Phnom Penh, Cambodia
Hebron International Hospital, Phnom Penh, Cambodia, May 15-25 2013
Team members: Andrew Kingsnorth, Scott Leckman, Denis Blazquez, Petr Bystricky, Simon Clarke, Sheri Kardooni (trainee) & Paulina Mysliwy (anaesthetist)
Darkness descended on Cambodia in 1975 when the Vietnam war extended into Cambodia and the Khmer Rouge took over the country. Evacuation of the cities, genocide of three million of its fifteen million people and 10 years of rule by the Soviet-backed Peoples Republic of Kampuchea resulted in unbelievable suffering and horrors for the surviving population. Since the country was reunited under the monarchy in 1993, huge strides have been made to re-establish the culture and rebuild the economy of a country that originated in the vast 9th century Khmer empire that dominated the Indo-China peninsula. Angkor was the centre of power of this empire, where an unimaginable series of temples (Wats) were constructed and which, through satellite technology has been established as the world’s largest pre-industrial city, with an estimated population of one million.
Cambodia has just lifted itself into middle-income status with an average per capita income of $1040, although 20% of people still live below the poverty line on less than $1.25 per day. Health indicators are dismal; life expectancy is 60 for men, and 65 years for women and 23% of children die before the age of 5 years. It is the third most land-mined country in the world; 60,000 have been killed and thousands maimed, many being children playing in the fields or herding animals.
Tourism is the second largest source of hard currency and the main exports are timber, rice, fish, garments and rubber. The legacy of the war-torn countryside is one of the highest levels of deforestation in the world: primary forest cover was 70% in 1969, in 2007 it was down to 3%. There is free compulsory education for 9 years, literacy rates are over 70%. Few hospitals exist, and healthcare provision is largely left to a poorly trained private sector.
Our base in Phnom Penh was in the remarkable Hebron International Hospital (HIH) in a poor district near to the international airport. It is staffed by a Korean Medical Ministry team, which provides two levels of care – primary care for local residents and a base for short-term mission teams such as Operation Hernia. HIH opened in a small house in 2007, progressed to construction of a 70 bed hospital with 3 operating theatres and a staff accommodation block in 2010, with a vision to open a nursing school and a medical school in the next 20 years. This degree of commitment is quite extraordinary.
We were housed in a respectable but inexpensive hotel in Phnom Penh, and transported by minibus each morning to the HIH. The team had two paediatric surgeons (Simon & Denis). Andrew, Scott and Petr were able to handle the older children, so we had decided to run a “Children’s Hernia Hospital” for a week. Without gaseous anaesthesia Paulina improvised magnificently to enable the team to operate on over 70 children in the week of the mission, which was a remarkable achievement and brought many happy and tearful smiles to the parents of these children .
The team managed a trip to the Angkor Wat at Siem Reap and harrowing visits to the Tuol Sleng torture chambers in Phnom Penh, and the mass burial graves and Genocidal Centre at Choeung Ke.
Operation Hernia has plans to provide a long-term commitment to HIH.