More Tales from the Island Medic by Tim Seel
In my previous article, I told the story of how, in late 2019, I came to be a volunteer nurse, single-handedly running a medical centre in M’Pai Bay, a small village on the island of Koh Rong Samnoem off the coast of Cambodia. I had, rather fortuitously, visited a friend who owns a business there and had instantly fallen in love with the place and its people. A medical centre had recently been built and equipped following a fundraising appeal spearheaded by an Englishman, the owner of a guest house in this tropical paradise. We teamed up and this resulted in us providing free health care for the local people in the village, as well as being available for tourists and Westerners who lived there.
In this new article I’ll share more of the stories of my life during the fifteen months I lived there, dealing with medical emergencies both day and night, with the nearest hospital in Sihanoukville over an hour away by ferry. This was all while the World changed dramatically in the face of a global pandemic, the like of which has not been seen in recent times.
It was always going to be difficult to provide health care to people when you don’t share a common language. There was a natural fear and lack of trust amongst the locals about this Westerner who was offering to care for them. When there was an emergency, this fear seemed to evaporate and they could tell that I was acting in their best interests. However, it seemed ever present when the more mundane, non-emergency care was needed. This village had survived up until now by dealing with injuries and illnesses themselves and this had worked, so why did they need me to treat them?
I feel the major breakthrough was treating the children when they attended Breakfast Club, our weekly health promotion event held at the medical centre. Inevitably, there were cuts and bruises to be looked at and with their teachers present, the children were happy and felt confident to let me look at their injuries and treat accordingly. This built the villagers’ trust in me and, slowly at first, I started to see an increase in Khmer patients. I will never forget a girl of about eight years old who I had treated, dragging her father by the hand across to the medical centre. He had a nasty leg wound that wasn’t healing, but within two weeks of treatment at the centre it was fully healed. It’s difficult to describe the feeling one gets while walking down the street and a gentleman who speaks only Khmer shouts out, “Thank you, Mr Tim!”
As time progressed, not only did the trust they placed in me increase, but genuine friendships began to build. Some of the local men from the village would call round to the medical centre to see if there were any odd jobs needing doing. They eagerly set about trimming the passion fruit trees that were growing at an alarming rate and blocking our sign and would always come straight away if I reported a problem with the water or power supply. The ladies took to bringing me food deliveries and I regularly enjoyed a fresh doughnut during a quick break in my morning clinic.
I need to mention here the support that I received from the whole community of M’Pai Bay. I had left a job in the UK to take up this volunteer position and many local businesses were very quick to recognise this and help me with daily living costs. Bars, restaurants and cafes all gave me credit in their establishments, meaning that I could live for a fraction of the cost. I am forever grateful to them all for helping me and allowing me to stay on the island doing the job I loved.
The support didn’t end there. Whenever there was work to be done at the medical centre, I only needed to post on social media and I was inundated with offers of help. People offered their time to help me deep clean the building and if they couldn’t join us, they fed the volunteers after the work was completed. This really was a community project with everyone doing their part to ensure its success.
A team of hard working volunteers deep clean the medical centre
This support allowed me to do the job that I was there to do, that of providing first aid and emergency care to locals, Western business owners, staff and tourists. I have many, many memories of patients I treated during my time on the island, yet certain ones provided me with more of a challenge than others.
One day, I was enjoying some time off and was kayaking around the beautiful coastline of M’Pai Bay, when my phone started ringing. It had been agreed that I was not permanently “on call”, but obviously, I helped if I possibly could. I answered the phone to a Khmer lady whom I knew to be in the second trimester of pregnancy. The panic in her voice caused me great alarm, and all I could make out was, “Bong (Khmer term used to address almost anyone), the blood, the blood!”. I have never in my life paddled a kayak as fast as I did that day!! Abandoning the boat on the beach, I ran through the village to collect the emergency bag and rush to the lady’s accommodation. I saw my patient, but realised there was no panic in those around her. I started my examination and questioning to find out what was wrong and it was with a sense of great relief that she said, “I think it’s my blood pressure, bong”. Apparently, she had felt dizzy and had remembered that I had previously told her this could be caused by a low blood pressure. Checks showed that it was not dangerously low, so I gave her the advice of plenty of rest, and I followed this myself as my arms and shoulders were screaming after my impromptu power kayaking!
I will add, that the lady safely delivered Lilou, a beautiful baby girl some months later and when I left the island, both were in good health and thriving.
Myself, proud Mum Kunthea and the beautiful baby Lilou
As the only member of staff at the medical centre, I cared for all ages, young and old. Children are the same the World over, always getting into mischief and they are no exception in M’Pai Bay. One day, I was called to a young boy of approximately 8 years old who had been playing with his friends around the fishing boats. Of course, there are hooks around these boats and, inevitably, one had unfortunately ended up stuck in the boy’s ear. He was distraught and I tried my best to comfort him as I asked his friends to go and find his parents. Mum soon arrived and we all walked to the medical centre, with myself trying to figure just how I was going to deal with this situation with only limited equipment available.
A bilingual friend from the village joined us in the treatment room to explain to both mother and son what we were going to try and do. Luckily for me, he was also able to hold the torch, as just at the most inopportune moment, the village suffered a power cut and the centre was plunged into darkness. I’ll spare the details, but eventually using medical equipment and the contents of a tool kit (sterilised, of course!), the hook was removed, wound cleaned and dressed, and the young man was sent on his way.
I consider that I have a broad range of skills from nearly 30 years as a nurse, but there are very definite limitations to the care I can provide, and it is amazing how sometimes Lady Luck can intervene. I had a young patient attend the centre complaining of toothache. I took a look inside his mouth, but was unable to decide the best course of treatment. Then I remembered, a couple of days before, I had treated a tourist who was a dentist. He was very impressed with our medical centre and said once he was recovered, he would be happy to offer his services during his time in the village. It was simply a case of getting him and the patient in the centre at the same time and later that day, the young man was examined by an expert and a course of treatment prescribed.
Dental examination for one of our young patients
As all who work in health care are only too aware, it is not all always a happy ending. In August of 2020, I was called to a fisherman who had been found collapsed and unresponsive and had been transported to the medical centre. Fortunately for me, the Khmer nurse who visited our village occasionally was currently at the centre and we both tried our best to look after the gentleman. The patient remained unconscious and we quickly realised there was a limit to what we could do on the island and we needed to arrange his transfer to a hospital on the mainland for a higher level of care. As you can imagine, this is not an easy task and it involved many phone calls and careful co-ordination between a large number of people. Eventually, the village chief agreed to fund a long tail boat and we could start the process of moving our patient to the pier. The ever present community spirit in M’Pai Bay once again shone through. I only had to walk into one restaurant to ask for help and I had more than enough volunteers to do the job safely. The gentleman was carefully lifted onto a handcart and with myself protecting his airway, we wheeled him through the village. The many helpers were able to lift him onto the boat to be taken to the mainland for further treatment. It was with great sadness that we learned he never did regain consciousness and passed away two days later in hospital. RIP, bong.
The emergency transfer vehicle in M’Pai Bay
I would like to give credit to a small group of my friends back in the UK who helped me in difficult situations. Most of the time, I was the only member of staff at the medical centre, single-handedly dealing with whatever came through the doors. Having no colleagues to discuss and plan treatment with was daunting at times. A group of very experienced, highly skilled health care professionals, who I feel lucky to call my friends, had said I could call them at any time for advice. This was a genuine offer on their part and I took them up on it a number of times. They would answer my calls or messages at all times of the night or day in a calm manner, giving me excellent advice, allowing me to deal with any issue I faced. Knowing they were there was invaluable to me in my role on the island. So, Sarah, Chris and Pete, thank you for all your help. I will never forget your kindness, and both myself and the people of M’Pai Bay will be eternally grateful to you.
The M’Pai Bay Community Health Centre was not only used for human patients! My skills lie solely in looking after people, but on one occasion we were excited to welcome a team of vets. Organised by House of Hounds, a charity based in Cambodia and led by an incredible lady called Nuria, this wonderful team would travel around the country neutering, spaying and generally caring for animals, both pets and strays. We had agreed that they could use the centre as long as they didn’t go into the room where I treated human patients. We set about converting the two other rooms into temporary operating theatres and a recovery area, and put the word out amongst the villagers. For two days solid, the team worked to deal with every single animal that was brought in, and I remember in a rare quiet period, one vet went walking around the village to treat any they have missed. This is a team of professional people who all have a big heart and I am full of admiration for the work they do.
Feline patients recovering from surgery performed by the volunteer vets
It was always the aim of M’Pai Bay Community Health Centre to be run by Cambodian people for the benefit of Cambodian people. During my time there, I visited a public clinic in Sihanoukville, a large town on the mainland. Run by Preah Sihanouk Health Department, the centre provided all forms of care to the local Khmer population. By visiting, I was able to form important links between the staff and our clinic. Also, as mentioned, there was an experienced Khmer nurse who would come to the village to hold clinics. These visits increased in regularity and he took more and more control of the centre. So, after 15 months, both myself and the founder felt happy for me to move on, safe in the knowledge that the clinic would go from strength to strength, and that we had achieved our aim.
I feel very lucky to have played a small part in this wonderful project and congratulate all who have helped to make it the success it is. For more information, why not go to the Facebook page and have a look at the current work being carried out.
ALL PHOTOGRAPHS PUBLISHED WITH PERMISSION
After such a rewarding experience I have to give thanks to M’Pai Bay Community Health Centre Project – which was initiated, project managed and continues to be supported by Beach House Cambodia https://www.facebook.com/beachhousecambodia/ for the benefit of the Cambodian community of M’Pai Bay, which has since expanded to all Cambodians of Koh Rong Sanloem. The guest house owner Rob, formed a collaboration with UK Charity ‘Rainbow Collections Children’s Foundation’ (RCCF) in 2015, to enable it’s fundraising via the UK registered charity’s virginmoneygiving.com/fund/CambodianMed-Centre
He provided me with food, drinks and the use of kayaks. He later asked me to look after the guest house while he explored other opportunities, allowing me to stay longer supporting the community. As my go-to for non-medical concerns, we worked out the opening hours and the organising of donations for tourist walk-in clinic consultations and call outs. We worked together to organise purchase of equipment from steel tables and oxygen to bean bags, an emergency response bag and an infra-red temperature checker. Beach House hosted volunteers to create wonderful art on its walls, help with the appeal and island collections. The partnership he formed with Cambodia’s Ministry of Health and working to engage and host 14 volunteers donors from Salesforce (Germany) was pivotal As well as encouraging local businesses to support the project through display of appeal awareness materials, fundraising tins and driving community fundraiser events.
RCCF is the beautiful brainchild of UK music artist duo Sophie Barker and KK – who create and sell wonderful music for children http://www.therainbowcollections.com around the world, channeling royalties into their foundation and promoting this and other appeals to their networks to fundraise. The registered charity aims to help promote education, relieve poverty and protect good health amongst children.