At the beginning of June, I returned to Cambodia for the first time on two months with Japan Heart’s founder and Chief Advisor, Dr. Yoshioka. As I had been tested for COVID-19 before leaving Japan, upon entering Cambodia and again 2 weeks after arriving, I was keenly aware of the situation in the world and difficulty of travel caused by the pandemic.
[Carrying luggage and donations through an empty airport]
As a result of the COVID-19 tests I took in Cambodia, I was able to prove that I wasn’t afflicted by the virus and could resume surgery for the first time in two months. On the night we began surgeries a boy suffering a stomach ache was brought in by his family. He had been diagnosed with typhoid fever at another hospital and had not been treated properly for several days. On top of that, he had been referred to our hospital with peritonitis (abdominal inflammation) due to acute appendicitis. Dr. Yoshioka immediately made a diagnosis and decided to perform an emergency operation to save his life. If we had waited any longer, his prognosis would have been worse. After the surgery everyone nervously waited as the tubes in the boy reduced day by day. In Cambodia, universal healthcare doesn’t exist so if you have no money, you often don’t have access to advanced medicine so it is very possible to die of treatable diseases. After WW2. Japan rapidly grew into an economic superpower and universal healthcare system was established to provide a high standard of medical care. I feel that medical care, which I wouldn’t have given much thought had I only experienced normal Japanese life, makes such a huge difference in quality of life and people’s wellbeing in different countries. When I faced reality in Cambodia, I felt a terrifying sense of responsibility for being able to take action.
Since March, the dispatch of paediatric surgery teams from Japan has been disrupted by the advent of the coronavirus pandemic and the prospect of further dispatches has become uncertain for the foreseeable future. The number of inpatients with paediatric cancer has increased and many children were waiting for surgery. Our adult patients were also waiting for surgeries as the gynaecology, mammary and ENT doctors could not come to Cambodia to perform surgeries. While there is no surgeon resident at the hospital and the acceptance of volunteers has stopped, from June to early July Dr. Yoshioka and our hospital team worked hard to make the most of our time. In the one month that we spent we did 146 operations including on paediatric cancer, thyroid gland, breast, gynaecological and digestive disorders and emergency surgeries. It was a busy time that flew by.
[You can see protective gowns made from plastic bags under the green surgical gowns]
It has been three years since I met Dr. Yoshioka in Myanmar for the first time. At the time, there was only one rookie local doctor at Wachet Hospital. From morning until the early hours of the next day, Dr. Yoshioka used local anaesthesia, lumbar anaesthesia and general anaesthesia to perform a variety of surgeries on adults and children. Testicular oedemas aneurisms, lipoma, angioma, skin grafts, cleft lip, nasal polyps, tonsillitis, angioma, thyroid gland, mastectomy, anal fistula, abdominal tumours, and brain aneurisms were treated. I am surprised at everything that I have experienced. Huge thyroid tumour surgeries in Laos and now in Cambodia. There have been gynaecological operations like C-sections, ectopic pregnancies, ovarian cysts, ovarian volvulus and uterine fibroids and a total of more than 10kg of intraperitoneal tumour and bowel resection. We also had cases of appendicitis, cystectomy, nephrectomy. Dr. Yoshioka said, “It has been a long time since we performed these kinds of surgeries. ” Even though some patients need surgeries that he doesn’t usually do,he tried his best to maximise what he could do for the patients who come and count on our treatment. His attitude motivated myself and the other staff and I spent this period giving my all.
[Giving enthusiastic guidance to young people]
I wonder how many other surgeons can handle a wide range of cases, from children to adults and am surprised by Dr. Yoshioka’s vitality. During this stay, Dr. Yoshioka gave detailed preoperative conferences and instruction during surgery. The doctors and operating room staff discussed daily CT, X-ray and echo results, surgical procedures and treatment policies so that local staff could gain a bit of experience. I was able to increase my experience during this period and I will talk about it in my next report.
[Reviewing surgical method]
Due to the influence of COVID-19, Japan Heart is only active in Cambodia out of the three countries outside Japan that we serve. Immigration restrictions continue to be severe in all of the countries we operate in. I am grateful to my supporters and all the people who helped me with the trip. I am happy that I can continue my activities and I will spend everyday cherishing it.
Japan Heart Cambodia Surgical Department Head Nurse, Chisato Tsunoda
