Battambang Hospital Thursday 10th August This afternoon I went along to have a look around Battambang hospital. The hospital is really basic. The beds are made of rusty metal and there are no sheets on the beds, just plastic covered mattresses. There are hardly any nurses and patients are looked after by members of their families. The families also have to provide food for their relatives and so come and build fires in the grounds of the hospital to cook food on and sleep outside the hospital too. I visited various wards including the intensive care unit where the only treatments available are fluid drips, the paediatric ward, the operating theatres and the maternity ward (lots of cute babies - but very sad as infant mortality is so high). I was shown round by an English volunteer who works as a hospital management advisor to several hospitals - she explained to me many of the problems that the hospitals face. (Mainly lack of funds, very low salaries which leads to a lot of corruption by the medical staff which means that the patients do not come to hospital when they are ill as they do not trust the doctors). While I was there I went to a meeting where an agreement was signed between the hospital and a US government funded aid agency to provide free medical treatment to the very poorest patients. The aid agency has identified all very poorest families in the province and will reimburse the hospital $20 for each of these patients that are admitted regardless of their length of stay. In the past poor families could run up crippling debts if one of them was admitted to hospital, but this should protect them from this. It was really interesting to see this aspect of development work at first hand. Friday 11th August I was invited to come back today as a medical student. There are several French medical students coming to the end of their elective here (I had met a few of them at the pub quiz). After the morning meeting of all the doctors and senior nurses (which was in Khmer so I didn't understand) I went along to the Obstetrics and Gynaecology department. I spent the morning in a Gynaecology clinic, which was one of the most disturbing things I have ever seen. I saw more this morning than I would see in a week in the UK. Women were coming in with problems that would never have had the chance to get so bad at home, and some of them were pretty horrendous. Operations were performed right there in the clinic, with people coming in and out, with no anaesthetic, that in the UK would be performed in theatre under a general anaesthetic. And the women don't even complain or cry out - you could only tell by their facial expression that they were in pain. The hygiene levels, though not disgusting were not really up to western standards. It was also blisteringly hot and stuffy, a little bit smelly and I began to feel really light headed, shaky and a bit sick. I was tipped over the edge by a particularly gruesome story by one of the French students of something that had occurred a few weeks ago. At that point I nearly passed out and had to go and lie down!! Very pathetic I know, but anyone who knows me will know that I am not squeamish at all and can happily sit and eat my dinner discussing guts and gore (obviously not in this heat!) so I think this shows just how shocking I found it. Its also very sad and upsetting seeing what goes on and the terrible stories I've heard. My proper placement starts in a couple of weeks, so hopefully I will have got used to what I am gong to have to cope with by then! Also, anyone who thinks the NHS is a mess doesn't know how lucky they are.