Here I sit in Siem Reap on Saturday afternoon. This is where Angkor Wat is and we have finished a tour of the main Temples that began at sunrise this morning. This is an incredible place and there are many other foreign tourists here. I would love to talk about Siem Reap but my day to post a note was for last Tuesday. Between our busy schedule and a fickle internet service this has been my first opportunity to post a note.
Before I came to Cambodia I was told the hospital does not have ventilators, I could not comprehend how the system would work without ventilators, and on Monday I found out exactly what that meant. A 15 year old girl was brought into the emergency room by her family with severe respiratory problems. They had kept her at home in the countryside (the Province) for four days trying to treat her with traditional Khmer medicine. I arrived in the Emergency Department just after she went into respiratory and cardiac arrest; an ER Dr. from California was able to resuscitate her. In the States we would use an Ambu-bag (to breathe for the patient) during the code and until we connect the patient to a ventilator. In Cambodia where ventilators are rare, the responsibility to continue “bagging” the patient is turned over to the family. I was thinking of how emotionally wrenching it must be to be responsible for breathing for your beloved family member. The father was there at her bedside, and another nurse and I were setting up a couple of procedures that needed to be done for her, when she coded again. She did not make it. I tried to communicate my sorrow to the father, he understood but I felt terrible to have the language barrier when he was suffering so much. The meaning of not having ventilators was brought home more vividly than I could have imagined. The solution of having a family member bag the patient may be practical, but incomprehensible to Westerners and the level of healthcare that we take for granted. I don’t mean to sound so depressing but I think it’s important for us to know what it is really like here.
The day ended a little better when Kelley and I branched out on our own and took a Tuk-Tuk to an “expatriate street” to go shopping. Some things never change…