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Ask the doctor: Rashes and over-the-counter care


While pharmacists in Cambodia are trained to give advice to walk-in clients with mild conditions, they are not trained to give clinical exams or prescribe all medications. Photograph: Reuters

The Phnom Penh Post has partnered with licensed doctors from the International SOS Clinic to answer readers’ medical questions every first Wednesday of the month. Send your medical questions to

Like my Khmer colleagues, I’ve started going to a pharmacist anytime I feel ill. Usually, I just describe my symptoms and the pharmacist hands over several types of pills with instructions. Are all pharmacists trained in Cambodia? Is there any danger in using them for diagnosis?

As in many Western countries, graduated pharmacists are allowed to give advice cautiously to walk-in clients presenting mild conditions. They are trained for that, and they know their limitations.

However, they are not allowed to perform any clinical examination or to give all kinds of medication.

The point to consider: is the pharmacist you are talking to really trained to give medical advice? Basically, they aren’t, and since behind many mild conditions a more serious problem can be hidden, I would be very cautious when seeking medical advice from a pharmacist in Cambodia.

For instance, a simple fever – which is not a big concern in Western countries – can be the symptom of a deadly disease as malaria or avian influenza; acute diarrhoea for an infant is usually a mild or moderate condition in developed countries, but can lead more quickly to a severe one in Cambodia (and many other developing countries) due to the heat and the humidity locally.

Due to the specific health risks in this country, it is more efficient to put preventative measures into practice daily, and to see a credentialled doctor.

I normally wear contact lenses. Is there increased risk of eye infection with the dust and pollution in Phnom Penh?

Dust and pollution are not Phnom Penh’s privileges, even in Southeast Asia. There is a lack of data, but having lived in Hanoi and Jakarta, I can tell you that it is not that bad here. (Nor are traffic jams!) However, usual precautions are valid.

Seek immediate medical care if:

  • There is redness, swelling, or increased discharge from the eye.
  • There is increased pain in the eye which is not controlled with medicine.
  • An unexplained oral temperature above 102°F (38.9°C) develops, or as your caregiver suggests.
  • There are big (marked) changes in the vision of the affected eye.

What is the recommended course of treatment for heat rash? Any prevention tips?

Heat rash is a common malady in countries like Cambodia. It can happen to infants, but also to others. It is caused by excessive perspiration, which damages the cells on the surface of the skin and traps the sweat underneath.

In turn bumps raise up and becomes very itchy. Once this happens, the skin needs to be cooled, and soothed with a lotion.

To prevent and treat wear loose cotton clothes, avoid nylon and other synthetic materials, stay in cool and ventilated spaces.

This week’s guest columnists are Dr Jean-Jacques Bernatas and Dr Nelson Velez of the International SOS clinic in Phnom Penh. Dr Bernatas is Chief Medical Officer of the clinic, while Dr Velez is a General Practitioner specialising in tropical medicine.
This article contains general information about medical conditions and treatments. The information is not advice, and should not be treated as such. You must not rely on the information as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.



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