Cambodia currently ranks 129th out of 177 of countries in the United Nations Human Development Index (HDI) and 73rd among 102 developing countries for the Human Poverty Index (HPI-1). Many aspects of Cambodian society were effectively destroyed by about 500,000 tons of American bombs between 1972 and 1974 and the Khmer Rouge regime that followed during which more than 1.5 million out of 7 million people died. This was followed by the Vietnamese liberation-occupation that ended officially with the Paris Peace Accords of 1991. Only during the past 10 years has the country has entered a period of stability, and achieved economic growth of about 7.4% per annum.*

Our second visit to Cambodia could not be more different from the first in October 2006. Unlike then, the weather was extremely hot and dry. This time, we have a strong team of orthopaedic surgeons, who helped to successfully conduct an External Fixator Workshop. The volunteers for this mission were:

1. Dr Abdul Malik
2. Prof. Bhurhanudeen Abdul Kareem
3. Dr Harwant Singh
4. Dr Kok Hong Seng
5. Dr Liau Kai Ming
6. Dr Mohd. Hyzan
7. Prof Saw Aik
8. Dr Yong Su-Mei

We were also joined by a journalist from Nanyang Siang Pau, Ms Tan Peng Cheak. The objective of this mission was to:

• Conduct a workshop on External Fixator for the surgeons in Siem Reap.
• Donate Eight sets of external fixators by Dr Hyzan and Sunway Medical Centre

25th April 2008

We arrived at Siem Reap International Airport at 8 am. At 10 am, we met the Public Relation Officer, Ms Ho Oma at the Angkor Hospital for Children (AHC). She showed us around the hospital and explained the process of registration, admission and subsequent discharge from the hospital. The treatment rendered at AHC is free of charge and sometimes patients are even given financial assistance to return home. The visit ended at 11 am.

We then visited the Rehabilitation Centre near Angkor Hospital for Children. Mr Koy Kol, the information centre officer explained to us regarding the center. It was established with the help of Handicap International. Since 2004, a full range of services in the area of rehabilitation and social and economic inclusion is provided to 4,500 patients with various physical disabilities per year. This is done at the centre but it also includes patient supervision, with services extending to the most remote villages. The goal is to improve the daily lives of the patients and to ensure the long-term existence of the services and their inclusion into a national rehabilitation system. The rehabilitation centre is well known for its work in helping victims of landmines. Landmines remained a major cause of mortality and limb injuries in Cambodia, long after the defeat of Khmer Rouge. The center is very innovative and managed to treat many patients with modified orthoses and prostheses. After the visit to the Rehabilitation Centre, we had our lunch.

Self made prostheses used by victims of landmines, heavy and uncomfortable

Mr Koy Kol explaining the types of prostheses made locally providing better and more comfortable prostheses for the patients.

How donation can be utilized…

In the evening we were shown around the Provincial Hospital by Dr Roung Rada. He is a trained surgeon with special interest in Orthopaedic Surgery. The wards in the Hospital were overcrowded. The condition was very basic, but patients were given great care by Dr Rada.

26th April 2008

The workshop started at 8.30 am the next day. A series of lectures were given before we started the workshop. There were 11 participants, including doctors and paramedics. The lectures given were:

1. What is external fixator?  (Dr Hyzan)
2. Indication for ext. fixator.  (Dr Kok)
3. Half pins  (Dr SM Yong)
4. How to make fixation stable (A/P Saw Aik)
5. How to take care of the wounds (Dr Su-Mei Yong)
6. Problems with external fixator (A/P Saw Aik)

The lectures were followed by a short break and practice on saw bones. Participants were shown ways to stabilise fractures. The workshop ended at 12 noon. At the end of the session, Dr Hyzan presented the Angkor Hospital for Children and the Provincial Hospital representatives with 8 sets of external fixators.

Demonstration during the workshop

Group photo

The rest of the day was free time, some of the doctors visited Angkor Wat, Tonle Sap, while the rest managed to catch their much needed rest. In the evening, some of us attended a concert at the Jayavarman VII Hospital. Dr Beat Richner was an eloquent speaker and engaging entertainer. He played the cello and explained the background of this charity hospital for children. There are five hospitals run by the same foundation, mainly funded by corporate bodies and private donors.

Tonle Sap – floating school with a basketball court at the upper deck

27th April, 2008

We left Siem Reap at 8.30 am. We were tired but glad that we managed to complete our mission with the cooperation, hardwork and time, so generously donated by all our team members. We are grateful to the staff at AHC, Dr Vann Thy, and Mr. Shoemaker, the Medical Education Director (and Deputy Director) of AHC for all the assistance rendered during our visit.

* Secondary Prevention of Disabilities in the Cambodian Provinces of  Siem Reap and Takeo: Perceptions of and use of the health system to address health conditions associated with disability in children. Report prepared for Handicap International Belgium by: Betsy VanLeit, Prum Rithy, Samol Channa. 28th February, 200