Ratanak International has long had a partnership with the Christian & Missionary Alliance in medical programs. From the early days of the civil war we have worked to bring hope to those who suffered long under war, revolution, isolation and poverty. It is a privilege to have built a hospital in Poipet, one of the "worst" corners of the country.
We as human beings need hope - without hope, all is lost. We need hope that someone does love us, that we are valuable and have meaning. The greatest appeal of the gospel is that we are loved and have meaning - even eternal meaning. And that is why the history of Christianity and medicine are so intertwined. We are purveyors of hope - hope for the temporal and for the eternal.
Through medical programs funded by Ratanak International we have worked hard to provide hope and dignity throughout the treatment process - recognizing the needs, fears and dreams of the patients, striving to become their friends and walking with them through all sorts of trauma. Even when the clinic has been overwhelmingly busy, the emotions of patients have not been overlooked. The staff have taken the time to sit with patients, listen to them, and pray with them. This gives the patients a sense of belonging often in their times of deepest fear and need. The Christian witness has not been taught, but modeled. The Cambodian staff have watched daily the example set by the expatriate CAMA team. They have watched how mature Christians interact, cope under stress, react to criticism, and trust God. Recently the Cambodian staff have been found spontaneously praying together for critical patients. They too demonstrate compassion and love and very naturally share their faith.
So what does all this look like day to day? There follows just a few stories of changed lives. Keep in mind this hospital exists in an environment where people have known only distrust and violence. There is no preaching but patients, knowing the reputation of the staff, ask for prayer and counsel. If asked the staff is always keen to share why they are there to serve the Cambodian people. What a wonderful testament to the staff that simply live their faith.
A man was recently attacked in the market by a knife-wielding mob. He was left for dead with a deep cuts to his neck and back, a large flap of bone, nerves and flesh hanging from his left arm, and a lung filling up with blood. Although people at the market told his wife that there was no hope, she insisted on taking him to the hospital where after several resuscitations, four units of blood and meticulous surgery, he pulled out of his encounter with death. The reputation of the Hospital has soared in the marketplace! The guard at the hospital made sure that everyone knew that God was to be praised for sparing the young man's life.
The ambulances or Emergency Medical Services (EMS) brought so many people to hospital that it became known as "The Saving Organization."
A woman had suffered at the hands of local "doctors" for the treatment of her large goiter. But while waiting for her surgery at the hospital, she was asked by staff if she was scared. She replied, "no, I'm not scared - there's something about this place." She wasn't nervous because she was treated compassionately and felt respected as a human being. She had heard that the staff treat people like this because they are Christians - she said she heard this but now she saw it.
Before and after images shown below.
After a man stepped on a landmine, he was brought to the hospital where he received much needed blood donated by the staff themselves. He said, "There's something different about this hospital..." Later his entire family became Christians and they've joined the church at An Sala village.
The hospital's reputation has spread. Recently, some patients from Prey Veng province were among those waiting to be seen. When asked why they came so far, they said they heard about the wonderful things this hospital does and its caring, compassionate staff. One said she would happily sell her cows to be able to receive care at the center.
An Email from Kent, The Team Surgeon...
Since I last wrote, we have had lots of excitement in the operating room. We have had the joy of doing surgery on many needy people during these months. God has blessed us with terrific outcomes with the hurting people of Cambodia. I didn't just say, 'with the hurting of Poipet'. That is because we are now getting people from all over Cambodia coming to this little NW corner of Cambodia seeking out surgical assistance.
I want to tell you about one interesting young lady that came our way. She came from three hours away reporting chronic pain in her abdomen that seemed consistent with gall bladder disease. Our ultrasound examination was not conclusive. We were hesitant to offer her a cholecystectomy. After hearing about the risks and benefits, she told us that she really wanted to go forward with the surgery. So we did. Upon taking her gallbladder out, there was a noticeable 'crunchiness' to its contents. I opened it and took pains to count every single stone - there were exactly 50! A good call! The humorous part came a few days later, at the time of discharge from the hospital. I turned around to see what the commotion was when I heard Dr. Elma exclaim that she had just gotten her first ever kiss from a patient. The little gall bladder gal was so thrilled to be free of her pain that she thanked her surgeon with a bashful kiss on the cheek - then she followed it up with a peck on mine, too. So, on the same day, Dr. Elma and I both each got our first 'thank-you' kiss from a surgical patient. It's great to see our patients do well and recover quickly.
Up until now, we have enjoyed seeing all our patients get better. Sadly, this last week has brought death two times. It was inevitable. We knew that death would sometimes be the temporary victor. Yesterday, we got an unexpected call at 7 AM. A young child was bleeding severely and needed blood immediately. The one year old girl had Dengue Shock Syndrome, pretty much a hopeless situation. She was bleeding into her abdomen, her lungs and her intestines. She was having seizures - an indication of bleeding into her brain. She was rushed to the hospital and we worked for two hours to resuscitate her. A couple of times we almost thought there might be a chance. Many of the church members heard about the situation and rushed to the hospital, volunteering their own blood to save the baby's life. When the baby's heart rate dropped into the 20's and stopped breathing we gave her to momma to hold. Within a few moments, she died in her mother's arms. What do you say to the mother in a situation like that?
Just two weeks ago, there was a mass casualty near Kobe. Thanks to Ratanak's support of the EMS system, there were three ambulances that went to the scene, working together to get the needy to a hospital. Thanks to your support, we have been able to help needy people like this woman, who was so disfigured by her thyroid goiter that she was making her living as a beggar on the street. Look at her, before and after surgery! It's been a joy to help people like this.
Ratanak has a big share in everything good that has happened here, from rescuing landmine victims to seeing many hearts turn to Christ. We couldn't have done nearly so much without the support you have given. Thank-you, Ratanak!
The History of our Hospital and Clinic Projects
The first project of Ratanak International was to bring in desperately needed medical supplies to Cambodia, then isolated by war, geopolitics, communism and an international embargo. The conditions in the country in the early 1990s, before the UN entered the country, were deplorable and tragic.
After the successful delivery of those supplies Ratanak International moved on to our first building project. This was a water tower and pump system for the provincial hospital in Kampong Cham. This was a challenging project as there were few building supplies in the country and fewer still skilled workers with the right equipment. But eventually it was successfully completed.
Battambang - through the fighting
In subsequent years Ratanak International partnered with the Christian & Missionary Alliance (CAMA) to build clinics and a hospital in the Sankai district of Battambang. This district had a population of about 200,000 with virtually no medical services. The need was urgent but these were difficult times to develop a health care system. The ruthless Khmer Rouge, who occupied territory near the Thai border, were never far away. Attacks were a constant threat and some of the clinics were destroyed. But with much time and effort, and the odd evacuation, this program was to have a huge and positive impact on the communities south of Battambang city.
Old Hospital
New Hospital
The Sankai district hospital which was largely derelict and unused in 1992 would be replaced by a new building which would be used to treat 1300 patients a month in 1994. The hospital would develop into a complex with a dedicated TB ward, pharmacy and out buildings which would act as a referral center for the 8 smaller clinics in the villages. This system of health care has long since been handed over to the Cambodian government but recent unannounced visits have demonstrated that it is still functioning well and there has even been an addition added to our original building.
Siem Reap - working in peace
From 1996 on it became much easier to work in much of Cambodia since the attacks were infrequent and sense of almost normality emerged. Cambodia was no longer considered an active war zone. Ratanak International continued its long and successful partnership with CAMA supplying, in 1997, a floating Clinic on Tonle Sap Lake and funding for medical development in the provincial hospital in Siem Reap and the Bakong district. This district of 60,000 people had been visited in 1992 but was too unstable to work in so it was a thrill to return some years later and put into action plans that had long sat dormant.
Poipet - the Wild West
In 2002 Ratanak International was specifically approached by CAMA to once again partner in a large medical program. The plan was to build a district hospital in Poipet, a wild border town on the border with Thailand. The conditions of the local people were terrible but it was no easy environment in which to work. Criminal activity, related to smuggling and gambling, seemed to permeate every aspect of local life; this was compounded by police corruption and the ever-present landmines that took lives daily. The day-to-day level of domestic violence in the Poipet area eclipses all other regions of Cambodia. So swallowing hard, we committed to building the Hospital in this difficult environment.
The hospital plan would soon develop into a beautiful in-patient ward and a separate surgical training center. This was a beacon of hope for many in the area who sought treatment there. The reputation of the place was so great that patients were travelling clear across the country to be treated by the wonderful Christian staff who not only treated them medically but cared for them, listened to them and showed compassion towards them.
The Future...
We are currently gearing up for another hospital program which we hope to have news about in the next six months or so.
"Without an element of risk in our exploits for God, there is no need for faith." - Dr. J. Hudson Taylor.
Medical Services on the Road
Ever since the Hospital in Poipet was completed Ratanak International has been supporting the associated ambulance service.
This area of the country is actually referred to in one of the major tourist guides as "the arm-pit of Cambodia". It is a wild place that, during the civil war, was fought over repeatedly and so is today laced with millions of landmines. The consequences for the local agricultural population are obvious. This is also an area that contains the busiest commercial trade route between Thailand and Cambodia. The number and size of the heavily laden trucks present a huge hazard on the roads which is compounded by the almost total lack of safety standards and local driving habits which are... well, frightening to say the least. Poipet is a center for smuggling, human trafficking, gambling and violence - it is a great place for Christian ministry!
Many of the road accidents are truly horrific involving many people. Often groups of people sit on the top of trucks as a form of cheap taxi. When such trucks roll over it is a mess. This, coupled with landmine explosions and the violence common to this area, keeps the ambulances very busy.
It was originally thought we would keep the ambulances at the hospital. This was quickly changed when we realized vital time was being wasted sending emergency crews out the scene of accidents and injuries. It was decided to develop an emergency system where the ambulances were kept on standby in different communities thus making for a much more rapid response and only a one-way trip into the hospital.
To date Ratanak International has provided four ambulances in support of the hospital. These serve 200 villages. They are all well used and crewed by trained Christian men from the local communities. A measure of how important these ambulances are to these landmine littered communities can be determined by those who showed up for the dedication of one such vehicle for the community of Malai. The Provincial Health Director and the Assistant Minister of Health were in attendance as were 1,200 other people! There were many speeches and much enthusiasm. Everyone in Malai was keenly aware that they had been given a gift that would save many lives.
The success of the program is illustrated over and over again in the individual lives saved, but a greater indicator of the degree of success can be determined by observing the degree of trust placed in the medical teams by the local people. So many people have been rushed off to the hospital and, against all odds, after emergency surgery have returned alive to their families that the ambulance service is simply referred to by the locals as "The Saving Organization." What a wonderful title!
Medical services on the water
In 1999 Ratanak International funded a floating clinic to be placed among the fishing community of Phlouck on the Tonle Sap Lake in the north west of the country. This was a community that migrated along with the water level - it had no medical services. This clinic moved along with the community for years before being retired to a stationary position when the lifestyle of the community changed, requiring less movement. It continues to serve as a static building today.
In 2000 Ratanak International began the funding of another water born medical service along the Mekong River. The "Boat of Hope" program served Touk Kleang on the east side of the Mekong about 90min south of Phnom Penh. Again there were no medical services for this area. In the first year of operation this mobile medical unit treated 21,000 people and performed 176 emergency evacuations to the capitol. The Boat of Hope team spent most of their time going flat out trying to keep up with the needs - exhaustion was never far away. The situation eased somewhat in 2003 as continued development of the infrastructure caused the program to change. The boat was still utilized but two permanent clinics were established at two strategic locations within the district which took pressure off the overworked boat.
By 2005, circumstances changed again and in response, the program was adapted to most efficiently serve the local people. In that year Cambodia's first High Speed River Ambulance was launched. This project had been a long time in development and had to overcome many Cambodian Government bureaucratic obstacles, but it is now operational.
Examples of its lifesaving capabilities are clearly evident in the comparison of some very similar cases. Before government approval was received for the high speed ambulance there were two medical evacuations from the project area to a hospital in Phnom Penh that serve as good comparisons.
The first was a woman in serious birth / labor difficulties. The evacuation took over 3 hours to complete in the old, slow boat and using a truck on terrible roads. The mother and her undelivered child died in the truck on the way to the city hospital. A week later a young mother, after an argument with her husband, consumed a large amount of poison, and needed to be evacuated by boat and truck to the city, again a trip of over 3 hours. She too died in the truck just as it pulled into the hospital grounds.
By contrast, after arrival of the high speed river ambulance, a tiny Cambodian lady in severe birth / labor difficulties was in the hospital in Phnom Penh in just under one hour. She delivered a huge 4.4 kilo (9lbs 7ozs) baby! (The mother probably weighed only 40 kilos (88lbs) !!) Mother and baby were both fine. Then a few days later, another woman drank poison after a family fight. She was evacuated to hospital in Phnom Penh in one and a half hours and was successfully treated and discharged.
With continued infrastructure development and much improved roads the utility of this program is once again being examined. It is expected that the ambulance will be retired shortly.
In 1997 Ratanak International funded a very small program run by a Christian nurse in the town of Kampong Cham. She had been there working on another project but she had started to come across more and more AIDS victims. The victims were shunned by their families who, despite loving them, were too scared to approach in case they caught the "skinny disease". With no other options and with deteriorating health these poor people would end up living outside the family home in a little make shift hut or sometimes even under tarpaulins or palm branches and would simply be left to decay. The AIDS victim of Cambodia was treated much like the leper of the Biblical times.
As the full force of AIDS hit the totally unprepared Cambodian society Ratanak International was asked to greatly expand this program from one part time nurse to an extensive program of volunteer home care teams. These teams were made up of those in local churches who wanted to break the cycle of fear surrounding this illness and show not only compassion to the victims but also teach their families how to care for them and that it was, in fact, safe to do so.
This was far from glamorous work. It was often filthy, uncomfortable and depressing. For these were the days before anti-retroviral drugs and having AIDS meant a long, slow and difficult death. Yet into this area of service the Christians of Kampong Cham marched. They dealt with much fear, misunderstanding and isolation but in the process demonstrated genuine love and compassion that had a great impact on the not only the victims but many of the families, many of whom would come to participate in the care of their loved ones.
Many of the AIDS victims, as they encountered the gentle massage of loving hands on their often filthy, skeletal and deteriorating bodies, found companionship in the volunteer caregivers who would choose to bond with those they knew would die.
Over and over again the volunteers would choose to be hurt as they grew to love those they cared for only to lose them. But in this terrible cycle of compassion and death there were riches to be found. Bonds were formed in a context of loneliness, isolation and death, yet there was new birth!
Utter helplessness gave way to a growing hope that there was a God of compassion who had come to destroy the chains of karma. The power of such a concept cannot be fully understood by we who know nothing of slow decay in isolation!
AIDS victim, shortly before dying.
One by one in the filth and decay lives were gently ushered into a wonderful eternity... for many of them were now ready to go.
There is a dignity in such ministry that defies all the dirt and the squalor.
Today the circumstances have improved as have the physical condition of those who live with AIDS. Ratanak International continues to support this ongoing program which has now grown into a ministry with several full time staff and 50 volunteers.
An 'on staff' doctor now assists volunteers with health assessments, treatment options and nutritional supplements, as efforts are made to improve the quality of life of AIDS victims or those with other serious illnesses. Family support and education programs have been developed and there is a "Big Friends" program to support kids in families impacted by AIDS.
Given the difficult nature of the work there is time and attention paid to supporting the volunteers. There is an annual picnic and fair for the volunteers and their families as well as on-going teaching, mentoring and encouragement. The impact of this project on both the community and the church has been very significant.