A helpful training course
During the months following the review we received a number of requests from Cambodia asking whether we could arrange an electrician’s training course for maintenance personnel. TMC is on a tight budget, but when our two instructors, Mr Edgar Kalås and Mr Øystein Stene, were both granted paid leave by their employers (Norwegian Broadcasting Corporation, Rana region, and Helgeland Hospital respectively), we found the funds to implement a four-day training course in basic electrical systems analysis. The invitation to a training course was sent to seven local hospitals in north-western Cambodia, and a total of 22 participants showed up for the first day of training on 10 February 2014. It turned out that only three of these 22 had any previous electrical training – the remaining 19 were doctors, nurses and midwives. In other words, the group that convened came from a variety of backgrounds and with very differing experience, and the instructors needed to make use of untold pedagogical skills. The teaching and lecture plans made in advance had to be scrapped, since most of the participants did not have even the most basic knowledge about the nature of electricity. The training course was therefore refocused on practical exercises and imparting an understanding of electricity. The instructors demonstrated safety equipment such as gloves and visors, and each hospital was provided with a simple multimeter for use locally. A practical course examination was held, including basic first aid in accidents involving electricity, before all participants received their course certificate.
Øystein, who is a medical-technical engineer, also performed additional maintenance and repair work on some equipment as part of his teaching, and he had rarely seen more enthusiastic helpers and spectators. As an example, it turned out that a defibrillator donated by an American organisation had been designed for 110 volts, and therefore did not function in Cambodia where the grid has 220 volts. Øystein rebuilt the defibrillator, to major accolades from the hospital staff.
The instructors and participants both had their greatest «Aha!» moment when they set out to repair the lamp in the operating theatre of the hospital where the training course was held. The hospital is relatively large and provides medical treatment of a high standard. The surgeons claimed that the lamp was faulty, since they received constant electric shocks while operating. It turned out, however, that the lamp was perfectly fine, but none of the electrical sockets in the operating theatre were earthed. In other words, all the equipment including the diathermy was electrically charged. All the course participants recognised the problem from their hospitals, and we may therefore assume that lack of earthing is a major problem in many Cambodian health institutions.
One of the hospitals represented on the course had been opened in the winter of 2013. The hospital was located in the north on the Thai border, and national authorities had devoted a lot of funds to the project. Its modern architecture, however, was not adapted to local conditions. Most rooms had no windows and thus depended on air-conditioning, and electricity is extremely expensive in Cambodia. After the first rainy season all the electrical equipment was destroyed by powerful lightning strikes. Patients had to be relocated back to the old one-storey buildings, where air could flow through windows and grills. The repair work was extremely costly. The director, who is also a doctor, is worried about the future in a building that would have served its purpose well in California, but not in the jungles of Cambodia.