I'll admit it--I'm at the level of medical training now where it is often painful to sit in the background without doing anything while another physician interacts with a patient. I used to dread this so-called "shadowing" back in the U.S., but here, it's definitely turned out to be a very educational experience. On a given day when I'm visiting the Outpatient Department, I can easily sit for hours watching patients and listening to the residents jabber to them in rapid Khmer.
Lately, I've been hanging out with H, a resident who seems keen on having me know as much as possible about traditional Cambodian culture. Sometime in the middle of his morning clinic, we saw the above patient, whose mother had brought him to clinic for suspicion of dengue fever. As he was taking a history, H pointed out to me that the patient was wearing a special amulet made partly from a stone as well as from monkey bone. Such charms are popular in Cambodia, where it is believed that they hold special powers to protect people from disease and misfortune. But unfortunately, as H later told me, they also serve as the nidus for disease in young kids, who tend to haphazardly put the amulet in their mouth. As a result, a lot of them develop various infections from bacteria that are harbored in the bone.
Just goes to show how important it is to ask about traditional remedies, I guess…
Of all the residents I've seen, H is the only one who takes a full History and Physical, remembering to ask every patient who comes in about remedies they use at home. And of course, there are a lot of them. Although AHC certainly runs a busy, efficient outpatient clinic, many families simply don't have the means of being able to come to town when their child falls ill. As a result, they turn to traditional healers, who, armed with their arsenal of herbs, amulets, and tools, quickly fall to the task of trying to heal patients without the aid of medicine.
Sometimes, the treatments work. Many a parent has come in, professing the wonders of herbal tea that can stop a fever or cure cancer. There are also plenty of children who come in with marks from being “coined” (having an area of skin rubbed vigorously with the edge of a coin) or cupped (where a small jar is placed on the skin and suction applied)—both treatments designed to draw out disease from the body.
Of course, I flash back to my own experiences with coining during my trip to Cambodia a couple of years ago. I had had a horrible migraine, which the family I was staying with attempted to cure with coining. There is much more to the story, which you can read here, but in any case, what I remember most about the entire ordeal was how much it hurt! I’m certain that just the sensation of having a rough, abrasive coin rubbed on skin is enough to distract one from a variety of different ailments. However, the Cambodians swear by it. Some even say that being coined is a very soothing experience. I’m still going to stand by my belief that it is something of an acquired taste.
But sometimes, the treatment seems more harmful than the disease. During H’s clinic, there was one 6 year old boy who came in with multiple scars on his belly. Upon closer examination, they looked to be old burn marks. H told me that one of the traditional treatments for abdominal pain or diarrhea was to be burned multiple times with a small flame. I cringed at the thought of this, imagining the agonizing pain as flesh was seared time and time again.
As the patient with the monkey amulet left, I couldn’t help but feel incredibly grateful for having access to actual medications. Granted, it would be arrogant to discount the value of traditional healing methods, seeing as many civilizations have managed to treat ills and ailments without the help of modern medicine for centuries. But given the choice between taking an antibiotic versus being burned to treat a stomachache—I would definitely prefer the former!
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