Before and after the collision

I’m sitting in the back seat of a friend’s car as we drive together to the hospital at 6:30 in the morning. She also works at Kantha Bopha Hospital in Siem Reap. As a Cambodian medical student, she’s completing part of her clinical training here. The night before, she invited Daphne and me to stay over at her place with her and a nurse from the Heart ICU. We ate together, laughed, and talked about our work as well as the differences between the Swiss and Cambodian healthcare systems.

We’re still half-asleep in the car when there’s a sudden crash about a hundred meters ahead of us. Two teenagers are thrown from a motorcycle. While the boy quickly gets back to his feet, the girl lies motionless on the road. Within seconds, people rush to the scene of the accident, carry her to the side of the road, and try to administer first aid. For a brief moment, it goes quiet in the car.

About two hours later, I’m standing in the neurosurgical operating room, dressed in sterile scrubs. I’m told that this morning we’ll be performing a decompressive hemicraniectomy on a young boy. He was admitted with a severe brain hemorrhage following a motorcycle accident.

Since the brain is completely enclosed by the skull, it has nowhere to expand if swelling occurs. The pressure inside the skull increases, healthy brain tissue is compressed, and vital structures can be damaged. In this procedure, a large portion of the skull is temporarily removed to make room for the swollen brain. The surgery is intended to relieve the pressure and prevent further brain damage.

As I stand in the operating room, I can’t stop thinking about the images of this morning’s accident. Over the past few weeks, I’ve seen numerous children at Kantha Bopha Hospital with severe injuries from motorcycle accidents. Many suffer from what’s known as polytrauma – severe injuries affecting multiple organ systems simultaneously. Traumatic brain injuries, internal bleeding, and complex fractures are particularly common. It’s not uncommon for these accidents to permanently alter a person’s life in a matter of seconds.

For many people, motorcycles are the most important – and often the only – means of transportation. Entire families ride together on a single motorcycle through the city or over long distances in rural areas. At the same time, safety measures are lacking in many places. Despite the legal requirement to wear a helmet, children in particular often do not wear one. High-quality helmets represent a significant financial expense for many families. At the same time, awareness of the serious consequences of a traumatic brain injury is not equally widespread everywhere. Added to this are poorly maintained roads and heavy traffic.

As I stand in the operating room, I realize how important prevention is alongside medical care. Over the past few weeks, I’ve seen in various wards how medical staff take the opportunity to educate people about health issues. In addition to surgeries that often last for hours, this preventive work is also essential to prevent serious injuries in the long term and give children better opportunities for the future.

What stays with me: When I leave the hospital after a long day of work and drive through Siem Reap, I suddenly see nothing but motorcycles everywhere. Small children sandwiched between their parents, families of four or five on a single vehicle – many without helmets. After my time in neurosurgery, I can no longer look at these scenes with a carefree heart. I think of the children I saw in the operating room, how much suffering could perhaps be prevented with effective prevention, and how the staff at Kantha Bopha Hospital fight every day to provide these children with the best medical care.

Best regards,

Ila