Phnom Penh (1)

  Phnom Penh, Cambodia
Monday, June 11, 2007

On 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).
 
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 minature 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.
 
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.

01 Phnom Penh slum

 
Day 3 (Tuesday)
 
I met Chhanvelith, 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. Chhanvelith 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 Chhanvileth, 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.  

05 Child of the wilderness

 
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.

08 Sick baby

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."

14 Funeral for young woman who killed herself

 
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 Chhanvelith 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.

15 Up these stairs

 
I'm sitting on he 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.

17 Woman and children

 
We had dinner with David's friend, Igor, from the Philippines. Back to our room for a shower and collapse. Thud.