We went with this agency for two weeks to provide medical support for severe cardiac cases to the poor of Cambodia. There is a hospital in Phnom Penh that is for the poor people. In the past the organization has worked through this hospital but was limited in the surgeries they could perform there. Last year they were able to work in the local Heart Center which was made possible by delicate negotiations. The heart center is very much a for profit place and people are asked to pay for their procedures and surgeries before they are able to be admitted. this leaves a large majority of their population unable to have much needed surgeries and is why we are seeing congenital birth defects in 30-40 year olds that would have been repaired in infancy here in the US.
So our patients would have to register at CSI hospital, then carry their charts to us at the heart center where we would evaluate them and set them up for surgery if it was needed. My personal part was in the evaluation. I would see the patient, take a history, do a physical exam and then send them for an echocardiogram. All of this was made very interesting by the language barrier and by the fact that the murmmurs these folks had are rarely heard here in the US and I had to rely on textbook knowledge - not experience.
It's amazing that we were able to negotiate with the hospital - we brought many supplies with us and because of that they were willing to let us do open-heart surgery on these people for $1000 each - their normal charge being about $3500. Amazing. We had negotiated to do 20 surgeries over the 2 weeks we were there - the hard part being that there were many more than that who needed surgery. We simply had to postpone theirs in hopes that they'll live another year until we come back in 2009.
These little cuties are the brothers of an 8 yr old with a congenital heart defect.
The local Khmear Dr.s at the heart hospital were able to repair her PDA, patent ductus arteriosis, using a catheter through her femoral artery - therefore she didn't need open heart surgery.
She was beautiful (looks so much like her brother facing forward here) and extremely afraid of foreigners. I tried to limit my contact with her because it made her cry, but it was difficult cause she was so cute.
Luckily she did very well and was discharged from the hospital quickly and home to her village.
another shot of her brothers with their dad. apparently he is a single dad - don't exactly know what happened to mom.
This is a woman who was a patient last year. Dr. Smith did valve replacement surgery on her then - she still has a few issues, but is doing quite well. I didn't work her up this year, but was in the office when she saw Dr. Smith. Her face lit up and it took a while to peel her off of him - not that anyone tried. she was so grateful and said that he changed her life. That was a familiar song this trip. It's amazing the pathology these people are living with - more than once after surgery Dr. Smith said "I don't know how they were living, their hearts were in such bad shape"
A walk around the heart center revealed this row of ambulances. I rarely hear a siren and we were on a very busy street.
This is where families stay wen their loved ones are in the hospital. they camp out on the grounds with hibachis - cook their meals and provide 24 hr care to their family member bringing them food, providing baths, toileting....
more families camping out on the grounds
An often seen sight is saffron robed monks walking down the streets . A very cool sight. Cambodia is a very Buddist country with shrines at every corner.
2 comments:
What a truly amazing experience!
Thanks so much for sharing it with us.
Wow, how amazing is this!
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