Fighting Hepatitis in Cambodia: The mid-point
At the half-way point of her assignment in Cambodia, Theresa reflects on what she's accomplished, and what she's learned about life as a doctor with MSF / Doctors without Borders... 
This week is the mid-point of my first assignment with MSF. It was hot season when I arrived in Phnom Penh, and whenever I was in the sun I believed I could feel my skin cells bursting from the transfer of light energy. “Better get used to it,” I told myself, “because you’re going to be here a long, long time.” Now it is the rainy season, and those flesh-melting hot days are a dim memory. I even find myself thinking hot season wasn’t all that bad after all.
People told me time would go by fast when working with MSF, and it has. Now four and a half months of my nine-month assignment have passed, I have been looking back on what I’ve accomplished so far:
  • Saw several hundred patients at various phases of direct-acting antiviral (DAA) treatment for hepatitis C.
  • Delivered 10 short talks on various medical topics.
  • Wrote one standard operating procedure (SOP), which is currently being used to train new clinic doctors and nurses.
  • Got interviewed for the MSF Month in Focus on the hepatitis C project
  • Reviewed and commented on 52 tough medical cases.
  • Pulled and surveyed about 500 patient files to find ways to streamline our patient care.
  • Wrote two proposals based upon the files reviewed.
  • Contributed to the MSF Cambodia Hepatitis C Facebook page
  • Helped with the script development of a waiting-room infomercial on hepatitis C.
  • Attended more meetings than I did during my last five years practicing medicine in the United States.

Looking at this list makes me realize how much time I’ve spent tapping away at a computer. Everyone tells me this is the reality of life as an MSF doctor: your administrative and training skills get used much more than your clinical acumen. It’s quite a change after thirteen years of direct patient care in the US, but I am learning to make peace with it. The truth is that my Cambodian doctor colleagues are much more effective at taking care of the patients than I am, because they don’t need an interpreter and they know the ins and outs of healthcare delivery in this country.

Your administrative and training skills get used much more than your clinical acumen

Most days I look at the list of goals I made for myself when I accepted this assignment. First among them: “Conduct yourself honorably.” I wish the basis of our collective humanity had evolved beyond the need to write this down as a goal, but there it is, and it makes good food for thought when I am pulling all those files to review.
Theresa, in a red top, sits at a desk covered in files and paperwork

The MSF doctor in her natural habitat. Photo: MSF