A Change of Guard

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Saturday, 9 March 2013

Cambodian, US providers share ER experiences

Cambodian, US providers share ER experiences Lance Cpl. Alyssa Gunton U.S. Navy Lt. Cmdr. Lawrence Decker, left, speaks with Royal Cambodian Army healthcare providers at the Phnom Penh Preah Ket Melea Hospital Jan. 25 during Cambodia Medical Exercise 13-1. The U.S. service members will work alongside Royal Cambodian Armed Forces medical personnel during subject-matter expert exchanges to increase Cambodian and U.S. medical capability, capacity and interoperability. The U.S. and Cambodian armed forces have conducted medical exercises together since 2007. Decker is an emergency doctor with 3rd Medical Battalion, Combat Logistics Regiment 35, 3rd Marine Logistics Group, III Marine Expeditionary Force. (U.S. Marine Corps photo by Lance Cpl. Alyssa N. Hoffacker)
PHNOM PENH, Cambodia - U.S. Navy emergency room providers observed their Royal Cambodian Armed Forces counterparts for several days at the Phnom Penh Preah Ket Melea Hospital in Phnom Penh, Cambodia, during the Cambodia Medical Exercise 13-1 which concluded this past week.

The sailors, who are with 3rd Medical Battalion, Combat Logistics Regiment 35, 3rd Marine Logistics Group, III Marine Expeditionary Force, took part in the exercise to share expertise and ideas, further develop the local militaries’ medical capabilities, and enhance the U.S.’s military medical flexibility with its allies. The U.S. and Cambodian armed forces have conducted medical exercises together since 2007.

“The physicians and nurses are trained very well, and they have adapted to their particular situation superbly,” said U.S. Navy Lt. Charles Kinard, an emergency nurse with the battalion. “In fact, some of the physicians have trained in other countries to include France, Canada, Thailand and Vietnam.”

The Royal Cambodian Armed Forces healthcare providers receive in-depth training, but medical care is often costly.

“It can be a challenge for both (countries) as medications and therapies we use in U.S. hospitals, which may cost hundreds of dollars a dose, simply are not available here. So we have to modify our treatment plans to accommodate for this,” said Lt. Cmdr. Lawrence Decker, an emergency room doctor with the battalion and the officer in charge of the exercise. . “Their treatment plans tend to be very similar (to the U.S.) and based on solid medical literature, but there are often some gaps, which we hope to fill.

Cambodia’s military healthcare resources can be challenging since they are a developing country.

“In the U.S., a hospital usually pays for online resources, as well as new technology, which allow our doctors and nurses to maintain the skills needed to give the best possible patient care,” said Kinard. “The Cambodian military does not have the funds that we do, or the equipment, and many of their resources are out of date. They still give the best care they can, but simple procedures in the U.S. can be impossible for the Cambodian medical staff due to lack of funding.”

The RCAF medical providers look forward to these exercises because they are able to learn current medical procedures, share experiences, and discuss practical techniques in the medical field, according to Royal Cambodian Army 1st Sgt. Pagnavuth Chhang, an emergency room doctor at the hospital.

The U.S. sailors observed RCAF providers conduct morning rounds where they discussed patients that were currently admitted or undergoing surgery.

“It is common amongst doctors to ask each other’s opinion on a diagnosis or treatment plan,” said Decker. “A good doctor recognizes he or she is not an expert on all aspects of the medicine, and so we are always asking others to get help and a different perspective. It also helps us to check our thinking process to make sure we are reaching the logical conclusion.”

These exchanges also benefit U.S. doctors, nurses and corpsmen, according to Kinard.

“In the event of a natural disaster, the Cambodian medical staff will excel because they already work under rugged conditions, such as frequent power outages, broken or lack of equipment, and a decreased medication arsenal,” said Kinard. “The U.S. medical staff can learn from these conditions and possibly save lives when we are placed in a situation like this.”

The U.S. service members and RCAF medical personnel will continue to conduct subject-matter expert exchanges to increase Cambodian and U.S. medical capability, capacity and interoperability.

“Formalizing these alliances for peace and prosperity for all of our people is an important part of preventing conflicts in the future,” said Decker. “Additionally, we have much we can share with Cambodia about modern medical and business processes that can improve the quality of care they provide to their people.”

“All in all, healthcare in the capital of Phnom Penh is pretty good. It still has room for improvement, but every healthcare system does,” said Decker. “The real opportunities for radical change lie outside the capital, in rural hospitals where modern techniques may not have permeated yet.”

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