Patience with patients

When I first got news I was going to Cambodia I was ecstatic. The people, the culture, the tropical wonder of a foreign country! I drooled over googled images of stereotypical Cambodia places: the temples of Angkor, the markets in Siem Reap, the food in Kampot. Like a good western-centric raised, twenty-something year old, medical student I was also looking forward to delivering much needed medical care to the Khmai people. After all, we're trained in arguably (very arguably, to some) one of the best medical systems on the planet. I was excited to give back. 

However, as I began to consider the trip, I began to worry. Delivering healthcare is complicated, and doing a good job of it, even more so. What can be done in two weeks? Sure, immediate concerns like infections, scrapes, and cuts can be fixed with some medications and stern doctorly advice. But what about chronic diseases, the things that really get you in the end, like heart disease, hypertension, diabetes (among others)? Many of these people have never seen a doctor before and these disease states are complex, requiring long term followup and good doctoring. Patients in America can barely be managed with these chronic disease, and we speak the same language as them! Now color me skeptical, because I know I sound like a cynic... but I was nervous. Treating chronic diseases with just two weeks of medications (our carrying capacity) and no long term follow-up (the nature of the situation) can do more harm than good. This third this year med student was nervous...were we actually going to make a positive imact on the patients we saw?

The first day clinic changed everything for me. I came to a realization that will change the way I interact with every patient I meet after leaving this beautiful chaos of a country: that by treating the immediate concerns of the patient (like the sore throats, scrapes, and cuts) you can actually get down to the good stuff, educating the person as to what they can do to improve their health and overall quality of life. In not so many words: education is sometimes so much more important than action. 

Despite the fact that some of our chronic disease medications are in short supply & limited in variety, providing the patients with the enlightenment that they even suffer from these diseases (like the aforementioned HTN, diabetes and CHF) is the most important aspect of our trip. By beginning the first step in the education rocess we can ensure that patients are made aware of the serious nature of their disease and continue to receive the care they need after we leave. Indeed, many are willing to and capable of continuing to see local clinics once they understand what they suffer from. That, I believe, is what makes this all worth it. 

Written by: Haresh Soorma, third year medical student and professional tuk-tuk bargainer.

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