PHNOM PEN, Cambodia – It’s 7 a.m., and in the outer reaches of Phnom Penh, set just off a disheveled highway, the Children’s Surgical Centre (CSC), which treats both children and adults, is already abuzz with activity. Dozens of men, women and children line up for a ticket and then wait their turn, sitting on wooden benches as the blistering heat of the day starts to rise.
“So, we are still seeing a slight perforation in the eardrum … about 15%,” says Dr. Touch Sokdavy, who goes by “Dr. Davy” at work. The 30-year-old heads the all-female ear, nose and throat (ENT) team.
Presenting to a room full of local Khmer doctors and nurses and visiting international fellows, Dr. Davy goes through the case, pointing to X-rays on an overhead projector and outlining the next steps. Beside her, the patient, a man in his 40s, sits on a small plastic stool. Dr. Davy touches his shoulder, reassuring him that all will be fine.
In Cambodia, where so many are impoverished and live far from reliable medical clinics, often depending on the services of local traditional healers, something as minor as a middle ear infection can become chronic or even fatal. These challenges are compounded by a healthcare system that is still recovering from being decimated by the Khmer Rouge regime of the 1970s, during which most doctors were killed or fled the country.
The center, which treats a broad range of medical conditions, was founded in 1998, but the specialist ENT team wasn’t established until 2014. First on board was Dr. Davy, followed by three more female surgeons: Dr. Sothea (full name: Chhea Sothea), 33; Dr. Kim (full name: Sroun Kimhout), 27; and Dr. Khim (full name: Va Sokhim), 26.
The hospital’s ENT surgical team. (Phot Courtesy of CSC)
“I wanted female surgeons to be recognized, and Dr. Davy was determined [to succeed],” says Dr. Jim Gollogly, a British-American surgeon who founded the CSC and serves as its CEO. “Even having one male scrub nurse brings attention away from the women, so I thought [an all-female team] would be a good idea.”
Dr. Davy says entering the medical field as a woman was challenging.
“When I was a medical student, I wasn’t seen as capable because I was small and female,” she said. “Our professor said, ‘Females cannot do anything, they cannot hold the endoscopy [tools], they’re too heavy.’ I know sometimes he was joking, but still, I wouldn’t always get the chance to work in operating theater like I wanted to.”
Her fellow ENT surgeons said this experience was all too familiar for them. While working at the center, however, they’ve received intensive specialist training from visiting fellows and leading experts.
One of these, the British surgeon Dr. Mahmood Bhutta, taught them to perform mastoidectomies, an operation used on cholesteatoma patients to remove life-threatening cysts in the middle ear. At the time, no doctors in Cambodia were trained to perform this surgery.
“I wasn’t sure what we could achieve in six months. This is a very complex surgery,” says Dr. Bhutta. “But they were very motivated to learn. To say they can now perform these operations to a global standard, as well as any of the top surgeons in the world, is quite something.”
A patient undergoes ENT surgery at the Children’s Surgical Centre. (Ruth Carr)
In 2016 alone, Dr. Davy and her team performed 244 operations and provided 4,824 consultations. And the Children’s Surgical Centre reports that, due to a backlog of ENT cases in Cambodia, the workload of the department is only increasing.
“For so long, our country only had foreign missions coming to Cambodia to do ear surgery,” Dr. Davy says. “But I don’t want patients to be forever on a waiting list.”