Cambodia Medical Mission Trip

So as i was saying previously, there was a lack of surgical exposure in this trip. Nevertheless, it was great experience medically and spiritually speaking. I landed at Siem Reap on 15 January 2008. Siem Reap is home to the Angkor temples and the most famous one of all is Angkor Wat, which is one of the 7 wonders of the world. Pretty cool stuff. However, what i dreaded was how we had to walk all around the temple before actually entering the main building which is actually the highlight.

We also visited one of the many killing fields that the dictator Polpot used, under the Khmer regime to commit his crimes of genocide. It was a solemn and harrowing experience. Some pictures below:

In all, there were 4 days of medical missions, all at different locations in Cambodia. Out of the map below, i’m glad i went to the 3 main cities - Siem Reap, Phnom Penh and Sihanoukville.

A typical session of medical mission involved clerking patients. I would take a general history and perform a relevant systems review and examination if needed. Then i prescribe the relevant medication and confirm it with a doctor. The 2 doctors we had with us were a General Practitioner (Family Medicine) and a Surgeon (Plastic Surgery). Both were from Adelaide.

That’s Bob and I in the middle taking a break. The translator on the far right.

Interesting cases i clerked were those presenting with vaginal discharge. This was the time when the language barrier actually did help in soothing all awkward-ness in the kinds of questions needed to be asked, like “Are you having sex regularly?” and “Do you have only one sexual partner?” or “Are you aware if your sexual partner has other/multiple sexual partners?” It was funny when i asked those questions and the translator goes “oh! urgh…” and get on with the Khmer translating. Thankfully, only one presented with fishy-smelling discharge, all had bloody urine though.

It’s interesting that we are giving treatment when we have no avenue or time for any sort of investigations at all. This will be starkly contrasted, i think, when i begin my 18-week General Medicine rotation at a metropolitan teaching hospital in Melbourne. This year, i will want to learn as quickly as possible how to ensure i am competent in interpreting all kinds of investigations. Ok, maybe not a MRI. But u get my point - FBEs, U&Cs, U/S, XRs, CTs, and the lot.

We also had a case of Pterygium. That was the first time i heard of this word and the plastic surgeon knew what it was when he examined the patient’s eyes but couldn’t come up with this term. It looked something like:

We had to refer her to the hospital, where they probably will be an ophthalmologist. (image credits 1, 2) There were other cases of cataracts which i successfully diagnosed (yea! and hey, the melbourne uni student thought it wasn’t!) and confirmed with the GP. Massive morale boost that was needed there and then. Why?

Because the other cases were mundane. I have had fever for 5 months. Yea right. I’ve got cough. Wet or dry? Any phlegms? What colour? The day-to-day common illnesses. I’ve got headache. Had it for 6 months now. What do you want me to do now? Order a CT to rule out tumours?

So pardon me if i sound excited when i could diagnose cataracts. A little victory is sometimes what we need amidst the routine and seemingly boring. And it is those who can remain as detailed and caring as ever in each case who will make great family medicine practitioners. I would say, i think i can’t. And right now, it’s just something i don’t think i will want to work hard toward. Give me some lumps and bumps anytime and facilities to excise them. Any. Yes, any operation. Any blood. Any laceration. Any wound. Something to do. That will get the adrenaline flowing.