"Modern" medicine

After I graduated from nursing school last year, I didn't stick around long before I was off volunteering for 2 months in Cambodia.  Those 2 months turned into 5 months, which is now turning into over a year here.  I didn't have time to take boards before I left last summer, so returning to the US and taking them in February was a challenge.  I hadn't touched a textbook in 9 months and had only been working with a few skill sets.  As I did practice questions before the exam, I had to remind myself that, no, the first step in inserting an IV is NOT to remove your shoes at the door, and I had to study terms that had become foreign to me, like "gloves," and "sterile."  Medicine in Cambodia and medicine in the United States are two very, very different things but still I am learning so much every day, and today was no exception.

Little Kunthea had fallen and hurt her hip before I even arrived 3 weeks ago.  She couldn't walk and has been in excruciating pain that seemed to get better one day and double back the next.  She was taken to the local clinic twice for an X-ray but the first time a doctor couldn't see her (still not sure why), and the next time a district-wide power outtage meant they couldn't do anything for her.  I've been doing my best to care for her, but as she quickly went back downhill we decided it was time to do more.

Kunthea rests in the Wat Opot health center.  I spoiled her with special treats and DVDs on my macbook (shh don't tell the others).  Here she is visited by her brother Chanthol (seated) and Vandy. 

With the Khmer New Year this week, the country has shut down to celebrate, including the local clinics and referral hospital.  To get Kunthea seen, I took her to Takeo hospital about an hour away with Long Dy, an 18 year old Wat Opot resident, to translate.  When we got there Kunthea was examined by the doctor.  First thing I learned: health histories and chief complaints are really irrelevant.  They didn't care about anything except that she had trouble walking and it was her left side that hurt.  6 years old, HIV positive, medications she's taking... does anyone want to know?  Nope.  Okay that's fine, moving along.  Next we were lead into the X-ray room where I had to lay her down.  At this point she was scared and in a lot of pain so I sat next to her on the table to relax her.  The technician moved around and did his thing and disappeared for a second behind a curtain. Second thing I learned: X-rays are like photo booths, anyone who wants to be in the picture, can!  He had taken the X-Ray with me on the table, and my leg in the picture, and didn't say anything.  "No sir, I'm not pregnant, and lead shields were never my thing so thanks for not asking me to wear one," I thought to myself.  Maybe I'm being dramatic, it just really caught me off guard!  Third thing I learned: radiation is an urban legend.  It worries me that the technician takes no precautions.  The only thing separating him from the machine was a linen curtain.  I had Long Dy tell the man that he needed to protect himself from the X-ray machine but the technician looked at me like I was crazy.  We said something to the doctor as well but nobody seemed too concerned about it.

I carried her back to where she had been examined to look at the images.  The doctor decided she had bruised the bone and prescribed her paracetamol which we had been giving her anyway.  Next came time to pay.  I had brought $100 and my credit card in case it wasn't enough, not having any idea what it would cost.  The grand total including the exam, X-ray (they only charged us for 1, I guess mine was free!), and medication was a whopping, bank breaking $5.00.  I couldn't believe how cheap it was.  You can't even park at most American hospitals with $5.00 and here, the whole thing cost that.  Unreal.

The whole adventure was wild.  The people in the village around Wat Opot are used to me and the other volunteers, but in Takeo hospital I provided a great deal of entertainment to the locals.  They were so curious as to what I was doing there, and kept asking me if Kunthea was my daughter.  I finally started saying yes just to give them more to gossip about.

I'm hoping that Kunthea starts to do better soon.  I've been trying to get her to move her legs as much as possible because she's so stiff and sore.  I hate seeing her in so much pain.

Her trip today was covered by a generous healthcare grant provided by the McConville family from Damascus.  With their contribution, we have been stocking up on new medications, replacing expired supplies, and treating the strep throat outbreak.  A big result of the McConville's donation is the resolution of chronic ear infections of two of our little boys.  Nak and Wey were started on a new ear drop course recommended by Deb, an American nurse who volunteers at Wat Opot each year.  I'm happy to report that their infections have made big progress and look great!  Thank you McConvilles :)

Wey is so happy to have clean ears :)

On a sadder note, today two volunteers left Wat Opot after a 10 day stay. Monica and Claire are sisters around my age from Australia who had been volunteering and traveling through Indonesia and Thailand.  I really enjoyed meeting them and hearing their incredible stories.  Wishing you girls a safe trip around Cambodia and back to Australia!  Can't wait to see you again some day!!