No abstract

Background: Elevated levels of arsenic in drinking water in Cambodia were first identified in 1999. The first cases of suspected arsenicosis were identified by the WHO in 2002, and the first laboratory confirmed cases were found in 2006. Objective: Present three patients with ulcerating tumors of the legs who came from two different districts in Cambodia. Results: Cutaneous lesions characteristic of chronic arsenicosis were exhibited, and squamous cell carcinomas requiring amputation had developed. The clinical features of chronic arsenicosis and its surgical management were examined, in addition to its impact in Cambodia and current preventive strategies Conclusion: There will be an increased incidence of these problems in the future. Medical practitioners in the Mekong River Basin should be aware of them, so as to recognize them early, and treat them appropriately.

Over a period of 12 years, 24 burns have been treated by a Cambodgian and French team (Doctors of the World). This experience has revealed some characteristics of this population: (1) a majority of young women (2/3), (2) victims of assault (20 cases). These notions are found in the medical literature particularly South East Asia. All cases are of a third degree. Every surgeon, every anesthetist should apply emergency measures which are recalled here. The aims is to close all the burns surface through a skin graft within a month. However the patients are treated 6 months to 2 years after the burn and have, at this stage, terrible sequella (22 patients). Treating them requires the coordinated efforts of a multidisciplinary specialized team. The challenge is to save the eyes, the mouth, the nose and give back a "human" face to these young burns who are often rejected because of their handicap. Enabling them to smile again is a strong commitment from the surgeon and from the patient who has to undergo multiple operations and a long treatment over the years.