Treating Children in Cambodia

Susan Opas is a pediatric nurse practitioner from Woodland Hills, CA who volunteered for Project HOPE on PacificAngel 16-2, a humanitarian and civic assistance mission led by the Royal Cambodian Armed Forces working alongside their U.S., Thai, Vietnamese and Australian counterparts and volunteers from nongovernmental organizations like Project HOPE in Kampot Province, Cambodia. Susan treated pediatric patients at two makeshift clinics over the course of five days in mid-June 2016. Pacific Angel 16-2 was Susan’s sixth volunteer mission with Project HOPE.

This mission began June 11 with a day to complete set-up that several U.S. Air Force and Australian Air Force volunteers started the day before. Our goal was to serve two community locations in the very south, central area of Cambodia. Both locations are in farming areas, but the first was quite more distressed than the second. In both settings we used local schools: the first was a middle school, and the second was an elementary school connected to a Buddhist wat (temple), which was incredibly gorgeous with walls and ceilings totally painted with Buddhist scenes.

Our first true day of mission work was June 13. Our clinics consisted of dental, optometry, general medicine, pediatrics, physical therapy and a pharmacy. The medicines provided were quite variable, so we had to stretch at times to utilize what we had. An example is loratadine (Claritin) for unavailable Benadryl. In addition to seeing patients, in pediatrics we each also dispensed our medication and, with interpreters, educated the patients’ parents about the medications.

My very first patient was an 8-year-old with subcutaneous tuberculosis. Yep, quarter-sized cysts full of TB. The next had his heart in the right side of his chest instead of the left along with a larger murmur, which seemed to be a hole in his ventricle. Cambodia has a much better referral system than other countries. So, our infectious disease person and the local hospital director coordinated the TB patient’s transfer and set up a plan for us to follow the patient’s routing throughout the mission.

The next day again I started with another heart murmur known as Stills Murmur, which is seen when significant anemia is present. Rice is the staple of life here, although I noticed on our van ride one hour from town that there are cows, chickens, turkeys and pigs. In some situations parents had the same complaints as in the U.S.: kids want the sugar and chips and somehow they have the money to get these. I saw lots of beer and soda available along the roadside.

On the third day, the last at this site, the number of patients seeking pediatric care dropped. I believe this was due to the kids being in school and unable to be seen while we were available. The most involved work of the day was cleaning skin wounds caused by kids scratching their bug bites without good hand washing. We closed our section early and began packing up for the move to the second site. We were awash with “gummy vitamins,” which patients, parents, the interpreters and the military were eating like candy.

Day four was a moving day. We started on a paved road out of town, but then we were on a red, dusty dirt road or muddy single lanes with lots of divots, which kept us awake until we arrived at the second site.