Blog

A New Chapter

Dylan Scott| Undergraduate Student| May 25, 2017 

            

Our lives are similar to the chapters in a book. As for how each chapter represents both an individual story yet a piece of a long novel, the moments of our lives represent individual adventures which are pieces of a continuation of life’s story and eventual legacy. Today, as I sit in Phnom Penh, Cambodia writing this out, I have started a new chapter in my life. I have begun my new story, but it is not the end nor the beginning of my novel. The previous chapters of my life have led me to this moment, and this chapter will go on to influence the rest of my life. Mercer on Mission Cambodia has proven to be a great experience within day one, and I can barely contain my excitement to observe what is to come. I write this blog reflecting the beginnings of my new chapter.

        

To begin the explanation of how the trip has begun for me, I must explain a little about my background. Since I was born, I have been born and raised in Ringgold, Georgia. Ringgold is a small little town in North Georgia mostly known for being “an exit with food” before Chattanooga, Tennessee. Ringgold is a typical Southern small town with family lines all living close by and ethnical diversity being almost zero. As such, I have hardly ever experienced different cultures or ideas from other populations of the world. To enhance this fact further, I have never traveled north beyond Baltimore, west beyond Texas, south beyond Florida, and east past the coastline. Even within the United Sates, I experienced little of what diversity truly was. Before two days ago, I have never even ridden in a plane, which is an experience in itself having your first flight as a fourteen-hour flight around the world but another story for another time. Upon landing in Cambodia, I experienced something new.

            

For the first time in my life, I was the minority in a given area larger than a building. At first, being in the position was uncomfortable. I looked around and saw Khmer writing everywhere. Yes, English was present on signs in smaller print, but it was weird having to be the smaller print. This seemingly obvious difference to expect caught me off guard by surprise because this change informed me of how things were going to be different. I had never experienced different and was uncomfortable with it, yet I was wanting to experience it at the same time. And yes, things other than signs in Cambodia are different from the United States, very different, but it does not mean the differences are worse. For example, the major religion of the country is Buddhism. I have experienced many Buddhist temples and observed prayers being made today. In these temples, offering are made in the form of flowers and money, and incense is burned. The traditions are different from Christianity practices back home, but were they worse, no. The people I witnessed observed to be very spiritual, reflecting a healthy wellbeing in spirituality and mind. The people practicing Buddhism in Cambodia are, frankly, nicer than most Americans as well. Do to the teaching of the religion, the culture of mannerisms has proven to be more friendly, open, and peaceful than back home. I am also surprised to find how many differences between cultures there are as well. Things such as driving, mode of transportation, shopping, foods, lifestyles, mannerisms, and traditions can and have vastly differed from areas of commonality back in the United States. Yet despite differences, many similarities also exist between the two groups of people. Coke and other large chain foods and drinks are still present, everyone still enjoys the nice breeze on a warm day, everyone lives life working a job to support their families, everyone is longing to be happy, and everyone in the world faces similar challenges in their lives from debt at the physical to heartbreak at the metaphysical.


 It has been unique to experience the differences and similarities a culture around the world can present to one who has never explored much beyond the southeast portion of the United States. I have begun a new chapter in my life, one filled with the adventure of experiencing the difference and witnessing the uniqueness to individuals it provides. I hope this new chapter will influence my novel in good light as I move forward recognizing and appreciating the world and its uniqueness.

 

 

 

Beautiful Cambodia
Taylor Childre| Nursing Student| May 26, 2017


This morning was such a nice refresher! We were free to explore on our own for a few hours. We got foot massages, had lunch at the local spots, and went to the central market to shop for anything and everything. The rest of the day was spent traveling south to Kampot. This is where we will be spending most of the rest of our time in Cambodia. 


Our few days in Phnom Penh has too quickly come to an end. Touring all day yesterday was hot, humid, and tiring but also full of awesome culture and beautiful sites. We were just beginning to feel more in touch with the people and more at home in the Ohana Hotel. Hopefully, we will just as quickly feel at home in Kampot!


Our Natural Bungalows are beautiful! Right on the river front and covered in lush green vegetation-it's like staying in a treehouse! So far the food in Kampot also gets 5 stars. We split up for dinner but all came back with great reviews of the restaurants we visited. It seems that we are going to enjoy our time here just as much we did in Phnom Penh.

First Day in Kampot

Taylor Boyd| Medical Student| May 27, 2017


Today started off really exciting for me. Our first day in Kampot, we got to tour the hospital where we are sending patients. After a year of clinical experience, it was really great to see how inpatient and outpatient fields function in foreign countries. It was especially exciting, for me, to see their operating theaters and C-sections rooms, and to see the environment an anesthesiologist functions in their hospital.    

 

In the afternoon, we got to follow local kids as tour guides through mountain caves. Many of my fellow adventurers jumped into mountain springs and climbed up the side of small cliffs. The beauty of Cambodia began to be exposed to us today.

 

More than anything, I am still most excited to work with patients and make an impact to these people. I am ready for clinic to start soon.

 

Fish and Bread

Ben Foster| Medical Student| May 28, 2017


Many of us went to a local Cambodia Methodist church service this morning. It was a great experience, a lovely church, and a welcoming congregation. The message was conveniently supplied to us in a paper with the English translation of the service. The message was the story of the feeding of the masses with the five loaves of bread and the two fish. The main theme of the lesson was giving or sacrificing what we can and receiving blessings back. 

 

The pastor talked about how when we invest in others and are willing to give what we have we always get something back. We might give through our time, knowledge, care for others or anything else; it doesn't have to be monetary. He also mentioned how we might not always get back what we want or expected, but it is always something beneficial to us.

 

Our team was also mentioned in the service message. In the words of the local pastor “Today, we have a worship service with the medical mission team from the USA. Do you know the reason why they come to Cambodia? I believe they came here to share Gods love. They want to share their time and their medical knowledge and their passion also. I believe God will show the miracle through their dedication."

 

No matter what faith you practice or what you believe in I think this message has something for us. It is the day before we start clinics. We are all eagerly awaiting the chances we will have to give and help others. Through this experience, we are going to get something back. It might not be what we expect, but it will be beneficial to us, and we are going to be better students and people having gone through it. 

 

First Day of Clinic

Deanna Joe| Medical Student| May 29, 2017


I had the most amazing day today. This was the day we had all been waiting for: the first day of clinic and for many of us, our first opportunity ever to interact with Khmer patients.  As a third year medical student, I felt anxiety and excitement leading up to this day.  This would be the first time that I personally would be the primary provider in seeing and making medical decisions for patients. Back at home, we would see patients and make diagnostic plans, but usually, our exam and work would be checked by medical residents. Here, it was ten medical students at nine stations, with only Dean Shelley and Dean Bina to supervise us all, as we saw over 180 patients over the course of the day.  

 

The anxiety quickly subsided as I realized how wonderful of a team I had working with me. Nita, a fourth-year medical student in Phnom Penh, translated beautifully and fully, and Jamie, an undergraduate completely "owned" the experience. She went above and beyond inscribing, asking pertinent patient history questions, and even presenting patients. In the afternoon, Faith, a pharmacy student, made drug recommendations and added greatly to my pharm knowledge. Twice, I had nursing students help a struggling me decipher how to use the multiple types of glucometers we had.  This was as authentic of an interdisciplinary team experience as you can get, and it worked unbelievably well.

 

Today also made me realize how much we take for granted in the United States.  The woman who fell two meters out of a tree would have already had an ankle x-ray prior to me seeing her, and I would have been able to give her more than a 2-week supply of medication for the chronic pain she's had since the accident one month ago. The older woman with cloudy vision would have been completely cured of her poor vision with a simple cataract surgery back in the United States. There were a few times thought I would feel dejected and unable to help, only to have Dr. Shelley remind me that the woman with a goiter and symptoms of hyperthyroidism and the young boy with a leg growth could be referred to Sonia Kill Hospital for additional evaluation.  Though extremely limited, there are some medical resources available here, and I am grateful to have the opportunity to temporarily be a part of this medical community, dedicated to improving the health of people living in southern Cambodia.

 

Lesson from Clinic

Arjun Bakshi| Undergraduate Student| May 30, 2017


After completing my first day in clinic, I can honestly say I have learned more in the last 8 hours than I would have in a year of learning in a traditional classroom setting. As we made our bus ride into the country side of Kampot, I began to feel overwhelmed with the tasks I had upon me. Being one of the undergrads on the trip, I had the least medical and clinical experience. I was worried that my lack of knowledge would burden the other students I was working with. However, once clinic began I realized that I was very wrong.

 

  As we first began taking in patients, both excitement and chaos filled the clinic. The entire team was hustling to perform their task effectively and efficiently. At intake, students were working hard with our translators to acquire patient's health history. The patients would then move to vitals where our team would take vital signs required to make a proper assessment. After that, the patients would finally have the opportunity to meet with the medical student. After combatting language barriers they were still able to provide an accurate diagnosis. The patients would lastly head to the pharmacy where our pharmacy student would provide them with the appropriate medications and treatment.

 

I believe my biggest take away from today was a result of the fear I had today. I realized that it is not about how long you have been in school, or how difficult one schools' curriculum is compared to the other. The reason our clinic was so successful today was because each member of our team performed their task to the best of their ability. Missing any single piece of our interdisciplinary team would have created a break in our perfect system. Each of our students, translators, and faculty members play a crucial role in making our mission successful. 

 

It is amazing how well our team is in working together to provide the best care for each individual. All of us, no matter our discipline is working at each station in the clinics so that we get an understanding of each other’s jobs. It is so incredible how much each person can bring to a diagnosis, whether they are a medical, pharmacy, nursing, or undergraduate student. Each of us is playing a significant role in caring for the people that step through the door. The Medical Students are great teachers and are willing to answer any questions, explain what they might be doing, and show us how to do different exams. I have been able to learn a lot from both Blake and Alayna. Both are so knowledgeable in their field and know exactly the questions they need to ask to figure out how to correctly diagnose the patient so that we can treat them to the best of our ability. I was worried the first day that when assisting a medical student that I would be useless as I had only learned how to take blood pressure a few days prior, but Blake helped me understand what to listen for when using my stethoscope to listen to the heart and lungs. They both allowed me not only to ask them questions but also to ask the patient questions as I became more comfortable. Not only are the medical students helpful to us undergraduate students, but the pharmacy students are providing the medical students with information on which medications might be better for the individual. The nurses also have been very helpful to both the undergraduate and medical students in teaching how to take someone’s vitals and glucose levels. It is awesome the amount of material we are learning from each other every day. 

    Not only do we have a great team from Mercer, but the interpreters we have are incredible and we could not complete our mission without them. Interacting with the patients can be a challenging task due to the large language barrier that is between our patients and us. I have found that a smile goes a long way and will never be wrongly interpreted. Even though all of the patients appreciate and enjoy watching us try and speak some Khmer, to help break the language barrier our translators have been amazing, patient and willing to assist us in so many ways. I honestly believe that they have the hardest job, because even though no one in the clinic stops moving and thinking all day, they are speaking two languages, and are not normally translators. All of our translators are medical students in Phnom Penh or work in local medical clinics, which is a great help to everyone. I have enjoyed working with all of them, they are useful when it comes to not only speaking to the patients, but I have found multiple times they gave their own input to assist in producing the correct diagnosis. I believe this is because they see a lot of patients just like the ones we are helping and they know more about the culture, food or lack there of, and some of the jobs that these patients have that might be causing their symptoms. I really do appreciate them for taking the time out of their own lives to help us. They deserve a lot of the credit for the help we are providing.

    Working as a team in this clinical setting has given me a larger insight on how important each piece of the healthcare system is and that each discipline deserves a lot of respect for what they do. If just one piece of the puzzle were missing from our group, our mission would not be as successful.  

Teamwork Creates Success

Meghan Rud, Undergraduate Student, May 30, 2017


It is amazing how well our team is in working together to provide the best care for each individual. All of us, no matter our discipline is working at each station in the clinics so that we get an understanding of each other’s jobs. It is so incredible how much each person can bring to a diagnosis, whether they are a medical, pharmacy, nursing, or undergraduate student. Each of us is playing a significant role in caring for the people that step through the door. The Medical Students are great teachers and are willing to answer any questions, explain what they might be doing, and show us how to do different exams. I have been able to learn a lot from both Blake and Alayna. Both are so knowledgeable in their field and know exactly the questions they need to ask to figure out how to correctly diagnose the patient so that we can treat them to the best of our ability. I was worried the first day that when assisting a medical student that I would be useless as I had only learned how to take blood pressure a few days prior, but Blake helped me understand what to listen for when using my stethoscope to listen to the heart and lungs. They both allowed me not only to ask them questions but also to ask the patient questions as I became more comfortable. Not only are the medical students helpful to us undergraduate students, but the pharmacy students are providing the medical students with information on which medications might be better for the individual. The nurses also have been very helpful to both the undergraduate and medical students in teaching how to take someone’s vitals and glucose levels. It is awesome the amount of material we are learning from each other every day.

 

    Not only do we have a great team from Mercer, but the interpreters we have are incredible and we could not complete our mission without them. Interacting with the patients can be a challenging task due to the large language barrier that is between our patients and us. I have found that a smile goes a long way and will never be wrongly interpreted. Even though all of the patients appreciate and enjoy watching us try and speak some Khmer, to help break the language barrier our translators have been amazing, patient and willing to assist us in so many ways. I honestly believe that they have the hardest job, because even though no one in the clinic stops moving and thinking all day, they are speaking two languages, and are not normally translators. All of our translators are medical students in Phnom Penh or work in local medical clinics, which is a great help to everyone. I have enjoyed working with all of them, they are useful when it comes to not only speaking to the patients, but I have found multiple times they gave their own input to assist in producing the correct diagnosis. I believe this is because they see a lot of patients just like the ones we are helping and they know more about the culture, food or lack there of, and some of the jobs that these patients have that might be causing their symptoms. I really do appreciate them for taking the time out of their own lives to help us. They deserve a lot of the credit for the help we are providing.

 

    Working as a team in this clinical setting has given me a larger insight on how important each piece of the healthcare system is and that each discipline deserves a lot of respect for what they do. If just one piece of the puzzle were missing from our group, our mission would not be as successful.  

Learning to speak the Medical Language

Mary Catherine Barnes| Undergraduate Student| May 31, 2017


As an Undergraduate Student going to Cambodia for Mercer on Mission, I wasn’t sure what exactly my role would be as part of the health team. Knowing that I was going to be surrounded by some of the best nursing, pharmacy, and medical students Mercer has to offer was intimidating, and I was eager to prove my worth. Despite my anxieties, I quickly found how each and every person, no matter their specialty, played an intricate role in our well-oiled machine of a health team. Over the past three days of clinic, I have been amazed at the ease with which our team works together. I can easily say that I have learned more about an effective health team in three clinics than in my entire career as a pre-medical student. Experiencing interdisciplinary medicine first hand will without a doubt make me a better healthcare professional in the future.

 

            I arrived in Cambodia with the amount of medical knowledge you would expect a junior in college to have. However, after day three of the clinic I have taken over 100 blood pressures, learned to do an abdominal exam, an eye exam, an ear exam, and I’ve learned how to effectively listen to heart and lung sounds. After working with several of the medical students, I can even help diagnose some patients. In addition to all of my newfound medical knowledge, I have also learned the importance of body language when treating patients. No matter what language you speak, a smile, a hug, or a simple touch makes the same impact. Crossing cultures is no easy task, but experiencing the love and gratefulness from every patient we have treated leaves a lasting impression like no other.

 

            I will forever be thankful for the opportunity to be immersed in Khmer culture for 3 short weeks. I know that the experiences and knowledge I gain from this trip will impact me for the rest of my life.

Learning to Serve

Jamie Haines| Undergraduate Student| June 1, 2017


Participating in the Mercer on Mission program as an undergraduate has allowed me to experience medicine in a whole new way. I've learned so much about the Cambodian people and culture, medicine, and myself in just nine days. I've learned how to adapt to the language and cultural barrier in order to serve and administer medicine to those who need it in Cambodia. Before leaving America I didn't fully realize just how hard the language and cultural barriers can be when practicing medicine.  It hasn't been easy to translate symptoms, medical history, diagnosis' and prescriptions (even with our amazing interpreters), but seeing how grateful these people are when just receiving ibuprofen is truly amazing. The medical students here with me have really taught me a lot about different symptoms and procedures. They've shown me how to do eye, ear and abdominal examinations, as well as let me practice them, take vitals, and ask patients questions. I didn't expect to be helping diagnose patients or taking blood since I am still an undergraduate, but by doing so I have learned a tremendous amount. I would never have this opportunity in an American clinic, so I really appreciate and value this experience. I believe it will help me better understand and treat the underserved in rural Georgia having seen how poor some people are in parts of Cambodia.

 

Although we've made a huge impact on the people we have treated, they have also touched us and helped us grow as doctors, pharmacists, and nurses. I believe this experience will change the way I think about the world for the rest of my life, and it has definitely reaffirmed my love for medicine and helping and healing others. 

 

 

Cambodia - Take 2
Kevin Jiles| Medical Student| June 2, 2017

How many times do you hear about a person getting to visit Cambodia? Honestly, how many people actually know where Cambodia is located? I’ve told several people that I’ve visited Cambodia, and they automatically say, “Oh, where is that in Africa?” It’s not very well known based on my own experiences. Now think, how many people do you know that get to visit Cambodia two times (within five years)? Not many right? I have had the wonderful opportunity to visit and serve the Khmer people in 2012 and now in 2017 as a member of Mercer on Mission. Coming back to this country has been really shocking. I remember traveling to Cambodia for the first time and visiting Kampot. The street running along the river did not have a complete walkway. There were four “safe” places to get ice in the city. The roads were not always lit with street lamps at night. The “new bridge” crossing the Kampot River still looked fresh and clean. Five years later, so much has changed. Sometimes, I walk around and think, “Am I even in the same area in Cambodia anymore,” because this isn’t what I remember; it’s feels like I’m either misremembering or have amnesia. Kampot is now full of people and resembles the typical hustle and bustle of a metropolitan area. Of course, it’s very different than a city in the United States, but it was shocking to see the progression that the city has made in just five years. The river front is full of activity. Boats doubling as restaurants line Kampot’s “River Street” offering evening dinner specials, beckoning tourist to try traditional Khmer food while also offering classic meals from countries around he world. I’ve been pleasantly surprised about how Kampot has grown and how much better the city appears. However, I’ve also noticed how some things have not changed since I last visited this country. We recently finished our first week of clinics in a rural church/school, and as a medical student, I’ve had the opportunity to act as an “intern” and see patients under the guidance of Dr. Bina and Dr. Shelley. I can’t tell you exactly how many people I’ve seen over the past week, but I can tell you that every patient who’s sat in my "work station" has demonstrated immense gratitude for our services. I had an elderly gentleman greet me on my second day of clinic with so much enthusiasm that I just started laughing. He was smiling from ear-to-ear and was rattling off “thank you for seeing me” in Khmer so quickly that I couldn’t even understand him; however, his facial expression said more than enough to tell me that he was truly grateful for the opportunity to see a doctor (or a doctor-to-be working with a physician). With the help of my interpreter, I found out that I was the first “doctor” he had ever seen in his life, and that he was so happy that we were offering our services free of charge. I sent the gentleman away with ibuprofen for joint pains, glasses for blurry vision, artificial tears for dry eyes, and multivitamins for malnutrition, and he walked away beaming. Two weeks worth of medications and a pair of spectacles were a blessing to this patient. Seeing someone pour out so much gratitude for so little was astounding. It reminded me of the patient’s I saw as an undergraduate in 2012 and how thankful the Khmer people were for the simplest acts of kindness. It’s amazing how even today the same culture of gratefulness exists, and to witness such appreciation has been energizing. I cannot wait to get back into the clinics next week. It’s worth enduring this drenching heat to see all the smiles on everyone’s face. 

Rest

Will Smith| Medical Student| June 3, 2017


Rest is a tricky thing on a mission trip. After a week of clinic, we now have the weekend off. We traveled as a team to Kep--pronounced "Kipe"--to recharge at the coast. On some level, I don't want to stop the work. Our time feels so short here, part of me thinks rest is unnecessary. The reality though, is that we're spent. All of us have taken on more responsibility here than is ever asked back in the States, and we were all in need of a break. These clinics have been an incredible experience. Taking ownership of a patient from start to finish calls for a different level of clinical and critical thinking. I confess there are times at home when I can conveniently shift to auto-pilot with little to lose. The nature of modern medicine is such that there are many aspects of hospital function mattering little to medicine and actual patient care. As a student in the age of EHR and hospital-specific protocols, the peripheries of healing contribute nil to learning and instead create excesses of what could only be called zombie-time. Minutes of every hour seem to be spent ogling over either social media or just the paint flecks on the walls while residents, nurses or attendings wade through the daily swamp of software errors, checklists and general drudgery so often cited in lamentations on "modern medicine." This paradigm is most certainly not at home here. We are down to brass-tacks medicine, and believe it or not, there is no specialty consult, online database or CT scan available when you're sitting in plastic chairs in a little church off a dirt road. Operating in a language I've never heard, knowing how to ask a question through a translator is just as important as the question itself. It's hot and humid, and we have seen some very sick people. Some haven't seen a medical provider in years and are carrying a laundry list of chronic issues. I continue to be impressed by the toughness of these people and their stories, and after we close out the weekend, we will head back to Kampot for our last week of clinic. I imagine it's still just as hot there and that I'll continue to be challenged and stretched both as a student and whole person. Should be fun. 

Culture and Medicine

Katie Rhoades| Medical Student| June 4, 2017

 

After a busy week of clinic, we were finally able to rest during our weekend in Kep. Our team has worked tirelessly together to see nearly 200 patients during each clinic. We’ve seen patients of all ages ranging from infants to the elderly with a variety of illnesses. Many common diagnoses we see are from many years of poverty and manual farm work. Some examples include osteoarthritis, lower back pain, and chronic dehydration. We have also encountered several acute problems, such as UTIs, that have become chronic due to lack of access to care. While making our diagnoses, we have all encountered some interesting personal stories. For example, I have seen someone who lost their arm to a viper bite nearly 40 years ago and an adult with a large congenital nose mass partially obstructing his vision. Another interesting element I have encountered is the practice of traditional Khmer medicine.

 

The first patient I met that practiced some traditional medicine was a young adult with chest pain whose family decided to use coining, a treatment where a coin is scraped across the skin until a certain redness is achieved to release any negative energies, in an attempt to heal the chest pain. Although their intentions were to help the patient, the bruising from the coining caused the patient more pain and ultimately complicated the clinical picture. Another patient presented with a headache for three months and symptoms of hypothyroidism after having her thyroid removed. The treatment was straightforward, the patient needed thyroid replacement medicine from her surgeon. Unfortunately, the patient had no transportation to get to her surgeon in Phnom Pehn, Cambodia’s capital, and had very limited financial resources. During our time together, the patient decided to scrape from between her eyes down her nose with her fingernails producing a new bleeding wound in an attempt to release negative energies since she worried that she could not get her medication. A third patient I met who practiced traditional medicine was an older woman who came in to have her arm evaluated one month after a motor vehicle accident. The patient went to a local hospital after the accident and received a splint for her injured wrist, but her family requested that she remove the splint since they prefer to use traditional Khmer medicine. Her injuries did not heal correctly, which lead to a deformed wrist and a barely functioning hand. The patient mainly attempted to use spiritual medicine, which made her feel better emotionally but did not heal her wrist. Although she did not want to have surgery to fix her arm, she believed that a mix of traditional medicine with some Western medicine would cure her. Overall, in one week I have learned more than I expected about traditional Khmer medicine and have seen the important role it still plays in some of the local people’s lives.

 

Providing care here is undoubtedly complicated. The local people we treat endure poverty, lack access to care, have minimal to no government assistance, and have less education. However, traditional medicine can add another level of complexity to treatment since some Khmer people still practice it. My experiences here emphasize the important role culture plays when treating any patient, whether in Cambodia or the US.

 

Tomorrow we begin another week of clinic with new patients and unknown challenges. After our restful weekend, we will start off the week with new energy and readiness to help the local people. There is no telling what we will see, but we are prepared to continue to work as a team to provide the highest quality care possible with our limited resources.

 

Back to Clinic

Callie Payne| Nursing Student| June 5, 2017


After a long, relaxing weekend, we are finally back in Kampot. Today we had clinic at Garuna School. It was Mercer's first time ever at this location, so we didn't really know what to expect. The pastor and director welcomed us with open arms and were both so happy. Clinic flew by very smoothly. We reorganized the set up, so there was a lot more organization and a lot less chaos. Today, we saw around 180 patients!


Today, I was paired with a medical student, Blake, for the second time. She has been so great to work with and she's taught me so much. As a nursing student, I rarely have the chance to communicate with the doctors in the hospital. It's very interesting to work side by side with the medical students as they diagnose the patients. They've been great at asking our opinions as nursing students, which helps us think critically too. The pharmacy students have also been fun to work with. They help me brush up on my pharmacology whenever I fill prescriptions with them . Lastly, shout out to the undergrads for being so helpful and eager to learn.


Mission work and serving others has always been a passion of mine. In the past, I've been on multiple mission trips with my church to other third world countries. There, I was able to play with the children and love on everyone. However, I found it very troubling that I could only do that; I wasn't able to fulfill their medical needs. This trip has been a combination of both! While our main focus in the clinics has been on everyone's health, I have been able to sneak away at the end of the day and play with the kids. So far, this experience has been amazing and I'm so thankful I was blessed with this opportunity. Here's to clinic #6 tomorrow!

A Day in the Pharmacy
Catherine Reisinger| High School Student| June 6, 2017

When we first started clinics last week, I got to experience all of the different jobs that were assigned to us. I worked first in the clinic as an assistant to the medical students for the first day. Then on the 2nd day, I worked in the clinic in the morning and worked as a floater during the afternoon. I learned how to do vital signs and intake as a floater. Then on the 3rd day, I was assigned to be the runner, and I would walk the patients from the clinic to the pharmacy. On the 4th day, I was assigned to work in the pharmacy, which I was really excited to do.  Working in the pharmacy since last Thursday has definitely been a fun experience for me. I have learned a lot about how to fill specific prescriptions and I have even been allowed to counsel with some of the patients as well. I have become much more knowledgeable with certain medications because I have observed the pharmacy students counsel the patients on those medications and how they help them.
 
I enjoyed working in the clinics and in vital signs and intake, but my favorite place to be is the pharmacy. Today I worked in the pharmacy and I mostly filled perscfiptions and made bags for adults and children. I enjoyed working really hard on all of that because it made me feel like I was really helping the team. The pharmacy students are also really helpful and always there to help me if I have any questions about a specific medication. When I was going through the process of filling more difficult prescriptions, I felt like a real pharmacists. I know that I am interested in being a veterinarian, but it was still really cool to see how prescriptions worked for humans. I have seen the vets at the place where I work prescribe things for animals, and it is not really that different. I find it extremely fascinating that both the human and animal medical fields share many similarities. 

My favorite part of the day was when I had to measure out 1 teaspoon to mark on a dosage cup that was only measured in tablespoons. The medicine that was used was Diphenhydramine, which was used for cold symptoms. I felt really smart knowing exactly where to mark because I used water to fill the cup with 1 teaspoon. It reminded me of marking syringes we use to let the animal owners know how much liquid medicine to orally give their pet(s) each day.  We also ensure that the patient knows exactly how much and how often they should take their medicine each day, which is important. The medicine is organized alphabetically, so when we fill prescriptions, things are easy to find with the system. At the end of the day we ran out of some medications and so some of the pharmacy students had to go to the pharmacy to restock. Tomorrow we will work on restocking those medications. Today was a very busy day for the pharmacy but everyone accomplished a lot and we were able to keep things running very smoothly. I look forward to helping tomorrow and Thursday in any way that I can because I love working in the pharmacy.

Interdisciplinary Lessons

Emily Thompson| Nursing Student| June 6, 2017


My decision to come to Cambodia with Mercer on Mission was finalized before I was even accepted if they picked me – I would go. After a whirlwind first year of nursing school, I was exhausted but proud of my accomplishment. During the craziness and chaos of class after class, with tests and clinical scheduled impossibly somewhere in the middle, I began to lose sight of the end goal. Why was I doing this? I decided that I needed something to reinforce my passion for healthcare and reignite my motivation.

            

After I learned I had been selected to join this team I was excited and hopeful, but admittedly a little apprehensive. I wasn’t sure if I would be good enough, know enough, or even be able to help. It has a pleasant surprise to learn that I am all three. Working with an interdisciplinary team has helped me pinpoint some of my clinical strengths and weaknesses. It has also taught me how to be both a better teacher and a better student.


Working with the medical students has allowed me to see how much I’ve learned and practice some of my basic assessment skills. They have all helped me to learn new things and refine what I already know. I enjoyed the challenge of transitioning classroom lectures into tools for clinical practice.  They also allowed me to branch out on my own to ask questions and even help gear the conversation towards a diagnosis. Even though I have been both wrong and right on that account, their attention to and appreciation for my opinion has given me a new confidence in working with physicians.


Working with the pharmacy students has shown me just how much goes into what can easily be the behind the scenes of patient care. So much more effort and thought goes into patient prescriptions than I ever realized. They really exemplify the checks and balances needed for successful patient care. I enjoyed working with and learning from them tremendously.


Working with the undergraduate students has refueled my passion for this profession. Their excitement and enthusiasm at getting even a glimpse into healthcare is contagious. I have really loved witnessing them learn and grow.


And lastly, working with the Khmer people has been the most humbling experience of my life to date. These are the kindest, most gracious, and most hardworking people I have ever been lucky enough to encounter. Despite their illness, they arrive at the clinic with a positive attitude and excitement at the prospect of being helped. They place so much hope and trust in us, it is impossible to not do everything in your power to change their lives for the better. It further reminded me that every single patient deserves the best care that we can possibly give them with no exceptions.


Fourteen days ago, I left on a trip that would take me 20 hours away from home with the hopes of returning with a humble heart. Now I can say with absolute certainty that the humility and compassion I have felt on this trip will permanently carry over to my patients back home. 

Resilience 

Alayna LeCroy| Medical Student| June 7, 2017


It’s hard to believe that tomorrow is our final day of clinic. The past two weeks have flown by. While I’m exhausted from being in the heat all day in clinic, I’m sad that our time here is coming to an end. Cambodia has been an amazing experience and I’ve become more comfortable and confident as a clinician. The majority of Cambodians that we’re treating are farmers and have chronic medical problems due to years of hard labor in the heat and sun.  It doesn’t surprise me when my patient’s chief complaint is back pain or knee pain; I’ve come to expect it. What amazes me is that many of these patients walk in with a smile on their face despite having untreated arthritis for years and continuing to labor in the fields. I prescribe Tylenol and muscle rub for the aches and pains, which is accepted graciously, and will make a world of a difference since they’re naive to pain medicine. I’m impressed and in awe of their resilience and hard-working nature.

            

Each morning we’re reminded to “touch the patient, look them in the eye, and hear their story.” It seems trivial, but it makes a difference to consider the cultural differences here and to treat the patient within that context and their personal history. This trip has been a great reminder to take a step back and remember to treat the whole patient, not just their disease.

Fear of Missing out

Ralph Rogers| Medical Student| June 7, 2017


When I first heard about coming to Cambodia for a medical mission I was sure that I wanted to come on the trip but I was also worried about missing out on some really important clinical experience in my internal medicine rotation.  Everyone that I had talked to said that internal medicine is one of the most important learning opportunities in medical school and I had fear of missing out, otherwise known as nerd FOMO.


Starting clinic quickly assuaged my fear of missing out on learning opportunities at home. In Cambodia the third year medical students have been given more autonomy than we have ever had at home. We are forced to come up with diagnoses on our own using only history and physical exam. Before this trip, I had heard and read numerous times how important the history and physical were but never really understood it with all of Epic (the EHR program at Memorial Hospital) at my fingertips.  In Cambodia, I have heard and seen physical exam findings that I have only read about. 


For example, In the last two days, I have heard two S3 heart sounds and seen a retracted ear drum, both of which I have never seen good examples of in the United States.

While the internal medicine rotation is wonderful and I would be learning tons of valuable information, Cambodia offers a unique experience to third-year medical students to learn the importance of the history and physical. It also has given me a glimpse into what Intern year as a resident may be like.     

Last Clinic

Faith Cayobit| Pharmacy Student| June 8, 2017


We held our last day of clinic today. We saw 245 patients today, and over 1500 patients total! The past 2 weeks of clinic have been both challenging and fulfilling. It is amazing to see how much each student has grown in just a short amount of time and how we have all become more proficient in our fields and patient care. I am sure each of us has gained a greater respect for each other's profession through this experience. 

Today was also our last day in Kampot. We had a reception for our interpreters to thank them for helping us bridge the language barrier and better serve our patients. They were truly an integral part of our team. It was bittersweet to say goodbye to them and our hosts at natural bungalows. Everyone has been so hospitable and welcoming, which can be hard to come across in the U.S. This experience has given me a renewed perspective that the world is much bigger than what is around me, and that a great cause can unite people together. 

Relaxing

Jake Pugh| Pharmacy Student| June 9, 2017


After a great last day of clinic where we saw over 240 patients and a celebration thrown by the staff at the bungalows, we had to get busy packing to leave early in the morning. The staff was eager to serve us a big breakfast at 5 AM after staying up late the night before hosting our party. They were all extremely hospitable and grateful for the work we were doing throughout our entire stay, which made being away from home for so long much more comforting. Leaving by 6 AM was rough, but well worth it for what was to come. The short flight to Siem Reap was much better than we had been prepared for after hearing about the planes in year's past. Landing in Siem Reap and driving from the airport to the hotel feels so much different than Kampot, and even Phnom Penh. The streets are much cleaner and we passed resort after resort on the way to our hotel. Walking up and down the Pub Street reminds me of Savannah and New Orleans with several neat bars and restaurants. After two rewarding weeks of proving care to over 1,500 patients, it feels great to be able to relax for a couple of days before heading home. I look forward to touring Angkor Wat and experiencing more of the culture tomorrow morning. 

 

Chomreab Lea, Kampot!

Aayush Patel| Pharmacy Student| June 9, 2017


In the past two weeks, we’ve seen 1,588 patients. All our clinics were hot, busy and cramped but the views of the rice fields, tall palm trees and mountains makes you forget the added stress. Many of our patients presented with the same problems, “abdominal pain, headache and blurry vision.” Yesterday was our last day of getting to hear real Cambodian’s stories. Clinics were the whole reason we were here. We have a little time left in the country as tourists, but no longer will we be interacting with Khmer people on a daily basis and hearing the concerns of the people at a grassroots level. No more farmers with osteoarthritis or GERD. Regardless of their past and current issues, they have a lot of optimism. I expected to educate the local population and provide free healthcare but I didn’t expect to learn so much about the Cambodian people after interacting with them for only two weeks. This country has taught me more about life than I’ve taught them about medications. I do not know when I’ll be back in the Country, but I’m forever going to be grateful to have had this opportunity to connect with the Khmer people.


Reflecting Back

Blake Foxworthy| Medical Student| June 10, 2017

 

After two long weeks of clinic, we were able to wrap up our time in Cambodia by visiting Siam Reap and touring several of the world famous temples here, most famously Angkor Wat. We saw absolutely spectacular structures, road elephants, shopped in various markets and got to experience the tourism aspect of Cambodian culture. These experiences have really brought the trip full circle. We started our journey by touring the killing fields and learning about one of the darkest periods of Cambodian history. Next, we were able to gain a greater understanding of the everyday lives of the Khmer people by working with them and for them in our medical clinics. Finally, we are able to see the grandeur of Cambodia's rich history in the carvings on temple walls and attractions so spectacular that they draw in tourists from all over the globe. I feel that we have truly gotten the full Cambodian experience and have opened our minds and hearts to understand such a beautiful and complex country.

 

As I reflect on this experience, I can say that it has truly impacted me as a person and as a future physician. For the first time, I was able to see patients alone (with the help of some truly incredible undergrad, nursing, and pharmacy students) and formulate a plan before reporting to an attending. I began to truly understand how to do a history and physical without the crutches of medical records, labs, and imaging. I have felt the frustration when there is nothing we are able to do besides give Tylenol to someone truly in need. I have learned the challenge of seeing 5 people at one time and have come out the other side still wanting to be a pediatrician. I have struggled with language barriers and have seen that smiles and expressions of gratitude are the same in every language. I have started to overcome some irrational fears (like not-so-small rodents), eaten some great food, and have made some great friends along the way!

 

Tomorrow, we will spend some additional time touring before beginning our long journey home to the United States. I think that I can speak for most of our group when I say that we will be sad to leave, but happy to be home! I hope that we can take the lessons that we learned here and apply them to our everyday lives as we return to our respective classrooms. I know that I look forward to seeing what comes next for all of the people on such an amazing team!

 

Cambodia, The End

Courtney Sanchez| Medical Student| June 11, 2017

 

When we boarded our first flight to Cambodia almost three weeks ago, we were an eager but nervous, excited but unsure, group of new acquaintances ready for the unknowns that lie beyond a 20+ hour flight. Now, we sit on our return flight: tired, but with a fullness in our hearts, sunburnt and exhausted, but with memories to last a lifetime. As we look at the newly found friends around us, we are not the same as we were three weeks ago. We have made an impact here in Cambodia, but this country and the people here have also changed us.

 

We looked into the eyes, touched, and listened to the stories of over 1500 patients. In doing so, we learned about ourselves, our own strengths and weaknesses, and also became more confident in our clinical abilities and our capacity to help these communities. I often found that if you listened long enough and truly heard the patient's story, they would eventually tell you exactly what was wrong. For example, "aches and pains" may eventually reveal a previous fall from 6 meters (it is rare that someone leads with this sort of information). Or, a gnawing abdominal pain may be that the patient isn't eating anymore because she has associated her skin cancer growth with food consumption. You can ask all of the textbook medical questions, but you will not get the straight answers you are looking for unless you try to understand their story and within the cultural context. You will not reach and educate your patients successfully unless you know their beliefs on the illness- so that they will start to eat again. We are returning as confident but humble, more culturally competent clinicians that will hopefully take the family, community, and culture into account in treating the whole person.

 

I was hoping to finally make a decision while in Cambodia on the specialty I want to pursue after medical school. Although I am still considering a few options, working in our clinics here in Cambodia has definitely reaffirmed my passion for primary care where I can form that strong physician-patient relationship and really hear every individual story.