Cambodia Medical Aid trip 17-27th March 2017

Team Name: – World Hope Network, Australia
Position: – Medical Team Leader
Destinations in Cambodia: – Phnom Penh, Kampong Speu, Prey Veng, Sisophon, Svay Chek, Battambang,

All told about an estimated 750 patients were served.  Whilst these numbers seem low, they include three new sites of contact and experience has shown that people are often reluctant to go to the first clinic in an area.  Usually, the next time we go there the numbers are much busier, the word travels far. Nevertheless, this current trip represented a lot of hard and interesting work as well as some sad situations.

One example was a man who presented with blurred vision and it was obvious that his problem was simply the long-sightedness of middle age but I noticed a lump in his left lower neck.  This is known in surgical circles as Troisier’s sign where there is a cancer in the abdomen, often the stomach and this has spread up through the chest and presents in the neck.  Unfortunately, there is not much that can be done with a patient in this situation, even in Australia and absolutely nothing for someone with this problem in Cambodia.  He was, however, given a nice set of glasses that gave him back the ability to read and he was really happy with the treatment he had been given.  Some people in the local church have agreed to help him in the future.

Another interesting side to the work was a lady we had seen in Sisophon last year.  She was known (rather unkindly) in the village as ‘No 7’ because she had been severely stooped over in this shape for more than ten years caused by a permanent problem with her lower thoracic spine. She presented to the clinic because her posture caused neck pain from constantly trying to look up and she hoped that the ‘clever’ Western doctors would be able to help her neck.

I was the one who first saw her but the best us “clever” doctors could do was prescribe her for some painkillers. One of the members of the team believed that she should pray for total healing, did this, and to everyone’s amazement on this, she straightened up with much joy and tears all round. I was not present to see her after being healed although I have seen her photo, delightedly standing straight her arms extended into the air like she hadn’t been able to do for a decade.  There were no photos of her before her condition was healed, and, of course, at the time I didn’t realise that I was going to be one of the last to see her in her deformed condition.

That was last year and whilst we did not see her this year but was able to find out about what has transpired since.  She has remained upright in body carriage and is really happy with her new posture.  She has moved home recently and we were not able to see her this trip but plan to follow her up and see if we can obtain an X-ray of her spine at our expense simply to see if we can detect how God healed her problem.

Interestingly enough, another lady presented with an almost identical disorder this year, although her hunched position had only been a problem for a little over two years.  This time we have very good photos of her before the team tried praying for healing. Similarly, to the last lady, when this person was prayed for, although this time by different team members, she also was straightened in the same way after prayer.  Again, to the astonishment of all around and this time we made sure that we had good photos of her both before and after healing. One of the pictures shows her at the registration desk where she could only just see over the desktop because of her severely stooped position.

Much to my chagrin, I didn’t see her myself at all, having been involved with a minor operation at the time,

For me from a medical perspective, most of this trip was fairly routine.  At the beginning, there were a few complications in Bangkok because one of our team came from Africa and when I met him there were a few difficulties obtaining a visa for him from Cambodian fears of terrorism.  With a bit of time and bullying of the poor officials by my part, we were able to smooth this all out.

In-country, we always start by taking all our team members to the killing field museum and the killing fields themselves.  We believe that to understand the psyche of these people we have to know the hideous parts of their history.  We don’t insist on people going there a second time and I have been there 4 times in the past and would always rather avoid going back if possible, it is rather upsetting.

We started off the clinics in Kampong Speu where a general is beginning a new hospital.

There were not so many patients here but we believe that this number will increase next time.  Here I saw a patient with what I think is an obstructive cancer of the oesophagus. The patient was referred to the hospital in Phnom Penh where I was able to arrange for him to be investigated.  This will cost our team some money but we were happy to arrange this. Unfortunately, he was rather disgruntled that we were not able to give him a few medicines to cure him. No matter what we said, I don’t think that he will be going until his situation is desperate.

I found a patient with a really complex anal fistula and rather anxiously arranged to attempt a surgical attack on this with local anaesthetic, something that I would be much more comfortable doing under general with the patient asleep. When we searched for the equipment, we found that the surgical instruments had been left at the hotel in someone’s luggage. Whilst we were able to arrange its travel up for the next day this did not help me in my already formidable dilemma.  I went to see our dentist who had some probes, scalpels and scissors, and we had found the local anaesthetic. I managed to complete the procedure without too much trauma but I don’t think that the patient realised that the surgeon was as nervous as he was!

That evening we were due to travel to a new place called Kampong Svay. This was supposed to be a 1-hour bus trip but the driver became lost and we meandered around Cambodia for 4 hours until we finally arrived and had a very late dinner.

The actual clinic the next day was due to be at a place called Prey Veng, theoretically an hour’s drive away.  You guessed it! The driver became lost again and we spent another 3 hours on the ‘scenic’ route until the locals sent a person from the district to drive ahead of us to show the way. Unfortunately, he also became confused and lost his way so we did not begin our “all day” clinic until 1 pm. When we arrived the place where we were to work was amazingly dirty. We spent some time getting a modicum of order but the buildings were of corrugated metal, not the most comfortable material in the tropics, and you can imagine what it was like to be donning surgical garb when the inside temperature was nudging 50 degrees C! Needless to say, when I removed my gloves my hands were white and wrinkled with being wet with perspiration for so long. The team saw 170 Patients in that afternoon in that heat so you might imagine how wrung out we all were at the end. It took 3½ hours to return to Phnom Penh and we had another late dinner; happily, didn’t get lost on the way back.

I was able to do a few minor operations although to the locals, these seem to be amazing but most of my work was more in the realm of general practice until another operation came around and I could return to the sort of work in which I was much more conversant.

Dr. Malcolm Hughes