Baylor University Medical Center Proceedings April 2014, Volume 27, Number 2 | Page 81

6 years ago and has 5 full-time medical doctors and 7 part-time ones to
care for up to 30 patients. I met with
Dr. Kamol Prinyanusom, a general
medical doctor and head of marketing. He indicated that they average
about one myocardial infarction per
month. They lack an on-site cardiologist but consult via the Internet
with cardiologists in Bangkok and
administer streptokinase when appropriate. Critically ill cardiac patients are transported 40 minutes by
plane or helicopter to Bangkok, and
they recalled three such transports
in the past year. They have an automatic external defibrillator, but lack
electrocardiography, treadmill, and
bicycle testing and do not provide
Figure 5. Dr. Uy Chanthol, the only “adult heart doctor” in Figure 6. Defused mines at the Landmine Museum.
cardiac rehabilitation.
Siem Reap, Cambodia, with his echocardiogram machine.
The hospital was immaculate
and seemingly catered to the more
tetralogy of Fallot. A handheld echocardiogram would have
affluent Cambodians and tourists. It was about to open an “antibeen useful.
aging” facility in conjunction with a center based in San Diego,
The internist asked my opinion about a 53-year-old lady
California, which will utilize chelation, cleansing enemas, and
with a cough and bibasilar rales. Her neck veins were a little
other alternative health measures.
distended and her apical impulse was displaced and diffuse. I
felt she did have mild heart failure, most likely due to a carTHE LANDMINE MUSEUM AND DEPARTURE
diomyopathy, as she lacked a murmur. Obesity was seen in
We did visit the Landmine Museum early in our extra time
<1%, as most patients were hardworking farmers and a few
and saw the thousands of defused mines that had been detected
were construction workers, subsisting on a largely rice-based
(Figure 6). A school accompanies the museum and initially
diet. Application of heated cups (Figure 4) was fairly common
focused on children who were missing appendages because of
to treat various pains in the head, chest, or abdomen. Goiters
landmines, but it now has mainly polio victims and other diswere rare, as was a history of diabetes.
advantaged individuals. An estimated 820,000 antipersonnel
Back in Siem Reap, I met with Uy Chanthol, MD (Figure 5),
mines, 20,000 antitank mines, and 1.7 million unexploded
the only “heart doctor” for a metropolitan area well over
ordinances were removed between 1992 and 2008. A local hero,
125,000. Dr. Chanthol is 41, trained primarily as a psychiaAki Ra, initially removed thousands of mines, using just a stick
trist. Because many of his psychiatric patients had symptoms
and a pair of pliers.
seemingly cardiac in origin, he recently took a 6-month intenWe celebrated the end of our enjoyable medical and dental
sive cardiology training course in Seoul, learning electrocardimission in the Elephant Bar of the famous Raffles Grand Hotel,
ography and echocardiography. He spends mornings overseeing
anxious to fly home before the arrival of typhoon Haiyan. On
the intensive care unit at the Siem Reap Provincial Hospital,
the plane, we met several members of the Johns Hopkins Carwith 5 to 7 patients at present, and afternoons in his small office,
diac Surgical Mission to the Jayavarman VII Children’s Hospital
seeing up to 10 patients. He states that he has a defibrillator in
in Sie