I want to go back

A Story about the Comprehensive Care Provided at AHC

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What started off as a story about a recent speech therapy training attended by our physiotherapists and breastfeeding counselor here in Siem Reap, quickly turned into a story about the comprehensive care provided at AHC. It involves top notch care in the ICU and IPD; quality continued care from our physiotherapists, social workers and breastfeeding counselor; and a four and half month old baby girl named Kaneka* whose life has been saved.

*Patient’s name has been changed for confidentiality

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JUNE 17, 2014

On June 17, 2014, one day old Kaneka and her 24 year old mother arrived at AHC to the Outpatient Department (OPD) where between 500 – 800 children and their families come each day. After initial assessment, Kaneka was diagnosed with severe pneumonia and sepsis, and was admitted to the Intensive Care Unit (ICU).

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LATER THAT DAY

After further assessment by AHC’s ICU team, Kaneka was also diagnosed with a rapidly developing, life threatening condition known as Acute Respiratory Distress Syndrome (ARDS)**. This is when the lungs become damaged so much so that they cannot do their job properly anymore so it feels like you aren’t getting enough air every time you try to take a breath. It is a sign that the lungs are failing and need critical support.

As a result, Kaneka was placed on a breathing machine.

JULY 28, 2014

It was around this time that Kaneka’s mother, started to say that she needed to take Kaneka back home to their village, despite the medical advice being given by our team of doctors.

Kaneka’s mother explained that they have another child which she, as the stay at home wife, needs to take care of and that by being away from home, this was causing financial strain on the family; Kaneka’s father is farmer making less than $1.25 a day.

DURING THAT WEEK

Although the doctors tried to explain that Kaneka needed to stay for continued treatment, Kaneka’s mother persisted to take her home so the doctors consulted with AHC’s Social Work team as they knew Kaneka’s mother needed skilled counseling.

When the social work team began speaking with Kaneka’s mother, they quickly learned that the bigger reason she wanted to go home with Kaneka is that because she felt entirely hopeless that her daughter was going to survive much longer and she wanted Kaneka to be home with her family.

**ARDS is known to cause a lot of distress for the family as it is not easy to be able to witness your child having such difficulty breathing. Initiated in 2010, AHC’s Social Work Program was the first of its kind in Cambodia where previously no hospital-based social work program existed. In addition to providing support to children, the social work team also works with caretakers, like Kaneka’s mother, to help them cope with their child’s illness and be able to make the best decisions in the interest of their children.

Untitled-8AUGUST 1, 2014

Kaneka’s mother took her back home to their village against medical and social work advice, but AHC staff provided guidance on what to do at home and also made it clear they can come back any time.

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AUGUST 1-5, 2014

Four the next four days, the social work team called Kaneka’s parents to provide counseling and encourage them to return to the hospital. They assured her parents that they would hire a personal caretaker to stay by Kaneka’s side so her mother could go home to take care of her other children.

AUGUST 5, 2014

Through daily counseling sessions over the phone and assurance by the social work team that they would hire a personal caretaker to stay by Kaneka’s side so her mother could take care of her other child, Kaneka’s mother agreed to bring her back to the hospital so she could continue to receive the medical care she needed.

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Featured in the photo above is Kaneka being fanned by the caretaker AHC employed on her behalf, to stay by her side 24 hours a day.

SEPTEMBER 12, 2014

From the moment Kaneka came under their care, the ICU team** provided the highest quality of medical attention and were able to cure Kaneka of a condition that has a 40% mortality rate in developed countries such as the United States.

When speaking with AHC’s Dr. Varun Kumar, he told us:

“Curing a patient with severe ARDS can already be difficult in the West, in Cambodia it is all the more impressive. To do this anywhere in the world, you need a medical team that can provide a very high level of skilled ICU care.”

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**The “ICU team” does not only include doctors and nurses. As the ICU is the most likely place for patients to get life-threatening hospital-acquired infections (no matter where you are in the world), housekeepers – in addition to the social workers, lab techs, purchasing department, etc. – are an integral part of the ICU team because their efforts to uphold infection control help to prevent mortality in the ICU.

Kaneka is discharged from the ICU, but it is not yet time to go home…

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THAT SAME DAY

AHC care did not stop after Kaneka was cured of her life-threatening illness. From being on a breathing machine for so long, it is common for infants like Kaneka to develop sucking and swallowing complications as a result of having a tube in the throat for so long. If Kaneka was discharged to go home, she wouldn’t be able to drink or swallow and could quickly become malnourished and eventually die as a result.

Untitled-4Kaneka was transferred to AHC’s Inpatient Department so she could continue to receive the comprehensive care she needed to make a full recovery.

THAT SAME WEEK

AHC’s breastfeeding counselor, Nurse Phannsy Sroeu, began to work with Kaneka daily to help improve Kaneka’s ability to suck and swallow so that eventually she will be able to eat and drink.

Untitled-3Until she is able to swallow fully, Kaneka will continue to be fed through a tube so she can receive the nourishment she needs to grow.

OCTOBER 23, 2014

Eager to continue their training to help patients like Kaneka who are unable to suck and swallow properly – (something we all take for granted but believe it or not is a major problem for many young children in Cambodia) – AHC’s breast feeding counselor and physiotherapist team attended a workshop by CABDICO to improve their knowledge and training in this area.

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When we went to see Kaneka in the Inpatient Department, Nurse Phannsy and the physiotherapy team were working with Kaneka on her sucking and swallowing, trying a little milk here and there on their pinky finger – as much as Kaneka could handle that is, until they played peekaboo with her for a bit to allow her to rest.

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Today

When we spoke with Nurse Phannsy today, she told us that she was happy with Kaneka’s progress and greatly hopes that with more work, Kaneka will soon be able to swallow and eventually eat and drink on her own. When they first started, Kaneka was entirely unable to suck and swallow, but now she is sucking on Nurse Phannsy’s pinky finger with a bit of strength and is slowly but surely progressing on her ability to swallow.

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On behalf of all the staff at AHC, and the patients and families we treat, we would like to say thank you to all those who support Angkor Hospital for Children and allow us to provide children like Kaneka with the happy and healthy future they deserve. Without your support, we would not be able to provide free comprehensive medical care for over 500 Cambodian children every day, and more than 145,000 free medical treatments each year. Thank You.

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Interested in helping more children like Kaneka receive the care they deserve? Here are a few ways you can support AHC and the children we treat:

For more information about Angkor Hospital for Children, please feel free to contact us at [email protected]

Thank You!

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