During our first consultation of the day, I felt a light tug on the back of my shirt. I looked down and there was a beautiful little boy of 10 years looking up at me with huge brown eyes, pointing down at his right foot with both hands. As soon as I saw what he was pointing at my stomach sank. His foot was black and purple, it looked necrotic (dead). Right across the top of his foot was a huge gapping wound, that was also black. The little boy was with his aunty, his mother was on her way to the clinic. Talking with his aunt, we discovered that he acquired his injury in the field which they had layed electric power lines in, to kill the rats, one in which had fallen on top of this foot. This happened two weeks ago. On closer inspection we discovered that the blackening of the foot wasn’t dead tissue but actually paint that they had used to seal the wound. This we found out is a common practice out in the remote villages if they have no access too wound care or medical centres. He had good movement and capillary refill (circulation) in his toes, but lacking sensation.
The foot was promptly soaked so it could be properly assessed. The paint took sometime to be removed, soaking his foot for about 15min. During the soaking his mother arrived with his little sisters (his sisters we will get to later). After cleaning his foot and wound with iodine multiple times the paint was finally removed, well mostly removed. The wound appeared pink (which is good) and as Caz was cleaning it he began to flinch (which was also good) meaning he had a little bit of sensation. It became difficult to clean due to his discomfort. It was at this point we decided that the wound would most likely need surgical debridment and assessment under sedation. Our translator informed us that this could be done for free at the children’s hospital in Phnom Penh. We discussed the situation and his need for further treatment with his mother. His mother became upset and ashamed as they hadn't been able to attended a clinic and have his foot treated sooner. Reassurance was given, but this wasn’t the only hurdle that this family had to cross. The boy’s mother was unable to go to the hospital with him as she had a 4 month old baby girl that was still breastfeeding, the hospital wouldn't allow to stay with the mother, and a 6 year old sister that appeared to be developmentally delayed. The father couldn't take time off work as the family couldn't manage without the income. This was a problem we needed to solve, as if this foot was left unattended he was going to lose it. Our translator asked around if there was anyone (a family member or a village leader) who could go with him. The boy's aunty who brought him to our clinic, agreed to take him, but had no money to get to and from the city. We informed the family that we would drop them off at the hospital and leave them money for food and their return trip home. The whole family was overwhelmed and overjoyed with our plan.

His foot was cleaned and wrapped up securely, and covered with a pair of funky socks donated by Elise, as the little man had no shoes. Aunty then took him home to prepare for their big trip to the city, which was his first time going to Phnom Penh.

 His 6 year old sister was next to been seen. She was tiny. It was hard to believe she was six. She weighed 10kgs, and although Cambodian children are small, this was different.
She didn't/couldn't speak yet. She communicated by grunts, groans and other cute little noises but no speech. Mum informed us that when she was 4 years old she was diagnosed with a hole in her heart. This explained her size. We didn't even have to listen to her heart with a stethoscope to confirm her status as a cardic kid, you only had to touch her little chest to feel her heart pumping abnormally. I personally have not felt anything like it in my 6years of nursing. Our fabulous doctor Dy confirmed that it was most likely an Atrial Septal Defect and would require heart surgery. Unfortunately they children's hospital in Phnom Penh won't perform this procedure, however, the free children’s hospital in Seim Reap would. Once again it was the issue of financial hardship and transportation that had stopped them from getting her the surgery she requires. We decided that she had to get this surgery and we were going to pay for the whatever they needed to make it happen. She had stolen all of our hearts and we wanted to fix hers. Her cuddles and aura were divine as was her laughter and cheeky smile. There mother whom was also awaiting surgery for a removal of a mass in her abdomen agreed to take her to Seim Reap as soon as her youngest stopped breastfeeding, as she knows she will have to be away from her baby for awhile. Plans were made to support Mum and the little girls surgerys ASAP.

 We then examined the 4 month old baby sister, who was thankfully perfect. She weighed 5.4kgs, which was more than half of what her older sister did. Mum gave birth to her on a little fishing boat by herself, unassisted and weighed her on the fish scales. Mum was very pleased and somewhat amused with how impressed we all were with this amazing story.

 After the clinic was finished we were met by the family to see the brave little man off on his journey to the big city. There were a lot of firsts for him today; first time in air conditioning (in the van on the way to Phnom Penh), fisrt time to Phnom Penh, and his first time to a hospital. Of cause we couldn't help but spoil and feed him up along the way. His face was priceless when we arrived in the city, he had never seen anything like it, so loud and busy. His eyes were wide open, he didn't want to miss a thing. We delivered him and his Aunt to the hospital and got them checked in.

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