Phnom Penh 2007 (1)

More photos on worldisround.compeople and hospital & related. Original travelogue on Travelpod.com 

2007 Trip: Getting ready, Hong Kong, Burma, Thailand, Phnom Penh (1) & Phnom Penh (2), Luang Prabang

Others of my sites: Home #2, Home #1, Journals 2007.22007, 2006, Personal Page, Asia Trips 2005, 2006, 2007, Asia Photos; Budget Guides to Southeast Asia & Hong Kong; A Cottage Garden; Refugees; Israel & the Middle East; Haiphong Red Flamboyant; East Dallas Restaurants

Phnom Penh (1)
Phnom Penh, Cambodia
Jun 10, 2007  23:06 ( local time )

Bangkok to Phnom Penh (Sunday)
 
Up at 4am. Shower, can of coffee, taxi to airport for 167B. We were 7 kilos over on luggage (Air Asia is cheap but strict on weight), so had to pay 1120B. Lucky us, they didn’t check the weight on our carry on, which has 7 kilo limit – ours was very heavy. Fast flight BK to Phnom Penh. Having done this before we were fast through immigration. When we walked out there were Samnang and Mony (I’ll explain who everyone is shortly) waiting for us. Slow drive into the city (Samnang always drives with majestic slowness). Photo: Mony, David, Sophea (at Hagar)
 
The family that has taken David into their lives has given us an aircon room with attached bath for the duration of our stay in PP. David lives 2 door away, so here we are – together again. Samnang suggested lunch at 12 – okay – but of course about 9:30 there was some food – rice with charcoaled pork, fried egg, pickled vegetables, and tea.


David and I carried his things to his apartment 2 doors away and 3 flights of stairs up. He had some Thai Intl. give-away things and a beautiful betel nut box for us. On our way back to Leslie, a woman neither of us had ever seen before stopped us and gave us a bag of pastries she was making on a griddle (like a miniature cornbread thing) over a charcoal fire. That was a nice way to start!

Lunch at 12 was chicken with a lot of ginger, soup with leafy green vegetables and little meatballs, rice, tea, and lychees. After lunch David and I walked over to the market for me to meet the shopkeeper he has bought some things from. As it turns out, she is the same person I bought some silver from last year. It’s very hot here, but not as hot as Burma. Back in our room Leslie was asleep. I showered and fell into a brief, deep sleep.
 
The family who has given us a room is headed by Samnang, a man my age – dignified, very focused, with much of his focus on his granddaughter, Mony. Samnang’s wife is Sokom, very beautiful, also dignified, and always dressed as if to go out for a ceremony. His son-in-law Than works at a hotel is quiet, reserved, and seems maybe a little sad. Than’s wife, Jeudi is jolly and cute. She works very hard in the home and little café downstairs and is a brilliant cook. They have two daughters, Sophea and Mony. Sophea is a basic cute 8 year old girl – especially with her school uniform on (blue jumper, white blouse, red tie. Mony is 10 and very bright and focused. She goes to two schools and in one (the private one maybe?). She is the youngest student, with most of the other children ranging in age ~12-16 years. Mony is pivotal in us being here.
 
Dinner our first evening is pleeah sat bo (phonetic) – beef, noodle, lime, herbs, fish sauce, and peanuts. Also soup with watercress I guess, rice, fruit.
 
We slept well and Monday the hospital van picked us up for a pretty crazy drive across town. I met with Phalla, one of the nurse educators and we worked out a schedule for this and next week. I had been concerned that they wanted me to teach hospital-based material (probably because that’s what they said in the original email. But, when we talked I learned that Phalla had sent another email after we left on the trip and the plan now is better than initially. Phalla and I have a lot in common and from the beginning I liked her seriousness and drive. Photo: Phalla and me at going away party

 

So the plan is I’ll teach things like symptom management, spiritual care, and psychosocial care to staff and program development and grant-writing to leadership. I’ll also be working some with the home care team in their HIV?AIDS project. Almost everything I’ll be doing is focused on capacity-building vs. actually providing patient care. Not my first choice, but I understand. Leslie is working on grant-writing and administrative things, ethical issues related to social work, and community education. I spent the rest of Monday putting classes for Tuesday afternoon.
 
Day 3 (Tuesday)
 
I met Chhavelith, the home care coordinator and two Australians (an ER nurse and a medical student) in the hospital “lobby” – an entranceway full of sick people. We rode motos to a slum area (that I later learned is called “the greenhouse” because there is a green sheet metal fence around most of the area. We visited several families with HIV infection and watched the HIV nurse making his weekly medication visit (I am he as he is me as we are all together – really, just like the sort of thing I do).
 
About 1300 families live here and conditions are pretty grim – people living in homes that are open-sided with thatch, plastic sheet, or tin roofing. All that I saw were about 8’x8’ up to 10’x12’ with wood platforms over dirt. There’s no water or electric and there are piles of trash here and there – but no particular stench, either. Chhavelith and the Australians talked with a widow (HIV+, her children, too) while the HIV nurse took care of medications for a steady stream of people and I walked around some. Not many of the children had the red-blonde hair of serious malnutrition, so that was good. After awhile I came back and sat with Chhavelith, who started talking about human rights and injustice. I’m listening and at the same time flashing on times I’ve heard other people talking about these things when the words were unreal. This is a good man.  

 

Heart of fire, on fire
Heart of water, flowing
Of diamond, gold, pure
Soft, embracing
Speak of justice like a vow
Like rain falling on dry land, thirsty
Speak the Word to the dying
Like coming home, at last.
 
We visited another family with HIV – the woman sitting on the living sleeping platform holding her sick baby. Her husband beats and humiliates her. He’s a drinker.

We stopped by a crematorium where a small funeral ceremony was being held in a corner of the roofed courtyard. The man who runs the place is an acharn (lay spiritual leader) who will cremate people on credit – a far-out concept, but that’s the nature of this whole bleeding scene. I set my bag down on a table and they said, “No don’t – it’s where they put the bodies.”
 
From there we went to an apartment building and walked up 3-4 flights of dark stairs (the story of my life) and when we got to the top a German shepherd dog (like it might have been a German guy who works as a shepherd) lunged at us, which was pretty exciting. We were going to a little house on top of the roof where a woman with HIV lives. She is a widow and is maybe demented or maybe it’s something else. Awhile back, her friend died and she took the friend’s children in. One of the girls is HIV+ and the other is not. Now the virus marches on in the woman’s body. The woman’s mother came over and told Chhavelith more details about her daughter’s mental illness. She has to help her bathe and sometimes her daughter has breaks and runs through the streets to her mother’s home (where another sick person lives). The mother cries and asks what will she do when her daughter dies? Who will take care of these two thin girls? No answers.


I’m sitting on the floor thinking of these children with only these moments – happy, it seems, right now, sitting on the floor with their dying, mentally ill adoptive mother.
 
Lunch with Leslie, David, and Gerlinda. I wrote about Gerlinda last year – a woman from a poor family in the Philippines, who went to medical school in cold, cold Soviet Union, who has worked in this mission for years – were we talking about hearts of fire? We had lunch at a place that trains street children, prostitutes, and people in like circumstances to work in food service: kitchen mission/good buffet.
 
After lunch I taught 2 classes on pain management. Most of the class time was spent on introduction. People in the class talked about what they do, the hardest part of their job, and why they became nurses. Mostly they talked about the same things any of us would – wanting to serve, to help, the pain of seeing people in pain and not being able to help, poor people – you know, universal things. Basically the classes were affirming for most of us I think. Hearts of Fire.
 
After work we went back to our room, except that David and I walked over to pick up some laundry and go see his friend Philinda (Linda). Linda and her mom are charcoaling and selling chicken, etc. outside their home across the street from the market. Across the road from Linda’s there was a ceremony happening – the 7th day after someone died – a lot of people attending, music, etc. The truly grand little girl (Ngam Ngoi) that we spent time with last time through was there, which was really cool. We all hung out on the corner – good times. Photo below: the story of my life
 
We had dinner with David’s friend, Igor, from the Philippines. Back to our room for a shower and collapse. Thud.

Phnom Penh (2)
Phnom Penh, Cambodia
Jun 11, 2007  01:11 ( local time )

Phnom Penh (Wednesday)
 
Worked all morning getting ready for meeting this afternoon. Like in the classes yesterday there were two primary themes in the meeting: compassion for the poor and pride in themselves and their hospital. From some notes I took:

 

“Very poor … we cannot accept … very, very sad. I want to help the person who is dying and cannot speak … maybe they want to say something before they die (but we don’t know how) … they want to go back home, but cannot. No family to care … poor … no food … no one to help to the toilet … he has a house (apartment on 4th floor), but unable to go up the stairs … patient hopeless/end stage so stays here until she dies. I want to help poor people. I love this hospital – helping the poor. My heart just pours out for the hospital … faithful to the hospital … faithful to the poor people.”
 
After work I walked up to the internet café while Leslie stayed in our room waiting for Linda to come and work on immigration papers. When I was finished, I went by Linda’s and discovered that she had not gone to our room to see Leslie because her grandfather is sick with a liver problem for which the doctor said nothing else could be done (it turns out he has liver cancer). And there he was, half sitting, half lying in kind of a chair outside their house with family all around. He was cachectic and too weak to stand. Linda said, “We want to cry, but cannot in front of him” (because he might lose hope). Photo: TB clinic


Thursday: I worked fast this morning to get ready for afternoon class. I remembered as I worked that the woman for whom the ceremony was being held at the crematory when we were there had killed herself.
 
Friday: Cambodian pho for breakfast – excellent as always. On the way to work stopped at the Central Market to buy some shirts (3 shirts for $7). Spent the morning working on a report on the 1st week’s activities. Went back to Hagar for lunch (the place where they help people in tough situations learn food service). While we were there I saw someone in a t-shirt that said “I Am Not For Sale.” After lunch we went to …

 

Community Resources Center (CRC) – Ahhhh, home at last.
 
We walk through the waiting area where people are waiting for direct observed therapy (DOT) for TB and up (of course, what else) 3 flights of stairs. When we get to the top we talk for a few minutes with Chhavileth and some other people on the HIV home care team. We all reflect on the photograph of the team member who died from AIDS 2 weeks ago – these moments of reflection seemed deliberate and important. Then (of course, what else) the plan was for us to go back downstairs for a tour and then (of course, what else) back up for a meeting with the medical director and Chhavileth. Leslie passed on the down and up plan. I went down and saw some of the people I met earlier this week – still today, taking care of people with HIV and TB. Then back up (have I mentioned that Asia is all about hiking up stairs?) to meet with the medical director and Chhavileth. It was a good meeting – Leslie and I will both work with home care, infectious disease, and hospice staff and some with patients. So everything seems to be coming together perfectly. Photo: outreach


Now we’re at a farewell event for the outgoing director and his wife. We’re in an auditorium that gets pretty warm about 4 minutes into the festivities. It all begins with a blessing flowers dance and just a few moments into the hypnotic dance I click well and truly into Cambodia. It’s not just the dancers, but the day of writing about what staff said to me, lunch with David, Leslie, and Gerlinda, the time at CRC …

 
Cambodia!
 
After blessing flowers there is some folk dancing (blessing flowers is a formal court dance). All the dancing is the best I’ve seen – no surprise, this being Cambodia and all. Some of the music is recorded and some from gamelan and the dancers as well. At the end of the dancing we learn that the dancers (~30) are orphans. Photo: David and Antone playing at Art cafe
 
Cambodia!
 
I’m sitting on a row that goes like this: me; my son David on his journey through Cambodia; Miriam, a quick, funny internist from Germany who has worked here for several years; Ian, an Australian CPA whose ongoing mission across Asia is to balance the books; and Leslie, ah, Leslie.
 
All the speakers at the event are men except for Karen (the director’s wife) who speaks for <1 minute. Hmmm.…

It’s evening, 7:30. We’re at the Art Café with Leslie, me, Igor (Filipino singer), and Cec (Filipina HIV educator), listening to David and Antone playing a Mozart duet – geckos on the wall, hunting mosquitoes, Bia Lao ... Photo below: Chris and Siv


Cambodia!

 

 

Phnom Penh - My Life
Phnom Penh, Cambodia
Jun 14, 2007  23:05 ( local time )

Saturday
 
Two hours at the Russian Market. Whew, talk about hot, still air. Hopefully I’ll remember to take some photos inside there this next weekend. After the market, a day of shower, rest, shower, rest ...
 
Sunday


Back to the market to get some silk.

 

Ran into two Belgians from the hospital (we’re all dripping sweat). Like at home, it’s always nice to unexpectedly run into people you know. Back to our room – I went downstairs for a cooking lesson from Juedi – how to make pleeah ta khorn (raw beef salad) and luc lac (fried beef). As I mentioned earlier, she is an excellent cook and is also a good teacher. Photo: rice with pork and cold fried egg


After lunch, more sleeping, shower, and then I caught a tuk-tuk to the riverfront to have dinner with Chris and his wife. I met Chris on a backpacker message board (where he goes by salaygomez). He and his wife, Siv work for NGOs in the provinces – she in a food program and he in community development. It was a very nice dinner – pizza at (the notorious) Happy Herb’s Pizza – but we didn’t have the happy kind. Chris and his wife both very interesting – not to mention extraordinary. He is Italian/Albanian with a lifetime spent in the 3rd World and a quiet commitment to One Love. Siv is a Chinese/Khmer biologist with life experiences beyond the pale. But then it’s fairly common here to meet people who are extra-ordinary.
 
I’ve met some nice people on/via the internet:
o  Chris – a true old Asia hand
o  Jo – who has a great website on Burma and who helped me so much with Burma.
o  Tao – one of the co-authors of the infectious diseases book.
o  Ken – my WWII Australian pal
And many more.
 
The tuk-tuk driver from our place to the riverfront took me through the amazing throng of people who come every Sunday evening to picnic in front of the royal palace and on the river. When traffic would stop (like about every 50 feet), there would be a press of people up against the tuk-tuk and there we’d be, inches from one another, sometimes touching, smiling at one another (girls giggling, like “Did you ever see anything like that old foreigner in the tuk-tuk?). All the way around, a good scene. Photo: Phnom Penh street


Tuesday
 
Pho for breakfast (allllright!) and on to the hospital. I talked some with Jana (say yana), a volunteer NP from Connecticut, who is here with her daughter, Molly, who graduated from Berkeley this year. Then I caught a ride to the hospice to see if I could do something with patients, but when I got there my contact, Mony was not there. So I caught another ride to the Community Resources Center and did some writing for Chhavelith. I hope what I did was what he wanted. When he and I were leaving he stopped to talk with a girl. I thought there was something special about her and the way she was interacting with him and I asked him about her. That’s how I learned what follows (he told me part and another man told me part).
 

A true story: back around 1997 there was a man working in HIV/AIDS outreach here in Phnom Penh. He found a woman very sick with AIDS and got her into a public hospital. When he came to the hospital to follow-up on her (follow-up – a man after my own heart) he found her alone in a room with no care, nobody to clean her or feed her. Her 2 year-old daughter was with her, and when the hospital would bring the woman food, the little girl would feed her mother the best she could. The man came back a day or two later and the woman was gone. He went looking for her and found her and her daughter sleeping outside a railroad station. “She was very skinny and small.”
 
He took her to Hope, where she and her daughter stayed for a year before the woman died. At that time there were no services for children with HIV, so the man’s mother-in-law took the little girl into her home. Shortly after that, Hope started the child on what was then called “highly active antiretroviral treatment” (HAART) and is now called ART. The drugs were very expensive at that time and were paid for by “…an American. He lives in Japan.”

The man’s mother-in-law died in 2001 – about a year after he and his wife were married. So a year after getting married, they were given a family of his wife’s two siblings and the little girl with HIV, who was 6 or 7 at the time.
 
The man said, “She was a good girl … respectful …not the one who always complain … we always trained her how to independence.”

“At that time she’s not good in school … because of her sickness” (2001-2002). After 1-2 years she improved and started doing better in school. Her grades improved to “fair and good, never low … At that time I sent her to drawing school.” About a month from now the girl will go to Thailand to receive an award for her art through Japan UNESCO.
 
The girl is now 12 years old and in grade 6. First-line ART is no longer effective and she has started on 2nd line.
 
Cambodia (Hearts of Fire)!

I wonder why. Why did Bounthy's M-I-L see the child? Why did Bounthy and his wife see the child? Why did Chhavelith see the mother and child?

Lunch with Leslie, David, and several other volunteers. After lunch Leslie and I went back to the hospice where I was scheduled to teach from 2-4. Surprise, I was only scheduled to teach from 3-4. Dooh! I went upstairs to see patients for a few minutes and then came back down to talk with Leslie, the Agape social worker and Bounthy, the hospice social worker (the man who adopted the child). Man, I’m moving in high places and I’m not kidding. I pressed Bounthy for details on the adoption …
 
Praise with elation
Praise every morning
Lovely creation
Of the New Day.
 
Upstairs in hospice there was a very thin young woman, close to death (actually everyone there is very thin). Her brother was sitting beside her bed and they were holding hands. Maybe half the patients had family members there. Some were in chairs (like what we would think of as lawn chairs), some on mats beside the patient beds, and some on the beds with the patients. There are three beds/room (except isolation) and all the rooms have a fan (no aircon).

Many, the hospice nurse said this, but I don’t remember the exact context: “Oh my God – I very cry for her!”


We had the class on pain management and after class David came over with Jana and Molly for them to see the hospice. Afterwards we all rode in the same van to our respective places. Molly told us she taught at an elementary school (after assisting in a mastectomy that morning) before they came over to hospice, except she didn’t really teach – just hung out with 5-6 Cambodian girls, having a good time and sweating (no electricity in the school today). The girls wanted to have a sleepover with Molly.
 
One of the things I’m reflecting on is the mission of Baylor University, where I work. It includes something like this, “to prepare young men and women for worldwide service and leadership.” I’ve always agreed with that mission and thought it important, and now I feel it deep and strong – the incredible importance of such a mission in a world so broken and hurting. From Baylor to Berkeley, on the same road.
 
Dinner, as usual, was David, Leslie, Mony, Samnang (except he only takes rice and tea because of sickness), and me. Tonight we had beef with oyster sauce and Chinese broccoli, a great sour soup with chicken, and rice. After dinner we had dragon fruit and mangosteen – the latter emerging as my favorite fruit. Eating with this family is like a tour (de force) through classic Khmer cuisine. And the fruit! It’s an extravaganza and so much better than last time, when we had more oily curry than we wanted and assorted okay street food, except the fresh corn was better than okay.

Back to our room with David. The three of us together (like Leslie said last December), “piled up like bunnies.” Mony (the 10 year old girl, not the hospice nurse) came by to hang out, so now Leslie, David, Mony, and I are sitting in our room with the three of them listening to music and I’m writing this and it’s all so good.
 
Praise with elation
Praise every morning
Lovely creation
Of the New Day.

Vanida flying in tomorrow from Laos. Good times. Photo: rainy day