Children’s Surgical Centre

NEWSLETTER

December 2017 | Issue 42

A Note from Dr. Jim

Contents

2

3

4

5/6

“Eyes” – A Year in Review

Stories from the Ward

20 Years! – Preparing for our 20th

Anniversary and Beyond

Highlights - Teaching and Training

Thank You and Happy Holidays!

Dear CSC Friends and Family,

2017 was another fantastic but busy year for us, with more than 3,530 operations as of mid-December.

Our ENT department is seeing about three times as many patients as three years ago, when we first

started the service, and we’ve been busy making a number of changes to the facility, including

refurbishing both the main OR and the Eye OR. We’re also moving our handwritten theatre booking

system to our new online teaching and patient management platform.

All the while, the patients keep coming. We continue to grow CSC in order to stay one step ahead of

what is otherwise available in the country. The challenges are great, but the rewards are immense. We

hope you enjoy the updates in this newsletter – Next year, we’ll be celebrating our 20th anniversary!

I will be heading off to Australia to join friends and families for the holidays, but I thank you all for

supporting CSC – and we hope to see you in the New Year!

Dr Jim Gollogly, CEO/Founder

Children’s Surgical Centre

7/8

2 Issue 42 :: December 2017

2017 was a big year for the eye

department! In February 2017,

CSC welcomed South African

ophthalmologist, Dr Greg

Fincham for a year-long

fellowship. Dr Greg has been

focused on working with our staff

to improve both the physical

space of the department as well

as encouraging and setting

protocols for audit and patient

management.

Now, our waiting room is more

spacious and patient registration

is more efficient; the random piles

of medical records are filed

away; the supplies are organized

– and with the new layout, long

gone are the days of waiting near

the stairwell after an anesthetic

injection! The OR has also

undergone refurbishments, with

new lights and 90° training arms

on the microscopes.est

Department

Aside from facility refurbishments,

audit, OR theatre booking, and

other protocols are being

introduced and/or moved from a

handwritten system to on our new

custom-built online platform

(more on that below!) Since the

implementation of these changes,

the post-operation complication

rates have dropped by more than

half.

The efforts of Dr Greg and the

team were reinforced by our

returning visiting surgeons, such

as: Dr Kevin Winkle, who visited

twice to work with the pediatric

ophthalmology team, and Dr Lee

Wan - who introduced the use of

our new “Infinity” phaco

machines, donated by Wills Eye

Hospital in Philadelphia though

the agency of Dr Karl Holzinger,

who visited us in January. From

the University of Hong Kong,

came 2 other ophthalmic

surgeons, Drs Carol Lam and

Justin Tong, and from America

came Dr Lauren Schatz.

Furthermore, other equipment

donations such as our new sterilizer

and A-scan from the local chapter

of the Church of Latter Day Saints

have improved the service.

Our permanent Cambodian staff

remain the core of the

department, especially many of

the nurses, who have been with us

for several years, and continue to

lead the way for change. Some of

them are learning to perform

routine procedures themselves, as

“Extended-Role Nurse

Practitioners”, which will increase

their skills, as well as the efficiency

of the department.

By mid-December, the eye team

has performed 13,240 consultations

and 2,315 surgeries. With the

volume and complex pathology of

the cases, the challenges remain

constant – However, the eye team

looks forward to 2018 and seeing

the longer-term benefits of all the

changes made this year.

team of surgeons and scrub

staff the change to practice

the operative sequence and

WITH MORE THAN 13,240 CONSULTATIONS AND

2,315 SURGERIES SO FAR THIS YEAR, “EYES” IS STILL

OUR BUSIEST DEPARTMENT

“Eyes” – A Year

in Review

3 Issue 42 :: December 2017

Srey Neth – Scoliosis correction

Socheat is in grade 5. She had blurry vision and

itchy eyes for about one year before

presenting to CSC. She and her mother were

really keen to keep her in school, but her vision

was deteriorating and she wasn’t able to pay

attention. On 20 June 2017, she underwent

cataract surgery. The next day Socheat left

CSC with improved visual acuity, and looked

forward to returning to school the next day.

Srey Neth, age 14 just before being

discharged from CSC

Srey Neth is 14 and currently in grade six.

She visited CSC in late 2016, and was

diagnosed with scoliosis. Srey Neth had

significant curvature of spine, well past the

threshold when surgical intervention is

suggested. Importantly, Srey Neth could

not comfortably sit at her desk in school,

and had developed difficulty breathing.

Srey Neth underwent scoliosis correction

surgery on the 19th of January. Her care,

including both consultation and surgery

has been managed by 2 Khmer surgeons,

1 Khmer surgeon trainee, and Professors

Ken Cheung from Malaysia and CC Wong

from Hong Kong.

Now 11 months post-op, Srey Neth is back

in school full-time and able to breathe

normally.

Stories from

the Ward

This summer, we made a Video about the long-

term follow up of two BPI patients. The video is

used as a patient education tool to emphasize the

importance of continued physiotherapy. Many

thanks to Raj, Wee Lam, Roma and their team for

leading the BPI training program at CSC.

Brachial Plexus Injury – Results from

surgery and the long road to recovery

Socheat – Cataract Surgery

4 Issue 42 :: December 2017

Our new online platform, focused on teaching, theatre

booking/management, and live data

After a six-month fellowship in 2013, I went back

to the UK to complete my registrar training in

Trauma and Orthopedics. Upon finishing earlier

this year, I was thrilled to be able to join Dr Jim

and the team once again. This time around, we

are focused on improving the internal systems of

the centre, in order to meet the many

challenges of delivering surgery and post-op

care programs in a low-resource setting.

5 billion people across the world lack access to

safe, affordable surgery. Next year will mark the

20th anniversary of CSC providing free surgical

care to the impoverished people of Cambodia –

performing more than 32,508 free surgeries to

date.

With this experience, CSC can and should be

able to lead the way in demonstrating good

clinical practice and provide lessons learned to

other global surgical programs wishing to learn

from our experiences – hence our drive for

making the following changes before reaching

CSC’s 20th year anniversary.

In September, a USD 30k refurbishment of the

main operating room has allowed for a brighter,

more spacious environment to perform our

complex surgeries.

Preparing for our

20th Anniversary

and Beyond

Contributed by Saqib Noor,

Visiting Fellow, Orthopedics

The new OR has been coupled with the

introduction of an electronic theatre management

system and a novel implementation of the safe

surgery checklist, resulting in a more structured

team approach to the immense challenges we

face.

Furthermore, we are now developing a custom e-

learning platform as an extension of our website

and medical records system. The new platform

facilitates education programs and prospective

research studies, including a “live wound study” –

looking at infection rates (including the great

number of those who present to CSC with an

infection), and generating live data of patients

with complications.

It has been an immense honor and privilege to

return to CSC and I look forward to continuing to

watch it grow and thrive.

The newly refurbished OR – from 4 tables to 3 (with a

separate adjacent operating room for patients who

present with infection; with dividers, new floors/shelves,

and new operating lights

5 Issue 42 :: December 2017

Highlights –

Teaching & Training

“CSC now forms an

integral part of not just

our work calendar, but

also our lives.” –

Dr Wee Lam

VISITING SURGEONS: Many thanks to our visiting

surgeons and health workers, many of whom

return year after year to maintain a continuum

of training. In 2017, we welcomed experts from

all over the world, including:

YOUNG RESIDENTS PROGRAMME AT CSC: Recognized as one of the top

training centres in Cambodia, CSC now accepts up to 6 surgical

residents at a time from the National system for six month rotations. The

program allows young Cambodian surgeon trainees the opportunity to

work at CSC with exposure to complex pathology and teaching from

both Cambodian and foreign senior surgeons. Starting in late December

2017 and continuing in the New Year, we will also be taking in six

anesthesiologist trainees on six month rotations. Dr Lim Heng, Current Resident

Prof Kenneth Cheung and team, Hong Kong, Spines

Dr Kevin Winkle, USA, Ophthalmology

Dr Eliza, Australia, ENT

Dr Masa, Japan, Max fax

Drs Gavin and Diarmuid, Singapore, Orthopedics

Dr Josephine and team, Hong Kong, Hands

Drs Tina, Mary, and Komal, UK, Ophthalmology

Drs Florian and Xavier, France, Oculoplastics

Dr Janius, Lithuania, Orthopedics

Dr Lauren, USA, Ophthalmology

Drs Justin and Carol, Hong Kong, Ophthalmology

Drs Fred, Franck, Aymeric, and team, France, Max fax/Neuro

Drs Raj and Wee Lam, Gus; Roma and team, Singapore/UK, Hands

Dr Mike, USA, General surgeon

Drs CC Wong, Jon, and team, Malaysia, Spines

Dr Mark Vierra, USA, General surgeon

Drs Inge, Connie, and Birgit, Austria, Plastics

Dr Chris Lyon, USA, Ophthalmology

Dr Charlie, UK, ENT

Drs Neil and David, Australia/USA, Hands

Drs Alain Corre, France, ENT

6 Issue 42 :: December 2017

AUSTRALIA: Dr. Davy, our head of ENT was

invited to deliver a keynote lecture at the

19th International Symposium on Recent

Advances in Otitis Media from 4 – 8 June

2017, in Gold Coast, Australia. Thanks to

Hannah Callas, and her crowdsourced

donation page, enough money was raised to

support Davy’s trip.

CSC staff with new friends at the 11th World Cleft

Lip/Palate & Craniofacial Congress in Wuhan, China

CHINA: In November, five CSC staff received

support from Smile Train to attend the 11th World

Cleft Lip/Palate Congress in Wuhan. The

conference brought together international

experts to focus on diagnostic technology,

surgical skills, nursing and post-op care, and the

latest genetic research related to cleft

lip/palate.

The Eye

Department

– A Year in

Review

NORTH KOREANS AT CSC: In November, CSC

took in 4 surgeons (2 plastic surgeons and 2

orthopedic surgeons) from North Korea for the

purpose of training in cleft lip/palate repair and

the management of club feet and other

congenital orthopedic conditions. The surgeons

worked closely with Dr Saqib, Dr Ratha, and Dr

Sokleng, and Dr Jim as part of an effort to ramp

up disability surgical services in their home

country.

CAMBODIA: CSC was invited to present 4 talks at

the Annual Conference of the Cambodian

Society of Surgery, including:

1. A new approach to the treatment of chronic

dislocations of the elbow at CSC

2. A post-operative radiological review of THR

replacements at CSC

3. Brachial Plexus Injury (BPI): results of treatment

at CSC

4. Operative results for Scoliosis correction

7 Issue 42 :: December 2017

New OR lights,

and monitors

courtesy of

Mark Moser and

DAK Foundation

Wendy Fyfe

sent support

and bears!

The Church of Latter

Day Saints in Phnom

Penh donated a new

retinoscope, sterilizer,

and A-Scan to the Eye

department

Thank you!

We simply couldn’t do it

without you!

Throughout the year, we received generous

support, including the following:

Charles Monat

Chris Snell and David Grosse for “Racing the Planet”

Church of Latter Day Saints, Phnom Penh

DAK Foundation

Dreyfus Charitable Foundation

H&M - Puls Trading Far East Limited, Phnom Penh

Janus Foundation

Love Without Boundaries

Lutz and Hedda Charitable Foundation

Anthony Morris

Mark Moser

Nick Gall

Rotary Club Phnom Penh

Rotary Australia

Royal City of Dublin Hospital Trust

Women’s International Group, Phnom Penh

SEE International

Smile Train

Sue O’Neill

Vision Beyond Australia

Watsi

Vanda Sports Group and the boxers

Wonderwork

Wendy Fyfe

West Island School

Wills Hospital

And others who we’ve forgotten (our apologies!) or

who wish to remain anonymous.

Chris Snell and

David Grosse,

Racing the Planet,

Patagonia raised

more than 50k

Vanda and the boxers in Hong Kong and

Singapore

8 Issue 42 :: December 2017

Happy

Holidays from

CSC!

CLICK HERE TO

DONATE TO CSC

So far in 2017, CSC has provided over 3,500 surgeries and over

20,000 consultations – free of charge.

The holidays are a busy time, but please consider donating to CSC

to support life-changing surgery to someone in need.

Every donation counts!

Srey Pich, age 5

Srey Neth, age 5