Volunteering as a nurse in Siem Reap, Cambodia

by Amanda Mason-Jones, Registered Nurse

Mornings in the health clinic were quite busy, mostly tending to the usual complaints of hypertension and chest infections. Occasionally though, things like monkey bites and possible Malaria were thrown into the mix- just to remind us that we are dealing with a very different population. One of the stunning things was how long people had often had their ailment. I often asked my translator to repeat himself when he would state the person had suffered this problem for X number of “years”.

The on-site Australian nurse manages a very efficient health clinic, combining local and foreign staff, as well as a mix of invaluable and lively translators. Three nurses and three doctors were working at any one time, with Khmer translators provided where necessary. Also, there’s a pharmacy on-site, providing the community with essential medicines for free. A positive and effective vibe pervades the entire clinic.

The afternoons usually involved home visits, some 10-15km out of town. This where I would awkwardly re-apply my mosquito repellent, whilst balancing on the back of a moving motorbike. Malaria is found on the outskirts of town, and I would probably rather fall off a ‘Moto’ than take my chances with those Mosquitos!

First stop was a discouragingly despondent young woman. I waded through the mud, the chickens, and the smaller siblings to approach her sickbed. She avoided my eye contact as I pulled across her Sari.

Seeing her gaping wound, I fell prey to the predictable mindset of many new volunteers. ‘Quick let’s get her to a hospital for advanced wound healing techniques’. It seems entirely too unpalatable to leave her in these extraordinarily basic conditions; with an open wound the size of a fist.

As I dressed her wound, I notice small ants trailing across her body. Now, in theory I might accept that she cannot access sophisticated healthcare; but in no way, practical or theoretical, would I accept her to be crawling with insects. As I smacked the ants off her, the translator was kind enough to explain the situation.
He calmly explained that in Cambodia the medical system is very different; this spiel I can tell he has said many times before. “Our healthcare system is different in Cambodia…if people cannot afford treatments, they simply do not receive them”. I made a conscious effort to suppress my self-indulgent mix of guilt and pity, and got on with dressing her wounds. Pity seemed to reconfigure as an empty and useless emotion under these circumstances.

This sentiment of medical inaccessibility was echoed the next day in clinic. A very unwell looking teenager shuffled in, supported by the arms of her mother. I locked eyes with the other nurse; there is something unmistakable about the colour of those close to death.

Mercifully, the other nurse sat the patient down and started taking her history. With a recent Leukaemia diagnosis, she was unable to afford treatment, and it was difficult to ascertain what treatments had been received thus far.

The Khmer staff knew the routine; if you can’t afford treatment you don’t get treatment. The exception to this rule is if the affected is under the age of 15.
The nurse hesitated to ask “What’s your age?”
“16”.
A hush fell upon the room, as we contemplated the consequences of this fateful and damning number.

But for all the dismal aspects of being irrevocably sick in a developing nation, there are innumerable daily victories. The provision of basic medical care undoubtedly changes lives. Simple medical procedures, the access to antibiotics, correct diagnoses and the dispensing of medication for chronic conditions all work to keep the majority as healthy as possible.

One such daily victory came in the form of a three year old girl. She presented to the clinic after having a surgical procedure at a local hospital. Her wound had started profusely bleeding after discharge. When she presented, we lifted up her little dress to find blood-soaked underpants and legs. Swallowing the shock on our faces, we applied pressure to her wound and bought her through to see a doctor. It was humbling that the mother knew she could carry this child to the clinic, for free and accessible care.

As the mother was leaving, she was had handed a tiny pair of new underpants from the ‘donations’ pile. This holistic care, and attention to detail, is ingrained in the daily running of the clinic that I was blessed to have worked with. I would so highly recommend a volunteer stint in Cambodia – you will think very differently after your return and with any luck you will have delivered help to the most deserving of communities.