Julie Tea, MD – Project Angkor

Written by Julie Tea, MD PGY 3 at Kasier Permanente Oakland Pediatric Residency Program on global health rotation with Project Angkor in Cambodia.

Project Angkor Medical Humanitarian Mission 12/28-1/10/2015

Day 1   12/28:  Flew from Seattle to Seoul, South Korea.  I flew on Asiana airlines, which had surprisingly good food.  Our first course was Bibimbap and our second course was rice and beef.  There was a selection of movies on board.  As I am becoming older, I am more paranoid about DVTs so I tried to stretch and walk around every few hours.

Day 2 12/29:  Arrived in Seoul, South Korea and then flew to Siem Reap, Cambodia.  I arrived late in the evening and checked into a hotel and promptly went to bed. As soon as we landed in Siem Reap, I could sense the humidity and warmth despite it being 11 PM.  There is a certain smell that I cannot describe in SE Asia, something akin to fruit mixed with a slight smell of garbage, not necessarily a bad smell that I noticed as soon as we landed.  I walked to the Siem Reap airport where customs was very long.

Day 3: 12/30:  Met up with Project Angkor and the rest of the team at noon for a lunch buffet at the Tonle Mekong Restaurant. It was extremely delicious.   Afterwards, on chartered buses, we drove to Sisophon which was 2-2.5 hours away.  The drivers in Cambodia drive on the right side but they have no hesitation about swerving, driving on the left side and there were no traffic signals.  The roads are dirt but flat and many of the large pot holes I recall from previous years seem to have been fixed.  It was great seeing old and new faces and catching up.  We arrived at our hotel, Botoum and found our assigned rooms and room mates.  Many of us unpacked and then went into small groups for dinner.  Sofie, Raj, Angela, Jenille, Shannon (OB resident) and I found a restaurant within 5 minutes and sat down to a light dinner to talk about our flight and excitement.

Day 4: 12/31 We spent part of the morning exploring Siem Reap, touring Angkor Hospital for Children, and many of us donated blood.  Although I tried to donate blood, my Hemoglobin was below the acceptable parameters so I was given an Angkor Hospital for Children t-shirt as a consolation prize which I gladly accepted. Angkor Hospital for Children was started by a Japanese photographer, who saw the need for a hospital facility so raised money by selling his photographs to tourists.  With help, he was able to raise millions of dollars to build Angkor Hospital Children which has operating rooms, an inpatient pediatric wards, and NICU.  The hospitals’ annual budget is $100,000 which is amazing!

In the evening, the governer of Sisophon invited Project Angkor volunteers to a Cambodian style New Year’s Eve celebration complete with Cambodian food, Khmer style dancing and singing, and announcement by Danny Vong and Nak Chhiv

Day 5: 1/1:  We set up clinic, opening boxes, setting out books, unpacking supplies and medications, arranging the hospitals and getting to know services available such as lab work, CXR, etc.  We also toured the facilities to learn where our colleagues would be working to help direct patients to pharmacy, OB/GYN, dentistry etc.  I want to mention that this year, Project Angkor had 140 volunteers consisting of nurses, residents, internal medicine, emergency medicine, OB/Gyn, pediatric and adult dentists, dental hygienists, 4 pharmacists, medical students, college students, medical assistants, Cambodian medical students who served as translators, and optometry assistants.  We have hundreds of pounds of medications, thousands of pairs of glasses.

Day 6: January 2^nd:  First day of clinic.  There were hundreds and hundreds of patients waiting to be triaged by the time we arrived at 7:30 AM.  We had our own pediatric nurse triage area, 2 pediatric pharmacists, and  7 pediatric attendings/residents.  Each of us had brought 2 or 3 textbooks to reference while in Cambodia that we ultimately donated to the medical students including Harriett Lane, Infectious Disease textbooks, pharmacopedia, and Physical diagnosis by Zitelli.  We saw over 120 families that day, each consisting of 1-4 children so about 250 patients.  Lunch was catered and we each had about 30 minutes mid-day to eat lunch.

Day 7: January 3^rd-5^th: We had wonderful days of clinic, seeing over 300-350 patients a day.   Many of the diagnoses we saw her parasites such as hookworm  or pinworm, scabies, malnutrition, dental abscesses, pneumonia, viruses, ring worm, lice, sepsis, tumors, TB. We saw everything, there was amazing pathology.  Each of us saw 40-50 patients daily and the smiles on the faces, the gratefulness of the families, the children, every second of clinic, travel, preparation was worth it.  I wish I could describe the feeling of doing, seeing, meeting, talking in clinic- small acts that revitalize your soul; it reminds you why you went into medicine.  Many of the children who were 7 looked like they were 4 years old due to malnutrition, it makes you thankful for everything you have at home.  Tuberculosis was extremely prominent there, as well as typhoid fever, and poor dental hygiene.  Some of the school-aged children had never owned a tooth brush or tooth paste so dental education was key.  We gave out multi-vitamins to all of the children.

Day 8: January 6^th:

Today was the last day of clinic.  We saw over 250 patients but clinic ended early at 4 PM to allow pharmacy to dispense medications, finish packing up, and disburse book to the medical students.  We saw some patients that I will never forget including mucopolysaccaridosis (untreated), Seckel syndrome, metastasized rhabdomyosarcoma, 3 month-old who died from sepsis, a 15 year-old boy with a facial tumor and no money for referral, hepatitis, etc.  I will never forget this experience.

Afterwards at 6 PM, there was a Project Angkor celebratory dinner at the governors mansion in Sisophon.  We each received a traditional Khmer scarf, a certificate, a handshake from the governor, and we took a group photo.  The dinner was wonderful, it had traditional Cambodian dishes of stir fry vegetables, curry, noodles, and dessert.

Day 9: January 7^th:  We traveled to Siem Reap from Sisophon on a charter bus.

Day 10: January 8^th:  Flew from Siem Reap to Seattle