What I Have Learned About Medicine In Cambodia

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Advice to travellers! If you sustain any injury more serious than a papercut, demand medical evacuation to Bangkok. I don’t know what the hospitals in Phnom Penh and Siem Riep are like, but in the provinces the situation is not great. I literally could not believe it when they told me they perform surgery at the hospital in Kampong Thom. How? It’s tiny. There’s no glass in the windows. The electricity goes off three times a day. There is a small herd of cows outside A&E. When I walked past this morning I saw a guy getting on a motorbike with an IV in his arm, attached to the handlebars with a drip stand made of bamboo.

The conditions are poor, but the doctors are incredibly dedicated and hardworking. They never complain. They speak of the NHS as if it were some kind of utopian medical paradise, which of course in comparison it is. I solemnly swear I will slap the next person who complains about the NHS, even if it is my consultant.

So, has accidentally ending up doing a psychiatry project prompted some kind of career altering revelation? Well. Psychiatric patients have disturbed me and upset me more than anything else I’ve ever seen. I would rather have anything happen to me than serous psychiatric illness. Nothing destroys your life faster. In a way, psychiatry is at the heart of all medicine. The worst part of any illness is the suffering it causes, and that is purely down to psychology. But I just don’t think I could be a psychiatrist. Not back in England, anyway. Not if we continue to head the same way as America, medicalising every bad mood or personality quirk to the point where everyone has a disorder. And psychiatry lacks something of what appealed to me about medicine in the first place. I don’t know what exactly. Maybe blood and sharp things, machines that go beep.

Somewhere like Cambodia, whatever field of medicine you enter will leave you feeling pointless and frustrated at times. The main problem underlying people’s ill health is their life situation. Here this basically amounts to poverty and the after-effects of war. If most of your family is dead and your husband beats you because violence has become a conditioned response, it’s no surprise that you’re depressed. If you can’t earn enough to feed your family, it’s no surprised you’re depressed. Your doctor can give you medication but they can’t fix what’s wrong. If you lose a leg to a landmine or your child dies because you didn’t have the basic education to know how to care for it properly, then politics caused your illness. Your doctor can’t treat the cause. All a doctor can ever do is patch people up and send them back out into the poverty and violence that hurt them in the first place. It’s a never ending cycle and you aren’t really improving anything. More patients will always keep coming.

So what do you do with your life if you want make other people’s lives better? Go into development, or politics maybe? I can’t see myself doing either of those things. Studying International Health this year has taught me what I DON’T want, and that is to spend long hours sat at a desk analysing or writing policy documents, reviewing literature or listening to John Wally. It’s just not my style. I just want to do something. So it looks like I’ll just have to be content patching people up one at a time, amusing myself with sharp things and machines that go beep.

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Photos

Team TPO
Not the men at the front feeling each other's knees? Not gay. In Cambodia it's normal for friends of the same sex to hold hands etc in public.

View
From my window, including duck enclosure and weird insect catching plastic sheet.

My Room
Note the Pound Puppies towl? Old school.

Market
Grim meat stall.