Dated on Oct.29, 2003 from Kashiwa

Dr. Tomoko Nishino, an ASAC's member and a doctor at a maternity clinic, finally visited Cambodia to give health guidance for pregnant women. The following are reports from her stay in Cambodia.


(Report from Cambodia No.1)

I am staying in Antak Som town, Ang Roka district, Takeo Province.
I don't know the reason but the only hospital in the district is located in the middle of the area and ended up being a million miles from nowhere, which is the government's typical ways of doing things, I guess. AMDA is one organization working on experimental Health Reform in Ang Roka, and other NGOs from different countries are also in charge of five other places.
I came here to give guidance on maternity especially on how to use echography. I will stay here for a month. Although they already had the machines, they seemed to have rarely been used because the staff didn't know how to use them well. Just before I arrived here, medical training had been given by another physician and the staff members were ready to learn how to carry out maternity examinations, too. Although there was a language barrier, we still managed to understand each other. Today we started to see pregnant women from the Health Center next door and give them free examinations so that the medical staff could get used to the method. Many of the pregnant women received an examination only once in spite of the fact that they were given maternity pass books. We have three women to examine a day. But two of the women we had today were already several months pregnant. Midwives from the Heath Center seem quite reliable. And we talked about those women who would be having babies pretty soon. When we looked at the echography, two out of three women had twins! But they didn't look happy or surprised. I guess it was because of their nervousness.


(Report from Cambodia No.2)

We started the free examinations with echo for normal pregnant women from early October and on the first day we found two pregnant women having twins. And the next day, one of the women came back to ask me to check once again if she really had twins. As a midwife also asked me to do that, I examined her again and I found that a leg of one of the fetuses almost touched the mother's pelvis. We immediately sent her to a hospital where Caesarian operations were available.
On the same day, I gave a lecture for staff on echography for early stages of pregnancy. The following day, a 44-year-old woman came in, saying she felt funny around her stomach and it turned out that she was eight months pregnant. So I was able to show hands-on what the staff had learned the previous day. I really feel that unexpected things always happen when dealing with pregnancy.
I observed a delivery in the Health Center next door yesterday. It was an interesting thing that I found that delivery is almost the same anywhere you go, even when we use different apparatuses. It was a good delivery with the help of skilled midwives.


(Report from Cambodia No.3)

I held the first seminar for midwives today. I am planning to give seminars once a week, for three weeks. Midwives from different Medical Centers got together to study how to use echography. The chief staff of our team interpreted the lecture in Khmer. I had prepared for this since yesterday and it went pretty well. After we showed them the examination method, we discussed what kind of cases would be possible in their Health Centers. It came as a bit of a surprise for me that they gave quick and quite reasonable answers. I also realized that the technical level of midwives with hands-on experiences is pretty high. It was also amazing that a doctor in charge of general health control, who came along with them, also had a good knowledge on maternity. In Japan, most doctors are not usually familiar with the technical terms outside of their field. Anyway, the first seminar on pregnancy finished without any trouble.

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