Supporting Infection Control in Cambodia – a nurse’s reflection

For a several years OFAAT have been working closely with a small health care centre utilised by many of the communities we support. Every time we visit, we are greeted by a team of dedicated nurses who have become familiar faces. They have a small team lead by a director, and despite only having a few staff members, they manage to provide round the clock care to many communities and villages in the area, being a primary maternal health centre and handling a vast number of different health conditions, from road accidents to severe infections and illnesses. They have very limited resources but do an incredible job with what they do have at their disposal, often needing to think outside the box to utilise what they have. An example of this that I love is scales to weigh newborn babies being fashioned from a washing basket!

Being a nurse in Australia, visiting Samroang Yea Health Centre, in Pouk District, I am always reminded how fortunate I am to have all the resources and equipment I need in abundance to allow me to do my job every time I go to work. This is a luxury the staff providing healthcare in Cambodia do not have. Their supplies are very limited, and they often rely on donations for essential medical equipment. 

On one of our first visits to Samroang Yea Health Centre, we were given a tour by the director of the centre to establish how the centre operates, and how we could support them in their provision of care to local residents. We were shown the room where most of the patients are treated and there were a couple of patients laying on the wooden hospital beds at the time. We were told that one of the patients was being treated for vomiting and diarrhoea, and the other patient, who was lying about a metre away (on the same bed) had just recently given birth. It was difficult to comprehend how these two patients could be sharing a room and be lying in such proximity, when the risk of a new Mum and / or baby contracting a gastrointestinal infection would be catastrophic. Due to the centre being so small and having limited space, this room is the only area for patients to be treated and the staff had no way of keeping patients separated to prevent transmission of infection. 

One of the next things we did was raise money to provide hospital beds, mattresses, and linen so that patients could have their own bed and even be moved out to an undercover area outside in the case of infectious patients. 

Another visit to Siem Reap we were fortunate to be given a tour of another rural hospital. During a discussion around their available resources, the staff there explained to us that they did have some disposable gloves that had been donated to them, but in order to make them last and not run out of their supply, they had been re-using these between patients. 

This concept seemed quite alarming to me, as the fundamentals of hand hygiene are one of the first topics taught to health care professionals during their education in Australia, but it is not always possible to prioritise this in Cambodia. I cannot imagine a situation where supplies of crucial resources are so scarce that re-using something that is disposable for good reason is perceived as the only option.

Nurses who are qualified and have completed university degrees or tertiary training are hard to come by in Cambodia, and as a result, staff who are less qualified and have received quite basic training in Cambodia are relied on to support those with more advanced training in order to provide 24 hour care. Often these staff are exposed to challenges their training has not prepared them for. In their clinical practice they have such limited resources and often need to improvise, ration, or simply go without the equipment they need to care for patients. Without the ability to adequately sanitise their hands and their equipment, and often being unable to provide hygiene care to their patients, the risk of spreading infection becomes a very sinister prospect.

In the last few years we have worked with the health centre to provide bathroom facilities including a shower (which they previously did not have), a kitchen to safely and hygienically prepare food, a washing machine (for white coats worn by staff and for bed linen etc), washing powder, hand soap and hand sanitiser, and educational resources for the staff to enhance their knowledge of hygiene principles and infection control techniques. 

Simple hand hygiene is the most crucial element of infection control and is essential to protect the health centres most vulnerable patients. With increased knowledge on the importance of quality hygiene practices and improved access to resources to facilitate this, health care facilities in Cambodia can hopefully decrease transmission of infections and reduce associated complications.  

If you are able to donate funds to purchase essential supplies in Cambodia or have spare (in-date) medical supplies (such as bandages, simple dressings, surgical scissors and the like) we would love to hear from you! 

You might also be keen to come to volunteer your professional services in Cambodia on one of our Volunteer Trips. 

Written by Bec Jackson, Bachelor of Nursing