Preparatory Mission Report 2019

The Hands of the Heart for Cambodia

Preparatory mission report

January 14-30, 2019

Participating

Edith Cwas

Lyna Trinh

And our interpreter Do Vireak, French teacher at Battambang High School

 

Thanks

We would like to thank the private individuals and organizations and companies who have generously contributed to our project.

Becker

Mathilde

monk

Nadine

BERTHONNIER

Eric

SMALL MORGAT

Marie-José

BLACHERE

Eliane

P

Jc

BONNINGUE

Marielle

Paul

Chantal

BURBAND

Mani

Poncelet

Claire

CALLAIT

CALLAIT Edith

Hervé

PRADER

Gaudenz

CALLAIT

Jeannine

SCHUHLER_PRAS

Monique

CATC

Alumni

SOUKHARITH

Michel

CHABRY

Germaine

Trinh

Lyna

CHAMPAVERT

Henri

TRINH BO

Lany

Christophe

Jonathan

VASSELON

Alain

CURVAT

James

MEYRAND

Patricia

DAILLOUX

Marie-Claire

DEYDIER

Laurette

FAVAUGE

jean-guillaume

FEBURU

Yvan

Geneva

Jacques

GORAND

Cécile

Hedon

Cathy

Heintz

Jean Robert

JUST

Nadine

LABEYE Margaux

LABEYE

Lucie

Longin

Claudine

MAGNOLON

Laetitia

Maigret

Brigide

MELET

Nelly

Thanks to Sistercienne Solidarity who validated and supported our first mission

 

The care material was given to us by

The PLANETA VERD laboratory and its manager Jade Thomassin

The association Hands of the Heart for Cambodia is based in

Hen the Charms

85 Central Street

Recorded in Villefranche on Saône under the number W6920006780

Finally, thank you to those who believe that even a small drop of water can germinate a seed...

 

Recalling the objectives of the preparatory mission

prerequisite

The establishment of a humanitarian mission in the field of Health requires validation and accreditation from the government authorities, the Ministry of Foreign Affairs and the relevant Ministry of Guardianship, namely the Ministry of Health and Social Services.

In Cambodia, any non-governmental organization (NGO) must be registered. The procedure can be long, some NGOs have taken 2 or 3 years. A 3-year renewable contract is signed with the State, which provides for actions and means of action over the 3 years as well as a financing plan.

To be registered, the association must have an address, and an open bank account in Cambodia.

 

  1. The objectives of the mission

Preparing is first and foremost about ensuring that our project is welcomed and validated by government and local authorities.

It is also about which Cambodian and non-Cambodian partners we will work with.

Finally, it is to ensure that our approach and our techniques of care are accepted by the population, that we are able to provide answers to the therapeutic needs of the populations concerned.

 

  1. Meetings at the government level

  1. The Ministry of Foreign Affairs

Ms Op Sopheap: Director of the International Department of NGOs in Cambodia.

  • How to check in and various formalities

  • Contacts at the Ministry of Health and various formalities

  1. The CCC Coordinating Committee of Cambodian NGOs

Mr Chen Sochoeun Director of Research and Sustainable Development

Mk Khorn Bunthong: Project Manager

The CCC is an important organization in Cambodia, both at the network level and on information on the actors in the field.

The project was enthusiastically received, many questions were asked, notably regarding possible gateways with traditional Khmer medicine, pharmacopoeia, the latest "Kru", traditional Cambodian doctors.

 

  1. NGOs

1 Pains Without Borders

Florence Chatot Country Manager

Dr Camille Desforges: medical coordinator

DSF has been implementing palliative care in Cambodia for years. They work mainly in patients, and have a few rooms in their premises.

The possible avenues of collaboration mentioned are an action to train their healthcare staff in pain relief and psychological calming techniques in order to accompany patients. Support for caregivers who take care of all basic care (hygiene, nursing, food) could also be a path for partnership.

  1. Cambodia HIV ,

Ms. Kolnary , Director

The Association acts primarily through information and awareness campaigns on infectious diseases.

Not intervening directly in care, it it is difficult to find an axis of practical cooperation with it.

  1. Lataste Home;

Anaïs Gallo administrative and legal officer

M Suo Malai, head of the Sisophon centre

The Association operates a children's reception centre and offers a range of educational activities, in the form of boarding school or day school in Sisophon.

A very interesting upstream contact with Anais, the association's administrative and legal manager around the creation of a health centre, to act in the surrounding villages.

The children of the centre are followed by a doctor from Phnom Penh, and a contract with a private clinic ensures the management of medical problems.

In the immediate future, effective collaboration sits premature.

  1. Ms. Sin Sothic, an osteopath doctor, leads health missions in various locations in Cambodia on behalf of humanitarian mission, a very active and multi-country NGO.

Very rich and very promising contact with Sotikhun, convinced of the interest presented by our techniques of care. She would like us to teach her and enrich her field practice.

The same spirit and ethics drive the mobile missions of

Docostcam, which have the same target populations as our association.

There are 2 to 3 missions per year in various regions of Cambodia, made up of volunteers from various disciplines, including non-medical ones.

We stay in touch to deepen the possible way of collaboration.

 

  1. Local authorities

1 Director of Moeung Russei District Hospital

Mr Peov Sovanarin:

Initial meeting: presentation of the project and the team. We get permission to start care without finalizing the administrative obligations. Mr Peov stressed the importance of setting up a training programme for its health care staff.

It will provide the necessary rooms for theoretical and practical training.

Final meeting, before we left: We obtained a validation of our action after he interviewed the patients and staff of the Talos clinic we had treated. An official letter thanking us and asking us to intervene in his district and hospital was given to us.

In addition, we were invited to organize tours with the doctors of the hospital of Moeung Russei, for a sharing of experience.

2 The head of the commune and the chiefs of the 9 villages

When we arrived, a meeting of village chiefs welcomed us. We presented the objectives of our mission, and summarized what traditional Chinese medicine was, and the techniques used.

We received an unconditional welcome to intervene in the villages. Some of them came to test our practices at the clinic, or sent their wives…

We were asked if it was possible to support a project to extend the clinic. We promised to talk about it.

We also get a letter of support and recommendation at the end of the stay.

3 the head of the Mam Satha clinic

She had prepared everything to receive us at the clinic: a room, beds… and the information had been relayed…

Mam Satha will be present throughout our stay, attentive, and considerate. She will also come to test our practices.

She is retiring in a month, and we do not yet know her replacement, whose caring collaboration she has assured us.

A meal will be organized on the last day of our mission with all the staff of the clinic and the great chefs of the hospital…

The entrance to the clinic



The practical phase and the course of care

The local population had been notified, a line of patients was already waiting for us by the end of monday morning.

We agreed to take only 10 patients a day, knowing that the treatment lasted about an hour. On the last day we treated 16 patients non-stop.

A room was entirely dedicated to us, with 1 bed of care and a sink.

  1. Appointments and registrations: patients came to the clinic to register.

At first the staff of the clinic, then their families… then word of mouth and expressions of satisfaction led those further afield to come and "test" this "funny medicine"

As the number of patients was limited to 10, we were unable to prevent frustrations, and only 4 patients were able to receive a second treatment during the week.

We had trained our interpreter in the basic questioning as to the reason for consultation. This saves time while we treat a patient and makes our assistant's work more alive and involving.

Over 3.5 days: 44 patients were received, 4 of them for a second session.

23 women

21 men

Average age 50 to 55

Patient registration

2) Patient care:

Health questionnaire and diagnosis.

Patients spoke with ease by describing their symptoms in a fairly precise and graphic way, which often made it easier and gave us valuable clues. No questions appeared to pose problems related to modesty.

  1. Pathologies encountered:

  • Multiple and chronic joint pain related to physical work: for most pains that have been present for years.

  • Insomnia with frequent awakenings or difficulty falling asleep

  • Traumatic pain related to motorized device falls (main mode of transport in Cambodia)

  • Pain sities related to surgical consequences: uterine ablation, anesthesia…

  • Memory problems, and nightmares, post-traumatic stress disorder

  • Stroke

.4) Treatment

The operation in pairs allowed a comprehensive and complete management of the patient: by practicing together puncture, and massage tui na, as well as moxibustion, we also used mobilization techniques, especially for shoulder pain.

During the treatment of the patients, our interpreter stayed behind the door, in order to preserve privacy and respect their modesty.

We might think that we would have to deal with needle anxiety: in fact the vast majority of people after a first puncture expressed their astonishment at not hurting. They expected a feeling similar to that of the blood test!

We explained to them how they could work with us by breathing, and if some apprehension could be present at the beginning of the session, it had completely disappeared after a while. Most of them commented on their feelings of treatment as they went along. We felt they were very participatory.

We asked them to grade their pain on a scale of 0 to 10, before session, and after session. (EVA, analog visual scale)

  • On average, we had a drop of 2 to 4 points at the end of the session.

At the end of the session, we heard the comments and questions asked of the patient about the "so, how did it go?", by outsiders

"Does it hurt?"

"Are you not in pain anymore?"

The feedback was probably positive: people were part of the process!

Knee pain and lower back pain: moxibustion treatment on needle

Massage Tui na neck pain

  1. In conclusion

We did not expect such a warm and positive welcome.

So much spontaneous confidence was very touching.

The use of various TCD techniques was not a problem, and no rejection. Even if sometimes, on "live" dispersals we observed some "grimaces" of pain … more related to apprehension than to a feeling perhaps… Patients emerged with a sense of well-being, testing the places of their "old pains" with vigor, astonished by the relief felt.

The population is overwhelmed with drug prescriptions, and an awareness of the harms, or even the ineffectiveness of these are beginning to emerge: Our patients were mostly on pain therapy, or anti-depressant… Our approach speaks to them, and a long and complete management of their ailments is a novelty for them.

This preparatory and exploratory mission convinced us of the usefulness and acceptability of our care techniques.

While our annual or bi-annual missions will be useful and will allow for wider monitoring and reception, it remains to allow and organize a transfer of know-how from local health care workers.

Projects are already in our heads on possible themes

Midwifery training

Pain relief

Basic care protocols

Etc…