Even today unidentifiable fluids dribble in patches down the stairs. But only a few patients sit outside the operating theatres that are the same as those in which Dr Carmichael and his team saved lives decades before.

Inside the circular theatre stands an operating table with rusty armrests. It all looks the same as in 1975, the Scottish doctor said, except that the floor is no longer covered with blood, and there are no buckets full of amputated limbs.

Primitive conditions
Back in November 1974, when Dr Carmichael came to Phnom Penh as a 33-year-old, he was part of a Scottish Red Cross team that treated people injured by the conflict that had spilled over from Vietnam.

Surgery was often performed under primitive conditions. The focus was on saving lives, rather than investing time and technical equipment in delicate surgery. There was little opportunity for post-operative care, so surgery was carried out with ketamine, a short-term anaesthetic that allowed patients to walk soon afterwards.

Once his team treated a woman who had been walking around for weeks with an M79 grenade lodged in her shoulder, fired accidentally by her husband when he’d been cleaning it. The grenade had to spin to be primed – this is perhaps why it hadn’t gone off, he recalls.

But when the surgical team wanted to remove it, they took special precautions. They took the patient to a sports field, where they put her in a metal box that would partly protect the team should the grenade go off. The operation went without a hitch and Dr Carmichael later used x-rays of the procedure to train students.

In those days, blood was in short supply. It was stored on a “bank” system where patients could only withdraw what blood they or their families had “deposited.”

As a result, Carmichael found himself visiting factories and monasteries to ask for donations. Monks were a good source of blood, although they were only willing to donate half a pint each time. Unlike others in the population, monks were well fed and unlikely to be anaemic.

Smiles amidst the hardship
One of the doctor’s strongest memories is of the cheerfulness of the Cambodians: “There was so much hardship here, but the Cambodians were wonderful people. They would smile and laugh and be friendly, even when life was collapsing about them. They tried to carry on in the usual way.”

Working conditions worsened as Khmer Rouge forces approached Phnom Penh. The team often found themselves in the line of artillery and rocket fire as they continued their work.

Dr Carmichael remembers walking down at the Tonle Sap River promenade one evening – against the orders of the Red Cross delegation. Out of the dusk, a rocket hurtled across the river and into a building on the riverside. He took cover momentarily and then went to see if he could treat anyone injured.

On another occasion he was hit in the stomach by shrapnel, but radioed for help before continuing to tend to others. When he returned to the hospital, his colleagues were astounded to see him.

“We thought you had been killed,” they told him.
“Yet you carried on working?” he joked with them.
“Yes – we didn’t know what else to do.”

After the United States withdrew from Cambodia and the Khmer Rouge took Phnom Penh, the doctor was one of about 2,000 people who sought refuge in the French Embassy compound.

Now he strolled around the park-like grounds of the embassy again, remembering the last-ditch attempts of the French officials to save the lives of foreigners and Cambodians.

Watching history unfold
Today, under the tamarind trees that shelter deer and monkeys, is the fragile green metal gate that the doctor and many others scrambled over to seek safety. This is the central image of The Gate, a book by Francois Bizot about a Frenchman’s horrific experiences during the rise of the Khmer Rouge.

Carmichael is also part of the composite character of Dr Donald MacIntyre, a Scottish doctor in the book and film, The Killing Fields. A plaque beneath the gate commemorates the tragic events of 1975.

Dr Carmichael remembers the embassy being like a goldfish bowl, from which residents could watch history unfold in the rest of the city.

Amid the tragedy, moments of lightness broke the tension. Dr Carmichael recalls an incident - also recounted in The Gate - when a sudden rain shower gave people camping without running water in the French Embassy grounds the chance for a wash.

Carmichael remembers that Bizot, normally a serious man, was the first to seize the opportunity, stripping off his clothes and grabbing a bottle of shampoo. The Scottish doctor was last in line for the shampoo, receiving it just before the rain stopped, leaving his hair sticky for days.

Near the Hotel Phnom Penh, now called Hotel Le Royal, home to many foreign correspondents and aid workers during the war, the doctor points along the road.

“This is where I had my first meeting with the Khmer Rouge. They stopped our ambulance, searched us and stole my watch.” The soldiers also opened sterile surgical packs to see what was inside, ruining them.

After the siege, the doctor and other foreigners were driven in convoy to the Thai border, passing empty towns and streams of ordinary Cambodians forced into the countryside. The driver, a Khmer Rouge soldier, shared his tinned sardines with the doctor and looked forward to seeing his family in Phnom Penh.

Risen from the ashes
The doctor hoped the expulsion of expatriates would herald the start of a positive new chapter for Cambodia. Instead, what followed were five years of forced labour, and the starvation or execution of up to two million Cambodians.

After leaving Phnom Penh, Carmichael returned to Scotland, then went on another Red Cross mission, to war-torn Angola, another country he was forced to leave because of conflict.

Today Phnom Penh is a graceful city of restored French colonial-era mansions and tree-lined boulevards. The thousands of refugees camped on grass verges are now only a memory.
“I feel lucky because I had the opportunity to help other people,” he said. “I’ve avoided coming back for so long. I worried about what I would find, what I would remember. But it's been pleasing to see that Cambodia has risen from the ashes.”

Although at peace, Cambodia is still scarred with the remnants of war. Every month, some 70 people are killed or injured by landmines or unexploded ordnance.

“The Cambodian Red Cross continues to cope with the aftermath of the war,” says its secretary general, Professor My Samedy.

“We have a landmine awareness programme to warn people of the dangers. We also work to minimise the devastation of mines. And we have a project to help people injured by landmines to support themselves and their families.”

During the Pol Pot era in the late 1970s, the Cambodian Red Cross split into four factions, each struggling to cope with overwhelming humanitarian needs. Today the organisation has been reunited with the vision of reducing poverty and protecting the humanitarian needs of vulnerable people.

Its work is desperately needed: Cambodia is one of Asia’s poorest countries, with one of the highest numbers of landmines and unexploded devices in the world, the highest rate of HIV/AIDS infection in Asia (2.8 per cent) and widespread malnutrition.