Susadey! I am Tsunoda, a surgical nurse in Cambodia. It is rainy season right now, but despite that, there is less rain than usual and it is quite sunny in Cambodia.
This is a report of surgical activities in August. A total of 44 operations were performed, 16 for children, and 28 for adults. Because of the Khmer New Year, there were a lot of holidays and the number of surgeries was reduced. There are many things to do during such lulls in work, such us spring cleaning, equipment maintenance and making gauze and towels. When it comes to cleaning and washing, we do it all ourselves!
[Operating Staff/Nurse Danny]
A new surgeon volunteer started last month and five biopsy operations for paediatric cancer patients have been performed. Of these, the boy pictured in the photograph had malignant lymphoma and thus it was necessary to inject anticancer drugs into his cerebrospinal fluid. Chemotherapy treatment started last month in the operating room with drugs that make you sleepy. Depending on the patient’s physical condition, the four round, once weekly treatment was successfully completed last week. He came to the operating room five times during these treatments, including the first abdominal biopsy operation. He must have been scared every time, but his expression gradually softened and showed a smile during the final round. You really tried hard! The staff are always cheerful and encouraging both inside the operating room and wards. I was sincerely hoping that his treatment went well while I was watching the children being treated. According to Dr. Kakazu, the head of paediatrics at JHCMC, lymphomas in children are likely to be survived even when only being treated with chemotherapy, so treatment will continue.
[Top: Dr Kakazu administering the first round of chemotherapy treatment; Bottom: last round]
A new midwife will be welcomed as a member of the operating room team for several months from September. She sometimes is involved with caesarean sections, but this will be an opportunity to learn more about the operating room. Her headwear is uncommon in Japan, but it is called hijab and many Muslim women wear it to hide their hair for religious reasons. She also wears long sleeves under her uniform to hide her skin, but removes them in the operating room for hygienic purposes. Out of our 70 Cambodian staff, seven of them are Muslim (90% of Cambodians are Buddhist, and 1-2% are Muslim). In our hospital there are Halal meals and prayer rooms in the facility. Religious consideration is important for the morale of the staff who spend their work at Japan Heart.
As an aside, I used the word “natural” in the title because I think that it is a no-frills word that suits the personalities and culture of Cambodian people.
Basically, patients are supposed to come to the hospital the day before their surgeries are scheduled, but sometimes they do not come. I ask the staff why the patient didn’t come and they just laugh and say “It’s sunny today”. At first, I didn’t understand what they meant, but after calling the patient we would find out that they really didn’t come because they had to plant or harvest rice. I just explained the surgery yesterday, why did you change your mind? I could have operated on someone else! I was confused at first, but many people think the same thing and tend to their fields when it is sunny. This is what it means to make hay when the sun shines! Their customs reminded me of my grandparents, who were lovely farmers tending to their farms with their cows and horses. I was almost convinced by their reasoning. However, such sudden cancelation of surgery is causing problems in the management of the hospital and surgeries, so I am considering measures to prevent it.
By the way, in Myanmar it was often the case that patients couldn’t come due to the road being closed by rain. Everyone came from far away. The rainy season goes until October.
[In Oudong, the activity area. The fields are spreading far away]
I have digressed too much, but there are many holidays from the Khmer New Year in August to the Pchum Ben Festival in September. Japan Heart’s Chief Advisor, Dr Yoshioka is planning to come to Cambodia. The summer here isn’t over, but I think Japan’s summer is about to end. I think there will still be hot days, but everyone in Japan should take care of themselves.