| Oct 06, 2015
Tyler Graf coordinates stories, photos and information about Medical Teams International's development work. In July, he traveled to Cambodia to document the ongoing work there. The following is a first-hand account.
At a little past noon on a hot and muggy July day, our SUV slowed as a small crowd crossed the road we were traveling down and gathered near a slim concrete sidewalk on the left-hand side.
It was hard to tell what exactly was going on, as our line of sight was obscured by the growing congregation of spectators. Clearly, something had drawn their collective attention. In a slow procession, they convened on the scene.
As we neared, at the slow roll of the typical rubbernecker, the gruesome sight came into focus. Two bodies – one slumped, the other sprawled – lay on the side of the two-lane road. A crumpled motorbike rested beside them.
(Photo by Sean Sheridan)
In Cambodia, the high number of traffic accidents coupled with inadequate ambulance service yield deadly results. Sothay, above, was in a motorbike accident but had the good fortune of being picked up by an MTI-trained EMT.
With nothing more to go on, it was immediately evident what had happened – more or less: The two men were riding a motorcycle when it slammed into a truck. On impact, they flew off onto the side of the road, where they now lay. They were motionless.
There was a strange and sad symmetry to this happening on our route, at a time when we were driving by. We were returning from a morning training session of Cambodian medical professionals. The topic was emergency medical services, commonly referred to as EMS.
While we tend to take for granted that we, as Americans, can dial 911 when an accident occurs and that an ambulance of trained paramedics will arrive, that’s simply not the case in Cambodia. The country has a very high incidence of traffic accidents, and deaths.
The scene before us drew that fact sharply into focus. The two men lay there as the crowd looked on. There was no ambulance in sight, not that one would have helped much. In Cambodia, ambulances typically act as little more than taxi services for the critically injured. They can transport someone from point A to point B. What they don’t do is provide much in the way of medical care between the two points.
Our SUV contained one American EMT along with two medically trained Cambodians, so we stopped the vehicle to assess the scene. It was evident from the outset: there was nothing we could do.
The men were dead.
One likely bled out from his injuries. If medical professionals had arrived earlier, they might have been able to stanch the bleeding. The other man looked like he’d died on impact.
The stark scenario is illustrative of Cambodia’s need for better-trained emergency medical professionals capable of responding to emergencies when they happen. According to a 2013 World Health Organization estimate, more than 2,400 people a year die in traffic accidents on Cambodian roads. The numbers will only increase as Cambodia develops better roads that can transport more people.
That needs to change. And it will, because of your donations, support and prayers.
That support provides training for first responders on how to assess victims of traffic accidents and then quickly transport them to medical facilities. Many treatable emergency conditions are neither recognized nor addressed at Cambodian hospitals as a result of the current lack of training.
The doctors, nurses and ambulance drivers who are trained take to the new knowledge like fish to water. For them, it’s a revelation. They learn how to assess a patient’s condition, conduct triage, and open blocked airways, along with other essential medical techniques. Once they’ve mastered the techniques, they train others. It's working.
That was evident one night near the Thai border, when a young man named Sothay slammed into the side of a car while riding his motorbike to a friend's house. As he lay bleeding on the ground, unconscious to the world, someone called the local ambulance. As it turned out, the ambulance driver had undergone training and knew how to properly respond.
The ambulance driver found Sothay, assessed his injuries, dressed them as best he could, and then transported him to the local hospital, where he stayed with the young man. With few health workers left at the hospital at night, the ambulance driver tended to Sothay himself.
Another doctor I talked to raved about what he’d learned, saying it transformed how he treated emergency patients, and not just accident victims. His name is Dr. Chea, and he practices medicine in rural Cambodia, near the Thai border.
He recalled when a mother brought him a 25-day-old baby boy suffering from bronchitis.
By the time the baby had reached him, the baby’s body was blue and he was having trouble breathing. The baby’s mother was completely beside herself, convinced that her baby was dying. She was distraught and crying, Dr. Chea said.
He assessed the baby’s condition and then delicately opened the airway to directly supply oxygen through gentle CPR. Soon, the baby started breathing on his own. Dr. Chea attributed his ability to bring the baby back from the brink to the training he received.
“It is very important to know this topic – how to open an airway,” Dr. Chea said. “I’m very excited that MTI is providing this training.”
Still, there’s more work to be done, as evidenced by the two men left dying by the side of the road. That’s not to discount the amazing work that has taken place, and the amazing work that’s still to come. It’s just to say that progress takes time.
After all, Cambodia is a country in the midst of growing pains. How easy it is to forget that only 35 years ago the Khmer Rouge was in power. The despotic regime led by Pol Pot murdered the country’s intellectuals and forced others to the countryside to live a purely agrarian existence, resulting in millions of deaths. It wasn’t until 1998 that the last remnants of the Khmer Rouge were defeated entirely.
Your support ensures that rebuilding efforts continue. Cambodia has taken huge strides to develop into a modern country despite horrific setbacks. The country deserves to be a place where medical professionals save sick babies, and where emergency care is an expectation.