Cambodia.... week 2

A second week in Cambodia..... a new hotel, exploring the inner workings of a hospital and site seeing

Our lovely water lady

- During the weekend we got sick of the hotel booked for us..... there continued to be rubbish piles on every landing for days at a time, mice and possibly bed bugs..... So it seemed high time to go hunting a new hotel!
This basically involved just walking down our street, there is a never ending supply of hotels to try, and climbing endless seeming stairways.
Hotels tend to be 4 stories upwards..... and we didn't encounter any with lifts!
Happily, for a whole $1 more we get lovely, clean rooms, with a shower that actually works, fridges in room, air-conditioning, and no piles of rubbish or evidence of rodents or bugs.

The sad part of moving hotels is that we are no longer right across the road from this lovely water-selling lady. She is so friendly and happy every day! She also teaches her foreign customers basic Khmer. Starting with thank you, and when she discovered that we were back everyday moving onto numbers. She taught me to count up to 5.... then, before taking this photo I impressed her by counting to 10 (which isn't too hard.... seeing as it goes 3,4,5, 5-1, 5-2, etc)! We have discovered a 3 for 2 water deal in the little hotel shop.... but every few days I still walk down the road to visit and buy the water from her. I should be everyday.... but we have been so busy this week that walking down the road seemed like climbing a mountain some days!

We also checked out the palace and silver pagoda. The silver pagoda is home to a crazy amount of gold, diamonds and includes silver floor tiles throughout. However, I presume to protect against damage and wear and tear they are mostly covered by rugs, and the view-able tiles aren't polished up. But once you actually realise that it is all gold and silver it is pretty impressive! Plus a gold buddha weighing 90kg and covered with over 2000 diamonds! A large jade buddha and cases and cases of smaller gold and silver and bejewelled buddhas. pretty incredible!
Unfortunately we are not allowed to take photos in the silver pagoda, but here are some from the palace!

Bonus monkeys hanging out in the palace grounds

The amount of ornate carvings and gold is pretty mindblowing

The pagoda gardens

During the week we focused on giving some lessons in our new improved classroom and health promotion! Mainly getting the kids to wash their hands every time they come into the clinic. They are already starting to do it automatically, and telling other kids to go wash hands before playing. This has to be an improvement on kids with snot and filth covered hands playing with the blocks.... that other kids then put in their mouths or play with.

The kids decorating the when-to-wash-hands poster

There was a lack of space for all the kids to trace and colour their hands
on the actual poster.... so we had 2 going!

We also saw our village kids with disabilities. Discovering that the teenage boy we see (I believe his name is Sila, but not really sure of spelling!!) actually has an exercise machine and walking frame donated to the family from somewhere. Unfortunately, because of the way his mum helps him to walk, he tends to lean backwards and so is unable to use the walking frame safely. The exercise machine also seems to strengthen the pushing-backwards type muscles.... but we have been practicing balance standing on his own, and standing leaning forwards on the frame. He has actually stood without holding onto anything at all a few times now. I think he and everyone around thought that he could never do that!

We also work on balance for this young girl. I haven't yet been able to establish her name sadly, but she is always happy to play! Lots of kicking balls and standing on one leg! 

We have also been visiting Fatima (the double amputee) in hospital. Lots of stretching her tight little hamstrings, trying to get some strength back into her legs, hoping to mould her stumps into a good shape for prosthetics and trying not to cause too much pain during this whole process! Translation difficulties add a level another level of complexity to this already mighty complex situation... for example Lucy "is this hurting her?" "translator immediately replies "no." Lucy "Can you ask HER if it is hurting?"

Maybe I don't give him enough credit..... perhaps he is actually a mind reader :P

We are also becoming more and more terrified of Cambodian hospitals after seeing photos of Fatima in surgery when she arrived, fact a side that people were just hanging out taking photos in what should have been a fairly sterile environment - she didn't appear to be ventilated. So presumably was either barely sedated, or was sedated with no assist to breathing. Then, as we left on Thursday the woman in the bed next to Fatima looked like she was going to get traction on her leg, but in walked a series of doctors in surgical scrubs and masks with a box of stuff and a makita drill. It looked like they were going to drill into her leg to do the traction right there..... we confirmed this today. They drilled rods into her thigh bones in the ward room. Which had 2 patients who are unable to move out of their beds and their family. Apparently no form of curtains or screens were used. This, is horrifying!

Weekend adventures

For the weekend we ventured down to Kampot.
Staying in lovely bungalows next to the river.... well, basic bungalows next to a lovely river!
We went on a strange day tour. It was meant to be a trip to the local mountain and national park, see the "black palace" visit a waterfall for lunch and swimming, then a relaxing sunset boat ride up the river.

This was possibly one of the summer villas,
the guide was confusing

The national park tour was more a tour of deserted buildings. Turns out the french and the kings of Cambodia had a series of hotels, casinos and summer palaces.... which were all abandoned in the 70s for about 30 years. Now they seem to be the main attractions. I saw no evidence of nice walks, like you would expect of a national park.... but that might be because of the distinct possibility of landmines in the area!

some cool graffiti in one of the buildings

view out a window

View of the ocean from the top of the mountain

This is an old french casino/hotel. It is actually in quite good
nick, just completely gutted of any fixtures.
I think with some wall papering and fixing, this building would be amazing!
Instead they have built a giant tacky looking casino and hotel not far away.

the balcony of the french hotel

We then went to the waterfall for lunch. Turns out, there is no water because it is the end of dry season. So no swimming. I went for a walk along the rocks and found a beautiful ledge to hang out on and watch the world go by. Lots of nice butterflies (who seemed to be confused by my pasty white skin and think my feet were flowers) and the sound of the little bit of water in the river, birds calling, general rainforest noise. It was quite a blissful, relaxing place to sit!

All in all, the tour wasn't what I expected...... but it was a great day anyway!

The next morning we just chilled out on the deck next to the river, drinking fresh juices and reading out books. Pretty good day really.

Then a long, bumpy bus ride back!

On the way back to the hotel we discovered that they had some serious rain before we arrived, resulting in some serious flooding!

week 1 in Cambodia

The thing that strikes me the most..... is how different life is here to Vietnam. I knew it would be different, but I thought, seeing as the countries are so close, and share some history / religious affiliations things would be similar.

Nope.

The next is the scale of poverty, and lack of education.

On our first day here we went out to the killing fields. It was horrifying. The area is really well designed for tourists to give the history while maintaining the respect for the people who were murdered there. You get an audio guide which includes stories of survivors.  It  was so intense, and traumatic that I became numb. I couldn't cry, just feel physically sick. And while it was a horrifying start to a Cambodian trip, it was also a very very important way to get an understanding of what has happened to the people here. Context for those who may not be aware of details......  Pol pot wanted the country to be a communist, agrarian society. He de-urbanized and forced people to work in mass farms. Often without enough food to survive, yet alone do that amount of physical labour. To regress the country more effectively education was more or less outlawed. All the educated, or progressive thinkers were killed. Literature was burned. Whole families were murdered - to prevent children from seeking revenge when they were older.

About a quarter of the population was killed. So when you think about the effects of killing the most educated, forward thinking, progressive 25% of a population..... it helps put into context why so many things that seem logical, and simple and easy - just don't happen now.

Kids playing and reading at the clinic

We also visited the national museum. Which is dedicated to more ancient history and has a lot of carvings and stone tablets. Amazing carvings, and it was nice that it was a much more positive place. I think it would easy for all museums to be taken over with Khmer Rouge information..... and there are enough killing fields and prisons to provide that!

Monday and we headed off to the clinic we will volunteer at!

This young girl appears to have cerebral Palsy.

This clinic is located in a slum about an hours tuk-tuk ride from Phnom Penh. It supplies free medical care for anyone who comes in. Most of the day there is a horde for random children in here playing. It makes it a little childcare-ish.... but, it means these kids aren't playing in filth water or piles of rubbish..... so it is probably a pretty good injury/ health prevention strategy!

We were hoping that the disabled kids in the area would be able to come in while we are here so we can try to do intensive work with them. There seem to be less than was first thought in the local area. So far at the clinic we have been working with the young girl who has CP. She actually gets around quite well considering her poor balance and contractures! but we are working on improving balance and hoping to do some writing and drawing next week.

We have also been seeing a teenage boy with cerebral palsy and working on strength and balance for standing transfers (he is in a wheelchair).

There is another 14 year old girl we see in hospital in Phnom Penh. She stepped on a landmine about a month ago. I need to confirm with the translators next visit.... but they seemed to say the landmine was right behind her own house. I had assumed that she was walking in the jungle, or an empty field. Not right in her own backyard! She has had both legs amputated below her knees. But thanks to Hoin, the organiser here in Cambodia, she was able to receive nine blood transfusions and is alive. We need to meet with the doctors and try to get her better pain killers. At present it seems like she is on paracetamol. Her mum said she is so skinny because the pain makes it hard for her to eat. And we really want to get her moving, get her doing exercises and strengthening her legs in preparation for (hopefully) getting prosthetic legs. But we need better pain killers if at rest it is so painful she can't eat!!


Back to the clinic:
The clinic provides an awesome service. They are able to give people free medications as well as clean and dress any wounds that people might have. This seems so simple, but in this filthy, hot, humid environment seemingly trivial cuts or scrapes or boils could so easily get really badly infected.

Kids reading books in Khmer and English

Because we aren't nurses, and the patient load wasn't so high that the nurse couldn't keep up - we haven't been doing that.... and it took us a couple of days to get our head around the place, and come up with plans for how we can be helpful!

We are trying to get the kids doing more productive things than playing with  blocks all day and so have set up desks in half of the waiting area where we can do English lessons and health promotion talks.The treatment area and not lockable cabinet of medications were all in the waiting room. Where kids are constantly hanging around reading books and playing. This seemed a bit - not private, to us (they did have a fabric screen to put up, but if anyone wanted help with private issues it would be obvious to everyone!) We spoke with the staff about reshuffling to make more space in the waiting area for the classroom..... and keep the medications and medical scissors etc. away from the kids!

The new classroom area 

The classroom area has desks and chairs that can be stacked together when not used to make more space. The other half of the room is open space and large chairs for people waiting to see the nurse.

new "medical" room

The new "medical room" is in the back (and a lockable) room. This means people can have some privacy, particularly if they need to talk about personal issues, or things that might make the kids be awfully kid-like, such as UTI's or sexual health. And I hate to think that people might avoid the clinic because of all the kids hanging around. But if you sent all the kids away they will be outside playing in garbage. Plus, at the moment the clinic isn't so busy, so at least the kids being here means the nurse / volunteers can give lessons, or teach health promotion things!
It also means that the medications and sharps are away from the kids, and away from anyone who might get tempted to have sticky fingers. After all, these people live in extremely dire circumstances, and if someone was starving, and walked past and noticed no one in the open waiting area at that point.... it could be tempting!

The only problem here is that the light isn't so great as in the waiting room. But they have a fairly bright fluro and a medical spotlight. We are going to try to get another light as well to fix that issue!

We also instigated a "any kids who come in the building must wash their hands immediately" rule. This has caught on and some of the older kids will now point out new arrivals and tell them to go wash! :)

We found a box of toothbrushes in individual bags with names on them. They obviously hadn't been used recently, turns out that's because the kids who own them don't come to the clinic anymore. Some might be at school more hours (a lot of kids do half days at school) and some might have moved away.
We sorted them out and are going to take them on our next walk through the town so that if we come across those kids / their families we can give them the toothbrush and some paste. They might not get used when the kids don't have anyone reminding and nagging them to brush, but they are a lot more likely to get use than if they sit in a box in the clinic! We are also planning to buy a bulk lot of toothbrushes for the kids who come now (and hopefully spares for new kids) and add daily tooth brushing to the daily handwashing routine. Hopefully we can slow some of the tooth rotting, and start some good habits! (anyone who would like to donate small change to the buying-toothbrushes-and-soap fund is more than welcome too!)

As soon as we made the "classroom" kids came and sat at the chairs looking attentive. Unfortunately there was a wedding being prepped across the road..... which means music being blasted at a teeth rattling volume. Preventing effective communication, or even effective thought! Nancye and I instead focused on planning what we will teach next week, how best to teach, and what / how to do some health promotion.

When we came back from the back room we discovered our model student happily writing on the board and teaching the other kids! We are going to use our little teacher's pet as our official helper. This doubles as us having a Khmer scribe, because I am never going to be able to write that beautiful, but complex looking script! Plus, it gives her a role as teacher (which she obviously loves) and which might slow down her yelling out of answers a little. She is actually comparatively quite good as English letters and basic words. And she is proud of that fact, so constantly yells the answer out before any of the other kids have even computed the question! Which is great for her..... but means the others just wait until she says the answer, then repeat it. She is obviously a great reader in Khmer as well. We are hoping that if we make games so the lessons are fun and provide a number of "teach yourself English for kids" type books, kids like her who are desperate to learn, might harass the nurse or the other staff who volunteer (local people) to run some simple English classes, or even classes in Khmer or math or anything!

The slum near the clinic.

Looking forward to getting some English lessons in next week, and slipping some translated "when we wash our hands" "why we wash our hands" type lessons in too!

We also went for a walk through the slum community. These houses are built over an open canal/drain. Which is full of garbage so floods the area and makes the whole place more of a filth-swamp. The nice clean wooden bridge you can see in the photo is brand new. I think they said it was donated by past volunteers, or maybe an NGO. Before it was built people had to just walk through the filth swamp of garbage, rotting food and I don't want to think what else! This is where the lack of education / forethought really strikes me. There is a few open fields near by, where the people who live in slightly nicer houses just across from this slum (so we assume they have a slightly better socioeconomic status/education) obviously walk out to throw their rubbish, and I think burn it regularly as well. The people living over the swamp just throw anything, plastic, food waste - probably human waste, out their doors and into the swamp. Which they then have to walk through. And which I have to assume must flood and wash into their own houses when it rains. The nurse said that they have spoken with people about not living in garbage - but I don't know if they spoke to everyone, and it would only work if everyone was on board. But it seems that lack the understand of why living in garbage is bad, and so can't be bothered to change. I know another past volunteer mustered local people to pick up garbage and clean up the area, but I don't know how  much for the wet filth-swamp garbage they cleaned up with their emu-parade.

some of the houses in this area

Friday the nurse does outreach to another slum community. This one actually is next to a rubbish dump. But when you look at how much rubbish is piled in/under their houses, compared to how clean the unlived in blocks of land next door are..... it is again obvious that that rubbish is all their own! The thing here that amazed me the most.... was learning that the people living next to this dump, pay rent!

 In this community the nurse visits a few people to check blood pressure and general health (I think this is of people she knows to be at risk). Then as they walk around anyone with cuts or sickness seeks them out for attention.

kids wanting to be photographed is pretty universal.
These girls kept shouting one more in Khmer.

They give out little baggies of medications, clean and disinfect any wounds and give people some supplies to re-dress the wound in the coming days (after all, they won't be back for a week!)

We busied ourselves entertaining the kids - taking photos and showing them themselves on the screen, and checking the kids out for any cuts or open sores that need attention. We did find one kids with what looked like burst (or about to burst) boils. but he was crying and curling up to avoid us getting to them to look/clean them. So the nurse was able to give his sister some anti-septic powder, betadine, and instructions so she can do it later.

Giving him painkillers and anti-septic cream
so he can re-dress the wound himself

The man pictured here came in with a large cut across his leg. Apparently it was done on broken glass. I really liked that all the kids stopped playing and came over to watch, so they were listening to the instructions (that I assume were about changing the dressing and keeping it dry and clean). I hope that it helps show the kids that when they huve cuts etc, they need to keep the filth-water out, and can come for treatment and medications.

view of another part of the slum

they seem to have amazingly tolerant cats here!

Tam Ky - Dioxin centre

Tam ky is about 1.5 hours drive away - it is a bit far to go on motorbikes regularly, but while the physio students have been here we have been going down in the van every Wednesday.

Kids dancing

The Dioxin and unfortunate children centre is a fairly new school and vocational training centre for kid with agent orange based disabilities (dioxin), and any other disabilities as well. The school is a bit bare at the moment, with one teacher, a nurse and the director. But it is a really nice place, they are all really happy to have any help at all and work with suggestions or ideas we provided. The kids get lunch there, and it is actually a nice looking lunch! (as opposed to the gruel that is served everywhere else!) meat, rice, vege. Good looking food!

Showing me how to use the incense making machine

At the moment they are not able to accept kids who need wheelchairs as they don't have enough staff to support those children, which is unfortunate.

The young adults also work together to make incense sticks. Which these gentlemen told us they love doing, I get the feeling they didn't have a role in their lives outside of the centre. Now they are in charge of the incense production line, teach the kids (and random foreigners who come sticky beaking like me) how to use the machines and get to sell their products to help support the centre and pay for lunch etc.

The fellow in the photo above has athetoid CP. So his left arm is constantly writhing and moving and throws him off balance if it is free. It is hard to see in the photo - but he has a piece of plastic twine tying it down. Which does work to stop his arm moving too much, but also bit into his skin!

The students got some leather in Hoi An one weekend, and we got out cook here to sew us a belt with a little loop for his hand to slip into. This is nice and stiff and stops his hand from moving around too much. Plus it is a lot thicker and softer than his twine, so now more cutting into his string! Sometimes, the littlest seeming things - like getting some leather and making a belt - can make the biggest difference. Now, if our belt eventually breaks at least he can take it somewhere and get a new one made to the same design!

We are pretty sure that the fellow in the background of the photo on the left is now also acting as a teacher. He seems to boss around the kids often, and sometimes the other teacher. If he is, what an amazing role model for these kids. Showing that just because he is missing a foot doesn't mean he can't do anything he wants! He also drives around on a cool three wheeler motorbike and was really keen to come to another centre (a place we were thinking about buying incense machines for) and teaching the young people there how to use the machines.

He also sold me 80 000 dong ($4) worth of incense..... which is actually 10 giant packets that fills up a shopping bag!! but it smells nice!

The very beautiful and photogenic kids of the Dioxin centre!

 The kids always get excited when they see a camera get whipped out and start posing, smiling, giving peace signs and generally doing entertaining things. If the camera is being held and not used..... constant tapping on shoulders and pointing at the camera to ask you to take their photos!

 It is hard to know exactly what the kids usually do during the day. It seems they get lessons and have books to write in. But there isn't a chalkboard in the classroom. So I guess everything is taught orally. One of the teacher's main concerns for physio was that the kids all have messy writing. I was amazed that half the kids could write at all! But Vietnam does have a big emphasis on neat writing. The kids we teach English too have such neat writing it makes me ashamed of mine!

 They also have a karaoke machine in the classroom. Because every kid should get to karaoke machine..... instead of a chalkboard! They do love it though. On our first visit we were hoping to get to see what the kids usually do.... but instead we got sung to by various children.





Including one (on the right) who apparently can't actually speak - but loves to sing and just make noise. It was actually quite tuneful singing too.
While playing with some beading I had her copying the colour names (in Vietnamese). Seems if you spend some time giving her the language she can copy and pick it up! But the only teacher doesn't have time to sit and do it all day, I guess her family is probably too busy working to spend the time. But it is so sad to see someone with so much potential who just doesn't have people with time to teach her.

dancing fun

 We decided to try to get some physical activity into the kids day. A few of the kids are on the bigger side, and tend to sit around all day not really running around and playing. So we started with the macarena - you can see in the photos that they are having a great time dancing!

teaching the kids the macarena

We had a great time teaching them. We also went through the chicken dance, and then a simple version of Gangnam style..... as soon as the music for gangnam style started playing the kids were laughing and getting more and more excited!

The only problems were the heat - which was getting intense towards the end of the 5 weeks! the weather here is really heating up!

Hopefully the school will keep going with the dancing, and hopefully they can do so early in the morning when it is slightly cool. The kids absolutely had a ball dancing, in the last week they were even singing along to the songs.

We also taught the kids how to play tunnel ball and bought them some balls to keep so that they can play soccer, tunnel ball, generally throwing or kicking the balls around.

over the top tunnel ball

intense tunnel ball action

Photo tour

Last weekend I headed back to Hoi An (a town that I find has distressingly harass-white-people-until-they-buy-crap type of ethos) for a photo tour. The basic idea that we can go to small villages and areas that it is hard to get to solo, plus get photography tips.

Taking her goods home from the markets

Hoi An river by night

And I discovered an awesome thing about taking the close, personal photos of people. You get the time, and don't need so much language, to make a connection with people. I was able to see how entertained people are by making the effort to have some (albeit limited) language compared to the people without any Vietnamese. People are so happy at just being able to say hi, to ask how old I am, or where I am from.... and the only slightly less common third question - which I have only started understanding this last week - are you married yet?

sorting, and selling her fish

When I try to have conversations with local people, I run out of Vietnamese in a minute.... or less. Then we sit awkwardly..... them being too polite to walk off straight away and trying to say things I don't understand, me trying desperately to remember how to say anything else and work out what they are telling me!

This girl was very excited to come out and say hi.... then shyly
run and hide behind the wall

However, when I go with my camera, say hi, ask how they are, then hold up the camera questioningly they usually nod and smile. And get very excited when they look at their photos on the screen. Often then calling more people over to look, laugh and have their photo taken. Occasionally claiming they are "ugly"... then laughing hysterically when I say no no no, not ugly.... beautiful - they always assume I won't understand.

On the ferry back to town

So on the first day we were up at 4.30 and off to a little fishing village. Only access is currently via ferry but they seem to be building a giant bridge. I believe to provide access for a future giant gold course. we went to the markets where the fishing boats come back and sell their catch on the side of the river.

This is a place that Etienne (the photographer) often goes with his half day tour. The locals are use to Westerners wandering around and taking photos. But because they aren't in Hoi an, they don't demand money from anyone taking their photo!

We also visited a fish sauce factory where I must have brushed up against something and ended up with some mysterious blog of terrible smelling (I have to assume fermented fish based) gunk on my shoulder.

Home for the hot and much to sunny middle part of the day, then back out in the afternoon to another small village. Up the river on a boat to the village with lots of friendly locals, and rice harvesting.

Lantern shop in Hoi An

Harvesting rice in the fields

 Day two, up even earlier and on a boat before the sun could rise. Worth it to see a particularly beautiful sunrise! We pursued a local market and then drove up the coast to some nice lagoons to work on landscape photography.

Sunrise over the fishing nets

Rice harvesters

Woman in the markets

Basket boat on the lagoon

Dawn on the lagoon

Day three was up before dawn and out the the lagoon to do some long exposure photography of the sunrise and spend time in the village.

The other half of the village is rice fields

Fisherman taking his gear home in the early morning