The familiar drive through the chaos that is Phnom Phen was now becoming pedestrian knowing what would be waiting at the other end. We knew this was the last day and we knew what cases were due for theatre as we had been part of the consulting process the day before as well as the morning rounds.

Geraldine Cox from Sunrise Children’s Villages had a 9 year old girl who had Brittle Bone Disease which had left her legs very bent from fractures. Jim wanted to do a an operation called Fragmentation, realignment and intramedullary fixation for tibial deformity. He explained this to us lot as the kebab procedure whereby he would extract the tibia, saw it into many pieces and then put a rod through it before re-inserting into the leg to make it straight. We all wanted to see this but Jim offered for one of us to scrub-in so we could assist. Chris Snell took up the challenge and for the next 2.5 hours worked with the team as they opened up the leg and performed the operation. As this was happening the other three tables went into action and Carl Griffith found himself scrubbing-in also. In all the guys worked 5 operations that morning.

During a break, Chris and I were out in the front when a car came in fast. The doors opened and we were beckoned over to find a man with a 10cm spike sticking out of his eye. Three days at CSC prepares you for most things and we guided the guy over to the waiting area. We found out later that his son had been hunting frogs and the spear had hit concrete and shot up into the fathers eye. Miraculously it had missed the actual eye and embedded itself into the bone at the side.

That afternoon we went to the house for the Cambodian Acid Survivors Assoc (CASC) where the residents are getting back on their feet and receiving treatment after acid attacks. This incredible brutal attack can kill but even the less severe attacks normally result in incredible pain and suffering and we had witnessed this ourselves in the OR when an attack victim was having skin grafts. The facility is part of CSC and allows survivors to interact with others, gain job training and therapy. Whilst there we saw the tailors that now work there and it dawned on me that we purchase 100 boxer uniforms a year for our events so we agreed that we could transfer this business to CASC!

Children’s Surgical Centre continues to go from strength to strength taking on more complicated procedures and operations every year. They work tirelessly but with incredible fiscal prudence that gives great confidence that every dollar we donate from Vanda is make a very real difference. Our target this year is $200,000USD donated to them and we are at $77,000USD year to date. I have every confidence we will hit this number and by doing so allow Dr Jim and his fantastic team the opportunity to concentrate on making the lives of the children better.

Day 3 started with our arrival at CSC just after 8am. There was already a mix of about 80 people outside waiting to be either seen by the doctors or getting ready for surgery.

The morning started with a trip around the wards. Dr Jim and his doctors assess each patient and continue to plan their treatment. Jim has a very direct, no nonsense style that is probably not seen to often in Asia but it is highly effective. He solicits opionion and is happy to engage in discussion but if he is certain on a certain course of action then it is prescribed without challenge. We met with all types of patients including adults and children. These included a snake bite victim, multiple limb breaks, cleft palate/lip babies, deformities and acid attack victims. In all I believe we went thorough 23 cases in an hour.

The rest of the morning was taken up with surgery in theatre and the guys were all scrubbed in to assist. I will leave it to them to explain the emotions and how they felt about the experience but it was obvious from their faces that whilst they were experiencing some major challenges they were finding it very rewarding. Whether it be cleft surgery on a baby, working with the lady with the snake bite or removing the rods from the leg of a young girl who had a major fracture, they all mucked in and got on with it.

A 4am start was required to get to the airport for the first flight out to Phnom Penh on Sunday. I called Andy from the taxi, as he has a track record of not being up on time, but found that he had decided not to go to bed this time.  It became quicky apparent  upon seeing him that he had been partying instead. Chris Snell and Carl Griffith turned up ready to go and were closely followed by George who has very kindly given up his time to do the video camera work. If you know how senior George is in the business (his last gig was producing the Liverpool v Singapore match), you will understand this could seem like overkill but we are very grateful to have him along.

We flew without event into Siam Reap before an onward flight to Phnom Penh. When we disembarked, there seemed to be some confusion on what to do with us but eventually a lady took us down the stairs, on to the tarmac and showed us through a back door out into the car park at the airport. This could have been viewed as very efficient and indeed Andy was celebrating the fact he had not had to part with $20USD for a visa. It then dawned on us, we were now illegal immigrants in Cambodia and we didn’t even have our luggage. We re-traced our route and 20 mins later we found ourselves back where we started and facing some embarrassed airport officials who now realised that their airport security had been pretty badly compromised.

The wonderful Emma, our liason at CSC, met us at the airport and we headed to the hotel to drop bags. The hospital does not do do surgery on Sunday so Emma, Andy, George and Carl headed off to see some of city whilst Chris and I headed to the Foreign Correspondents Club (FCC) to do some writing (how else did you think the blogs got written and the websites updated)

7.45am today and we headed over to Dr Jim’s Chenda clinic, a facility of CSC, to get our scrubs which is the clothing you wear for operating theatre. Chris, who is our resident comedian, having done stand-up, spent the next  20 mins doing Grey’s Anatomy jokes. We were then driven to the CSC hospital where upon arrival we could see a hundred or so people already waiting to be seen on the first set of consultations of the week. The guys were paired off with some medical students from the UK who were in town and who had started the consultations and I headed off to spend my morning with Dr Jim.

It is hard to describe the energy of a CSC, it is invigorating. Everyone has purpose and regardless of how may people are waiting outside to be seen, you know their day will end better than it started because of the CSC team. Dr Jim and I started in the operating room as he checked on the operations for the day. Monday’s are normally quieter in the OR as the consultations normally see people get scheduled for the Tuesday as they have probably eaten that morning. However, there was already a young lady in being prepped for a toe amputation as she had six toes on each foot and on the other table was a young boy having a hernia operation.

Dr Jim asked me to go get a medical student and whichever one of my lads that was shadowing so they could  would scrub up and he would do the amputation. Vanda’s very own Andy was the lucky man and he experienced his very first operation which included assisting Dr Jim in the proceedure. Meanwhile, on the other table, a baby who was 6 months old was having a cleft palate operated on and Carl Griffiths was assisting the surgeon and clearly enjoying the experience.

During a typical Khymer lunch we were discussing the cleft palate surgery on babies and Chris was telling us that he and his wife had forgone a wedding list to have people donate to have cleft surgery done via The Smile Train. It was therefore a very happy Chris that spent the next two hours in theatre assisting on a cleft surgery for a 5 month old little boy. This video is Chris at the table about 1 hr in.

I spent my afternoon with Dr Jim and we saw a huge variety of cases. One patient’s results came back as cancer so we went to his bedside to tell him that time was against him and he should head home. Another was a hemophiliac that needed risked bleeding to death every time his wound dressing was changed having been amputated on one leg to the knee. He need to get specialist care and that was discussed. We then moved on to a fresh burns victim, this time a male who had had one skin graft following a having acid thrown all over his body and the one ear. Words can’t describe the horror of an acid attack and the pain they go through healing. Each time a dressing is changed it is agony and I witnessed human bravery at its best.

Finally we went to see the eye surgeons as they finished off. They had completed 17 operations that day and the same would happen again tomorrow. Every person seen today, every operation, every procedure and follow up is done by CSC at no charge. They receive no funding apart from donations and that is why we continue to support them. Today, like in previous trips, we have converted another four guys, having witnessed the wonders the team does. Tomorrow we will be in theatre at 8am to witness 9 operations scheduled and witness another incredible day at Children’s Surgical Centre in Cambodia.