Ryan and I got to go out on a home care visit one morning. We trekked (by van) into incredibly rural areas outside of Siem Reap to follow-up with patients right in their homes. We saw two kids with HIV, one in a nicer wooden house, and one in a grass hut. Both had lost their mothers to the disease. This was a pretty incredible experience!
The next day, I went out on a dental outreach visit... and by dental outreach I really mean pulling teeth, because that's really the only thing they can do with their limited resources. The dentists were already wondering why I was there after I said I was a business student, but I certainly didn't help my case when they started work on the first patient. Who knew dentistry was so violent? After giving this poor girl some hefty doses of something in a giant needle, the dentist started digging through her mouth like she was hoping to scrape gold off the bottom of it. This was gross enough. Then she actually started cracking her teeth into pieces to get them out. I'll spare you the rest of the details, but just hearing those noises was enough for me. Inside I'm thinking, I'm already not a lot of help right now... imagine how NOT helpful I would be if I passed out. So I decided to wait out the rest of the surgeries from the bench outside... peering in whenever I felt so inclined... much to the delight of the other Cambodians, who seemed to find this REALLY FUNNY. I got the last laugh though... most of them were waiting for their turn in the chair.
Sunday, August 24, 2008
Behaviour, Birth Defects, and Natural Remedies
Ryan and I learnt a lot about Cambodian beliefs and medicing this week. There was an interesting case of cleft palate/lip in the hospital, and I went with my office counterpart Nerai to document the case. I was expecting to find an infant or toddler for our patient, and was surprised to find a 14-year old girl. She had never seen a doctor, and only came to AHC because her aunt visited Siem Reap and heard about the hospital. They live over 240km away, which by Cambodian infrastructure standards, takes 11 hours by car. What was most interesting to hear was that many Cambodians believe that if you are born with a birth defect (be it cleft lip, extra fingers, missing limbs etc), that it is payment for bad behaviour in your past life. On a related note, I saw a kid with six toes. Apparently this is not uncommon, but in North America, they would have already cut it off.
My second story came about when Ryan told me there was a premature baby born at 24 weeks in the hospital. Babies are normally in the womb for 40 weeks and aren't generally considered fully formed organ wise until roughly 28 weeks. In Canada, a baby born before 25 weeks is usually not worked on by doctors. David says that Canadian doctors working on babies under 26 weeks are usually doing it for the good of their career and not the good of the baby. Never-the-less, I was curious to see this tiny wonder. After speaking to David a little bit more I found out that in Cambodia, it is really bad luck to have a baby born in the 8th month of pregnancy. He said that the actual gestational age of a baby can really only be determined by a physical exam and a rough guess because mothers will NEVER tell you that their baby was in the 8th month, they will always say the 7th. They are also careful to make sure this falls after their wedding date... So the likelyhood the baby is 24 weeks is slim, but it is certainly no older than 28.
At AHC you will often see kids with bizarre marks and scars on their bodies from traditional healings. Some of the staff even practice this medicine on themselves, although they are more careful to hide it. The first technique involves burning three marks (like cigarette burns) into a child's stomach to act as protection. The second is called cupping, and involves rinsing a cup with gasoline, lighting it on fire and putting it on your skin. The fire burns the gasoline and doesn't touch the skin, but the need for oxygen creates a sucking against the tissue and, for all intensive purposes, creates a giant hickey. This method is supposed to suck the poison out of you that is making you sick. Another technique is called coining, where they scrape burning hot coins down your back, also to remove poisons.
Lots of interesting medical stories... but I guess when you can't get to a doctor, you make do with whatever you can.
My second story came about when Ryan told me there was a premature baby born at 24 weeks in the hospital. Babies are normally in the womb for 40 weeks and aren't generally considered fully formed organ wise until roughly 28 weeks. In Canada, a baby born before 25 weeks is usually not worked on by doctors. David says that Canadian doctors working on babies under 26 weeks are usually doing it for the good of their career and not the good of the baby. Never-the-less, I was curious to see this tiny wonder. After speaking to David a little bit more I found out that in Cambodia, it is really bad luck to have a baby born in the 8th month of pregnancy. He said that the actual gestational age of a baby can really only be determined by a physical exam and a rough guess because mothers will NEVER tell you that their baby was in the 8th month, they will always say the 7th. They are also careful to make sure this falls after their wedding date... So the likelyhood the baby is 24 weeks is slim, but it is certainly no older than 28.
At AHC you will often see kids with bizarre marks and scars on their bodies from traditional healings. Some of the staff even practice this medicine on themselves, although they are more careful to hide it. The first technique involves burning three marks (like cigarette burns) into a child's stomach to act as protection. The second is called cupping, and involves rinsing a cup with gasoline, lighting it on fire and putting it on your skin. The fire burns the gasoline and doesn't touch the skin, but the need for oxygen creates a sucking against the tissue and, for all intensive purposes, creates a giant hickey. This method is supposed to suck the poison out of you that is making you sick. Another technique is called coining, where they scrape burning hot coins down your back, also to remove poisons.
Lots of interesting medical stories... but I guess when you can't get to a doctor, you make do with whatever you can.
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