Off to new horizons

August is starting a little differently for us this year. Instead of a leisurely brunch or a fireworks show on August 1, we’re traveling to a country that’s still completely unknown to us. After about 20 hours of travel, we land in a new climate, a new city, and a new culture. We’re surrounded by new smells, sounds, and animals that we rarely encounter in Switzerland: little bats, little monkeys! We’ve arrived in Phnom Penh! After a warm welcome from hospital director Santi and his team, our first week at Kantha Bopha Children’s Hospital begins. I’m heading to the surgical ward, while Melina is starting on the medical ward.

During the first few days, we get to know many of the staff and gain an initial insight into daily life at the hospital. At the same time, we also have some time to explore the city and the country. We get to enjoy Cambodian cuisine and spend the weekend on a trip to Koh Dach, an island in the Mekong River. There, we take a guided tour of a traditional silk weaving workshop and even get to try our hand at it. As exciting as our experiences outside the hospital are, our everyday conversations keep coming back to Kantha Bopha. There’s just so much exciting stuff happening at this hospital day after day.

Every morning at 7:15 a.m., the morning briefing takes place, just as we know it from Switzerland. However, here we experience it on a somewhat different scale: the entire medical staff, as well as a large portion of the nursing staff, gather in the same room. Together, they discuss the events and patient numbers from the previous day. And that’s where our amazement begins anew every day: More than 2,000 emergency cases are the norm, while at the same time at least 1,700 children are being treated as inpatients at the hospital. Special emphasis is always placed on dengue cases. Because while dengue is endemic in the country, the onset of the rainy season in August marks the transition from endemic to epidemic.

With the onset of the rainy season, the number of dengue infections in Cambodia rises significantly. During our first week, the number of children hospitalized with dengue fever rises steadily: while there were just under 100 children at the start of the week, by the end the number had already surpassed 130. The effects are immediately apparent. In the internal medicine ward, many of our young patients are now sharing a bed with one or even two other children. Space must also be shared in the pediatric intensive care unit: while there are typically 10 to 15 patients on the ward outside the dengue season, there are now over 30 children. And while the wards are so full, Kantha Bopha is leading a training campaign on dengue in collaboration with its sister hospital, Jayarvarnam VII, in Siem Reap. During our first week, numerous training sessions were held for hospital staff as well as for external doctors and nurses. The focus is on the early detection and treatment of severe cases of dengue.

As important as dengue treatment is right now, it’s only a small part of what we encounter at the hospital. Everyday life in Phnom Penh goes on—and with it come children with a wide variety of illnesses: We see congenital disorders and syndromes that only become apparent as the child develops. We also see children following acute incidents, such as traffic accidents, falls resulting in broken bones, and various infectious diseases—ranging from the well-known chickenpox to melioidosis, which is less familiar to us. The range of diagnoses is enormous.

This wide range can likely be attributed, among other things, to the fact that Kantha Bopha is one of Cambodia’s most important pediatric care facilities. Especially in cases of complex clinical presentations, children are referred to Kantha Bopha from other hospitals and clinics because those facilities simply lack the necessary diagnostic, therapeutic, or financial resources. For us, this means that already in our first week, we are exposed to an impressive variety of clinical presentations and gain valuable insight into a healthcare system. And although the healthcare system here in Cambodia differs from that of Switzerland, the underlying principles reminded us of those in Switzerland: patients are at the center, and the entire environment is designed for their well-being.

After just one week, it feels like we’ve only just arrived. At the same time, we’ve already seen, learned, and experienced so much, and we’re looking forward to the weeks ahead.

Warm regards from Phnom Penh,

Melina and Romain