Medical inequality exists everywhere in the world, and I experienced it first hand in the Hopital Calmette in Phnom Penh. Nothing against the hospital. The staff were wonderful, but our experience proved that money can buy health — and we bought it.
What just happened? I went from having an annoying little gastrointestinal issue to not being able to pick myself up from the bathroom floor, and falling further downhill rapidly, in just a matter of hours.
I woke Mark at midnight to let him in on what had been occurring for the last two hours, and the look of horror on his face made it clear that I was truly as bad off as I thought I might be. He’s normally dismissive of health complaints, but he sprung into action, calling our travel insurance company, looking up hospitals in Lonely Planet, and getting a sleeping child ready to accompany us to a Cambodian hospital.
The problem was, the patient didn’t think she’d survive the walk downstairs, much less the ride to the hospital. There were no ambulances, so we were going to have to get ourselves there if we wanted to go.
With more than a little insistent coaching from Mark, I willed myself down three flights of stairs and laid down on the sidewalk outside our hotel gates while Mark went in search of a late night tuk tuk. Our driver didn’t know the hospital we were aiming for, but between google maps and the impetus of a vomiting woman in the back, he ran every red light we encountered and flew us across the city in the middle of the night.
My dignity had long since departed, and at this stage, it likely goes without saying that the “exit directions” don’t take turns when it comes to this kind of sickness. I arrived at the hospital a mess, trying to hide my shame, and clutching my plastic bag full of what I had brought up on the ride over.
I got about two steps off the tuk tuk before I was immediately put onto a gurney and wheeled into a room filled with other miserable people of varying descriptions.
I was vaguely aware of families camped (literally) outside the ER, and each person inside was accompanied by a carer who had brought blankets, pillows, wash cloths from home to tend to their loved ones. There were daughters, wives, sons and girlfriends, all lovingly trying to ease the suffering of their people.
Austin was forced to wait outside on a bench with the other families, alone, so Mark spent his time going back and forth between me and our son. Our little man bravely did as he was asked, quietly waiting with the masses of strangers after watching his mother be wheeled away into a foreign hospital where he wasn’t allowed to go. What a brave little champion he was.
The patients inside ranged from elderly men and women in their final days, to a young professional, the victim of what looked like a motorbike accident. His mangled foot was pouring blood, and his girlfriend found it hard to stop her tears as he writhed in pain.
What I saw in that flourescent lit room told the story of these people, and their history in a way that a book, documentary, or even conscientious tourism never could.
The elderly men and women, suffering through their final days in a crowded room – some peacefully, some writhing in agony made me consider what they had been through in their lifetimes. Family members cared for them, lovingly keeping them cool with wet cloths and ensuring their dignity remained as much as possible. They bore vivid scars, huge tumours, and deep lines that showed a life of hardship on their faces.
And there was me. A foreign tourist with an intestinal issue.
I was separated into a back room, alone. I saw the panic in their eyes when I said diarrhoea. This was not something they wanted infecting their room full of sick people, doctors, nurses and hordes of families waiting out their loved ones’ ordeals.
My arm was roughly swabbed with whiskey, it’s sickly sweet smell turning my stomach further. The biggest needle I’ve ever seen was roughly inserted into my wrist, and the pain was excruciating. I shouted at the nurse, and he tried another spot, and yet another.
They finally got a line in, and I was quickly put on a drip for rehydration – I had lost an indescribable amount of fluid in a very short amount of time. They took blood, and then added something else to my line. Something that made my body shudder as the medicine worked its way into my system, starting its fight with whatever it was that was making me so sick. I then melted away into delirium, waking only as I was asked in rough English where my husband and my passport were. “With my child” was all I could say.
We’ve met farmers, tuk tuk drivers, baristas and chamber maids who speak perfect English. But these doctors, nurses and orderlies spoke only Khmer and French. So communication was limited. I learned I have more French vocabulary than I thought, and my Spanish surprisingly helped me read the Colonial French of my reports.
Everything that poked me or went into my body was indeed sterile – I checked. I had resigned myself to accepting the level of care on offer, recognising that these doctors were doing the best they could in a crowded emergency room, with the tools they had available. If that meant being swabbed with whiskey before being poked with a sterile needle, then so be it. I was in bad shape, and this was of only a few hospitals in Phnom Penh. Lonely Planet and our insurance company recommended it, so it had to be okay. Right?
The rapid succession of rehydration IVs helped to bring me back around, and the enormous bottle of antibiotic slowed the frequency of what was happening in my gut. I was taken for an ultrasound, where the technicians spent an inordinate amount of time studying one odd looking black lump near my intestines. In the end, the tech either told me that the ultrasound was no more (done), or normal. Her accent was thick, so I wasn’t sure, but I’m sticking with the latter, and the former was a given.
After waiting in the large ER for a little while longer, I was wheeled, still on my gurney, to another wing of the hospital. Mark was forced to help push wherever we went, and Austin was able to follow everywhere except for inside the ER. We passed long corridors full of families camped with tents and mats outside of their loved one’s wards in open air hallways. It was wall to wall carers – there for the long haul – determined not to let their suffering people be neglected.
We were taken to a shining new Neurology wing, and Mark and I exchanged a few glances, as we didn’t know what could be happening to warrant me going to neurology. It turns out I was being moved to the “nice bit” on the (correct) assumption that we’d be happy to pay for private care. Having seen the lengths that people will suffer through just to bring their loved ones some comfort, I felt incredibly guilty to be on my soft white bed, in my massive, gleaming private room, my husband sleeping on the the couch, and my son watching Cartoon Network on the television.
I was given the option of a private or a shared room. At 216 USD per night, it was ten times the rate of our nice boutique hotel in Phnom Penh’s nicest neighbourhood, but I wanted to keep my boys near me. It was 05:00 now, and they had suffered enough at my expense that night. I signed up for the private without a single regret.
We were supposed to have been boarding a bus to Vietnam at 7 that morning, with a hotel reservation in Ho Chi Minh City, and specifically dated visas to do so. Clearly that wasn’t going to happen, and after a couple hours’ rest, Mark took Austin back to our hotel to reschedule the bus, extend our stay in Phnom Penh, cancel our room in Ho Chi Minh City, and bring back some essentials. We were going to be here a while.
The nurses were kind and attentive, and worked in pairs – always one who spoke French and one who spoke some version of English recognisable only to themselves. I was still “experiencing my illness” with some frequency, when they asked me to produce a sample in a comically small vial. My brain and body decided in unison that wasn’t going to happen, and it took several hours to finally accomplish the task. One never regains dignity while in hospital. It sinks to depths lower than your lowest nightmares. I was beyond caring.
Stool sample finally accomplished (I hope it’s enough), baguette eaten, and copious amounts of water drank, I settled in to wait for them to come collect the prize I worked so hard for. I was starting to feel better, and the “action” thankfully slowed down and eventually stopped.
But I still wasn’t allowed to go home. For two days I was told “maybe tomorrow”. Mark and Austin were staying in the room with me, and while they could come and go as they pleased, I was a prisoner of my white tiled cage – not allowed to leave my room because I had the disease that must not be shared.
We were all starting to go a bit stir crazy, and I set Mark and Austin out one night to go have some fun. Mark interpreted that to mean “ accidentally take our six year old son on a walk through the red light district” where he spotted a bar called “Angry Birds” he was desperate to go in to. Mark eventually caught on to the “atmosphere” and steered him out of the district, then fed him ice cream in a bar for dinner.
Austin promptly blasted the ice cream right back out, vomiting all over the bar, down the sidewalk and into the tuk tuk — and again twice more in my hospital room. The doctor came and checked him out, and we all agreed it was the ice cream, and I hadn’t somehow infected him. What a horrible coincidence.
But that was my final straw. My baby was getting sick, and I needed to remove my family from this purgatory. I was going home. They wanted me there for two more days until the antibiotics and antimicrobial courses were finished under their watchful eye. I couldn’t do it, and I couldn’t subject my boys to it any longer. We had all had enough of this adventure, and $580 later, I signed myself out with a handful of pills and instructions to come back if “it” comes back.
Solemn promises made, I walked out of the hospital into a sea of people camped out on the hospital lawns, and through a busy lunch market that catered to the constant masses. The sights, the smells, the sounds, the chaos all hit me like a brick wall. I was in Asia again. A little shell shocked, I slowly relaxed into being on the outside again as we made our way back to our quiet little hotel for a shower, a rest, and another try at leaving for Vietnam.
It was, without a doubt, our worst week.
Spending three days in a Cambodian hospital wasn’t on the itinerary.
We suffered the embarrassment of privilege, as we were shown to a shining new private room while other families camped outside of the wards where their loved ones were housed.
Medical inequality exists around the world, and its the poorest who suffer the most. No matter where in the world you are, money can buy comfort, access and higher quality care.
In the public ER, my arm was swabbed with whiskey. In the private wing, the resources were more sophisticated.
Three days and $580 after arriving on a gurney, I walked out with a pile of prescriptions in hand proving money can and does buy health.
This isn’t just, but I didn’t turn it down either.
We were humbled in many ways by this experience, and it was one of the most impactful lessons of our journey so far.