Cambodia:Episode Five

by Nik Munirah Nik Mohd Nasir

Friday 4 August 2006
Last Day

It was the last day for clinic and circumcission. This last kampong also took about 2 hours from our accommodation.

I was sad at the prospect of farewell, after working with all this people for the past few days. Although there was clearly a language barrier, but I have come to learn that ukhuwwah or brotherhood knows no boundaries. Yes, this bond of brotherhood that could only be forged from the depths of hearts filled with love for Allah.

How else can you explain the dedication of En Sokry , Dr Sulaiman and the rest of his Cambodian team in making us feel right at home in this strange country? How they’ve helped to arrange every detail of this mission, despite not getting any worldly benefit in return? En Sokry had helped to arrange the transport, the accomodation and food, all the while trying to get the best bargain since he knew we were here on our own expenses (All the money we received from donation were used on purely things related to our mission and the Cambodian people e.g. medication, transport to kampong, surgical instruments. Things like our accomodation and food, and also our flight tickets were from our own pockets) Dr Sulaiman and his team of doctors has meticulously taught us how to perform circumcission, ever so patient at our fumblings and mistakes. (In the words of Dr Sulaiman himself : ‘No problem sister. No problem.’

Dr Sulaiman was especially famous for his advices. He had repeatedly told everyone of us to study hard, study hard. Don’t be lazy. You must study hard and become a doctor to help the Muslims. Coming from himself who was raised in an orphanage, those words are like precious pearls awaiting to shine on those who took it to heart. When he was young, he worked really hard as his ambition was really to become a doctor to help the Muslims. He was a brilliant lad, and got a scholarship to pursue his studies. But of course, he didn’t stop there. He went on to learn English and later taught the language to other people. His passion lies in helping the Kampong people, going over to visit them and help them with the mobile clinics.

The clinic today was more orderly than it was yesterday, probably because there is more space around the clinic area. The villagers had set out like a small tent where we set everything for the clinic under it. I was on the consultation station and business is as usual.

Probably the most difficult part of the consultation bit is trying to put what the translators had translated for me on behalf of the patient into pigeon holes I am familiar with. I wish I could get the usual complaints of chest pain, or any pain anywhere so I could go through the usual 8 questions that goes with it. Unfortunately, as we are being told often, people don’t present like they do in the books so its up to the doctors to try to make sense of it all. I was flabbergasted when the translator told me that this woman’s presenting complaint was, feeling of ‘getar’ which literally translated means ‘shaky’. Ok, so is it some sort of a fit shaky or feeling chilly shaky or like a Parkinson type shaky? When asked specifically, she said its her heart that is feeling shaky. So it might be just a case of palpitation.

This is one of the many examples of how important it is to communicate efficiently with a patient. One word can mean so many things, especially when it is of a different language.

Another point of lesson that I realized from after going through this clinics is the stamina you need to survive as a doctor. I recalled commenting to a doctor in A&E how busy the outpatient was during the day when she remarked, “ Oh, the number of patient are 10 fold at night.”

Going through all those patients kind of gave me a picture of how it would be in the real working life. Since there are so many patients, you really don’t have a lot of time to spend on just one. 7 minutes tops. At the same time you are asking all those questions, you are really trying to think what is the problem and later, what is the cure? What advice or medication should I give this person. It’s a big mental exercise. Then the next patient comes and the same cycle goes on.

And of course, throughout this whole mind bending experience, you need to maintain your composure and
smile.

So that’s it. The 3COMs to effective consultation. Communication, composure and compassion.

When we got back that evening, the last day of our mobile clinic, Dr Muslim was already waiting for us and took us out for dinner.

Dr Muslim is an interesting character, nevertheless inspiring as well. He has dilligently came over to visit us right after his shift at the hospital since he could not go with us to the kampongs. (It was our fault as well for not telling him the change of plans. Earlier we planned to go on the 27th of July for which he had already booked his holiday so he could be with us, but we delayed the mission due to technical reasons to 30th of July.)

We went out to the usual food stall, one of the only 2 food stalls serving halal food that they know of in Kampong Cham. We had the usual menu, stir fried mix vegetable and chicken soup with rice. Dr Muslim even treated us to a glass of ice blended mixed fruits which tasted awesome.

to be continued...