I am a 39-year-old government official, and I would like to share my own experience and views after receiving treatment at the Khmer-Soviet Hospital for three weeks.
- Infection and early symptoms
In my case, I contracted the virus while attending an international conference in France, which had about 30 attendees. The conference was immediately halted after a Filipino attendee was found to be infected with the coronavirus. All other attendees demanded to be tested for the virus, but the French denied, claiming that they had no symptom. Two of the attendees told us that they tested positive when they were back in their country.
Once I was back in Cambodia, to protect my family, I rented a condo to live for 14 days to distance myself from them. One day, later, 7 days after I was exposed to the infected person, I started to develop some symptoms, including rapid shallow breathing and diarrhea, but no fever. Next day, I still had diarrhea although I did not eat anything wrong. I was shivering, had a sore throat and a fever, sweating at night, and having fatigue and body aches. I thus asked to be tested for COVID-19. They collected the sample from my nose and throat with swabs for a lab test. When they found that the result was positive, they asked me about who I have met, where I had meals and so on, and they told me that my identity would be kept hidden. My condo was sterilised, and my cleaner was put under watch.
The most important medicine is Kaletra, which has been used to treat HIV. One of its side effects is stomachache, which disturbed my sleep. On the third day, the doctor gave me Chloroquine, which is used to treat malaria. These medicines do not cure COVID-19, but they prevent the disease from spreading in the body. Apart from that, the types of treatment depends on certains symptoms, for example, Doliprane for fever and diarrhea medicine for diarrhea.
The patient with mild symptoms was prescribed only with Kaletra, but I and a Frenchman, who had respiratory problems, were also prescribed with Chloroquine. I had it for 10 days to get through the most dangerous phase of the inflammatory lung. These stage is characterised with three symptoms: persistent fever, cough and short breath. However, I did not have persistent fever.
3. Various symptoms and disease situation
When I was accepted into the hospital, the patients included a British couple, a Belgium man, two Frenchmen and 4 Cambodians. They did not share the same symptoms. Of all ten patients at the hospital, only I and one of the Frenchmen had respiratory problems. The rest of the patients only witnessed fever or insomnia or a stomachache which is the side effect of the drug.
The symptoms continued to come and go. I continued to experience a worsening sore throat, as if I have some bugs in my throat. I had never had a respiratory disease before. My voice became hoarse, and I coughed every time I opened my mouth. I could breathe out normally but breathing in was very hard, with coughing and shortness of breath. The virus and the drug’s side effects often cause stomachache, loss of appetite, night sweat and so on. But, the doctors did not ask me to abstain from any type of food; I could eat what I wanted.
One time, I was energetic, and at another, I was very tired. This is an experience shared by all other patients.
On the tenth day, I felt that my throat had been clearing up and this made me very happy. In the afternoon, however, the sore throat returned. I wanted to recover soon, so I forced myself to eat, stand under the sunlight for 30 minutes in the morning and another 30 minutes in the evening. Yet, forcing myself too hard worn me down. I found it so hard to breathe that I had to rely on a ventilator. It was the worst day for me. The next day, I resumed taking good care of myself, without overeating or excess exercising.
I tried my best to listen to my body. I ate a little but more often, to reserve my energy, i drank a lot of water to clear my throat. When I was weak due to low blood pressure, I had nightmares. The others foreign patients also said the same thing to me.
The balance in healthcare and energy preservation is the key. There cannot be forced recovery.
- Tracing the virus
At first, the doctors said we would test for the coronavirus every three days. If the result was found to be negative, the patient will be relocated so that his or her place could be reserved for new patients. Later, they tested us once every two days. After the result was negative twice in a row, the patient would be released, but his or her health would be monitored for two weeks. During these two weeks, he or she would have to test once or twice to ensure that the virus is gone.
Two negative results in a row did not come fast. The patients, including myself, needed at least 3 weeks for the virus to disappear, depending on the seriousness of the disease and the immune system of our body. Some may take longer or shorter; there is no exact timeline for recovery.
- Care for mental well being
As I have mentioned, it is not easy to test negative twice in a row. Sometimes, the results came negative at one time but positive again in the next test. Something like this causes a load of stress for the patients. The foreign patients were afraid they would not be able to fly back to their countries, so they had been very upset. The elder English lady was crying every day. The Belgian man was yelling. A Frenchman, who had not had any symptoms, also suffered from shortness of breath due to panic and anxiety attacks.
So I asked them, “What is the point that Cambodia has to keep you in the hospital if you have already recovered. I even asked to be tested in France and was denied.” And they were silent. I did not even finish my sentence by saying that Cambodia was treating them for free while it also has to look out for its people.
I told myself I would not care about the temporary result; all I want to know was the two negative results in a row. When I was feeling unwell, I did not even want to be tested. It was not that I did not want to leave the hospital but I understood that I have to be patient, no matter how long it would take, for myself, my family and society.
The Cambodians took great care of their mental health, through their daily prayers and could manage well their mental anxiety.
All those foreigners were complaining about no one coming to clean our ward. We, the Cambodians were different. When we were free, we cleaned the ward and the toilet by ourselves for good hygiene. Seeing us doing that, the foreign patients also did the same. They should have known that this is not a hotel, and the medical staff are not serving us all the time. They were also afraid of being infected.
- The facilities
At the hospital, COVID-19 patients were isolated in an enclosed building, with no entry to anyone. The building is separated into 4 divisions: the ward, the doctor’s office, sterilisng room and the sun deck for the patients to exercise and sunbathe. The sterilising room stands between the doctor’s office and the ward. The medical staff wearing protective gears from head to toe are sterilised with alcohol whenever they enter or leave the ward.
There are only 10 beds in the ward. The doctors explain that the room is designed to contain pandemics, with fans and enough ventilation, UV light, CCTV for the doctors to monitor the patients and phones to call the medical staff when the patients needed anything. The medical staff came to look at the patients thrice per day, to keep track of the patients’ health as well as to bring medicine and food and to clean the ward.
- Preventive measures and preparation for the emergency
Looking at the measures taken by the Ministry of Health, I can see that Cambodia has taken appropriate actions in tracing the patients. We are having close cooperation with the World Health Organisation (WHO). Cambodia has tested many suspected cases for free. In France, on one hand, they did not test me and no one questioned anything from those who had direct interactions with the infected individual. In Cambodia, on the other hand, MoH asked me even about the smallest detail. My condo cleaner was also put under watch for 14 days. The way the ministry has tracing the Cambodians who contracted the virus also involved asking many questions regarding contact and travel history. This is a good measure to prevent and contain the disease. The Ministry is working cautiously and patiently. In some cases, it sounds like the patients were arrested because they tried to avoid being isolated in the hospital.
The medical staff on the frontline have sacrificed a lot. While they are caring for the patients, they could not meet their families and when they got out of their shift, they have to go into quarantine for 14 days and have their health monitored before they can reunite with their families.
Our biggest problem is the lack of medical staff and facilities with standard technology and hygiene. Although the Khmer-Soviet hospital already has high standards, it was not prepared for the most serious cases. For instance, I had a lung problem, but there is no screening equipment in the isolation building, and I could not be screened at the other building either. The isolation building should have another separated room for the serious cases.
Meanwhile, the medical staff do not have equal qualifications. Some of them cause the patients’ noses to bleed while collecting the specimen and some others made mistake while collecting sampled from the throat or giving injection, and so on. Yet, these were only a few of them. However, the medical staff, in both urban and rural areas, should receive training to prepare themselves for the emergency situation. More staff are needed, including those in the backline to protect the public and the medical staff in the frontline. With enough training, they will be confident in their work and also gain people’s trust.
The biggest concern is the technology standard and level of hygiene of the facilities in the countryside. This is not a simple matter; it requires proper preparation based on specific scenario, place and equipment, with detailed planning.
“Okayism” is a danger, but “panickism”, associated with the doomsday, is also scary. Therefore, we have to face the fact that COVID-19 is a huge risk, and in the meantime, we need a detailed plan to prevent a huge wave of panic if the emergency comes. The preparation needs cooperation from both local authorities and the people. The public need to listen to the instructions from the authorities on self-control and self-monitoring and avoiding panicking and believing in fake news or information from untrustworthy sources
A government official and a recovered COVID-19 individual in Phnom Penh