May 29, 2017: Hope Hospital and Preparing for Poipet

Today, the undergraduate nursing students went back to Hope Hospital here in Phnom Penh while the graduate nursing students went on home visits in the area. This morning eleven students and our three professors piled into the hospital van with several huge, military green duffel bags full of supplies to donate to the hospital. Dr. Massie led a Memorial Day themed devotion en route. When we arrived, we walked into the lobby to take a group photo with all of our donations. I have noticed that so many people want to take photos with us, and I have not encountered that on previous study abroad and mission trips I have been on.

Our group of eight students split into two, and we were led on a tour of the hospital. We were informed that Hope is known throughout the country for providing excellent care, and Cambodian nursing students love having the opportunity to learn at the hospital. Our guide explained to us how the hospital used to take pride in providing completely free healthcare to its recipients but decreased funding has forced it to start charging (albeit minimally) for services. We were led through the different departments, such as the Emergency Room, a minor procedure room, and Radiology. These are among the few of the only air-conditioned rooms in the entire facility. Instead of indoor waiting rooms, patients wait outside because the sun kills Tuberculosis. We walked through the beautiful courtyard with a large mango tree into a clinic and the lab. We finished our tour by visiting the medical and surgical wards on the second floor. Each ward has about 12-13 beds; there are no individual patient rooms. If a patient needs privacy while a procedure is performed, curtains are pulled around his/her bed. There are no patient care techs or nurses aides. Family members help move the patient from stretcher to bed and are taught by the nurses how to help in managing the care of the loved one. Coming to this hospital also makes me realize how much we waste in America’s hospitals. They do not dispose of chest tubes or other small things that we usually take for granted.

We dropped off five students to shadow local doctors and nurses. Two other students and I followed Dr. Massie, Dr. Taplin, and Dr. Wofford to the medical and surgical wards to look at charts. Charts here are still done through card copies. Dr. Taplin told us that every hospital in the country is required to chart in either English or French (two of Cambodia’s official languages, after Khmer); this particular hospital uses English because it was founded by English speakers. In the medical ward, Dr. Taplin opened the chart of a patient with abscesses in his spleen. They had found growths of what are called Burkholder’s pseudonomas (a term that was not even in Stedman’s Medical Dictionary) which is a type of bacteria common to this region. We then looked at the chart of another patient with Cirrhosis who had come to the hospital with ascites, which is fluid that has shifted into the abdomen. The doctors had just finished performing a paracentesis, draining 1.5-2 liters of fluid from the man (this is the maximum amount that can be drained per day.

We then went to the surgical ward where Dr. Taplin went over the chart of a woman who underwent a mastectomy to remove a huge tumor that had been growing for three years. She had not had access nor the education to wellness check-ups or cancer prevention that we have in the States. At this point, the woman was put on palliative (comfort) care because there is nothing more that can be done for her. There is no chemotherapy in this country. People who have the money can go over to nearby countries, such as Singapore, for treatment, but for the poor there is no such luxury. Dr. Taplin, Dr. Massie, and Dr. Wofford led the three of us students in a discussion about how care differs in this country compared to the States. Again, this hospital is known for providing quality care. So while there are many differences between the two systems, just because they do things differently here does not necessarily mean that it fails to provide great care to patients. It was a very informative and thought-provoking discussion.

We later regrouped with the other five students and went to lunch at Flavours Restaurant, where we went for dinner our first night here. We are now preparing for our nine-hour drive to a province called Poipet tomorrow where we will set up clinics.

 

 

Mission to Cambodia: “The Killing Fields” – may 27

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Many people in many different countries around the world have been affected by genocide. When most people think about genocide they think about World War II and the Nazi’s decimation of Jewish people. Many people think that genocide is a thing of the distant past, but in Cambodia it is all too recent. From 1975 to 1979, only 38 years ago, Cambodia was thrown into chaos, by a radical regime, the Khmer Rouge and their leader, Pol Pot. Pol Pot saw hardships faced by people living in provinces outside the cities and blamed it on the people living inside the city. He saw education and wealth as a selfish and destructive nature that needed to be eliminated. Yesterday myself and others on the trip visited a cite where his radical ideas became a reality, and what a disgusting and horrific reality it was.

Upon arriving, the first thing you notice is an articulate archway, created in the traditional Cambodian fashion, as well as a tall building built with the same beautiful architecture,  about 100 yards away from the entrance. After we walked inside the camp we dawned our headsets and began the audio tour. Another student on the trip, David, explained an interesting view of this after the tour stating that it felt odd to him that we had the privilege to listen at our own leisure and pace while we were walking on the souls of thousands. As we walked towards the first checkpoint, we grew nearer to the large ornate tower in the center. As we came closer the beauty of the architecture fades away as you notice the thousands of skulls and bones displayed inside; it was truly perturbing.

Entrance

Entrance

tower in center

tower as we came closer

I won’t go into every detail of the audio tour, as it would take up too much time and my memory would not do it justice. As I began to walk around one of the things I noticed was birds singing and wildlife in full bloom. It was an oddly peaceful and almost tranquil place to be; almost as if it were a place to meditate and relax.

The path we walked and the audio tour portrayed a very different more terrifying realization. As you walk down the path there are sometimes fragments of bone and teeth scattered on the ground. There are dozens of pits and small mounds where mass graves had been excavated and the horrible reality hidden beneath brought into light for all to see. On the tour there were signs with descriptions of each area and recreated pictures of what the place was like while the killings were happening. Death and despair was everywhere and you could feel it.

The mass graves have been decorated by tourists with bracelets as a sign of respect and sorrow for the victims, two places in particular had many bracelets; the mass grave of women and children and the child killing tree.

As the tour moves on. It brings you to a tree titled “The Magic Tree” that is explained to be the same species of tree under which Buddha found enlightenment. However this specific tree is ironically called this and was used to hang tools of massacre as well as lights and speakers that blasted revolutionary music to drown out the screams of agony. The audio tour provided a music clip of the music combined with a diesel generator recreating the noise the victims last heard. This was the hardest part of the tour for me and many others. The noise was terrifying and seemed to bring up the emotions of the anguished souls. There are no words to describe the feeling.

At the end of the tour we were allowed to visit inside the tower, I think it was called the Shtupa but don’t quote me on that. As we entered, we took off our shoes out of respect and were offered to buy incense or flowers to leave for the memorial. Inside the tower were many skulls and bones as well as the killing tools. Each skull had a different marking describing how they were killed.

This place is rough on the conscience and for religious people can be a place of questioning. If there is a God how could he let this happen? How can the world be so cruel if there is an almighty? Many people would answer different things, but none of them can take away the heaviness of the reality. After leaving this place I felt I will never be the same. It is hard to go on living the privileged way we do when you know there was and still is so much hardship for others. This place and this country makes me feel ashamed of my fortune and ashamed of my trivial worries. There is nothing left to do but give back as much as I can and try to better myself and the people around me one action at a time. Let this place be a reminder to all of the terrible possibility of genocide. It could happen anywhere, but when the time comes we must make an effort to prevent catastrophes like this to ever happen anywhere.

 

Mission to Cambodia: May 24th

24/5/17

Today was my first day in Cambodia. My group and I woke up early, had breakfast, and walked through the city to the river. Most notably it was hot, and I sweated a lot. The city was pretty and the people were nice, so that made the heat slightly more bearable. Later on in the day, I went with a group to visit the S-21 prison museum. S-21 was first a school before the Khmer Rouge took power. The Khmer soldiers decimated the school and turned it into one of many torture camps used by the Khmer Rouge during the Cambodian genocide. Their prisoners were held in hardly livable conditions, tortured daily, then killed slowly and painfully after they had given confessions to crimes they never committed. In each of the buildings, there were pictures of the prisoners and the cells they lived and died in.  The whole experience was hard to swallow, but I forced myself to look at the pictures, the torture devices, and the bones of the prisoners. I forced myself because it’s easy to look away, to not think about it and forget it happened – especially to an American. However, I see it as the least I can do for the people who can’t look away, and who can’t forget no matter how hard they try. They people who died there had no rights, no freedom, and no say in what happened to them, but I believe they have a right to be remembered; and I believe that it is our duty to remember them and the injustice of the Khmer Rouge so that those injustices will not be repeated. I think S-21 is a perfect example of what the Khmer Rouge did to Cambodia: destroy education, replace it with misery and death, and then leave it to be forgotten. There was a monument constructed at S-21 declaring that the information there is the right and property of humanity as to not forget the cruelty we are capable of.

Day Four: Freedom’s Promise School Clinic

Today (Thursday, 5/25) was the fourth day of our trip, but with travel was our second full day in Phnom Penh, Cambodia! After spending yesterday exploring the city and learning more about the history, we were going to engage in the community around us through a variety of ways. Following breakfast at the hotel, our group of fifteen split into three different groups. One group went with a Social Worker to do HIV home visits and another group went to a local hospital to assist with check-offs for their staff. The group I was with was six of us going to a local school through the organization Freedom’s Promise. At the school we would be holding a clinic for Well Child Checks.

As we arrived in the area with the school, the van dropped us off across the street and walked through a small street, similar to an alleyway. The bleak reality of these peoples’ living conditions shook me. Small rooms, which consisted of little more than dividing walls and a cover were homes for families. Running water and simply a place for trash were non-existent. After walking along the row of homes, we were then in the area with the school. It consisted of several classrooms, an office, and a library. A teacher directed us to their covered play area with tables and chairs to use for our clinic. Lauren and I, both nursing students, set up to do height, weight, vital signs, and an eye chart. The two Doctorate of Nursing students, Kim and Paige did thorough assessments. Dr. Wolford and Dr. Massie were assisting anywhere and everywhere – from aiding in assessments to helping prescribe to keeping kids entertained as they waited.

A health issue noticed in nearly every child was tooth decay. This may seem somewhat insignificant to us and an easy fix, but for these kids it can be so much more. If further decay occurs, they could end up without teeth or an infection. While the United States has fluorinated water to help prevent this, these children come from families without running water (and Cambodia’s water isn’t drinkable, much less fluorinated). For the most part, brushing their teeth isn’t a priority. A toothbrush here costs $1, which seems insignificant to us. Yet, for many of these families, that is a day’s wages – not to consider the need for toothpaste or the lack of access to clean water. This simple issue made me realize even further how we take so much for granted back at home.

Dr. Wolford, a pediatric nurse practitioner, made an important point at the beginning of the day. She said that “Kids were kids, wherever you go.” This simple statement eased some of the nerves about not speaking the same language, as I found this reminder to be so true. Smiles, laughter, and even many games are so universal. Even if it was after a little misunderstanding, we learned their games as they did cartwheels over a string made with rubber bands. They learned limbo and we played their version of jump rope. As they waited for the next part of the assessment, Lauren and I were taught some of the shapes in Khmer. We sang “Head, Shoulder, Knees, and Toes” and taught some boys how to flip a half full water bottle to make it land correctly and cheered after many attempts for each of us. These kids were full of joy, despite their circumstances and I think that was the most powerful part of the entire experience.

Hope Hospital & Home Visits

Sarah Balding

Study Abroad in Cambodia
by Sarah Balding, Nursing Student

 

We started the morning early again, eating breakfast and doing our devotional around 7 am.  After we ate the group split up and got ready to head for the day.  I went with Kate, Jenni, Megan, Tiffany, and Amanda to do 4 more home visits.  The rest of the team headed to HOPE to work in the hospital and the outpatient clinic.  Once we arrived at the home care office we were greeted by the social workers, and got ready to head to the market.  We were able to get the same food and hygiene supplies for each family again.  The bags of rice and the other food items are able to feed the families for anywhere between 2 weeks to 1 month.  This is extremely helpful and will help ease the financial burden on some of these families.  Once we had gathered all of our supplies we loaded everything up on the Tuk-Tuks and headed out towards the first home.

Continue reading

Home Visits, Nursing Check-Offs, & Hope Hospital

Sarah Hintz

Study Abroad in Cambodia
by Sarah Hintz, Nursing Student

 

Today (Thu 5/21) some of the Community Health clinical groups were able to partner with HOPE organization and participate in HIV home visits.  Even though it was only for half of a day, I feel that it was one of the most impacting parts of our trip.  There were only four of us; Cassie, Dani, Sarah (our wonderful social worker and leader during the visits), and myself, who went on the home visits.  Other groups went to the hospital to help with nursing check-offs, which we eventually also got to be involved in.  It was so exciting to be with these nurses and see them take the knowledge they knew to relate it to real-life situations and understand the concepts of what they were learning. Continue reading

Clinic and Sihanouk Hospital

Jenni Massie

Study Abroad in Cambodia
by Jenni Massie, Nursing Student

 

Today (Wed 5/20) was a great day.  We (Belmont Nursing) had our first outdoor free clinic under a beautiful tree-covered veranda that provided shade so we could care for the Cambodian people.

JM1

JM2

A room at the guest house adjacent to the veranda was used for breast and pelvic exams.  The organizations Precious Women and the Kone Kaming clinic provided this space.  Our clinic also benefited from having a student of social services (Sarah) and physical therapy (Kate), this has allowed us to expand the care of the clinic beyond nursing.

The Clinic was set up in stations.  Triage is responsible for vital signs, height and weight, getting a short history, and chief complaint.  The assessment station, where I had the opportunity to work, further explored the patient’s history, performed a focused physical assessment, made a diagnosis, and recommended treatment or medication.  Then the patient was directed to the pharmacy and treatment area. Continue reading

Church/Shop/Rest

Hodge

Study Abroad in Cambodia
by Sarah Hodge, Nursing Student

 

Today (Sun 5/25) was a great day! We attended church at Phnom Penh Church of Christ.  The church is filled with the most beautiful of souls.  People are so welcoming and inviting.  The service was filled with spirited worship, a baptism, and communion.  I was extra relieved to see Pheap, a friend of Dr. Taplin, who I have formed a friendship with.

We then ventured down to the river that runs through the city to a restaurant known as FCC, a traditional place for foreigners to come and meet.  It was fancier than where we have gone to eat.  The food lived up to the high prices!  It was exceptional.  Comparably, the view over the river and the palace was fantastic.  We were welcomed with a breeze to cool us off. Continue reading

Teaching at Asia Institute of Sciences School of Nursing

Erin Cantrell

Study Abroad in Cambodia
by Erin Cantrell, Nursing Student

 

 

Today (Sat 5/23) we were warmly welcomed to the Asia Institute of Sciences in order to teach other nursing students:

erin pic 4

erin pic 3

We were each split up into groups and taught the following topics: SBAR (a communication tool for nurses at shift change), physical assessment, vital signs, hand hygiene, signs/symptoms of depression and anxiety, as well as physical therapy techniques.  There were several classrooms full of students eager to learn our topics.  As we finished each presentation, we went to the next classroom to meet more smiling faces.  The students were great in that they had many questions to ask which kept us on our toes.  It was nice to work alongside my classmates and even more fun to work with Jenni Massie, who is currently in the Masters program: Continue reading

Sonja Kill Hospital & Travel Back to Phnom Penh

Sarah Hintz

Study Abroad in Cambodia
by Sarah Hintz, Nursing Student

 

Today (Tue 5/19) was our second and last day at Sonja Kill Hospital. Many of us woke up to the sun’s rays peering through the “mountains of Kampot”; however, less than 12 hours before the break of dawn, we stood under the covering of the star-filled sky.  Certainly, the most star-lit sky I have seen in my entire 21 years of existences.  During our time here we have experienced, that from the moment when we wake up to the moment when we fall asleep, we are surrounded by Beauty.  It is a beauty that goes beyond the word itself because it carries much more meaning than that.  It carries comfort, peace, and humility.  Surrounded by such beauty we are humbled to be a part of something bigger than ourselves.  Just by simply being on the hospital grounds we are in awe of the Creator of the Universe and feel a part of His continued work with humanity.  We have the opportunity to partner with God’s heart, what He is doing, and what He has planned for Hope International (the organization that supports Sonja Kill Hospital). Continue reading