Bhavna writes... (May 2011)

I loved my medical elective at Rose Rehabilitation/Rose eye clinic in Cambodia! I sit in clinics now wondering what I would be doing if I was still out there and reminiscing about this unique experience. 

Cambodia as a country is amazing, it is full of the friendliest people I think I’ve ever met; everybody is keen to help you and make you feel welcome.  This was no different at Rose Rehabilitation centre in Takhmao.  It was a slightly awkward moto journey arriving there from Phnom Penh (capital city) but all the angst quickly disappeared once I saw Joanna, Sophak, Rith and the rest of the team.  They were extremely welcoming, friendly and inclusive; even when there were no medical issues for me to be getting on with – Joanna always invited me to visit the rehab patients in the community to take histories, examine them etc and even teach me.  She (and the rest of the team) answered my questions; always allowing time for me.  It was truly extraordinary to see the healthcare running successfully with limited resources and the variety of patients that Rose Rehabilitation deal with; the immense clinical signs really tested my (limited!) medical knowledge and allowed me to see the aftercare involved in a surgical patient – something I rarely see in hospitals back at home.  This was such a great opportunity to really test my clinical skills too and offer some medical tips back to the team.

I have to stress though that this is not always the case for visiting medical students – it just so happened that my visit coincided with Dr. Sarom’s (the head surgeon) visit to Australia and so I was only able to spend about a week with him.  I had applied for this elective because I am highly interested in surgery and did get to see some cool cleft palate repairs, plastics and grafts but never got a chance to assist unfortunately as I believe Dr. Sarom was training a Khmer doctor at that time. 

It was lucky for me that I have a keen interest in ophthalmology and so I split my time between takhmao (Rose Rehabilitation) and the eye clinic (based in Phnom penh) where I sat in the clinics for the morning and then assisted – that’s right – ASSISTED in ophthalmology surgery in the afternoons!  The eye centre is run by Dr. Vra (who predominantly performs cataract surgery) and his Ukrainian wife – Dr. Natalie (oculoplasty etc) – the rest of the team are lovely however, language is a major problem.  If, by chance, you speak Russian or Khmer – then great!  You will be fine – but if however, you only speak English – it makes life somewhat interesting.... Of course you pick up little things here and there but you can’t really run the clinic or ask the patients much yourself – without a translator.  I was lucky that Dr. Natalie was so keen to teach and wrote everything in English.  She was also very eager for me to practise my surgical skills and although I’m sure I was the local attraction/entertainment at the clinic – her teaching was invaluable.  The very first day there, she made me do an interrupted suture with tiny thread on a blepharoplasty . It soon progressed to me doing complete operations on my own – supervised of course.  If you’re keen or even interested in ophthalmological surgery – this is the place to be, there is nowhere in England that you will get such experience at our level – it is impossible so I am truly grateful for the opportunity I had to complete my elective here.  However, if you are squeamish, then I suggest maybe just attending morning clinic (start at 8am-12pm) as all the patients are under local anaesthetic only for their surgeries!

Bits of advice/ things I wish I’d known before I came:
-    Bring your own scrubs especially for eye clinic and id suggest taking your own crocs too but they all wear flip flops.
-    If you can get sterile hats then bring them too.
-    I’d suggest staying in Phnom Penh – purely as there’s so much more to do there, and it really caters for westerners.  I stayed in Europe Guesthouse on Street 136, which had the perfect location and was run by the loveliest family!
-    Take a book with you to read if you’re spending time in Takhmao as everything runs on “Cambodian Standard Timing” and you do end up waiting around for patients etc.  There is a medical ward there but the doctors speak only Khmer or French.  Dr. Sarom is excellent and speaks good English however. 
-    Getting to Takhmao – if you can arrange for the directions to be written in Khmer and find yourself a nice tuk tuk driver that will do you a deal – take it! I went with a friend of mine (Physio volunteer) from Phnom Penh via tuk tuk there and back and it came to $7 a day but I’m sure it can be done cheaper.
-    At the eye clinic – there is a nice canteen around the back where doctors and other volunteers from the opposite surgical centre eat – lovely dinner ladies and you can eat as much as you want for 2000 riel – that equates to around 25p!
-    Definitely try sugar cane juice when the lady comes around on her moto too.
-    Uniform – it’s so hot (esp. during march-may) that I wore cropped trousers, shorts, and decent tops – there’s no need in dressing too smart as everybody is pretty laid back.
-    Be prepared for things to “go with the flow” – it is not a regimented elective – which I think is good as it really allows you to immerse yourself in Cambodian nature.
-    Ooh if you’re vegetarian – learn the words in Khmer for “no meat, no fish” etc and just re-iterate that when you go to eat. I found it difficult to find vegetarian food – esp. in Takhmao but it’s understandable as it’s not in Cambodian nature to not eat meat!  However, Sophak, Sokney and Joanna all made sure the dinner ladies at Takhmao had some vegetables for me; they really look after you during your elective so just remember to have fun!