SHAHZADA Tayyab Salim, The Chinese University of Hong Kong

GX Foundation is a non-profit charitable Chinese organization that primarily aims to deliver international medical and public health humanitarian assistance in the Belt and Road countries. The Foundation aims to build programs that facilitate health, and well-being and promote sustainable livelihood all around the world. Two of the organization’s key programs at the moment include the Cataract Blindness Elimination Project and the Vector-Borne Disease Elimination Project, both of which are in the process of being launched in countries including Cambodia, Laos, and Djibouti. I am eternally grateful to my mentor, Professor Emily Chan, who provided me with the opportunity to engage in this trip, despite her many responsibilities. For her, I saw the type of person I wanted to be, discovered my passion, and I am inspired every single day to continue my pursuit in helping others. I would also like to extend my gratitude to my supervisors, including Ms. Caroline Dubois, Ms. Irene Fung, and Ms. Mauraeer Lai for guiding me and supporting me throughout my endeavors with GX Foundation and humanitarian work. Finally, I’d like to express gratitude to all members of the GX Team, our friends in Cambodia, the CUHK Faculty of Medicine and the Reaching Out Award Scholarship for allowing me to engage in this opportunity successfully. 

 

This program participation was as a part of GX Foundation’s pilot project in Phnom Penh, Cambodia. The project focuses around cataract surgery, and provides effective and free-of-charge care through the deployment of Mobile Eye Treatment Centers. Ultimately, upon set-up, the project aims to recruit needy patients and provide immediate surgery. Alongside there would be co-benefit programs, in the form of education and information to support communities in health education and improvement – the Vector-Borne Disease Elimination Project is a core program of this sort. My participation in this trip was to lead the Vector-Borne Disease Elimination Project, which my colleague and I had developed ourselves in our previous internship with the organization. We would also contribute to the work for the Cataract Blindness Elimination Project, for which we had designed protocols and were involved in the early stages of its development. This included, but was not limited to, meeting the Ministry of Health and other local health authorities to establish the organization in the area and to allow the smooth running of the program. We also met with important counterparts to understand the local situation, before taking the field visit to health centers and hospitals directly to organize the program and trial the co-benefit programs. I also engaged in a full-day clinical attachment to Prey Veng Provincial Hospital, attaching to various specialties to further understand the local clinical situation and needs to advise further programs which may be considered in the future.

 

The experience in Cambodia was truly life-changing. We participated in various activities, including meeting important local counterparts such as the Ministry of Health. From a field-trip perspective, we visited a total of four health posts to explore the local situation and deliver our vector-borne disease elimination project. To enhance our medical understanding of patient illness and dynamics, we also engaged in a full-day attachment to the Prey Veng Provincial Hospital. Finally, from an academic standpoint, and to enhance our local understanding of eye health, we also participated in the Workshop on 2030 Insight Cambodia Policy Dialogue.

 

From the moment I step foot in Cambodia, I realized my privilege and why I was here. Even the mere opportunity to travel in the midst of a pandemic was a reminder that I carried with me a responsibility to make sure I made the trip count. Despite the obvious difficulty of maintaining my energy levels across an intense 10-days, this reminder kept me motivated and on my feet. Driving through the streets of Cambodia, I realized that the country was slowly finding its footing as development was taking place – the role we served was to ensure that while all this development took place, the less privileged and their health needs were not forgotten. Our visit to the Museum was more than just a simple visit, it served a key purpose, which was to understand the horrific struggles faced by the Cambodian people. This gave me an insight into the stories each individual I met carried. The history and culture of Cambodia are both rich and heart-wrenching. We were in awe of the art collections before and throughout the Khmer empire as well as the vast collection of sculptures depicting the importance of Buddhism throughout Cambodian history. As we walked past in the Museum, we noticed students from schools exploring the site too – the importance of understanding context and culture cannot be overstated. I firmly believe that in order to truly be able to interact with individuals from different backgrounds on a deeper level, understand their struggles, and be able to help them, you must first appreciate their identity and that inevitably stems from tradition and culture. There is pain and struggle in the history of Cambodia, and we must respect this everywhere we go.

 

One of the most challenging aspects of this trip was the delivery of the vector-borne disease elimination project. One night prior to our delivery, we realized our intervention was not as fine-tuned and as smooth as we wished it to be. However, we knew we had to make the opportunity count, so we pushed ourselves through the night and made sure that when it was time to deliver the intervention, it was really our best effort. In fact, these difficulties brought with them some of the most memorable moments of the trip, which was the opportunity to finally deliver our project. In essence, at each health center and hospital, the team would first explore the local situation and clinical caseload through a tour by a local doctor. This would be followed by GX staff Ms Caroline Dubois guiding a discussion on our Cataract Blindness Elimination Project, looking into the local cataract burden. Through this, the team hoped to share with the local health center what we aimed to do as an organization and had their support to enhance patient recruitment and maximize the impact of our project. At each center, we were assigned to deliver the Vector-Borne Disease Elimination Project, an intervention where we would carry out a short presentation on primary level prevention measures against vector-borne diseases and specifically explain how to use anti-mosquito UV lamps. As part of the project, we organized the donation of leaflets, posters, and anti-mosquito lamps to each center in the hope that we can enhance their knowledge and support them in the battle against vector-borne diseases. While developing this program, I often wondered of its utility and whether this would truly be useful to the local population. However, getting out into the field to experience the local situation and needs, I realized that such programs truly can be invaluable. We were able to first-hand see the prevalence of vector-borne diseases both through observation and discussion with local health officers. Such an experience allowed me to see the importance of my work and was a rewarding moment. 

 

Another memorable moment was our meeting with the Minister of Health. Despite I merely observing and taking notes during the meeting, this was an important moment as it allowed me to see the inner workings of a charitable organization trying to make an impact overseas. The dynamics were fascinating, and from a personal point of view, it really pushed me outside my comfort zone and forced me to test my own skills in communication and networking. In fact, one of the skills which I really developed in this trip was my ability to communicate at all levels. Sometimes, this would be communicating with our team, sometimes with high-up health officials, and oftentimes, with patients, even though there was a strong language barrier. To be able to practice communicating on these different levels was an opportunity itself. In particular, I found that sometimes even when language is a barrier, you can still communicate very deeply with people through emotion and body language. For the meeting at the Ministry of Health, despite my nervousness, I also pushed myself to engage in dialogue. I believe these are all important skills as this is the ambition I have for myself. As someone aspiring to combine medical and humanitarian work, I believe communication is the most important skill. In the future, if I am representing my own organization, the observations and skills I learned here will be absolutely invaluable. 

 

One of the most interesting aspects of the field trip was the opportunity to participate in the 2030 Insight Cambodia Policy Dialogue at Khmer-Soviet Friendship Hospital. Here, I gained greater insight into eye health and the healthcare situation in Cambodia. The day was filled with important speeches and dialogue, including remarks form the International Agency for the Prevention of Blindness and the Minister of Health. In the small group sessions, I was able to interact with representatives from important global and local players in eye health including organizations such as Fred Hollows Foundation, Seva Foundation, Heart to Heart Foundation, Eye Care Foundation, Caritas Cambodia, Sight for All, and Takeo Eye Hospital. The experience not only broadened my knowledge but forced me to test my confidence and skills to communicate in professional settings. I was also able to learn about the nature of healthcare from professionals in the field. It was clear that we all had the common goal of eliminating preventable blindness by improving access to eye care for those in need. Sitting with them, we also learned about the nature of medical practice in Cambodia, how most doctors served in both the private and public sector (public in the morning, private in the afternoon), and how private care could sometimes be cheaper for ophthalmological cases, and how resources for carrying out major procedures such as cataract surgery are lacking and depend heavily on non-governmental support. 

 

A key component of field work is the ongoing acquisition of new knowledge and enhancing understanding of the local dilemmas and situations. As such, we undertook a full-day attachment to the Prey Veng Provincial hospital. This was a fascinating experience where I learned many lessons. It was interesting to see how nurses were less prominent caretakers in the hospital setting, rather the family played a greater role in patient care. The doctor-patient interactions were far different from Hong Kong too. Given the lower education levels, patients were more passive in allowing the doctor to guide their treatment. Moreover, doctors had to be very simple with their language as most patients simply could not understand complex language. During my time here, I was able to observe interesting wards including Internal Medicine, Pediatrics, Obstetrics and Gynecology, Ophthalmology, Infectious Diseases, and Emergency services. Each provided an opportunity to observe the situation, learn more about the developing context, and contrast it to our local situation. 

 

The Reaching Out Award (ROA) provided me with the necessary subsidy to embark on this humanitarian field trip. As an aspiring doctor, I hope to carry with me a responsibility towards the less-privileged individuals not only in Hong Kong but all around the world. The opportunity to understand how new NGO-led projects would be set up as well as direct experience the challenges and needs of individuals in developing countries was invaluable. I was able to better comprehend the difficulties and expand my worldview on how we as those in privileged positions can support them. It also further inspired me to continue this work as it instilled a unique drive in me to see everything first-hand. As a medical student, I was also able to broaden my understanding of how medical care is approached in a developing country. The resources are far different, and so are the patients and the dynamics – the skill of adapting to unique contexts is a powerful one if one wants to engage in humanitarian work. As such, this opportunity, provided by the ROA, has truly enhanced my skillset and created a drive within me to continue to pursue this path in the future.

 

For other ROA recipients, perhaps my greatest advice would be to remember that even the mere opportunity to sit behind our laptops and apply for such an award is a privilege. With this privilege, we carry a responsibility to not forget those who are less privileged in society. No matter what your expertise is, there is always a way to help people while you pursue your own dreams. In Medicine, this is perhaps to tackle the health issues within society. However, each expertise has something to offer and you may be able to contribute to a meaningful cause to help the needy. This is exactly what ‘Reaching Out’ is all about – we owe our efforts to those who were not lucky enough to have the same opportunities and privileges as us.