid, hosted a worldwide International Day of Prayer event on November 2. We were invited to join them during the hour of prayer set aside for Myanmar. We are thankful for the many believers around the world who prayed for us.
Along with reading Psalm 91, below are some of the prayer requests our staff shared. Please continue praying with us for:
Their work to be hidden from those who want to harm them.
Rest, energy, and good sleep.
Cessation of the fighting and the military’s violence to end.
The children who have only known war, to receive care and education.
All who have lost friends and family members.
Wisdom to help students and patients.
The people in Myanmar to come to know Christ more.
The churches and organizations that support Myanmar both spiritually and physically, and their leaders as they lead.
God to provide essential supplies and food so none go hungry.
Clarity, favor, and new relationships.
Jehovah Shammah: “The Lord is there, we are not alone.”
Jehovah Shalom: “The Lord is our peace.”
Case Report: Saw Ywa Hay Blut (Year 5 PA Student)
By Bway, Communication Manager
On the night of March 28th, 2025, our clinic received a radio call about a pregnant woman who couldn’t deliver her baby. Saw Ywa Hay Blut, our Year 5 student on duty, immediately went to see the patient with the Stronghold ambulance to bring the woman back. After about an hour’s drive, they arrived at her house, where two local midwives were already present. The pregnant woman was in pain.
Ywa Hay Blut spoke with the midwives, who said she was not progressing in labor and the contractions were still weak. He suggested transferring the woman to our Rain Tree Clinic for delivery, but she firmly insisted on giving birth at home. (In remote areas, many people still hold the belief that they will be better cared for by their ancestors if they give birth at home.)
Together with the midwives, Ywa Hay Blut waited patiently until she was ready to deliver. Around 4 or 5 in the morning, the baby was born after he performed an episiotomy because the mother’s birth canal was too narrow for the baby to come out. After the baby was safely delivered, he also performed the stitching.
Eight months later, the baby came to the clinic with a common cold. We took a picture of the baby with Ywa Hay Blut, both smiling and healthy. Two days later, the baby went home, fully recovered from the cold.
Build a Future Leader
Tomorrow’s leaders are being formed in our midst—because your belief in our students makes it possible! As a sponsor, you get to hear from your student as he or she learns and grows. Thank you to the 75 sponsors who have adopted 19 students so far.
“In my community, we have to hire doctors from other regions to meet our needs. I aspire to establish a better healthcare system in my community. I believe that the more educated individuals we have, the greater our development and success will be.”
Saw Hsar Gay Htoo, Year 2 PA Student
Saw Hsar just needs $3,504 to finish funding his next year of education. Would you join his team? Give online through the link below, or send a check to PO Box 6411, Siloam Springs, AR 72761.
P.S. If you’re interested in sponsoring a different student or multiple students, let Jill Carver, Associate Executive Director, know at jill@earth-mission.org!
Case Report: Learning from Loss
By Dr. Hsa, Medical Director
This month’s patient case describes a tragic loss that reminded me of humility and the need to keep learning. Sometimes we stand on the mountain of success; other times, we must walk through the valley of sorrow.
A 75-year-old woman came to RTC with right upper quadrant abdominal pain lasting several months. Due to the difficulty of travel, she could not come sooner.
Ultrasound revealed large gallstones and a thickened gallbladder wall, diagnosed as calculous cholecystitis. She was started on IV antibiotics and electrolytes before surgery.
During the surgery, the gallbladder was found to be severely inflamed and tightly attached to the liver bed. Two gallstones were noted, but dissection was very difficult. A partial cholecystectomy was performed, both stones were removed, and the cystic duct was ligated.
After surgery, bile leakage was observed from the wound, suggesting duct injury or leakage from the liver bed. We couldn’t immediately reoperate as the patient’s electrolytes needed to be stabilized, and replacement fluids had to be ordered from Thailand.
After we received the needed medicine, a second surgery was performed on the seventh day and a drainage tube inserted to allow external bile flow. Despite intensive postoperative care, the patient’s blood pressure remained unstable, and she had to be ventilated. She started breathing briefly but passed away later that evening.
This was a frail, high-risk patient with infection and severe electrolyte imbalance. The delayed second surgery, technical difficulty of receiving medicine, and unrecognized anatomical variation contributed to the poor outcome. This case deeply reminds me that surgery requires not only skill but humility, awareness of limitations, and timely decision-making. Each loss teaches us to serve our patients with greater care and wisdom.
Rain Tree Clinic (RTC) Hospital & Campus
In October, the RTC Hospital saw 485 outpatients (106 were children under 5 years old), admitted 68 patients, performed 28 surgeries, and delivered 8 babies.
A visiting U.S. Physician Associate taught the students better ultrasound imaging techniques. They performed 44 ultrasounds for patients who came to the outpatient
With roads reopening soon, the fighting is predicted to get worse. Pray for wisdom and protection for all our patients, students, staff, and families.
Primary School
Staff and patients have families who stay here on campus. As their children grow, the preschool has turned into a primary school! There are currently 3 children in preschool, 2 in 1st grade, 3 in 2nd grade, and 1 in 5th grade. Pray for their hearts and minds as they grow in wisdom and stature.
Staff Retreat
Every November and December, we bring RTC staff to Mae Sariang for respite, spiritual development, and team building. As they live and serve in a very difficult, dangerous location, it is important to invest in their physical, spiritual, and emotional well-being. We’re looking forward to time for exploring waterfalls and hot springs, Bible study, shopping, and plenty of rest. Please pray for their renewed strength.
Engineering & Building Projects
With the rainy season nearly over, the engineering team is busy:
Repairing roof damage to student dormitories and the outpatient department.
Repairing critical equipment all over campus like trucks and motor bikes, water pump, generators, and oxygen concentrators.
Mobile Karen Surgical Hospital (MKSH)
In October, the frontline team saw 64 outpatients, 2 inpatients, and treated 4 war-related injuries due to landmine and mortar blasts. The mobile hospital is preparing for the opening of roads at the end of rainy season and potentially more patients and injuries.
Because of your support, they are able to be a light in a dark area. Eh Blu Htoo, Year 1 Surgical PA student, reports on a case:
“On 8 October 2025, a soldier, Saw Htoo, was injured due to an air strike with two of his family, a daughter and a niece.
Around 2:00 p.m. that afternoon, he went to find vegetables with his family and to fish at the pond. At 4:20 p.m., a military jet fighter bombed straight on that place.
They were all injured.
Saw Htoo had a very severe injury and picked up his radio to call for help. The medics and his friends didn't find them for 30 minutes.
At 4:50 p.m., the frontline medics got to them and gave first aid. Then the medics took the patients to our front-line hospital (MKSH), which was 30 minutes away. Our Surgical PA was there, and together with the frontline medics tried to stop the active bleeding as quickly as they could. They applied the dressing and gave 3 units of whole blood.
The patient had severe injuries: left elbow-joint auto-amputation and right knee open patella fracture.
Antibiotics and pain killers were given to stabilize his condition. Then he was referred to Thailand for further management and orthopedic surgery at a hospital there.
This transport from MKSH to Thailand included being taken by boat for a few hours, then by bambulance for a few hours, and then by boat to Thailand… a very difficult journey.”
What is a “bambulance”? Watch one in action.
Get Involved
Once rainy season ends and jungle roads are rebuilt, we will have just a few months to send supplies into Myanmar again. Conflict can escalate at any time, but your prayers and gifts make it possible to transport people and supplies. Thank you for being part of this mission.
We have many ways you can help make a lasting impact on the Karen people!
Become a monthly donor
Give by personal check
Start a fundraiser
Get your donation matched by your employer
Legacy & planned-giving
Donor advised funds
Qualified Charitable Distributions
Stock & mutual fund donations
Mail a check to our address below, give online, or contact Jill Carver, Associate Executive Director, at jill@earth-mission.org to explore your giving ideas.