After returning from Siem Reap on Sunday, we geared up for another busy week at the hospital. Since I am in the physiotherapy department, I will share a bit from my experience. We see both outpatient and inpatient. Inpatient has been mostly strokes, severe broken bones, and brain injuries. Outpatient has been moto bike fractures and dislocations. Unlike the US, many of these fractures and dislocations are never properly healed, leading to deformity and prohibiting return to prior function. I have been teaching the 2 physiotherapist more than I expected (making me very thankful for my neuroanatomy and orthopedic classes).


I will share an exceptional story that happened today. There is a 19 year old paraplegic who has been confined to his bed for 12 years. His hips and knees are bent at a 90 degree angle (contractures). He has scoliosis so severly that he has problems sitting. He has 3 pressure ulcers so big and deep that several inches of bone is exposed. He also has no family to take care of him. Today, we went to see him. We did some bed mobility, range of motion, sitting balance. At the end, I was doing some arm exercises (PNF), and he thought it was a wonderful game. He was working so hard, but smiling and laughing the whole time. The other physical therapist translated for me, and told me that the boy really enjoyed the treatment and having someone spend that much time with him. It was a very fun, rewarding experience.
The group is also preparing for our weekend trip to the village where we will be doing nutritional assessments on a school with 400 students. We have a supply of general antibiotics and vitamins for the entire community. We met with the Cambodian man who will be guiding us to the village. He gave us some helpful hints about what to bring, and warned us that people from neighboring villages have heard that we are coming and will be traveling to see us. There is no health care in the area and no health care professional has ever visited. We were rather overwhelmed by the news, but can only promise to treat everyone we have time for and would benefit from our care. We have been reading and researching about health problems in the area. Your thoughts/prayers would be appreciated in preparation for this weekend.
And the last thing to write about, our afternoon trip to the Killing Fields. The Killing Field is the place where the Khmer Rouge would take people who were too weak to do manual labor or they suspected of crimes against the government. (Please see my last entry for a brief history of the Khmer Rouge.) The people were forced to dig their own graves, and then brutally killed. In 1980, they discovered piles of thousands of dead bodies in the field. It was powerful to see the tower of skulls, piles of clothing, and deep holes where the bodies were disposed.
Overall, we have been staying super busy by learning a ton about the Cambodian culture and teaching small things to help the hospital run more efficiently and provide a higher level of care. Be sure to check out the next blog for a nursing student’s perspective of the hospital….

We knew that today was going to be exciting when we saw both an elephant and a park full of monkeys on our morning run.
The hospital where we will be for the next few weeks is run by the Center of Hope Worldwide. It offers the only free healthcare for adults in the country. The building was larger than I expected. It has 2 operating rooms, an ER and surgery room with 10-15 beds in each room, a new x-ray machine, and even an air-conditioned lab. The staff warmly greeted us, and were very excited to see the return of Ms. Taplin, who acted as the head of nursing for 2 years. We spoke with the staff to see where they needed our help, and it seems like we will be doing a bit of everything. Tomorrow we will put in a full day at the hospital and will really see what it is like.

In the late afternoon, we traveled to Toul Sleng, or the S-21 Prison. Brief history – in the mid to late 1970s, civil war broke out in Cambodia. Pol Pot headed what is known as the Khmer Rouge and began taking control of the country. Their communist agenda was to move people out of the cities and into the rural areas. The genocide that followed killed almost 2 million Cambodians. S-21 Prison was an school transformed into a building of torture. People were tortured until they agreed to sign documents claiming they committed crimes against the government. They were then taken to the Killing Fields about 15km outside of the city.
To see the pictures of the men, women, and children who were tortured and killed in that very building was quite moving. Many of the cells where they were chained in were only a few feet wide. I find it interesting that a mass genocide that happened only 30 years ago is not more well known. Everyday people in this country lived though the Khmer Rouge. We were at the hospital today and one of the workers shared his story of the Khmer Rouge. He was separated from his family at the age of 14. For 3 yrs, 8 mo, and 20 days, he worked to build a dam, receiving only one bowl of rice soup a day. This strong, successful man is now only in his early 40s. It was amazing to hear such a story straight from the source. We all admire his strength and bravery for surving and sharing his story with us.
Today was an educational, eventful day. We learned much about the culture and history of this country. Tomorrow should bring more knowledge and excitement….