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Harsh Reality

Our 3rd Day at the Angkor Hospital for Children demonstrated the reality of delivering medical care in Cambodia. A young boy was brought to the hospital the previous day with acute abdominal pain, and during the following 24 hours, the child rapidly decompensated and went into septic shock. They were unable to obtain a blood pressure greater than 50/30 despite an epinephrine infusion. Eventually, the child was considered stable enough to be brought to the operating room for an exploratory laparotomy. Prior to surgery, the child experienced a cardiac arrest and required CPR. Once a pulse was re-established, the surgery continued. During the 3 hour operation, the child had another cardiac arrest, and was revived again. The child was brought to the ICU following the surgery, and no clear diagnosis for the septic shock and multi-organ failure was ascertained despite the attempted therapy, the young boy died a few hours later. I was later told that during the rainy season, this type of case occurs every few weeks, and often the underlying cause of the massive systemic infection is never known. It is just a part of the harsh reality of medical care in an underserved nation…

Dr. Chris Perry- Anesthesiologist

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