A Fond Farewell to Cambodia

We'd finally fallen into a comfortable rhythm: wake up, rush to the Mekong Restaurant $2.75 breakfast buffet and eat enough pastries, eggs and rice to last us all day, hop on Bong Soriya's moto for a 20 minute ride to Takmao, attempt to locate and latch onto a physician to shadow, chat with Bill, Jan and the rest of the amazing Rose staff, spend the afternoon at the eye clinic watching surgeries or walking around Phnom Penh, have a strictly unhappy dinner at Happy Pizza and down a few $1 fruit shakes, chat with the kids who sold books and bracelets on the waterfront, play thumb war with a few of them as we walked home, then relax with a book and Asian music videos on the tv before bed. And suddenly it was time to leave.

Our beloved driver Soriya

Moto ride to Takmao

Chay the tireless thumb-war player. I finally broke down and bought one of his bracelets...

Bill and Jan invited us to a series of goodbye dinners and activities, including one very entertaining evening that involved Bill's guitar and a song about a sloth (as soon as I can find a decent internet connection I'll upload video footage).

The highlight, however, was a trip to the Dr. Fish booth, where Danielle, the bravest girl I know, had a full-blown freakout and squealed and writhed with the urgency of a nine-year-old being tickled to death. As the typically less brave member of our traveling duo, I took a sick pleasure in her obvious discomfort.

Testing the waters

Nervous giggle

Can't contain the hysteria

Full on freak-out

Moving over to the tank with the small fish in it to calm down

Not that I was totally comfortable with the sensation myself. There's something about a hundred tiny mouths nibbling at the skin between your toes that just doesn't feel right.






Our last night in town, we went to Bill and Jan's for dinner, and Jan presented us with the perfect gift: gray T-shirts that had "My name is not Tuk-Tuk" and "Don't call me Tuk-Tuk" scrawled on them in permanent marker. We already miss those guys.

Danielle and I with Jan and our new favorite T-shirts

A Summary of Our Time At Chey Chumneas Referral Hospital

Outside the eye clinic

It's difficult to summarize our experience volunteering with Rose and observing physicians at the Chey Chumneas Hospital in Takmao. There were aspects that were disconcerting, such as watching a hernia repair and a total hysterectomy performed with only local anesthesia. Other differences between US and Cambodian surgical procedures seemed more comical and adaptive to the climate. Operations were performed in flip-flops, some doctors went shirtless under their surgical gowns, and every now and then the anesthesiologist would grab a bug zapper shaped like a tennis racket and swing it through the air. It made a loud cracking sound sound each time it connected with a mosquito.

The hospital itself was beautiful. Although the buildings were rather plain and poorly stocked compared to the high tech hospital rooms I worked in last year, they also seemed more inviting and family-oriented. Doors and windows were wide open, Bougainvillea blossoms surrounded most of the compound, and families took a more active role in feeding and caring for the sick. This may have been necessary, since the hospital probably doesn't have a budget for kitchens or extra nurses or aids, but it was still nice to see. Danielle and I had several talks about how the US could learn a thing or two from Cambodia about creating an environment conducive to healing. As long as that environment still includes general anesthesia.

Of course, the most inspiring part of our experience was watching the work of intelligent, dedicated people as they tried to improve the lives of others. Many of the doctors had worked longer and harder than ever would have been necessary in the US to obtain an education and competently practice medicine. While a few seemed like stereotypical type A achievers, others took the time to carefully explain complicated procedures in a foreign language to 2 clueless American girls, made room around the operating table and invited us to peak over their shoulders, let us take a few pictures for Bill to share with Rose supporters, and managed to play host to us while holding someone's life in their hands.

And then there was the Rose staff. Dr. Sarom was performing surgeries from dawn to dusk the entire time we were there for an Operation Smile initiative, but still helped us observe surgeries at the hospital in his absence. Sokny played tour guide during our trip to the countryside, showed us some of his amazing work, and let us practice our dismal Khmer on him over lunch. Rith, the office administrator, introduced us to doctors and helped find people for us to shadow. And of course our BFFs Bill and Jan went out of their way to find opportunities for us, entertained us with dinners, serenades, trivia nights, and stories from their travels, and generally spoiled us.

Despite a few miscommunications and the fact that a few of the doctors didn't seem to know what to do with us other than lose us like Jason Bourne losing an FBI tail, the time we spent at Rose gave us an incredible opportunity to observe the everyday operation of a health care system that is vastly different from the one we're used to. Our experiences were more than we'd hoped for, and probably much more than we are entitled to as an art/math grad and a premed student. We've become believers in the effectiveness of Rose, and with the help of Bill and Jan are already lining up more Rose-endorsed charities to volunteer with in Uganda and Nairobi. If any of you have cash burning a hole in your pocket and want to find a reputable charity to donate to, this one's a keeper.

Our Hero

We'd spent every morning for a week at the hospital in Takmao, futilely trying to keep track of the physicians we'd been informally assigned to each morning. They seemed to have advanced training in evading intruders like us, because they all knew how to lose us in a matter of minutes. We'd usually hang around their offices or the nearby hallways for an hour or two, looking sad and trying to impose ourselves on them, before giving up and heading across the Japanese American Friendship Bridget to the eye clinic. The physicians there were stuck in the small OR all afternoon and couldn't escape us even if they tried. We weren't at all impatient; we'd seen dozens of amazing eye surgeries, and recognized the difficulty of fitting into a doctor's busy schedule, especially with a language barrier present. But we were beginning to feel awkward hanging out in the hospital halls giggling to ourselves while families of patients eyed us warily, no doubt hoping we had nothing to do with the care of their loved ones.

With Dr. Sarom's help we had finally made it to the surgical ward to see a hernia repair surgery, an incredible thing to watch. The kind anesthesiologist had gone out of his way to help us understand the surgery, walking us through the process of injecting the anesthesia between L3 and L4, showing us the monitors and explaining the patients history of hypertension, and shepherding us into a space at the head of the bed where we had a full view of what was going on. He even invited us back the next day for a "tibia repair", although I got suddenly and severely dizzy as they were finishing the last stitches and didn't have time to clarify the details.

All dressed up in our borrowed scrubs

We returned at 9 a.m. the next day in our blue and green scrubs ready to see more. We confidently walked through the door to the surgical office and made our presence known, only to find more doctors who didn't seem to understand why we were there or what to do with us. We were directed to wait on the bench in the hall. We'd been through this before, so we settled in and prepared for a long day of people watching. We made faces at a few children who passed by, and watched in amazement as a medical team carried a young girl with an IV drip out to a waiting moto, set her down behind the driver and in front of a woman who appeared to be her mother, and handed a bottle of liquid to the mother to hold up as the moto took off down the bumpy road. For the millionth time I thought about what my mom's appalled face would look like if she had been in Cambodia with me.

Suddenly the kind anesthesiologist rounded the corner and saw us. In my mind we were saved. We told him we were here to observe more surgeries and he started to invite us into the OR, but after talking briefly with the other doctors asked us to wait on the bench again.

Danielle had accepted that we were about to be ditched and moved on to a task on her ipod, but I kept saying that this anesthesiologist was different. I had faith in him. He'd been our hero the day before, our advocate and champion, and I wouldn't let go of my hope that he'd do the same today.

We waited for an hour and nothing happened. Danielle turned to me to gloat. "Where's your hero now?" she said jokingly, but at that exact instant he returned in all of his anasthesiological glory to usher us into the OR. He came back for us! Danielle and I started giggling (our response to everything) and I beamed at him as he led us to the room, where we observed the world's most confusing tibia repair (turned out to be a hysterectomy, but it took us a few minutes to figure out why they were cutting into her abdomen, and then a good half hour to guess which organ they were removing once we'd gotten tibias out of our heads).

When the hysterectomy was over we watched an appendectomy. We enjoyed watching the anesthesiologist. He was gentle with his patients, often pausing to put his hands on their heads in a comforting gesture and respectfully making sure they were draped and covered as much as possible. After the appendectomy he tapped the patient (an 8 year old girl) on the cheek while repeating her name. After she was awake he gingerly lifted her up and carried her to the recovery room in his arms. In my imagination he's a superhero.

Photo of the Month

This photo is so hilarious that it inspired a new blog tradition of photo of the month. What makes this so hilarious is that it was completely unprovoked and unplanned and we were not even aware of it until later when looking through our photos. It reminds me of when I was in my film class in high school and would play with the jog-shuttle button (a highly sensative and controlable fast forward buttom used for making perfect film cuts) to see how many contortions our face could make in the space of one word. When we would happen upon a really good one we would pause the image and call our friends over to laugh and point. So Bill, please forgive us as we call all our friends over to laugh and point, but your face wins!!! PS we love you!!

In fact, it is worth noting how much we really do love Bill and Jan, our coordinators at Rose Charities. Aside from having two new idols, and a plethora of projects we want to help with, we also have two new friends. Upon arriving at Rose Charities we soon found out that the doctor on duty, who was meant to take us around while we were here, was at the last minute called to help out with a big important project during our whole stay. So Jan and Bill didn't skip a beat and have managed to find things for us to do daily, including but not limited to watching live eye surgeries up close, watching the delivery of afterbirth and post delivery stitching, going on physical therapy rounds in the countryside to do impromptu art therapy, hooking us up with people to give us tours through orphanages, but mostly inspiring us with their amazing attitudes and life full of work and help. They are the kind of people who want to help, have ideas, and do them. I am proud to have met them and hope to be able to take a piece of their goodness with me. Thank you Bill and Jan!!

Weekend in Sihanoukville

We had Friday off last week so we took a long weekend trip to Sihanoukville ($5 each way by bus) to find a beach to lay on for a few days. In that goal we were completely successful. Our 2 days on the beach only involved a few activities besides lazing.

Reading books

Playing with strays

Watching the sunsets

Being served breakfast, dinner, and many many fruit shakes in our beach beds

It was a pretty ideal vacation from our pretty ideal 9-month trip.

The Massage Parlor Next Door

What's better than having a massage parlor next door that charges $5 for hour-long traditional Khmer massages? Having a massage parlor next door that charges $5 for hour-long massages and gives you free access to the gym, sauna, steam room, jacuzzi, and showers, as well as toast and jam and AMAZING ICE TEA!!!

Danielle's face after trying the amazing tea

Pretty much the only thing this massage parlor doesn't include is a free visit to the chiropractor, which you'll need after experiencing a $5 traditional Khmer massage. We're going back as soon as we recover.

Cambodia

During a brief study abroad in 2005, I toured a clinic operated by RoseCharities in Phnom Penh and was impressed by the efficiency and dedication of the medical workers there. In fact, this was the clinic that first sparked my interest in becoming a doctor. It was one of the few NGOs my class visited that offered both immediate and long-term relief to people struggling through the effects of poverty: immediate relief through life-saving medical procedures that would have been otherwise impossible for the clinic's patients, and long-term benefits through community outreach programs and an emphasis on improving the quality of life in Cambodia.

Even in the few short weeks we spent in Cambodia studying aid organizations, it was easy to become discouraged by the waste, and sometimes obvious corruption, that plagued well-intentioned charities, but the Rose Clinic seemed to stretch every dollar it received. As I saw firsthand in 2005, a $20 donation to RoseCharities can restore a person's sight, and $50 can repair a cleft palate or give a child the ability to walk. For more information on how to donate to RoseCharities, please see http://www.rosecharities.info/donate.htm.

The organization's efficiency can be traced to its formation, as outlined on the RoseCharities homepage:

"Founded by aid workers who were disillusioned by the waste and bureaucracy often seen in international aid, we started in Cambodia in 1998. The aim was to deliver effective, sustainable programmes directly to those in need, with minimal bureaucracy, and with transparency at every stage....We are run by volunteers, so administration costs are kept to a bare minimum, with 98% of donations going directly to support our work."

- RoseCharities
http://www.rosecharities.info/

I contacted Rose last October and asked if they'd be willing to take us in for a few weeks as volunteers, and they graciously agreed. Since then, Bill and Jan Johnston have been bending over backwards to find opportunities to put our random interests and talents to work. We started last Wednesday with a short tour of the gynecology ward in the Chey Chumnas General Hospital in Takmao, the hospital where Rose Cambodia is based. That afternoon we helped enter patient files into the computer (data entry is a rare example of a skill that Danielle and I both possess).

Thursday we traveled to the countryside with Sokny, the physical therapist on staff at the Rose office, to work with a woman who had laid in bed for 30 years after a debilitating bout with encephalitis (for more info visit the Rose Rehab page: http://www.rosecambodia.org/?page_id=12). The physical therapists at Rose have been working with her to help her gain the strength to sit up, and in order to get her hands moving Danielle brought a bunch of art supplies. We made simple shapes for her to paint in, and Danielle taught her a few strokes. Danielle and I were so absorbed in watching her work that it took a while to notice the dozen or so kids from the village in a semicircle around her, jealously watching her paint. It was a great visit. As we left, Danielle hung some of her paintings next to her bed with ribbon.



On the way back to the office, we stopped to visit a woman who had been badly burned on her legs by gasoline, and the physical therapists changed a bandage for her. Apparently a skin graft had failed to take, so there was still a gaping wound behind her left knee months after the accident. While we were visiting her, her neighbors brought another potential patient to see the therapists and placed him on the bed next to her. The man had been in a motorcycle accident and could no longer move the left side of his arm. The physical therapists assessed him and made an appointment to see him later at the clinic.

As we were about to leave, the neighbors convinced the therapists to see a woman next door who was having trouble walking. While the physical therapists did their thing, Danielle and I hung back and smiled shyly at some very friendly older women, who seemed to be staring at us. One of them started talking, half at us and half at the women around her. She then started wiping at her nose, as if to inform me that I powdered sugar on the end of mine, so I self-consciously started doing the same but she just laughed. One of the therapists translated, "She wants your nose." This seemed hysterical at the time, so Danielle and I giggled about it for a while.

After the therapists had finished their work we got back in the tuk tuk, but before we could go there was some kind of commotion. The lady who couldn't stop looking at my nose jumped into the tuk tuk and handed us each a coconut and a straw. We very gratefully accepted and drove off.


We made one last stop to see a beautiful young girl who was working with the therapists to build the strength in her arms and legs, and then we took a holiday all weekend (2 working days is long enough...)

Today Bill gave us a tour of the Rose Eye Clinic just outside Phnom Penh in the morning, and Danielle and I returned in the afternoon to observe glaucoma surgeries. We watched for 2 and a half hours as nearly a dozen patients underwent the 20-30 minute procedure. It was one of the most amazing things I've ever seen.

I may move to Cambodia when I'm a doctor just so I can operate in flip flops

More to come on what we've been doing with our play time in this wonderful country.

The Tuk Tuks

The persistence of the tuk tuk drivers here in Cambodia has nearly forced us into hiding. Every seven seconds, or more often at corners or markets, we'll hear the familiar call of "Tuk tuk lady?" Danielle adapted immediately and is able to ignore most of the ruckus. I, however, feel responsible for answering every single shout with a polite shake of the head or a "no thank you." it might seem more humane but it's not, it just gives them false hope. They end up grabbing their poster of attractions and following us, expending their precious energy in the heat of the day, chanting "where you go tomorrow? Want see killing fields? Museum? Tuol sleng? Discount for you." I continue to say no in every language I can think of until finally I say, "we like to walk!" and make a little walking gesture with my hands. This seems to confuse them, and they either laugh or frown at us and walk away. Although we've had many entertaining interactions under these circumstances, and generally find the drivers to be very charming, we've decided to put a stop to the incessant attacks by going on the offensive.

So tonight while we ate at an adorable pizzeria on the riverfront and watched Valentines Day revelers celebrate (apparently it's a very big thing here - it looked like a pink bomb went off in the middle of Phnom Penh), we selected a driver who had parked near our table. After we paid our bill we waited for him to walk away from his tuk tuk, then we hurried onto the street and stood right next to his little vehicle. Four or five other drivers saw us and started screaming "Tuk tuk ???" like mindless drones, but we just pointed to the driver we'd picked, the only one who hadn't had a chance to yell at us yet, and said, "We want him." Then we crossed our arms and started tapping our feet as if we'd been waiting for him for a long time.

The other drivers looked like we'd stabbed them in the heart. It must have seemed so unfair for him to get the commission when they'd clearly called dibs on us. But that one driver smiled like he was king of the tuk tuks. He swaggered over to where we were, hopped on the moto seat and took off down Sisowath Quay. As soon as we were on the rode Danielle and I broke out in peels of laughter, and we could see from the mirrors that our driver was laughing just as hard. That'll teach them to yell at us all day.

Tuk Tuk drivers: 0
Jessi and Danielle: 1

Our favorite Siem Reap tuk tuk driver, Zut (center)

(Actually Written By Jessi)

Haiku

Illegal
Hikes like Haiku Stairs
Rock my world

We've only been traveling for 3 weeks and already our trip has reached such extreme levels of epic-ness that Danielle has decided to make a stamp of the word "epic" so we can stamp all of our most epic experiences in our various journals. That way when we come home at the end of the year and return to our normal, mundane existences we'll never be able to forget the extremity of our bizarre new lifestyle.

The most epic of all our epic days was Tuesday Feb 1 to Thursday Feb 3. It counts as one day because we really didn't sleep much in between. It started out kind of normal. We spent most of Tuesday on the beach and in the BYUH library, catching up on facebook, pampering our beloved blog and futilely trying to plan our stubbornly unplannable romp through Asia (unless you are my mother, in which case EVERYTHING IS UNDER CONTROL). We left Laie around 9 p.m. planning to camp for the night at Bellows so we could get up early and beat the crowds to Hanauma Bay. Unfortunately our permit had expired before it was even issued. Thanks Satellite City Hall. The military guard at Bellows pointed to the discrepancy and turned us away.

It was getting late, and it seemed pointless to drive all the way back to the northshore to sleep and drive all the way back in the morning, so we decided to sleep in the car again. We spent an hour circling the area trying to find a hiding place for our car that was unobtrusive enough to prevent cops from noticing but close enough to the cops to prevent other sorts of people who hide from cops late at night from noticing. Being homeless involves a very delicate balance.

We found an ideal spot across from the beach park next to a high fence on a residential street. Once again Danielle stretched out in the back while I reclined the front passenger seat, and we slept about as well as you can expect to sleep in an economy car in a strange neighborhood waiting for cops to come knocking at the window.

The next morning we got up with the sun and realized we were next to one of the most beautiful beaches we'd ever seen, so we walked around for a bit before putting on our swimsuits and driving towards Hanauma Bay, where we spent a perfect Hawaiian day.

A scenic overlook on the way to Hanauma Bay

I want to put a house on this island

We rented snorkels and followed around schools of brightly colored fishes and perpetually indifferent-looking sea turtles for an hour or so, then laid out on the soft sand. When we had been there long enough to acquire funny looking tanlines (especially Danielle, who got tiger stripes on her derriere from her flashy bikini), we drove to Honolulu and got curry at our new favorite Thai restaurant.

We were feeling so refreshed from our relaxing day at the beach (and annoyed at the idea of spending another night in the car) that we decided to stay up all night and hike the Stairway to Heaven. We found a Walmart and morphed our sweet travel shirts into clubbing attire (what can I say? Danielle's a genius), used beach grime to style our hair, and spent the evening in Waikiki dancing with some very fun Chilean boys at Senor Frog's. As someone who doesn't go clubbing very often and doesn't have anything to compare Waikiki's nightlife to, I don't think I can adequately express how much fun we had that night so you'll just have to take my word for it when I say it was awesome.

We left our new friends around 3:30 a.m. and drove to Kaneohe, where we loaded up on caffeine, called my incredibly tolerant friend Ryan at 4:45 a.m. for directions, stumbled through a bamboo forest, hopped a fence laced with barbed wire and manure (we found a lot of amateur booby traps along the way), and began our ascent.

All I can say about the hike was that it was EPIC. See for yourself.

Pre-dawn

Slowly getting lighter

Almost to the top

Getting close...

Boom! The sun's up

I got a lot of shots of Danielle's back...

We reached the first landing just as the sky started lightening, and got to the very top in time for a brilliant sunrise. Then we ran down the stairs as fast as our shaking, sugar and caffeine crashing, sleep-deprived legs would carry us to avoid the awkwardness of blatantly walking back to our cars in front of the security guard who arrives at varying times every morning.

Our last stop was the STD clinic. Somehow Danielle had managed to avoid her routine Hepatitis B shots in high school, and the oversight hadn't been caught before we left Colorado. Luckily my mom had found a clinic in Honolulu that offered free Hepatitis B shots to "at risk" groups, and with the huge bags under our eyes, matted hair, and heavy day-old makeup we certainly looked the part. We stared at the small TV in the waiting room like zombies as it played a high school drama promoting the use of condoms on repeat for an hour and a half, got the shot, and somehow managed to drive back to the northshore before crashing on the beach. Not a bad way to spend 72 hours.

(Actually Written by Jessi)