Burma 2024 Trip Recap - Dr. Hsin

Air strikes on Hpasawng Town

Recently I (Dr. Hsin) and Coby Hsin had the privilege of joining the Free Burma Rangers (FBR) on a Humanitarian Relief mission in Kayah State, Burma. The country of Burma, also known as Myanmar, has been in turmoil for over 60 years ever since the military regime took control of the country in 1962. Since then, war has raged throughout the region with the Burma army attacking ethnic communities, burning villages and killing its people. Though there was a short period of relative peace when Aung Sun Suu Kyi held the presidency from 2016 to 2021, a coup d’etat ousted the democratically elected government in early 2021. Since then, the military dictatorship, led by Min Aung Hlaing, redoubled its efforts to subjugate and oppress the ethnic minorities.

Dr. Tom treating wounded soldier at casualty collection point

With assistance from Russia and China, the Junta leads a violent genocidal campaign against its own people. Indiscriminately, they bomb churches, schools and hospitals, slaughtering protestors, and displacing over 3 million IDPs (internally displaced peoples).

Today the war rages on, but fort he first time, there is unity among the many different ethnic resistance forces as they battle the atrocities committed by the Burma army.

Two years ago, a small group of doctors and medical students who protested against the oppressive regime joined the growing civil disobedience movement and fled into the countryside where they opened up a clinic to treat the victims of the persecution. Their clinic was promptly destroyed in an airstrike, as were all other medical facilities supporting the resistance. However, this did not deter the small band of doctors from building a secret hospital hidden beneath the canopy of the jungle. For the past two years, this “Last Hospital” in Kayah State has treated countless victims of war-causalities among which are the result of gun shots, mortars, bombs, and artillery fire.

Dr. Sue and Dr. Hsin using household drill to fix arm

With few resources and even less medical equipment, they have remarkably saved many lives and limbs in their small one room operating theater carved into the side of a mountain. They have no address. They have no website. They are an ad hoc hospital hidden deep in the Burma jungle. The Burmese Army reconnaissance planes and drones fly overhead daily, hunting for the “Last Hospital” of the resistance in Kayah State.

This past February, I traveled to Burma, joining Coby and the rest of the FBR team in Kayah State. We spent one week at their hospital working alongside the doctors and students. We were able to bring some orthopedic and medical equipment which they desperately needed, and which were almost completely used up by the end of our time there. We found that the doctors and students were well trained, and had good fundamentals, but lacked proper equipment.

Femur fracture shattered by artillery

For example, for orthopedic surgeries, they used a household drill and wrapped it in a sterile linen. For a saw, they used a household hack saw and sterilized it. We were able to bring them a donated orthopedic drill and an orthopedic saw. They also lacked basic implants such as plates, screws, intramedullary devices and basic bone fixation devices and tools. While there, we treated mostly injuries caused by gunfire, artillery, mortars and landmines. We applied so many external fixators to open fractures, that we ran out of pins and fixators. As the only remaining hospital treating combat injuries, their needs can hardly be overstated. As you can see, the “Last Hospital” is not your typical hospital. They are in desperate need of orthopedic equipment, and they need it yesterday. The war rages on, and the resistance army has no one else to care for their casualties.

The story of these brave and resourceful doctors was featured by Sky News and documented in this short video. Please watch this video and share their story. The world needs to know.

Joining the Free Burma Rangers and Coby for the latter part of their mission, I witnessed hope and healing on the frontlines and to the IDPs in the countryside. As airstrikes and bombings were a daily occurrence, the FBR medics would help IDPs escape the villages and towns where the fighting was fierce, transporting thousands in trucks to nearby safety. The wounded were brought to a casualty collection point (CCP) for medical treatment. We worked alongside another surgeon from Germany as well as the FBR medics to stabilize the wounded at the CCP before being transferred to the hospital for definitive care. However the most encouraging part of the mission is the Good Life Club, a program featuring FBR staff singing and dancing and doing skits for the kids; and providing a message of love and forgiveness. It was joy to see the children dance and laugh amidst the war. For a moment, if only for a short time, they have hope. Hope for a better future and a hope for peace.

To learn more about the ministry of FBR, or to support their cause, please visit their website at Free Burma Rangers.

JoeHsin, MD

Cambodia 2023 Trip Recap

After a month of processing the immense impact of our Cambodia 2023 Medical Mission here are some thoughts from Dr. Joseph Hsin who led this mission. We are excited to share the impact of this year’s trip to Cambodia and how that ties into the impact of our longterm relationship with our friends in Cambodia over the past 23 years.

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When the Cornerstone Foundation first arrived in Phnom Penh, Cambodia, in 2000, things were dismal at best. Having gone through years of political turmoil since their holocaust in 1974, the people of Cambodia finally arrived at some semblance of peace following the last coup d’etat of 1998. However, the tragedy that befell this small country the size of Colorado, exacted a large price on its people. Over 30% of its 7 million people were killed over the four years of terror known as the Killing Fields. 

A medical school had been established in Phnom Penh in 1950 and by 1975, there were about 950 well-trained physicians in Cambodia caring for its 7 million people. During Pol Pot’s reign of terror, all but 38 physicians were killed; and only 20 of these remained in 1980 to try to reestablish medical care. The medical school was re-opened in 1980 and anyone with medical training was given 6 months in the classroom followed by 1 year of on-the-job training and then sent out to the cities and provinces as a “physician”. 

It is estimated that approximately 1,000 of these “physicians” were sent out in the last 20 years. The medical school has since reopened, and students now are able to gain better training there, as well as with studying abroad in France; these young doctors hope to bring their country out of the medical dark ages. However, the medical infrastructure is lacking as are supplies and equipment. 

The Cornerstone Foundation has been sending surgical teams to Cambodia for 23 years. In October, 2023, the Cornerstone Foundation sent a team of 15 physicians, nurses, ancillary personnel and students to Phnom Penh, Cambodia to perform surgeries on patients and to support Dr. Sim Sokchan at the Christian Medical Ministry to Cambodia - Jeremiah’s HopeClinic. Dr. Sim Sokchan was born right after the Khmer Rouge were in power in 1979. His parents were forced into an arranged marriage by the Khmer Rouge regime along with 17 other couples. 

They hoped to find stability outside of Cambodia so they fled to Thailand, hoping to make it to a Thai refugee camp. Their travel was hampered and they were forced to walk back to the city from Preah Vihear province near the northern border through the jungle. “My mom said she had me in her womb when she had to walk back through the jungle. People step on land mines and exploded. They took many days to arrive in Phnom Penh,” recalled Dr. Sokchan. His dad, a factory worker and his mother, a primary school teacher made a life in the city and so Dr. Sokchan grew up in Phnom Penh. He decided to enter into the medical field and was able to attend medical school early in Phnom Penh at age 16. After spending 7 years in medical school, he met doctors from Colorado who sponsored him for a three month visit to do an externship rotation in Colorado in 2001. He completed his medical training and did 3 years of general surgery residency in Phnom Penh. He was accepted to do a fellowship in France in neurosurgery where he studied for two years.

Over the next 15 years, Dr. Sokchan has emerged as the leading neurosurgeon in his country. There are over 30 neurosurgeons in Cambodia, all in the city of Phnom Penh. Patients from rural provinces and even adjacent countries are referred to Phnom Penh for neurosurgery care. Dr. Sokchan became an international member of the American Association of Neurological Surgeons in 2016, then international fellow of AANS in 2020. He teaches neurosurgery residents and will be appointed assistant professor soon. While Dr. Sokchan is able to purchase Chinese made spine equipment to perform his surgeries, he is continually plagued with breakage of screws and rods because of the poor quality of the materials. 

One of the volunteers on a Cornerstone Foundation trip connected us with Zimmer Biomet and in 2018, Zimmer Biomet donated $5.7 million dollars of surplus spine equipment to Jeremiah’s Hope. Over the past 5 years many Cambodian patients have been helped with those donations. Most of the smaller sizes of screws and interbody devices have been used. On this current trip, ZimVie donated additional inventory to Dr. Sokchan, making it possible for ongoing care of Cambodian spine patients who otherwise would not have options. 

On our most recent visit, we had the privilege of meeting one of the recipients of ZimVie’s recent donation, a 64 year old farmer from Kandal province with chronic low back pain and right radiculopathy for a year. He had increasing difficulty walking for 3 months and was unable to work. His X-rays showed multiple levels of degenerative disc disease and spondylolisthesis at L5-S1. He underwent a successful four level decompression and fusion which resolved his sciatic pain. 

For the past 23 years, various NGOs such as ours have striven to improve healthcare in Cambodia, and have been able to do so only by generous donations of time, money and medical equipment by companies such as Zimmer Biomet and ZimVie. One cannot understate the impact of such generosity, and the lives that are changed by the surgeries we perform in the short time we are there. 

-Dr. Joseph Hsin, Cambodia 2023 Medical Mission Team Lead and Cornerstone Foundation Board Member

Cambodia 2023, Day Six

Friday

Our last 2 days have been awesome! We performed 4 ACL repairs and one knee replacement! As we wrap up our time at the hospital we had say difficult goodbyes to all of the amazing staff! We truly had an amazing time and are so great full for this experience. We will head back to the hospital one more time this morning and then we are off to Siem Riep for the weekend! 

Cambodia 2023, Day Two

Sunday

Today was an amazing day! It was our first day at the hospital. We met all of the amazing staff, unpacked all of our supplies and talked with patients! After the hospital, we headed to a market where we did some shopping and explored more of the town in Cambodia! Tomorrow we will perform the first surgeries! 

Cambodia 2023, Day One

Saturday

After our almost 30 hour journey, with 27 bags of equipment, we have arrived in Cambodia! We started our day touring the Tuol Sleng Genocide Museum and then made our way to Khmer Surin for dinner. Tomorrow morning we are headed to the hospital to unpack and get all settled in! 

Day Four in Cambodia

Wednesday

We arrived at the clinic today planning to perform four surgeries: two ACL reconstructions, an osteochondroma removal, and a non-union sequestrum. We ended up having a walk-in patient scheduled for a tibial tubercle avulsion at the end of the day after being cleared by our anesthesia team, making for a total of 5 surgeries today. 

Because we saw only two ACL patients today, we were able to run both ORs at the same time and knock out the first four surgeries by lunchtime. Dr. Kanora was able to perform most of the ACL reconstructions as the lead surgeon with Dr. Hsin’s supervision and guidance. Training Dr. Kanora on these techniques is a huge step toward advancement of medical care specifically relating to knee reconstructive operations in this country because there are currently no options for these types of surgeries in Cambodia. Dr. Kanora will be performing both of the ACL reconstruction surgeries tomorrow as well under Dr. Hsin’s supervision.

ACL reconstructions are time consuming operations, so while those were going on in OR1, the osteochondroma removal and the non-union sequestrum were performed in OR2. After lunch, the last patient on the schedule was prepped for surgery and the tibial tubercle avulsion began. Between surgeries, Dr. Cabrera taught lessons on anesthesia blocks and epidurals in a classroom full of eager nurses and CRNA students. He also demonstrated with the ultrasound machine how to identify nerves and nerve bundles for specific nerve blocks in the shoulder, neck, arm, and leg.

Once all operations were finished for the day, our team visited the Central Market and went to dinner at a Vietnamese restaurant. Tomorrow we will wrap up our final surgeries at the clinic before we head home this weekend! 

Day Three in Cambodia

Tuesday

We arrived at the clinic bright and early this morning, ready to perform our ACL reconstructions. For training purposes, it’s best to have both Dr. Hsin and Dr. Bierbrauer in the OR teaching the local Ortho doc Dr. Kanora. Due to the lack of  a full size autoclave, there is over an hour and a half of turnover time for sanitizing equipment and prepping patients, so with two sets of usable equipment we were able to stagger all four surgeries throughout the day. Dr. Kanora is the orthopedic surgeon at Jeremiah’s Hope clinic and today was the first day he was able to scrub in and learn hands-on ACL techniques. 

Our last surgery of the day was on Yuth, a former professional soccer player for the Cambodia Junior National Team. He tore his ACL during a match against Australia about four years ago and has been unable to play since then. He is really hoping to get back into playing soccer, but in the meantime he started volunteering at youth soccer camps for underserved communities in the Phnom Penh area. He works for a church and has found a lot of faith in Jesus through his injury, which he thought would be career-ending. When he heard about our trip, he felt excited to have the opportunity to heal his knee and try out for the National Team again. We are looking forward to sharing more of his story with you, so stay tuned for updates on Yuth and his journey.

At the end of our long surgery day, our team headed back to the hotel and decompressed before going to dinner. We went to a pizza place recommended by Yuth and walked around the riverside near the Cambodian Palace. 

Tomorrow we will have two ORs operating at the same time with two ACL reconstructions, an ostechondroma removal from the left tibia of a missionary boy, and a non-union sequestrum of the left ulna of a young girl.

Day Two in Cambodia

Monday

Today we arrived at the clinic, prepared to perform two ACL reconstructive surgeries and see other patients in between. So far, we have seen around 33 patients and scheduled 10 surgeries. Most of the surgeries we will be focusing on during this trip are ACL related, and almost all of them are futbol related injuries. There is such an influx of ACL injuries here in Cambodia because there’s a lack of training surgeons in reconstructive ACL techniques here, so if a patient needs a surgery like this, they would need to travel to Thailand or Vietnam. When we arrived, there was a long list of patients with knee injuries hoping to see our docs while we are in town, so they can expect to be very busy during the next few days. 

We started the day off with the first ACL reconstruction with Dr. Cabrera utilizing a Butterfly ultrasound machine to place a nerve block, Dr. Hsin operating, and Dr. Bierbrauer refreshing his memory on ACL surgery and prepping the removed patellar tendon graft for placement in the patient’s knee. Next, Dr. Hsin reviewed scans of patients and provided prognosis for each. Some will need intensive surgeries, while others will require a few months of physical therapy or simply wearing a brace. 

During this time, Dr. Bierbrauer prepped for the next ACL reconstructive surgery. We have two available ORs, but with just two surgeries today we decided to use the same one. The second reconstruction was successful with a minor bump in the road at the very beginning: humidity and temperature changes in the OR caused the scope to become blurry! This issue was quickly solved with a new scope lens and temperature monitoring. Both patients were sent home at the end of the day with braces and plans for physical therapy as they begin their healing journey over the next year. 

Lastly, our Anesthesia team interviewed patients that were previously cleared for surgery by the docs. Tomorrow, we will perform four more ACL reconstructions and potentially see more patients if necessary. We’re looking forward to sharing more stories about our patients here, so check back tomorrow for more photos and a recap of Tuesday! 

Day One in Cambodia

Sunday

Today was our team’s first full day in Cambodia! Dr. Hsin and Dr. Bierbrauer saw patients in the clinic and decided which were fit for surgery. We are planning to perform as many surgeries as we can while we are here and are planning to be in the OR from Monday to Thursday. They cleared two patients for surgery tomorrow. In the meantime, the rest of the team got acclimated with the local medical staff and unpacked all of the medical supplies we brought. Our circulating nurses also prepped OR equipment and supplies for tomorrow’s surgeries.

Once our work at the clinic was complete, we went out for lunch at a nearby beer garden. We are really looking forward to starting our surgeries tomorrow! 

Zimmer Donates Spine Supplies to Cambodia Clinic

Zimmer Biomet donated $5.7 million in spine medical equipment to the The Cornerstone Foundation and our team delivered it to Dr. Sim Sokchan, Neurosurgeon and Country Director for CMMC Jeremiah’s Hope Hospital in Phnom Penh, in January of 2020. The only conditions of the donation were the implants would not be sold and patients would not be charged. We are thrilled to be a part of this incredible donation and very thankful to Zimmer and their generosity.

"I am so fortunate to have this equipment and am probably the busiest surgeon using the equipment,” says Dr. Sokchan, He points out not many facilities exist in the country that can do spine surgeries – only three national hospitals and Jeremiah’s Hope.

And the timing of receiving this donation could not have been better. “I was about to order spinal screws, but they are very expensive. My wish was to order them from Korea, but they are still very expensive. So, I was about to buy some more affordable spinal screws from China, but they are not top quality,” he explains. Then, this donation came through. Not only did it contain screws but also, rods, everything for deformity, fractures, fusions, cervical, thoracic, and lumbar products.

He is encouraged that his team will no longer be limited by lack of equipment and that this donation will cover five years of lumbar spine, thoracic spine and cervical spine instrumentation surgeries. He estimates that in an average year, he completes about 90 procedures using spinal implants. With the Zimmer Spine equipment, he expects to double this number to 180 per year.

This is a story of “if you ask, you shall receive,” a total hip replacement.

This is a story of “if you ask, you shall receive,” and how we all received some extra joy from this young woman’s turnaround in her quality of life.  

It started with a simple conversation and a lucky coincidence.  In the last week of January, Ed Correia told his physical therapy patient Stacy that she would have to work with another therapist while he was away on a trip.  When Stacy asked where Ed was going, he told her about the medical mission trip to Cambodia. Stacy took a great interest in this because her in-laws have been missionaries in Phnom Penh for over 20 years. Bit of an understatement:  Sou and Ted Olbrich, are the founders of , which cares for 2,400+ separated or orphaned children in Cambodia. Through Sou and Ted’s initiative, thousands of orphans have been cared for, loved and educated through the FCOP International’s ministry.

Stacy mentioned that she had recently been on a mission trip to Cambodia with her family, working with FCOP International.  She brought to our attention that a young girl named Dany was in need of hip surgery. “This is a long shot,” she said and asked if there was any way that the Cornerstone Foundation team could provide care for her during our visit. The answer was yes!

About 7 years ago, representatives of FCOP International helped to get Dany out of a house with an abusive stepfather.  In Cambodian culture, stepchildren can be treated very poorly, frequently like a servant instead of a son or daughter. When she was only 11 years old, her stepfather got angry with her, and pushed her off the roof of their house on stilts, which meant that she fell down two stories to the ground suffering multiple injuries including a broken hip.

Someone in her local village took her out of her home at her mother’s request, because her mother feared for her safety in the presence of the stepfather, but the mother stayed at the home.  At this young age, Dany had a broken hip, infections at the injury site and tuberculosis of the bones. The free children’s hospital completed a surgery to clean the hip joint, but the hardware failed and she has walked with a painful limp for the 7 years since.  She also walked with a bent leg, stepping on only her toe, instead of using her whole leg and foot.   

Despite her pain and difficulty in walking, Dany goes to school now.  Even though she is 18 years old, she is in the 8th grade because she is catching up on the school she missed during the difficult years in her step-father’s home.  

Dany loves to perform traditional Cambodian dances, but she can do only certain dances and then only in pain.  Once she gets through her hip repair, she dreams of playing sports and dancing all of the dances that she cannot perform right now with her hip injury.  Her goal is to be a lead dancer and even a singer in the worship team at her church.  

Her treatment with the Cornerstone Foundation team started with Ed Correia (whom we have to thank for this entire experience).  Prior to surgery, he gave her physical therapy instructions so that she can go into the surgery prepared and come out of it stronger.

Dr. Ian Weber performed a total hip replacement on Dany.  Later that same day, he assisted and coached her as she walked her first even steps in seven years using her new hip, evened-out legs and both feet flat on the ground!  

The team rejoiced in Dany’s successful outcome and cheered her as she walked.  Dany lives with a loving foster family thanks to FCOP International. This family, a local physician and a pastor are providing her post-surgical care and facilitating her physical therapy.

What makes her different from any other girl her age? She is a double below-the-knee amputee who walks on her knees.

Chantrey means “shining star at night.”  Little Chantrey loves to go to school on her island of Koh Dach, because there is a large playground where she likes to play on the swings and the slide.  She also likes the subjects of math and reading in school, plus she says she is learning karate and judo.  

What makes her different from any other girl her age?  She is a double below-the-knee amputee who walks on her knees.  

Chantrey lives with her mom, two sisters and three brothers in a house on stilts on their home island.  She is the youngest of the six of the six children. Her father drowned in an accident years ago. To help the family get by, her mother collects recycling to make money, and four of the other children are already working.  In addition, neighbors on Koh Dach help their family by finding work for the children. Koh Dach is an island in the middle of the Mekong River, so the family takes a ferry to access the “national road” to get to Phnom Penh.

Chantrey’s mom drives her to school on a motorbike, because at 100 meters away, the school is too far for her to walk to on her knees. Her mother explains that her little girl Chantrey is growing quickly and getting heavier.  The entire family lives in a house on stilts, because in the rainy season, the house on this island in the middle of the river would otherwise flood. Right now, family members are still able to carry her up the steps to the house, but her mother emphasizes with a smile that they carry her up a long set of 17 steps to get her into the house. Her mother really emphasized the 17 steps.

Her mother told us about Chantrey’s early childhood.  She was born in 2012 after a full-term pregnancy, with her two full legs but with feet that were not fully developed.  Shortly after she was born, she underwent four surgeries on each foot. Chantrey’s feet became very infected. Following these multiple surgeries, the infant girl was getting weaker and weaker in the hospital, according to her mother, and was being nourished by tube-feeding.  The doctors wanted to do one more surgery on Chantrey’s feet, but her mother refused. She said she was feeling “hopeless” and just wanted to bring her baby daughter home and breastfeed her. She brought Chantrey home, continued with the breastfeeding and cared for her daughter as she healed.  Her mother said that she grew up healthy in every other way after she was able to bring her home from the hospital. 

Chantrey could stand on her below the knee amputated legs at the age of one.  At the age of 1 ½ she started walking on her knees. Her mother says that Chantrey never had any serious illnesses after the many surgeries and that she is an easy child. Even when she gets a little bit sick, she never complains, she is very patient and she never cries.  

About a year ago, when Chantrey was 7 years-old, a charitable organization provided her with prosthetic legs.  She received training to help her walk with the prosthetic legs, but it hurt her to walk with them and she gave up after a few months. The consult with Dr. Daniel Ocel revealed that her bones are growing out through the bottom of the amputation sites, resulting in a very painful base and connection point for prosthetic legs.  She is a growing girl with a growing skeleton! Right now, she cleverly fits the portions of her legs that are below her knees into a set of rubber sandals and walks on her knees. We heard she even runs on her knees!

Another memorable aspect of Chantrey is that she has an extra intra phalangeal crease in her finger, which means that one of her fingers has four segments instead of three.  According to palmistry, an extra crease provides a heightened ability to communicate. She sure charmed us!  

Dr. Ocel’s summarized the surgery as, “It could not have gone any better. We were very lucky.”  The repair of the flaps on the bottom of her legs went perfectly. When Dr. Ocel showed her the mom the pictures of the new revised legs, her mom started to cry.  Then, when he told her mother “no more surgeries,” that’s when she really felt the emotional relief.  

She and her mother were brought to Mercy Medical Center in the south of Phnom Penh when Dr. Ocel and Ed Correia were there giving their presentations to the staff.  Her Scottish case worker was extremely helpful is making the introduction and doing the translations.

We are grateful that Dr. Ocel was able to take this case in a matter of days to manage the travel that this mother and daughter need to do back-and-forth between Mercy Medical Center in southern Phnom Penh, Jeremiah’s Hope in central Phnom Penh and their Koh Dach island home which is 2.5 hours travel each way. 

This young man is ten years old and has learned to live with this condition.

This young man had a congenital deformity known as pre-axial polydactyly, a condition in which he was born with two thumbs on each hand. It is actually not as uncommon as one would think. Here in the U.S. it is usually taken care of very early, even by the time the newborn goes home.  This young man is ten years old and has learned to live with this condition. In Cambodia, it does “take a village” to survive as most people are farmers and they survive together as a community. The young man and his family were slowly pushed aside by the community because they believed that the young man was cursed due to his extra thumbs. Being ostracized in Cambodia is a very serious issue. Without the communities support this young man and his family were in a very tight spot.

Dr. Ocel performed the operation to remove his extra thumbs. The surgery turned into quite the event. During surgery dozens of people gathered waiting to see the boy post-op. After the surgery the boy's family and the people who had gathered were overjoyed to see the boy with only ten fingers. The boy has gone on to become a well-known bike mechanic and a local celebrity for his physical transformation. The family is no longer on the “outside”, and is vital component of the interdependent community.

This boy had a femoral osteotomy performed.

This young boy is a good example for a typical orthopedic case that we run into on our missions in Cambodia. Many skeletal issues if untreated lead to chronic problems later in life. This boy had a femoral osteotomy performed. This is a surgery in which the physician cuts the femur and realigns it. The operation is extremely vital especially for young children like this boy. Without the operation there are many likely resulting handicaps such as hip impingement, articular cartilage damage, labrum tears, and hip joint damage. In Cambodia these are all extremely life threatening issues as much of their livelihoods depend on farming, a labor-intensive occupation.

A tibial plateau fracture (knee fracture)

Post operation

This man had been hit by a scooter and suffered a tibial plateau fracture (knee fracture). Pedestrian accidents as well as driver accidents are quite high in the city as there are very few pedestrian and driver regulations or rules. The lack of safety leads to many different types of injuries as well as fatalities. We first met this patient when we went to visit him in the inpatient unit to set him up with a knee brace. Upon seeing him initially, it was evident that he had lacerations and bruising about this face. He was in a considerable amount of pain. Alongside him was his family, concerned and unsure of what was going on. Luckily, a Cambodian nurse was able to  bridge the communication barrier and communicate to the patient that we planned on surgically repairing his fractured knee. He was so thankful to have medical care.

Cambodian staff and one of our team members displaying Exceptional teamwork!

The following day the team was able to repair his fracture, ultimately enabling him to return to his occupation, family responsibilities, and future desires. Furthermore, we were able to serve people in a way that they were able to “pass on” and continue to improve Cambodia with their own unique talents and abilities. Another aspect that was amazing was the level of teamwork that our team from Colorado and the Cambodian staff was able to accomplish. While we were in the clinic one patient exclaimed, “Come back sooner next time!” We will.

Kheav's shoulder had been dislocated for more than two months. His humeral head was sitting inches below where it should and it was fractured.

On the July 2012 trip to Phnom Penh, Cambodia, the orthopedic team sent by the Cornerstone Foundation met Kheav, a 50-year-old poor farmer with a shoulder injury that rendered his arm useless. In May 2012, Kheav was plowing his field when his water-buffalo kicked him in the shoulder. Kheav experienced immediate pain and found that he was unable to move his arm. Realizing that without the use of his arm he wouldn't be able to farm nor feed his family, Kheav sought a local physician for help. Since there are not any X-ray machines in Kompot, the country providence Kheav is from, the physician was unable to diagnose him and told him he did not know what was wrong with his shoulder. Kheav returned to his farm where he struggled to plow the land and maintain the fields alone with only one functioning arm. After struggling for awhile, Kheav realized he couldn't farm anymore, so though already stricken with poverty, he was forced to hire people to farm for him. Kheav's situation seemed hopeless; he had one functioning arm, one completely useless arm, he was poor and forced to use what little money he had to pay others to work for him. He still did not have a diagnosis and there was no solution in sight.

Two months later, in July 2012, a missionary in Kompot told Kheav that an orthopedic team had come to Jeremiah's Hope clinic in Phnom Penh and advised Kheav to travel to the capitol to see if they could help him. After an expensive three hour drive, Kheav arrived at Jeremiah's Hope* on July 23, 2012 where he met Dr. Joseph Hsin. After a quick X-ray Kheav finally discovered the cause behind his pain and his inability to use his arm; Kheav's shoulder had been dislocated for more than two months. His humeral head was sitting inches below where it should and it was fractured. Dr. Hsin gave Kheav the news that he had been hoping to hear ever since his injury; his shoulder could be fixed. Just two days later, Kheav was taken to the operating room at Jeremiah's Hope where his shoulder was surgically repaired and put back in place. Although Kheav's story is unique to him, people all throughout Cambodia find themselves in similar situations: different injuries and various medical conditions without money to pay for health care or the ability to find physicians who are available and capable to treat them.

The amazing thing about Kheav is, although his shoulder was dislocated for two months, he never complained of pain or the unfairness of the situation. Instead, he only voiced his desire to have his shoulder repaired so that he could work and support his family. It is a selfless attitude that seems to be universal amongst the Cambodians. In spite of a government that has let them down and in spite of not having access to health care, the Cambodian people demonstrate a calm acceptance of the way life has turned out. They are friendly, always willing to help, and do not complain. Kheav, along with the rest of the Cambodian patients, simply appreciate that a doctor from America cares enough to help them.

*Jeremiah's Hope is the clinic that the Cornerstone Foundation partners with in Cambodia. All surgeries are performed at this clinic and this is where most of the donated medical equipment is sent.