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Friday, November 28, 2008

Doctors on Stage

Doctors on Stage
The Lake Clinic Cambodia

Serving the Underserved

The Lake Clinic is a project dedicated to bringing basic healthcare, as well as disease surveillance and proper medical referrals to a severely isolated and underserved region of Cambodia -- the Tonle Sap.
Dr. Mette and Dr. Hal set up their respective areas while dental nurse, Phaly, provides oral health education to the early crowd.
Hal described his experience as "dental aerobics".

By Drs. Stein and Mette

Having passed the midway point in our two month mission to the floating villages of Tonle Sap, it is time for a first, brief summary and some reflection.

Being G.P.’s from a city-doctor-practice-in a well-developed country like Norway, we were well aware of the fact that not everything would be exactly like back home. Furthermore, we had been given valuable briefing and information by Jon and other informants prior to our first mission. The talks had been about the already existing health care system in Cambodia, which is not absent, but to the remote villages of Tonle Sap it is not easily accessible - it had been about a medical culture and thinking that is very different from the one in Norway , about illiteracy and ignorance, about TLC’s aims and goals and about our own expectations.
We thought we were to some extent prepared for the first mission.
Well, we were not really.

By the time we at lunch-time, reached the first village, Moat Klas, after a three hour ride in the village chief’s taxi boat, starting to unload our stuff, we already found ourselves surrounded by some fifty-odd villagers/patients wanting to see us. Within a few minutes we were having the first consultations, mediated by the young translator, Sothat. The patient waiting room was about 20 cm away, 50 pairs of eyes following every word and move we made, while discussing themselves in between in Khmer. Add to this a huge machine for fish-chopping in full action abut 4 meters away, and an on-going boat race on the river lake, producing a cacophony of sound rising to unbelievable peaks. We found ourselves in the middle of an absurd theater, playing the main parts.

With the help of our crew, we slowly got better organized, and we were able to communicate , understand or not understand, consider and give medication, and even to distinguish a few really sick patients whom without our presence would have been worse off.
Exhausted, excited, happy, overwhelmed and inspired we closed down the Lake Clinic at sunset the first day. An excellent Khmer dinner cooked by our midwife, Kim, finished the day, and by eight thirty, the batteries, and consequently the light (except for a spare battery serving the chief’s TV set transmitting a Cambodian Karaoke show!) went out, everybody turning to their hammock or mattress with mosquito-net, and with the help of modern pharmacy, we had a few hours’ well deserved sleep.

At this time we have completed 3 missions, whereof the last 2 on the restored TLC-1. You can imagine that the comfort is a little closer to our usual standards on the TLC-1 than on the chief’s fleet – and I have deliberately omitted the most private part of it – the TLC1 offers possibility for a cool shower and even a toilet.

Following the Hippocratic motto: Sometimes cure, often relieve, and always comfort, we realize that there is a long way to go for The lake Clinic. But everything has a beginning, and as we learn more about what is possible to obtain and what is not, as we learn better to understand and interpret the villager’s expression of health problems, and as doctors learn to live side by side with the ghosts, spirits and ancestors, we will slowly get better both in the here-and now situation, and hopefully also in contributing to basic health needs such as better nutrition, better hygiene, birth control, etcetera et cetera, the list is long.

We both feel privileged to have this unique opportunity to participate as pioneers from the very beginning in this ambitious project, - SERVING THE UNDERSERVED.


Jon Morgan is executive director of the Lake Clinic Cambodia.

From 1998 to 2007, Jon was the first executive director of the Angkor Hospital for Children, in Siem Reap, Cambodia. More about John Morgan

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