“This is it!”
This was my thought as I am aboard the plane from Phnom Penh, Cambodia on my way back home to Dallas, Texas. I had just spent 2 weeks in Cambodia – my first time after having been lucky to survive the Khmer Rouge. I was both exhausted and emotionally charged after a week of providing anesthesia on the medical mission trip and another travelling through Cambodia.
The medical mission
The group that I had joined with is called CHPAA (Cambodian Health Professional Association of America) and this is their 9th mission. They go to different parts of Cambodia every year as many underprivileged Khmer would not have the means to seek medical or surgical care without the mission’s help. This year, it was in Kampong Thom, located approximately in the middle of the Kingdom of Cambodia. There were 2 hospitals where we had performed surgeries, approximately 45 minutes apart. The one I was at did outpatient cases such as hernias, orchiectomies, and lumps and bumps type; the other one was for more complex cases such as hysterectomies, slings, etc. That hospital had capability of providing inpatient and critical care. My 2 CRNA and Anesthesiologist colleagues were at that hospital. The Anesthesiologist and I at the outpatient hospital performed about 40 anesthetics in 5 days. The mission’s goal was 100 surgeries between the 2 hospitals (2 ORs, with 2 tables in each OR, separated by a divider). Our mission had performed 98 cases. The medical team saw many patients, and as word got out that we are there to provide free medical care, the line of prospective patients was out to the streets every day. In addition to the medical and surgical care provided, the dental service performed approximately 1000 extractions. The mission also had specialists who hand out glasses, provided physical therapy and acupuncture services.
There were also many lay volunteers to help out with logistics, IT, and running errands. They were instrumental in supporting the overall mission and taking care of the providers. Additionally, the mission had invited students from all the medical schools in Cambodia to help with the care and serve as the liaison between the non-Khmer speaking providers and the patients. They also helped with the anesthesia and surgery if they were interested in the respective discipline. It was a brilliant idea as these future doctors will be the ones taking care of their people when they become attending physicians. The mission also involved local physicians to help with identifying surgical candidates and follow up care.
It was a busy and tiring week, especially with temperatures in the mid 90’s every day. Despite that, everyone was willing to roll up their sleeves to help and look out for one another. On January 8th to the 23rd, 2020, CHPAA will be embarking on their 10th mission. It will be in Kampong Speu, Cambodia. I look forward to being part of this mission again.
What a medical mission means to me
As I look back at where I was and where I am now in life, I am very blessed. The ups and down that I encounter is small compared to what I have faced in my childhood. For those who have read Part 1 of my blog, you can understand why I feel this way. I have a wonderful spouse, a great family, and 3 wonderful dogs (for those who are dog lovers, you understand!). I believe I make an impact on my patients’ lives every day in the ICU and in the OR. When I hear of colleagues going on mission trips, volunteering at the local shelter, building homes in Mexico, or packing to go help in hurricane ravaged area, I am so excited for them. I want to be there, I want to extend the gift I was given to help others. But my thought has always been “is this the right time, is this the right mission, is this the right place to be?”
“You should go” that was the advice my husband gave me. I am so glad that I took the plunge. I just experienced the trip of a lifetime. The temples were unbelievable, the landscape was beautiful, and the people were so friendly. Most importantly, what I had witnessed on the mission was had transformed me to want to continue on more mission trips and to be affiliated with CHPAA. I had witnessed kindness, self-sacrifice, and generosity within the group. As we went on the tour around Cambodia, I was so touched by the kindness that my fellow CHPAA team members showed to the Khmer people. As we travelled, we saw socioeconomic extremes even in neighboring homes. Our team members gave money and food to those appearing to not have had a meal in days. At the restaurants, some divided their meal and what was left over, careful packed it to give to those on the streets or the tuk-tuk drivers (a popular form of taxi service in Cambodia). They were also very generous in tipping the bus drivers and tour guides who took us through Cambodia.
Some days, I cannot believe I am here across the world doing what I enjoy – providing care and teaching. I was taking a break thinking about this when I am struck with emotions that I cannot figure out. Am I in tears because of the observed poverty in a country that is so rich in beauty or am I just grateful for what I have thus allowing me to be here to lend a helping hand? I was lost in thought when the executive director for CHPAA, Dr. Tan, had asked me if she could have my seat to take a picture of a Mom and her child. The child has severe CP and is utterly emaciated. My suspicion, which was confirmed with Mom, is that as he eats, he aspirates. He drools all the time and is not able to walk. CHPAA was working on purchasing a wheelchair for Mom so she can get him around without having to carry him all the time. As Dr. Tan was leaving, she gave the Mom money to buy food for her baby. As I counted the money for her, she burst into tears. Dr. Tan turned around and gave her more money, thinking that this may not be enough. The total amount was $50. This may not be a lot of money for us and it certainly does not last long. But this may be her only income and the money will provide food for her child for a very long time. There is no such thing as public assistance in Cambodia. The generosity of CHPAA also allowed for the ambulance transport of 3 patients to a higher acuity hospital (it is 2 hours away), pathology analysis, and follow up care.
Putting things in perspective
We all have bad days, especially when we are caught in the daily grind or the minutiae, when we have a bad outcome at work, or our interaction with our love ones is not so great. These are the times that I questioned what I can do to be a better person.
Gandhi said “The best way to find yourself is to lose yourself in the service of others.” After having been on this mission trip, I have found my mission in life. “This is it” was precisely my thought as I boarded the plane home. I have found my calling – the “ah-hah” moment. I want to be in Cambodia, helping my fellow Khmer. But it will not be the only mission that I will go to. There are too many people in the US and across the world that need help so they can live a quality life. The medical and surgical care provided may allow that person to work thus providing income for his/her family which enables the children to attend school, receive basic care, etc.
If you ascribe to Maslow’s hierarchy of needs, the majority of us have attained basic and psychological needs and are looking for personal fulfillment. In achieving self-actualization, Maslow added self-transcendence; that is, the need to altruistically help other people. I believe that helping others in need helps me place a new perspective on my life. I helps me not get bogged down on the little things in life, feeling sorry for myself that I did not get the job that I believe I am qualified for, or feeling let down when my children did not get the grades that I believe they are capable of achieving.
What a medical mission means to society
In Cambodia, approximately 23% of children die before the age of 5 years due to lack of medical care. While those who need care receive care, the wait is very long. Also, many do not have the means to travel to the nearest state facility to be cared for. Medical mission provides much needed medical, dental, surgical care for those who are young, elderly, or underprivileged in addition to providing education on common health care topics. Unfortunately, Cambodia is not alone. Many emerging countries are facing health care crisis such as this. The US spends approximately $8200 per person on healthcare, whereas some countries of southeast Asia and Africa spends $25 per person. Most importantly, there is a lack of providers such as surgeons, OB, and anesthesiologists/CRNAs.
We take our healthcare system, though not perfect, for granted. There is public assistance and public healthcare for citizens. I asked one of my RN colleagues why she chose to go on medical missions abroad versus staying in the US. She told me that it is about stepping out of your comfort zone, utilizing your training to the fullest extent, being creative as you do not have to all of the latest and greatest technology available to you. Lastly, she said that while many are poor in the US, there are programs to help them. In countries that she has been to, there is no bootstrap that people can pull themselves up with. It is up to each of us to make the sacrifice to help out our fellow human beings. Gandhi would agree with this as he once said “Gentleness, self-sacrifice and generosity are the exclusive possession of no one race or religion.”
My intention of this blog is to share with you how my upbringing influence my view on life and how I discover my life’s mission. As professionals, we have a thirst for servitude. What will we do to achieve that personal fulfillment? For each and every one of us, will that be coaching on our child’s sport team, becoming a big brother or big sister, volunteering at the animal shelter, or be the best clinician that we can be? Will it be educating future clinicians, spreading the message of our God, or both? I believe that it does not matter what we do, as long as we are involved and committed to improving the lives of others.