Blood & Fire

This week wins the trophy for Most Hectic Week in the History of Clinic Here. And part of the reason is because we took care of some very special people. A group of Jarai people traveled to Poipet to see the doctor and receive some badly needed medical care.

Jarai are a people group from northeast Cambodia. Only about 21,000 live in Cambodia; over 300,000 Jarai live just across the border in Vietnam. Many do not speak Khmer, the national language and live as subsistence farmers, living off the jungle around them. Education levels are very low, and they live in one of the poorest, least developed provinces of Cambodia (Ratanakiri). However, there are many missionaries working in that area to improve the Jarai's lives, and many churches have been started there.

Red area shows the Jarai tribal land. Taken from the Joshua Project.

Not surprisingly, they have very little iodine in their diet, which has led to many of them having iodine-deficient goiters. So a large group of women came to the clinic to get checked out. Only a few spoke Khmer, and I got the feeling many had never been to a doctor before. When one of the nurses asked a woman to give a urine sample, she received back a specimen cup of water. The woman innocently explained she had urinated in the toilet, then dipped the cup into the toilet bowl to collect the urine. There was obviously a lot of education to be done!

One of the women had severe anemia, and the decision was made to give her a blood transfusion. This whole procedure was much more complicated than in the United States. First, Cambodia does not have a national blood bank. If a patient needs a blood transfusion, family and friends must be the donors. We found three healthy men from the Jarai group willing to donate. Then the testing began - I learned how to test their blood for their blood type to make sure they were a match.

We used microscope slides on a paper towel and needles to mix up the antigens with the drops of blood. Very high tech - that's how we roll here. In fact, we had a moment of panic after cleaning up the slides and realizing we'd thrown away the paper towel - with all the blood type results written on it. After frantically looking through the trash can, I realized we'd taken a photo. Technology saved the day.

Thankfully, two of the men matched their blood type with the patient's. Then we tested the donors' blood for diseases, like HIV and hepatitis.

We worked into the evening past sundown three nights in a row. By Thursday, I was definitely ready for a break - but so happy to have the opportunity to help the Jarai people.

Friday was going to be a stay-at-home-and-study day. And partially, it was. But over lunchtime, a friend called me. A noodle shop next to her house had caught on fire and completely burned down. Her house's front entrance had some smoke damage, and one motorcycle had been completely destroyed. But amazingly, no one had died. Fires in Cambodia can be quite deadly. Old houses are built completely of wood, definitely not "up to code", and people often cook meals over open fires next to gas tanks without any regard for fire safety. When blazes do occur, people react in panic, and many cities have no access to fire trucks. Luckily for Poipet, we have plenty of casinos with fire trucks available to send to fires in the community. They quickly came to the house and put out the blaze. But, for the noodle shop, it was too late to save it.

It may be difficult to see, but in the top of the photo  you can see several children carrying yellow and orange bags. As soon as the fire was put out and the ashes cooled, street scavengers descended on the site and started taking away any piece of tin or scrap metal they could find so they could sell it. Men pulled up with carts and pulled off whole pieces of roof tin to cart away. Many families in Cambodia have their homes and businesses in the same building, so a fire like this is devastating. Most don't have the capital or savings to recover their homes or businesses - insurance does not really exist for families like this! 

We were able to help our friends wash off the floors covered with soot and put things together again. And Saturday, I slept. A lot. Enough to feel somewhat re-energized and ready for whatever crazy adventures this next week holds for us!