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Logo of Phnom Penh Post newspaper Phnom Penh Post - Army doctor: "We never have enough blood"

Army doctor: "We never have enough blood"

H uw Watkin managed a rare visit to a military hospital in the north-west - hospitals

that are now strictly out-of-bounds for most journalists.

BATTAMBANG - It's the smell that hits first; a cloying sticky-sweet stench of congealed

blood, antiseptic and a hint of infection.

It's dark in the room and the air is damp and thick with that smell. Hard up against

one wall are three beds. On two of them, covered with tattered blankets, lie two

young men with unfocused eyes. A middle-aged woman sits by, listlessly fanning the

expressionless face of one of the soldiers.

On the third there's another youth but his eyes are shut tight and he draws short,

sharp breaths through clenched teeth, rocking his head from side to side. His left

leg is gone from mid-way down the thigh. Two or three flies crawl across his right

leg which is pitted and scorched black-brown from a land mine blast.

Pen, an Agence Khmere de Presse photographer, says quietly that this is his cousin.

He doesn't say hello, just clicks off a couple of frames and follows us into the

dusty, sunlit compound of Battambang's military hospital. If it weren't for the livid

bullet scar on his own forearm, Pen's apparent indifference might have seemed callous.

We move on, but the smell stays with us.

We shouldn't really be here - then again, nor should Pen's cousin. In January, the

Ministry of Defence announced that this year there would be no dry-season offensive.

But each of the two hundred beds in this hospital are full.

Land mine victims occupy six out of every ten beds.

The rest, according to the hospital's director Captain Nek Vanak, are suffering from

gunshot or shrapnel wounds. Up to 30 percent also have malaria, but unless they're

wounded they stay out in the field.

In his camouflage fatigues, forage cap and combat boots, Capt Vanak doesn't look

much like a doctor. But after six years of training in Vietnam and eight years of

"practice" in Cambodia, he must be one of the most experienced battlefield

trauma specialists in the world.

We are not quite sure why he is talking to us, but he does and one gets the impression

that Nek Vanak has nothing to prove to anybody. His tone is straight-forward, matter-of-fact.

"This year we are doing much better. This year I have three ambulances and we

can get our soldiers here very quickly.

"We now have many soldiers at the front who know how to give first aid very

well. That is the secret, that and getting them here to hospital quickly."

Nearby at the Provincial Hospital, Eves Coyette agrees that this season the military

is doing a much better job evacuating and treating its wounded.

As medical coordinator of Medicines Sans Frontiers (MSF) Battambang Project, Coyette

agrees that quick first aid and rapid evacuation mean more survivors.

"With trauma caused by land mines [and most other battlefield injuries], people

die from losing blood," he says.

"In a land mine injury you can lose one, two, three liters of blood very quickly.

"We don't know how many people die in the field here in Cambodia, but experience

from places like Afghanistan and Mozambique suggest it's around one in five.

"But if you have people in the field who can stop the bleeding and apply a good

dressing you can reduce that number... if you can get them to hospital within about

six hours and have drugs to prevent infection, then their chances of survival are

pretty good."

MSF has been working in the provincial hospital since 1991. Coyette is enthusiastic

about the project, praising the hospital's staff and the Ministry of Health for their

efficiency, dedication and skill.

He says the Ministry of Defence however is not so well organized, but he's complimentary

about the skill of the RCAF doctors, saying they do a good job with little help.

MSF, he says, is one of the few NGOs to help Cambodia's military.

Last year they provided training for some army doctors, and this year have helped

negotiate a deal between civilian and military authorities.

"We try to work in good cooperation with the medical services of the Cambodian

army," he says. "The military are responsible for initial treatment and

evacuation to Battambang, but we have agreed to accept the most severely wounded.

We have better equipment and we have a blood bank. Once wounded soldiers are stabilized

we transfer them to the military hospital."

But already, most of the wounded in the provincial hospital are soldiers, and the

offensive is only around a month old.

"It's getting harder because the military hospital is full and we are afraid

that in a few weeks [both hospitals] will be running short of medical supplies,"

Coyette says.

Vanak agreed:

"I need more trained medics, ambulances, intravenous fluids, dressings, antibiotics,

antiseptics, surgical equipment... "But what I need most is a blood bank...

I ask my staff to give blood all the time, but we never have enough blood."

When asked about international support, his smile was ambiguous. "Most NGOs

don't want to give help to soldiers... It isn't good for their image.

"Last time I got some medicine from the ICRC but I couldn't use it for the soldiers.

It was for the civilian victims of war.

"The Australian army have been pretty good... they gave us an ambulance and

a generator, but most medical aid for the military goes to Phnom Penh. We need it

... there is lots of fighting here."

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