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.