After an arduous 4-hour drive in the rural district of Pakseng (northern Laos), the Outreach team arrived at Namthip's house. The team had come to bring Namthip back to Lao Friends Hospital for Children (LFHC) to get an urgent blood transfusion and surgery.

*Namthip with her little brother and mother, preparing to go to Lao Friends Hospital for Children*

12-year-old Namthip is well known to the LFHC’s Outreach service as she has been coming to Lao Friends Hospital for Children (LFHC) for several years under the care of the Thalassemia Clinic. She’d missed several follow-up blood transfusion appointments, and the surgery to remove her enlarged spleen has been postponed several times due to her low blood count. Concerned that her condition is getting worse, the outreach team pursued bringing her to the hospital and getting the urgent care she needed.

Shy and gentle Namthip lights up the room when she smiles. Her parents describe her as their ‘little angel’. She never complains and always helps out in the house, cooking and carrying water every day. She lives in a very remote area with her parents and her little brother. It takes around two hours' drive from the hospital, but the road conditions, especially now during the rainy season, took the team more than four hours one way to reach her.

Namthip has thalassemia, an inherited blood disorder that prevents the body from making enough healthy hemoglobin. She also has hypersplenism, a common complication in thalassemia where the spleen enlarges and starts destroying blood cells faster than they can be replaced. Namthip needs surgery to remove it, but the operation has already been postponed more than once because her hemoglobin levels have been too low for it to be done safely.

Living with Thalassemia in rural Laos

For children with severe thalassemia, regular blood transfusions are essential. Without timely transfusions, children can become severely anemic, weak and exhausted, and over time may develop serious complications affecting their organs.

For Namthip and her family, this means returning regularly to LFHC in Luang Prabang for monitoring and blood transfusions. But for a family living below the poverty line, getting her to the hospital is rarely just a matter of making the trip. It is a matter of cost, and of logistics that can quietly overwhelm a household with little to spare.
Her father is a farm laborer, paid only when a contract ends, which can mean months without income. Her mother forages for vegetables and takes odd jobs in the province to fill the gap. To afford Namthip's hospital visits, the family took out loans they are now struggling to repay, with interest piling up faster than they can clear it.
Every trip to the hospital means both parents lose a day's income, sometimes several, since Namthip's treatment can keep her admitted for days or even weeks at a time. For a family already stretched thin, that cost is often the difference between going and not going. It is why her appointments had lapsed, and why our team went looking for her.

This is the reality for many families across northern Laos raising a child with a chronic illness. LFHC's social work team helps with transportation costs when possible, but even with that support, coming to the hospital still carries a real cost, in lost wages, in time away from home, and in the uncertainty of not knowing how long a stay might last. Blood supplies in Laos are limited, and finding enough compatible blood can take time. As a result, a hospital stay that might otherwise be short can stretch into several days or longer, deepening the very hardship that made the trip difficult in the first place.

**When Namthip missed another appointment, waiting for the family to return was no longer enough.**
The Outreach team set out to find her.
When the team finally reached the family’s home after traveling through difficult rainy-season conditions, nobody was home.
A neighbor pointed them further down the road.
There, they found Namthip and her mother surrounded by hundreds of small potted plants.

Namthip’s mother had been preparing as many plants as possible to sell. The little money she could earn would help cover the family’s everyday expenses while they were away from home.

When the Outreach team arrived, she was still rushing to finish as many as she could.

Before leaving, the team helped her count them.

“We missed appointments because we couldn’t afford the cost of transportation, and the road to our village is so deep in mud that even walking is impossible, but still they came to pick up Namthip because they really care. ”

— Namthip's Mom

Then it was time to go. Namthip was brought back to Lao Friends Hospital for Children.

By the time the team found her, the effects of her missed treatment were clearly visible. She was extremely tired, her skin and eyes were yellow from jaundice, and her abdomen was swollen. She needed medical care urgently.

For the past two weeks, Namthip has remained an inpatient at LFHC, receiving the blood transfusions and medical care she needs to become strong enough for surgery. Her operation remains urgent, but her surgeons must wait until her haemoglobin reaches a safer level and her condition is stable enough for the procedure.

For now, she is doing better.

Between treatments, Namthip can sometimes be found spending time with LFHC’s Child Life team playing, talking and sharing moments of normal childhood in a place that has become very familiar to her.
Despite everything she has been through, Namthip is already thinking about other children.
Ask her what she wants to become when she grows up, and the shy 12-year-old does not hesitate.
**“I want to be a doctor so I can help others.”**

Challenges during this heavy rain season

Namthip’s story is deeply personal, but it is not an isolated one. Across northern Laos, children living with serious and chronic illnesses face enormous barriers to accessing healthcare. During the rainy season, those barriers become even greater.

Heavy rains can turn already challenging rural roads into mud, wash away sections of road, flood river crossings and leave remote communities increasingly isolated. Journeys that normally take two hours can take four, eight or more. In some areas, our Outreach teams may need alternative transportation or additional assistance simply to reach a child.

For patients who need regular treatment, these delays can have serious consequences.

Namthip was fortunate that our Outreach team reached her and brought her back to LFHC. Today, she is receiving the care she needs and is waiting until she is strong enough to safely undergo surgery.

But other children are still out there.

For families like Namthip’s, this support can mean the difference between missing another appointment and getting a child safely back to the hospital.