Thursday September 28. 2006



Where do I begin....


I arrived on the 23rd of September after a long 28+ hr plane ride (again) from Boston to Phnom Penh. It took me about 3 days to finally get over my jet lag. I am staying with Dr. Sok Thim (the research director and co-founder of the Cambodian Health Committee) and his family. They are one of the nicest people you could ever meet, and I am just grateful that they have invited me to be a part of their family. They have two little boys, ages 4 and 2 who keep me entertained everyday. It's funny for me to see these little kids speak such perfect Khmer, while I still struggle. But, on the flip side, Thim and his wife are excited to have me living with them so that I can speak English to their kids and help them practice.

I have officially started working with the Cambodian Health Committee this past Tuesday. My job here is basically to improve the quality of nursing care in the pulmonary department at the MKS hospital in PP. Sounds simple…but when I arrived to the hospital this past Tuesday to meet with the doctors, nurses and other healthcare workers and tour the department, I realized quickly that there was A LOT of work to be done, and I could not help but feel a little overwhelmed.

The pulmonary department is located within the MKS hospital (the biggest public hospital in Phnom Penh) with the capacity of holding more than 300 beds. The pulmonary department was just recently renovated and has the capacity to hold 120 beds. So far only 1/2 is being utilized with the majority of patients diagnosed with TB. The building is divided into two floors, with the first holding HIV negative patients and the second floor with HIV positive patients. CHC (the Cambodian Health Committee) takes patients who are HIV+ and have TB (from the second floor) and admit them into their ARV/TB therapy research program.
CHC began working with this department in 2004, since the majority of patients admitted are TB patients who are infected with HIV. These patients are one the most discriminated groups of people in Cambodia but with the help of CHC, through education, care, and research, there is a better understanding of the disease.

As I toured the wards, I realized how basic and poor the quality of care in this facility is. First of all, the layout of the wards is one that is brand new to me. Everything is open to the outside. Each room is connected to the outside hallway, almost like little dorm rooms. Patients lay on mattresses that are about 2 inches thick, with a straw mat placed on top. There are no monitors or machine beeping to alert you for help. There are no calls lights or means of letting nurses know if help is needed except for the patients’ family members walking in and out of the patients rooms. Doctors round and access patients from 8-12pm and then are all off for the day. They usually leave for lunch and then around 2pm there is one doctor supposedly on call until the next day. The system has many holes and the lack of organization and management makes everything pretty chaotic!!!


Pulmonary Ward

CHC building

TB paient