Care in the Cambodian community: Rebuilding lives at the 11th parallel

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Sometimes, the community you live in isn’t always the community you help. Just ask John Cho, an occupational therapist at St. John’s Rehab Hospital.

This past winter, Cho jumped at the opportunity to volunteer for one month at PT House, a physiotherapy clinic in Phnom Penh, Cambodia. Thanks to the support of friends, family and staff at St. John’s Rehab, Cho fundraised $3,000 to offset the cost of his February 2007 trip.

“Originally, I heard about the opportunity from several colleagues who had gone to work in Cambodia. Their experiences intrigued me, as it sounded like the perfect blend of vocation and service,” explains Cho of his decision to volunteer.

“It’s really important to look beyond your own community, and try to be of service to people outside your frame of reference.”

Armed with the specialized knowledge and techniques unique to occupational therapy, Cho arrived in Phnom Penh ready to help a community he had never before visited.

The PT House is a rehab facility within the Children’s Surgical Centre (CSC) that treats acid burn survivors. In Cambodia, acid is relatively inexpensive and accessible, which unfortunately makes it a common weapon. Acid can melt flesh and even bones, leaving victims with life-long emotional and physical scarring.

According to the Children’s Surgical Centre Website (www.csc.org), an acid burn in a developing country such as Cambodia is akin to disease because of its appalling effects on life. Many of the children at the PT House have thick scarring or painful burns over significant portions of their torsos or legs. This makes everyday tasks such as housework or walking very difficult.

Cho’s skills as an occupational therapist help patients learn to perform meaningful activities to regain their independence.

Cho worked with Thary, the lone physiotherapist at the clinic. Cho quickly learned that to provide effective care, he would have to draw on his abilities – not only as an occupational therapist, but also as an athlete, leader and observer.

“Despite all the available resources, I discovered that there were significant environmental, economic and cultural barriers that impeded effective treatment delivery,” Cho recalls.

Since physiotherapy and occupational therapy are relatively new disciplines in the field of medicine, they are often met with skepticism.

“One of my biggest challenges was ensuring clients complied with their independent programs,” Cho notes. “People are usually agreeable to passive treatment, such as therapist-administered scar massage and stretching. I faced a lot of difficulty explaining the importance of continuing the program at home.”

In addition, Cambodia is extremely hot and humid. This means that traditional burn treatment options – such as pressure garments, splints or pre-fabricated braces – were simply not viable. These options would cause increased perspiration, skin breakdown and overall discomfort. Cho recognized that he would have to be creative to deliver the best care.

“Many of our clients had acid burns to the face, torso and legs, making it especially important for them to stretch and move around,” Cho explains. “I had to think of other ways to promote exercise.”

Cho’s work with St. John’s Rehab Hospital’s multidisciplinary team means that he knows what it takes to rebuild lives after life-changing illness and injury. With strong knowledge and extensive experience in occupational therapy, Cho drew on his creativity and improvised to create new programs tailored to the community’s needs.

“I noticed that they played a lot of soccer. Soccer is a great form of cardio exercise that also requires a lot of movement and physical activity.” Cho and Thary purchased any sporting equipment they could find – bicycles, soccer balls and racquets – and began initiating pick-up games of soccer and racquet sports to connect with clients and monitor their progression.

By linking a fun, normal daily activity to a prescribed treatment, Cho had built his therapy into the clients’ daily living. Along the way, he also learned a few things about creative treatment options.

“My whole experience really challenged me to test my limits professionally. I’d love the opportunity to do it again – I’m already looking into other communities where I can volunteer my skills.”

Cho’s newly gained knowledge has truly broadened his personal and professional horizons. His experience in developing creative, individualized treatment options is sure to enrich care – both for St. John’s Rehab patients at home, and people abroad.