Working on my thong tan...

So yesterday I was riding to the post office but It was closed and I was on a bit of a roll ;) So I just kept riding. I rode down by the river for a while checking out all the beautiful temples and the riverside shacks, It was lovely and I rode out along the highway for a bit through the rice paddies with the strangely bony cows and people working on skeletal bamboo frames around the cement foundations of new buildings. It was really nice to be going along at my snails pace and just seeing Cambodia, and providing a source of amusements for a lot of locals :P

This morning I woke up feeling a bit funny so I decided to go to the markets, get some food, do some life chores etc. As I passed the markets I thought, ‘I’ll just go for a quick ride along this road first…’. I rode until I got out to the rice paddies and rural houses and it was so lovely, quieter than the highway and one of the first times I’v felt almost alone in ‘ the nature’ since I got here there was a lovely breeze and it was really peaceful and I felt heaps better. As I kept cycling I got to the rubbish dump, which was on fire and really stinky, I decided to go back cause I’m pretty sure the fumes would have been carcinogenic as well as just really unpleasant. As I was passing the building that I thought would be the ‘waste management centre’ or some Cambodian version of this, A small boy with full face makeup rides out on a little pink unicycle….    That was a little surprising and I wanted to use my little bit of khmer so I went to say ‘la-or nah’ (very good). As I rode over a tree started saying enthusiastically ‘Hello!’ and I noticed it was full of children, and then about four more extremely made up kids came out of the building and started chatting to me, turns out it is an English, circus and cosmetics school! Of course! Don’t know why I didn’t recognise that straight away! I chatted to them for a while and then headed off wondering about how they work all day in that smell and with all the burning chemicals etc.

I followed what I thought was the road back to Battambang and rode happily for another 40 minutes or so before the lack of breakfast and water started to get to me and I decided I really needed to figure out where Battambang was and go there, It was fairly embarrassing having to point both ways down the road and say ‘Battambang!?’ and I think it was pretty funny, my go-to for any situation where it’s a bit awkward and I can’t explain myself is to grin and laugh a little and sometimes say ‘have no brain’ cause it’s one of the few things I know in Khmer, it seems to have gone down quite well so far… got a few laughs and smiles at least.

I arrived back in Battambang sweaty, very sunburnt and shaky with low blood sugar, but happy to have made It back. I really want to try this again with water and food and maybe even a map or vague plan cause Its really fun. I also found some lovely picnic spots that I would like to get back to if I can.

And my thong tan slowly improves.

First moment of homesickness

So last week I had my first feeling of homesickness…  It was the day Nat moved out and therefore I started living alone and I was trying to sleep because I had a nightshift that night. It was hot and I couldn’t sleep and I had just been beginning to realise that I live in a different country now to a lot of my friends and family. I woke up in the middle of the day lonely overheated (the power had gone out) and just missed home and the support network that I have there.

I went in for my night shift and realised that I had looked at the roster on so usually I work a night shift with one of the khmer nursing supervisors so that I can communicate as my Khmer is barely existent yet. I called my boss and told her and asked her what she wanted me to do and she asked me to check on a COPD patient who had been a bit sick when she left, and then either stay or go home depending on whether I felt comfortable. So I walked into the ICU and went to see the patient… Who I couldn’t rouse at all, I got the nurses to tell me what his GCS had been because to me it looked like it was a 3/15 now, I gave him a sternal rub but got no reaction, one of the nurses managed to get a 7/15 but this was down from a 12/15 and obviously he was pretty  unwell, I listened to his lungs which sounded super wheezy/crackly and noticed he had pitting oedema… I also noticed an audible wheeze from his airway just sitting next to him. We have to real option to intubate or use NIV here yet, and I wouldn’t have liked his chances of getting off a ventilator even f I had so I called my boss to update her and she and then her husband (the head medical Dr) came in and had a look. We had started the guy on new antibiotics and Dr wanted to keep him in to see if the second dose would improve anything, but the family wanted to take him home if he was going to die. As this was happening the Dr was called to see another patient, and it turns out this patient had angina, and ?MI so needed to be transferred to the ICU for a nitroglyceride drip and “cardiac monitoring” Which in this case involved me hooking up the archaic defibrillator as a monitor… We continued to monitor him overnight, with on and off chest pain etc, but he stabilised which was good.

About 5am I came into the ICU to find one of our severe head trauma patients (GCS 7/15) sounding like she was breathing underwater and looked to see her O2 mask had traces of vomit and although she had been suctioned her airway was obviously threatened and she had aspirated on her vomit. She had a guedels in and I suctioned her but with little effect, I could tell she was in respiratory distress due to the fact that she had just aspirated, and I also knew that her quality of life was not going to be great if she did survive, I didn’t know what else we could do apart from saline nebs, chest physio, suctioning and starting antibiotics, I suctioned her again and managed to get her airway sounding a bit clearer, but when I left in the morning I was still worried about her and later on I found out that she had died during the day.

It is so frustrating in those situations, not to be able to speak to the nurse’s doctors and family with any degree of clarity, to be unsure if these patients are getting a high quality of nursing care, to be unsure if the family member has been properly informed that their loved one may die. I was feeling pretty overwhelmed and unsure of what I could do, if I could have done anything better that night and what I could do in the future to make sure that the standard of nursing care is high and that families are informed of what’s going on.

I was also really tired as I hadn’t slept the day before, and as I rode home I bumped into a car on my bike, It wasn’t very hard and I didn’t fall or anything It was just very shocking and I couldn’t understand what they said when they wound down the window to yell at me, but I was already feeling a bit fragile and it just scared me.

I didn’t get to sleep for a while that day, and in my usual stubbornness I was determined not to let anyone see that I was feeling teary, but also just missing the ease of being able to call a friend to hang out or cry to someone who knows me and whom I am not shy in front of. I woke up that day and had a little cry to myself and was starting to feel really awful and so hot so I decided to go into work to at least be cool and be around people, I got in there and it was nice and I ended up skyping Liz for a few hours (thanks Liz :p ) and then going to dinner with most of the Battambang CCT crew who are super lovely for Nat’s B’day. After that I felt so much happier and appreciative and realised that I do have support both from home and here and I don’t need to be so stubborn.

This weekend we went to Siem Reap and had a lovely weekend J and now I am in Battambang ready to sleep and go back to work tomorrow. I feel so glad to be making friends here, the weekend in Siem reap was really lovely, and I really appreciated the luxury of nice food and a foot scrub and dancing and drinking and company of great people J Also staying in touch with people back home, I feel so lucky to have the support and love that I do, and I often find myself smiling or chatting away in my head to someone from Australia, and it means the world to be thought of by people so busy with life and so far away J

 (also sorry for all the unexplained medical stuff, I’v just written how I would talk and it’s just in there for anyone who’s interested but if you want to know more or it’s annoying just let me know.)

Xx

Starting work

So time seems to have flown a bit since I started here and I haven’t had much time to email or post (sorry mum!) but I will try and catch up a bit now…

The hospital that I’m working at was originally founded in 1997 by an Italian NGO called Emergency.  It was started to treat victims of war and landmines, so was set up as a surgical trauma hospital. As the war ended and now the amount of landmine injuries has thankfully decreased somewhat, the hospital continued treating trauma patients, the majority of which are from road traffic accidents, in particular motorbike accidents. As it no longer fit the description of what Emergency does and the government didn’t want to take it over the handa foundation took over the hospital in 2012, and that’s who I am working for now.

 The hospital has an ED, an OT which I don’t know much about yet, an ICU, a men’s surgical ward, a women and children’s ward, and a ward for patients with infections. There is also an outpatient medical clinic, a lab and they are currently building an endoscopy unit. For CT scans we send the patients to one of the clinics in the area.

We are also about to open a new wing which will have medical ICU patients and medical patients. As we start to bring medical patients into the hospital we are trying to do some teaching about medical patients and their needs, we are also trying to implement some of the structure and infrastructure and standards of the kind of hospitals that we have come from. This is a very interesting task and there are many challenges involved, not least of all my lack of khmer language skills (although I have my first lesson on Thursday!!).

 I feel funny being respected in this hospital and listened to by nurses with so much more experience than me, simply because I am white and ‘western’. I forgot to tuck my septum piercing away this morning for the first few hours and no one commented… I wonder what people think of me this funny western woman with no idea of khmer language or culture. I am really keen to learn more, to be able to talk to the nurses and patients and get a better feel for who they are and how they work.

So anyway, my role as I am learning, is to work with the existing ICU and the new medical/ICU wards, their NUMs and staff to implement new policy, start talking about nursing education and how we can get that going, try to fill any gaps in education with the staff, and assist the NUM’s to become NUM’s as this is a relatively new role here, as well as trying to create a culture of critical thinking, problem solving, self reflection and improvement and respect for one another.

This is all intensified I guess by the fact that almost everyone we are working with has lived though the khmer rouge, it’s hard to imagine the difference between the three young Australian and American nurses who I’m pretty sure all grew up in comfortable middle class ways and have only a few years each of in hospital clinical experience and our Khmer counterparts whose lives I don’t know much about yet.

I was pretty intimidated by the job when I first heard what it was, and rightfully I feel, I do not have the qualifications or experience to be doing this kind of thing, I know my knowledge is lacking and there is a lot I need to refresh and work on, but I think that the value I have is mainly in the fact that I have worked in well run, high standard, well resourced hospitals with a strong idea of professional nursing, and that experience is what I have to offer and try and teach about at the same time as hopefully learning some skills form the staff, and yea… working together I guess.

I decided to just be positive and do my best, I know many people who could do this job much better than me, but I am here and I am of no expense to the hospital, so I will just do my best! I have decided to just be positive and try things and believe in myself, I have had a lot of lovely feedback from my friends telling me that things like that I have value because I am level headed and listen to people, and so I am listening to them and trying to trust in myself and my ability to hopefully do a half decent job!

Sorry this is so long and scrappy! My head goes slightly at a million miles an hour with these long intermittent pauses, I have also been having fun making new friends, I went to Siem Reap for the weekend and love riding my bike around Battambang, especially on cool days with the wet season rains. It’s lovely staying with Nat, her house is lovely, and I miss and love you guys so much!

X

C

 

Travelling with my sister

So Keda and I actually travelled quite well together! I think we both had our misgivings about how we would go being such different people, but I found, stick us together with our packs and a tatty map and we quite happily bump along together. We both enjoyed Phnom Penh more than we thought we would, and neither of us were particularly smitten with the delights of Siem Reap, (The delights lessened further by suspecting that I might be a bit sick but feeling ok and going out only to realise that no, I need to sit down before I pass out/vomit and having to get some poor tuk tuk driver to drive me home).

Things got harder when we got to Battambang and it finally started to sink in that I am going to be living here for a time, and I had little idea of what I would be doing or if I was capable! Keda says I got more intense, I say she got more annoying :P

It was really lovely having Keda come and see the town and take me out for dinner J and squabble like siblings together, I think we both had a great time and when I put her hungover and bleary onto the bus this morning I realised I will miss her little chattery presence J

 

So here are some pictures of us having fun together :)

Awesome! swimming in the rain in a rooftop pool, look at our happy grins!!

(Words fail me trying to caption this...)

                                                                              

And you can check out Keda's version of events at  Keda's blog

Are you ready for my first Cambodia inspired joke!?

So Keda and I were enjoying the neon delights of Siem Reap's tourist bars last night and young Keda got herself rather inebriated....

This morning upon waking she asked me 'How did I get home last night?' to which I promptly replied,

'Don't worry Keda, I tuk tuk you home'

*Keda would like me to remind you this is a joke - all characters are fictional, all scenes entirely whimsical, any similarity you think this may bear to real-life experiences are ENTIRELY FIGMENTS OF YOUR IMAGINATION!

Free the Bears!

So I may have been a little dubious of the ‘free the bears’ day, thinking it might be some weird tourist focussed “volunteering” with the bears kinda situation, and in a way it was, but in a way I liked, I guess.

We got picked up in the morning by some of the keepers (and their dog Rosie! so nice to play with a puppie) and one other aussie girl and drove out to the sanctuary. It is in 25000ish hectares of protected forest, which also has enclosures run by the government for lots of other animals, monkeys, birds, elephants, lions etc. The bear section is run by the ‘free the bears’ charity which was founded by an Australian woman called Mary who saw something about bear bile farming on TV and decided to do something about it, eventually leading to the organisation today which has a few sanctuary’s across south east asia for bears rescued from bile farms, resteraunts (bear paw soup), dancing bears and those from the exotic pet trade.

                                                   

Currently they can’t re-release the bears as poachers trapped the only bears that they tried to release and one of the bears died of it’s injuries.

The aim of the “volunteer” program seems to be mainly to educate the “volunteers” about what free the bears does and to let us do a few activities related to the bears (like preparing feed balls, and hiding scatterfeed in the bears enclosures for them. It was pretty fun! I liked climbing around the enclosure hiding food and then watching them find it… but I think mainly this post should be cute bear pics so…

                                              delicious bear snacks...

             Keda throwing our newly made snacks to the bears!

                          Bear checking out the snacks :)

                                                      

I also got into a fight with a monkey! we were near the cage of these massive pythons and a friendly monkey came over to say hi, turns out the monkey was a little over friendly and some of the other people ran off screaming... I thought that the monkey would back off, me being much larger and scarier then it but apparently not, so I hissed at feinted towards it and it hissed and feinted towards me until I realised I was trapped between the python cage and a big rock... and the monkey was still hissing and making to attack me (I realise I am probably about to get bitten by said monkey and briefly regret not having got a rabies shot) and then one of the friendly people starts pegging sticks at the monkey until it backs off. My pride took a bit of a knock at loosing a battle of will with a monkey!

 

 

 

 hiding food for the scatterfeed

 

 

The bears finding the food we hid :)

 

And yea, this happened...

Choeng Ek Killing fields and S21 prison

*this could be triggering* – It’s about the Khmer rouge, torture, murder and genocide - I am so sorry if these things have touched your life.

We visited Cheong Ek Killing fields near Phnom Penh, and S21 the torture prison in Phnom Penh. It was an intense experience, and I’m not sure I can really articulate or understand the experience, but I will try to share how I felt.

The Killing fields when we got there were felt peaceful, there were tree’s and grass and butterflies flying around, It was fairly quiet. We got the headsets that tell you about the different parts of the site and walked around the area listening to the audioguide.

It’s so hard for me to imagine in anyway what happened there, especially to relate a site that felt so peaceful to such cruelty and suffering.

 I can’t relate to the experience in any way and I think I am a very experiential person or learner. To imagine what happened I feel like I use a part of my brain that imagines the imagery of a story I read.

Having been lucky enough to never really have had my life or the life of my family, friends, loved one’s threatened, I just cannot understand how horrific it must have felt, and still be for the people who suffered under the Khmer rouge, My sister realised while we were there that the regime occurred within her lifetime, so all of the people her age and older had lived through it. It is so recent still, It almost amazes me to see so many people living their lives in what looks like normality and to know that there must still be such trauma and pain present.

I like to believe that people are good, to give them the benefit of the doubt, despite knowing in my head that people commit awful atrocities against each other, I just can’t reconcile this with the truth that these sort of things happen everywhere and often, and often go unreported/noticed/mourned. I know I am lucky to be so naïve, to never have been faced with what a person can do to another.

How  can humanity encase such beauty, wonder, generosity and love and also such violence hatred, and brutality? And I suspect it’s not even always clear cut the differences, I don’t like to think of ‘good’ and ‘bad’ people, I think I have elements of both as do most people I suspect.  Are the people who worked in the Khmer rouge messed up, ill, evil, or were they terrified of what would happen to them if they didn’t obey? In which case who masterminded it? Are there single people to blame like Pol Pot, or Hitler who somehow made millions of people kill, and terrorise millions of others?

 Part of me doesn’t want to understand that brutality in a real sense.

We also visited the torture prison S21.

I don’t think I want to write about it. It was awful, people being absolutely destroyed in every sense of the word. It just makes me question how I see us human beings, I don’t know if I can fit these things into my worldview and still be hopeful and believe in myself and other people.

But does that disrespect the memory and experience of the millions of people throughout the world who have been faced with this sort of violence and terror firsthand?

I have no answers, this is my attempt to share how It felt.