For all still-developing medical projects, Clinics is perhaps the most anticipated, yet the least sustainable and impactful aspect of our work. At the end of the trip, we will always ask ourselves if being there has made any difference to the community at all, that if by going there, the greater benefit came to those who went, not the people we are going to help. Project Lokun has acknowledged this fact, and aim to take our work to a strong and sustainable level. Hence, having been to Cambodia 6 times already, we have researched and brainstormed several key ideas to follow up with.
The Clinic
As with Clinics, we have our usual team of 18-22 students who follow a range of 3-5 doctors to the various villages where we had originally carried out screenings for the students there. The schools have kindly allowed us to use their premises. Leading to our trip, Father Hernan will help us inform the various villages we are visiting when we will be arriving so that villagers may be prepared to come visit us at the right days. At each place, once we set up our clinics plan moves as follows: Registration, Triage, Consultation and Pharmacy. Project Lokun have planned several measures which we would like to share with you!
~ Registration: In Project Lokun 6, we implemented a new system to computerize our documentation of each patient that we see. In previous years, it was very difficult to search through files to find the same patient if he/she had come before on past trips. We had also tried to give appointment cards or notebooks which within 6 months, found that the villagers were likely to lose them. Hence, we invested in a fingerprint scanning and cataloguing software that would allow us to capture each patient's fingerprints, store them, and be able to find through referencing the same fingerprint. This will also store information like precinct, village and mode of contact for followup. Currently, we have been sponsored with one fingerprint scanner and software and are hoping for more help in the future.
Triage: This segment is fully run by medical students. However, as a proportion of the team consist of Medical Year 1 & 2 students, pre-trip trained is carried out by the doctors we accompany to learn how to take a proper patient history, and the principles and techniques behind a patient examination. Thus equipped, we are able to assist the doctors in gathering proper information to ease his/her workload.
Pharmacy: Here we have an appeal for help, for we still have an issue with getting adequate drugs for both our and CROAP's local clinic and we hope to find sponsors willing to help us out for a longer term.
As with each station, we have translators who aid us in translating both our instruction and the patient's presenting complaint. We are also very flexible with schedule and timings and doctors who can only join us for a short time are still welcome.
Referrals/Followups
Having our sustainable avenue lying here, we at Project Lokun found that at clinics we would often detect chronic diseases or surgical emergencies we are unable to handle. Hence we have devised systems of referrals to send patients to the nearby Pursat Hospital or Phnom Penh Hospital for further medical attention. Several NGOs like St. Elizabeth Sick Shelter and St. Joseph's Church have kindly volunteered to house our patients and provide transport back should the need arise to go to Phnom Penh Hospital. The patients who need this referrals are grouped into urgent and chronic cases (eg. TB, Hypertension..). If the urgent cases turn out to be emergencies that require more immediate courses of action, we would follow the patient to the hospital within the trip itself to ensure the patient is treated before he leaves and chooses not to respond to followup. Chronic cases are converted to followup cases where Father Hernan and his team, and the local doctor take up our mantle to contact these villagers and ask them to come down so as to collect medication and review.
Potential for further work
During the last trips, it has come to our attention of the government's efforts to bring healthcare to the poor. These come in the form of Provincial Health Centers which are located in most villages and provide free treatment for specific diseases like TB. During Project Lokun 6, we contacted them and ascertained that future trips would serve as means of detecting said diseases and referring them to these Health Centers. It is also our aim to foster more trust and community bonding between the Health Centers and the villagers so as to allow better access and distribution of healthcare to the the people.
We are also in current contact with Youth Council Cambodia, an NGO set up to engage the youth in being involved with Cambodia's issues. While we are still in discussion, YCC has provided ideas about aiding us in our healthcare education and allowing for more possibilites to be explored.
Other issues we have brought up comes in the form targeting what causes common disease we meet. This involves proper water sanitation, where other teams like the recent NTU team have come down to build water tanks. We would appeal to other groups too to be able to raise funds for more water tanks and filters to be installed.
