The idea with this project was to look objectively and conduct a medical assessment on how Expert-Exchange alongside other Doctors and professionals could help with Cambodia’s medical system and infrastructure. Expert-Exchange and Dr Messer from One Good Turn completed a brief medical assessment over an 8 day period in September of 2017. Before OneGoodTurn’s arrival Expert-Exchange conducting it’s own research and aligned Dr Messer with several meetings ranging from universities, to clinics, to elected official, for an ideal overview of the medical situation at hand. Coming into this knowing education would be crucial for solving the problem and getting volunteers and outreach.
We recently welcomed Dr Messer from OneGoodTurn.org to Cambodia for an 8 day intensive medical assessment of the health care education and system. Dr Messer started the trip of by meeting with the University of Punthisastra and meeting with their Steering board and departments heads from the Pharmacy, Nursing, Dentist, and Medical departments. The meeting was Dr Messer’s first in Cambodia and turned out to be very fruitful. At the meeting we went over the great need for hands on clinical experience for the Cambodian Medical students and help structuring the curriculum. Dr Messer has agreed to tenatively return and help develop the curriculum and teach with University of Punthisastra, ideally bringing more Doctors to volunteer and build a better partnership in the future.
Expert-Exchanges idea and future role besides facilitating important connections like this and our vast network in Cambodia, is to work alongside universities that have a developed medical curriculum and enable students from all provinces in Cambodia to become involved and get educated. Our thinking is if Expert-Exchange and other people can sponsor students that are highly motivated and intelligent and have them upon graduating agree for a period of time to work back in their own community or a community of our choosing that is in higher need of medical assistance, this will expedite the development the medical system and also build infrastructure with a university alumni network. If we do this over a period of time we will help restructure the medical community in Cambodia and spread the amount of medical competency across the country quickly. The idea is to have a good base of education, followed by a good network with outreach giving back to rural clinics and larger hospitals. All of this will be under the Ministry of Health so Cambodia is taking charge and developing its medical infrastructure alongside the next generation of Cambodian medical students. This will result ideally in organization and cut down on aid work being done under the radar of government super vision.
After visiting with the University of Punthisastra Dr Messer joined Expert-Exchange in Siem Reap province to conduct a more hands on assessment and meet with local officials in charge to get their view. We linked up with Trailblazers Foundation in Siem Reap and Ratanak who is a Cambodian that understands development very well. Trailblazers Foundation and Ratanak main focus is on safe water access with water wells and filters along with helping with agriculture, but since they have such a good relationship with the community they were able to help make introductions to the local clinic doctors and the District Commune Governor.
Dr Messer’s first day of work included three clinic visits and one meeting with the District Commune Governor in Siem Reap. The first clinic that we visited was recently built by the US Navy Seabee’s and was very impressive structurally. The main concern of the head doctor and nurse at the clinic was lack of medical training along with proper medical supplies. This issue was not uncommon as we went on with our assessment. We found the clinics to be built nice, however understaffed and lacking the medical education. All of these things are fixable and can incorporate more medical volunteers to engage with education, alongside using the medical students at the colleges to do hands on work at these clinics with the medical doctors volunteering.
Expert-Exchange is always looking how to help a project with focus on sustainability in the long-term so we are not having to repeat our work 10 years down the road. We find that with the medical projects it is a good mix of short-term fix solutions, with Doctors helping hands on at the clinic alongside local Cambodian Doctors, Nurses, and Medical Students. Along with this having a good long-term effect by exchange of information and education in a developed curriculum and outreach education program. This is why the Ministry of Health’s involvement and higher standards will be so important for the future success of any medical development project.
The second clinic we attended was located behind a landfill and the community often went through the trash in search of items to use or sell. This clinic was understaffed and in need of some basic medical equipment. Their room where they females gave birth lacked a light, which was the most alarming and urgent need we came across here. Like all the other clinics that were extremely open to receiving more volunteers and education exchange.
After this clinic Dr Messer, Expert-Exchange and Ratanak ended up meeting with the District Commune Governor about his concerns for health care and the community. The Governor was very open to the idea of Dr Messer and Expert-Exchange helping as long as we included the Ministry of Health. The Governor voiced his concerns on 2 districts in specific that needed help the most, one of them lacked a health care clinic and was a community on the water and the other was more rural so volunteers didn’t attend that clinic as easy as others closer to Siem Reap town. With the permission of the Governor and Ministry of Health we went out to the two locations suggested by the Governor.
The first location that the Governor suggested we visited immediately after the meeting. This clinic was again structurally built very nice and had the same issues as most clinics. There were a few things that were concerning with this clinic, 1) the high rate of TB in the community and whether they are accurately diagnosing this correctly and 2) The education level, we showed up and there was a dengue test positive on the table for a patient. The nurse informed us though that the patient did not yet have dengue, even though the test was taken and it showed a positive result. This raised another issue with when looking at the diagnosis and pharmacy logs, are they over prescribing things wrongly and are local clinics accurately able to diagnose TB and Dengue along with other illnesses. These are all concerns that will loop back to the universities and the education level aspect with hands on experience and in the long-term with medical students being educated with more hands on approach solve this issue through out Cambodia.
After this clinic, Dr Messer and Expert-Exchange decided to visit the floating village the following day and talk to the village chief and hear his concerns for the community. This village was also the Governor’s priority and the village is located on water 6 months of the year and the water dries up the other 6 months of the year, so half the year it is floating and the other half it is dry land. They recently had a private company from China come in and install power, however this private company charges 5 times the normal prices and many homes can not afford the power so they still use generators.
The village chief was very open and helpful with explaining the main medical problems faced in the area and open to Dr Messer’s feedback and help. We also met with the village nurse who was able to indulge in more detail on specific diagnosis and numbers of cases. Their concerns were the same as the other clinics along with them not having their own clinic. Their community suffered from a high rate of alcoholism too. Among that we found upper respiratory infections to be the leading illness in the rural areas we visited. Also Diabetes, high blood pressure, arthiritis and this year was higher than normal for Dengue. Every 5 years there is usually an uptick in Dengue and this year is that year.
After listening to the village chief and the nurse Dr Messer decided we would run a basic Albendazole and Vitamin A clinic the following day. Expert-Exchange also provided tooth brushes and tooth paste with soap. Dental hygiene is of concern in Cambodia and that would be a completely separate medical assessment.
That following day we had two separate clinics in the community and saw around 600 people. The clinic turned out to be a success and Expert-Exchange will return in 6 months as promised for their follow up doses. With Albendazole and Vitamin A they are taken one time every six months for preventative measures and helps with deworming and cognitive health.
After the successful outreach and health clinic Dr Messer and Expert-Exchange flew back to Phnom Penh for a few follow up meetings. Dr Messer was able to meet with two highly motivated medical students from University of Punthisastra to ask them questions about their education and also what their concerns and feedback would be about the healthcare system. The meeting was extremely productive and has resulted in Dr Messer planning on returning to Cambodia to teach classes here and possible help develop the medical curriculum.
Expert-Exchange will be releasing a detailed report of our medical assessment project soon and if you are interested in receiving a copy please contact Expert-Exchange. With Dr Messer and the support of everyone involved we were able in a short period of time to take an in depth look at multiple angles of the health care system from public to private sectors, along with local government to the Ministry of Health. We were able to look at the health care system and assess from the basic clinic level from public and private clinics, to understanding the education and supply chain, to understanding the future education and helping implement a deworming clinic, and also making sure to work hand and hand with the Ministry of Health in recording and conducting outreach. There was a lot done and Expert-Exchange provided Dr Messer with a clear medical assessment that covered a variety of levels that make up the whole. Expert-Exchange will now continue with the assessments in more areas and conduct basic Albendazole and Vitamin A clinics at the request of provinces and communities in Cambodia.
Executive Director's Blog
Follow Macie through SE Asia as he embarks on a humanitarian adventure and assists inspirational individuals to improve their life quality.