Surprised by JoyWith apologies to C.S. Lewis, for use of his book title, I submit this report of our medical mission to Cambodia. A team of 18 people, mostly from the Louisiana Annual Conference, traveled to Phnom Penh, Cambodia, in February, 2008. Louisiana has an ongoing relationship with the Methodist Church in Cambodia, so this was a return trip for many, but the first medical mission they had sponsored. The team consisted of 3 physicians, a dentist, 7 nurses, 2 of them nurse practitioners, a pharmacist, and several helpers. We obtained many of our medical supplies from Kingsway, including albendazole, used for intestinal parasites. We purchased other medicines, and made the mistake of asking folks to get drug samples from their own physicians. I say this was a mistake, because it yielded us small amounts of somewhat esoteric formulations – what the drug companies are trying to push in an affluent US society, not necessarily what is needed in Cambodia! The most efficient use of our funds came from purchasing pharmaceuticals locally, saving the hassle of transporting meds through customs. Purchasing in-country also pumped money into the local economy, and allowed us to use drugs which we knew patients could obtain later as needed.
We worked closely with the missionary community in Cambodia, again a product of previous teams and relationships already established. Esther Gitubo, the missionary UMVIM team coordinator, and Irene M’Parutsa, the nurse working with Community, Health, and Agricultural Development, collaborated in planning a very successful team mission. One of the most important things they did was to present our medical credentials to the Cambodian Ministry of Health several weeks prior to our arrival. They also obtained written approval for the team to practice medicine and bring medications into the country. This proved to be critical when a local administrator challenged our right to be in the province holding the clinics. Our hosts also succeeded in getting a Cambodian physician’s assistant assigned from the government hospital to our team for the week. They had arranged for 5 clinics to be held in the province of Kompong Chhnang , 3 at one church location, and 2 at another. The pastors of those 2 churches and others nearby were very involved in the planning and execution of the clinics.
In total we saw about 300 patients daily. I share in the concern raised by many about the usefulness of “tailgate medicine” as it is frequently practiced by such teams. I have come to the conclusion that while it may not be perfect, it is a good thing to relieve suffering, even if only for a while. Helping people alleviate pain is good; providing antibiotics for an ear infection is better, and diagnosing hypertension or cardiac disease can improve quality of life for a long time if appropriate care and referrals can be made. This is where the planning for this team paid off in huge ways. The pastors were present at all the clinics, and were constantly being taught how they could become advocates for health for their parishioners. When patients needed referral – for follow up care, surgery, medications – the pastors arranged that referral. Irene had pastors accompany her and the patient to the provincial hospital, to learn the ropes of admission, find supplemental funds to pay for care, and learn potential side effects of medications. The hope is that this knowledge will enable them to continue this process long after the team has gone.
Another important part of this mission was to acquaint rural people with “western medicine”, which is practiced in the government hospitals, but not trusted. If you think about the recent history of Cambodia, you can readily understand why anything promoted by the government might be distrusted! So as we worked, we were careful to point out the facilities for care in their area and encourage them to avail themselves of it. Having the Cambodian physician assistant there was part of this promotion. I believe that Irene is practicing community based primary health care; our team was one of her tools.
The title of this report sums up my response to this mission. Because of my knowledge of the past 30 years of Cambodian history, I had expected a depressed, brow beaten people. Some of them are – there is a deep distrust, not only of government, but of neighbors and family members. Large parts of a generation are simply missing and their loss deeply felt. But the Cambodian Christians live a life of joy such as I have rarely seen or experienced. The pastors, our translators (all of whom are young Christians, but not all Methodists), the church people playing in the praise bands or preparing out meals – all were absolutely bubbling over with the love of Jesus and the inspiration of the Holy Spirit. They were welcoming, happy to see us, grateful for the gifts and skills we brought, abounding in generous hospitality, but at the same time very aware that God is the source of their strength and vitality, not donors from the USA. The church there is growing by leaps – from 3 Methodist churches in 1989 to more than 150 today – and that’s just Methodist! God is doing a great work there, and I am grateful to have experienced and perhaps played a small part in it. Praise be to God!
Submitted by Sylvia Reimer, Lousiana Conference