Surveys the nutritional and other tropical diseases likely to have been encountered 20 or so years ago by volunteer medical workers treating Cambodian refugees in camps in Thailand. Experiences at Thailand’s Sa Kaeo refugee camp suggested that medical teams came across conditions for which they lacked practical training. For example, mass starvation was rampant, the most common conditions being marasmus (an overall deficiency of calories), kwashiorkor (a protein deficiency), beriberi (a thiamine deficiency), and anemia. Some patients showed elements of all 4 conditions, with symptoms that included emaciation, edema, digestive disturbances, enlarged heart and liver, cardiac failure, and peripheral neuropathy. Since overenthusiastic attempts to re-feed and re-hydrate can cause sudden death, a basic 2,200 calorie-per-day meal of rice and thin soup was given to patients, along with vitamin supplements. After malnutrition, malaria was the most common problem. Lessons from experiences at Sa Kaeo pointedto the importance of administering a therapeutic dose of an antimalarial agent to every febrile patient. Medical volunteers were encouraged to take care of their own health because of the demanding work situation.
