ABOVE: Dr Ninan Mathew and Dr John Arvier are off to Cambodia to offer their surgical skills to help residents and train Cambodian doctors.
ABOVE: Dr Ninan Mathew and Dr John Arvier are off to Cambodia to offer their surgical skills to help residents and train Cambodian doctors. Rob Williams

Ipswich doctors to treat and train while in Cambodia

IPSWICH Hospital surgeon Dr John Arvier will spend the next two weeks using his skills to change the lives, and faces, of people in Cambodia.

Dr Arvier has been travelling to developing countries for more than 30 years in a joint mission to treat people and train other doctors in the intricacies of maxillofacial surgery.

He and fellow Ipswich surgeon Dr Ninan Mathew landed in Cambodia late yesterday and made their first consultation only hours after landing.

They'll spend just under two weeks working cases such as trauma injuries, unrepaired cleft palates and facial tumours.

"A lot of it is trauma," Dr Arvier said.

"The roads there are chaotic.

"There's also a high incidence of benign tumours - the sort of things that would get picked up here very early - around the mouth and jaws.

"They grow to enormous sizes in rural areas there."

Dr John Arvier in the operating theatre.
Dr John Arvier in the operating theatre.

As a surgical registrar learning the specialty of maxillofacial surgery, Dr Mathew will use the trip to learn from Dr Arvier and assist in the operating theatre.

Dr Mathew's trip has been partly funded by the Australian and New Zealand Association of Oral and Maxillofacial Surgeons, the body responsible for a training program due to have its first Cambodian graduates later this year.

It is his first time travelling overseas as a surgeon after first taking up the maxillofacial registrar role on February 1.

The Cambodian program is one of several established by ANZAOMS that allow local doctors in countries such as Bangladesh to learn from experienced surgeons like Dr Arvier.

It also allows Australian trainees to be exposed to injuries unlikely to be seen in this country.

Many patients at the Khmer Soviet Friendship Hospital, where the two surgeons will be based, don't come into the hospital until days or even weeks after they've been injured.

It's one of many challenges patients and doctors face in the Cambodian medical system.

"A fracture that's a couple of hours old is much easier to treat than a fracture that is a couple of weeks old," Dr Arvier said.

One man Dr Arvier operated on in 2011 was the sole survivor of a car crash that killed seven people. Dr Arvier said the man arrived at hospital 15 days after the crash with severe injuries to most of his face caused by a pole.

Dr John Arvier attending a patient in Cambodia.
Dr John Arvier attending a patient in Cambodia.

In a surgery that lasted all day, Dr Arvier and a team of surgeons rebuilt the man's face.

"The problem was he couldn't close his lips or swallow, so he'd only been able to have sips of water," Dr Arvier said.

"Before he was even fit enough to anesthetise, he had to have a couple of litres of blood and a couple of litres of fluid to get him healthy enough to have the operation."

Dr Arvier said young Cambodian trainee surgeon rallied his friends to give blood so the man's surgery could go ahead.

"They've got to buy blood, which is very expensive, or arrange relatives and friends to give whatever they need. There is no great blood supply," he said.

Restricted public transport, lack of income and heavy expectations on family and friends to perform the role of nurse also present challenges to medical care for Cambodian residents.

"There's no expectation that when you're crook that you'll be treated, like there is in Australia," Dr Arvier said.

"Hospitals aren't free - they've got to pay a nominal amount for even basic submission.

"A lot of the country are subsistence farmers - they don't have money, they just trade crops.

"They also find it very hard to get to Phnom Penh (the capital city)."

Dr Arvier has performed about 34 similar volunteer trips to Somaliland, the Congo, Bangladesh and New Guinea.

He operates across South-East Queensland and visits Ipswich Hospital each week.

An Ipswich Hospital spokeswoman said the volunteer trip would not affect treatment times for any local patients.



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