Malaysian Musings

As a tourist in Cambodia you get a one month visa upon arrival, with the option to renew for another month before you are required to leave the country.  My time to exit the country was due next week and this was playing on my mind.  Then last week one of the orphans was summonsed to Phnom Penh for an appointment.  Arrangements were made for her surgery at the relevant hospital but the young staff member escorting her was not confident to travel and locate the hospital alone.  They asked if I would go along.  This was the excuse I needed to leave town (and country) and sort out my visa.  The cheapest option was an overnight trip to Kuala Lumpur.  I wrote most of this from a bunk bed in a hostel on a busy tourist strip of central KL.  When I re-enter Cambodia this afternoon I hope to obtain a general visa, allowing me long-term, multiple entry into the country.  It seems I’m going to need it, although exactly how I am going to spend the rest of this year remains an unconfirmed outline which could change at anytime.

The airport in KL is enormous.  I think I walked my 10,000 daily steps just going from the aeroplane, through Immigration, to the exit yesterday.  It’s modern, spacious and full of glitzy shops and restaurants.  A far cry from Cambodia!  On our night in Phnom Penh together, the three of us from Phter Koma ate out and walked away reeling that we’d spent US$15 ($5 each) on a single meal – probably the most those two particular Cambodians ever spent on themselves in one sitting.  On arrival in KL my Cambodian-trained brain took me to a cashpoint in the airport and I withdrew 300 ringit, which equates to around US$100.  That’s a week’s budget in Cambodia so I figured it was more than generous for a single night in Malaysia.  It took a couple of hours to knock that sense out of me!

After checking into the hostel, I headed out the door almost immediately in search of somewhere I could check off my to-do list (hair cut and colour, medications for one of the orphans which we couldn’t find in Kampong Cham, and a few other bits and pieces far easier done in the First World).  Following directions I found the most amazing shopping mall filled with glitzy shops, food halls, displays etc and promptly got lost in the vast extravagance.  Hours later I somehow managed to find the correct exit and re-emerged onto the street with new hair, new nails, and in possession of my first pair of Havaiana thongs.  These are important because on Saturday Bea and I are going to a wedding under a tent on a rural dusty road somewhere near the town of Skun, an hour out of Kampong Cham.  For the occasion I needed a fancy pair of shoes – they are blue with pink straps and they are going to end up dust-orange!

Back at the hostel I dumped my bags and headed out to the local restaurant strip.  One wine and one Diet Coke later, I found myself in the embarrassing position of owing 65 ringit (about $20) but with only 54 ringit in my purse.  Negotiations with the bar manager saw me escorted to a cashpoint by her waitress, who apologised to me as soon as we were alone.  When I said I understood, she called me “Mummy”!  This apparently sudden transition into a mother of adults perplexes me.  In 2007 I quite enjoyed 13yo Mathew calling me “Mum”.  Even though I was more than old enough to be his mother, I rationalised having a teenage “son” by understanding that I was just being slotted into the obligation system, where everyone earns a family connection of some sort and it is common for young people to refer to themselves as aunts, uncles and grandparents.  I used this same rationalisation two years ago when his sister had her first baby, introducing him to me as my grandson, then again as recently as last week when her second-born was announced to me via a connected friend who gleefully emailed “congratulations grandma!”.  But my rationalising lost it’s effectiveness last week when one of my old staff introduced me to his tiny twin grandchildren who both started crying when the white lady looked at them.  He laughingly reassured them there was no need to cry because “she is your grandmother”!  I keep asking myself, how did I miss being a mother and suddenly inherit all these grandchildren and adult offspring?  There is no point caring I guess.  Wrinkles and grey hair only happen to the luckiest of us, after all <sniff>.

Anyway, it turns out that my Malaysian “daughter” is actually Filipino and moved to Malaysia for work.  As a waitress she earns 1,000 ringit (about US$270) per month, working 6 x 12 hour shifts per week.  Once upon a time this would have shocked me but again my Cambodian brain kicked in and thought how generous this sounded, at three or more times the amount many of my Cambodian friends and colleagues earn!  As I sat in the restaurant watching tourists enjoy their opulent holidays I pondered on the varying degrees of wealth in the world.  Tourists to this part of Malaysia are likely on the lower rung of the financial ladder in their respective  western countries, choosing a comparatively afforadble destination.  Yet to the local staff serving them they must appear extremely affluent.  Most Cambodians laying eyes on this particular place, would consider even the wait staff to be affluent.

For obvious reasons Cambodians don’t travel, busy as most of them are, simply surviving from one day to the next.  Any flight I have taken into or out of Cambodia has contained very few Cambodian passengers, similar to the observation you can make on commercial flights in and out of the heavily-indigenous areas of Australia, which contain very few indigenous passengers.  Flying, and travel in general, is another entitlement enjoyed only by the most privileged of us.  Leaving Phnom Penh Airport yesterday morning we were delayed as a chartered Laos Airlines flight carrying “a dignitary” (according to our pilot) arrived amidst pomp and ceremony from out of the window as we sat at the gate waiting for clearance to take off.  How such pomp and ceremony can be considered relevant in a country where the masses are literally starving, is beyond me.

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As we descended into Kuala Lumpur, about 1.5 hours after leaving Phnom Penh, the woman in the seat across from me answered her telephone!  Shy of making a public scene, I decided not to challenge her, choosing to let her risk interfering with our landing gear instead!  Glaring at her, I was doubly horrified when her friend then pulled out her phone and began tapping on the screen, then I looked through the gap in the seat ahead of me and a woman there was also playing on her touch phone!  The airline staff were all seated for landing and I spent the entire landing time arguing with myself about whether to shout at them or stay quiet.  I was probably wrong to stay quiet but I live to tell the tale.

Kuala Lumpur is a big, bustling, first world city with a very different atmosphere to anywhere in Cambodia, Phnom Penh included.  The population are a mix of Indian and Chinese Malay, with Seikh and Muslim attire scattered amongst modern fashions.  My taxi driver, who also announced halfway to the city that he wanted to go out with me “because I like mature women”, before explaining to me that the reason he can’t get a date is because “women are the problem”, told me that Kuala Lumpur is a very multi-cultural place with no racism, moments before informing me that the Africans in Malaysia grow and sell drugs!

Chinese New Year celebrations have been in progress since last week and, like Cambodia, setting off ridiculously loud firecrackers is a popular way to mark celebrations in Kuala Lumpur.  Walking to the cashpoint machine with the waitress last night, a yellow dragon with many human legs danced in the street to the jingle of Chinese chimes at a crowded temporary market erected in the road much like Cambodians erect wedding tents.  Whole cooked pigs adorned with salads and fruits lay on an infinitely long table under awnings decorated with red and yellow lanterns.  Waiters shouted above the din at the crowds walking by, inviting us to feast, and a fireworks display flashed above us between the lights of the skyscrapers towering over the scene.  Almost every restaurant advertises it’s Halal status for the sake of Muslim clientele, who walked past the displays of pork without any glimpse of concern and burqa-clad women with only their eyes on show wander alongside skimpily-clad tourists.  In one direction local Indian restaurants line the street while in another, Chinese and Vietnamese restaurants are the theme.  In between the two, an undercover area serving Islamic customers.  It is perhaps one of the most multicultural places I’ve ever visited.

Arriving at the check in counter this afternoon I was informed that my return ticket was booked for the 27th March rather than today.  US$160 later a new ticket was in my hand.  Feeling sick about the extravagance, I sat down to check my emails and learned that our 14yo orphan not only had her damaged ear drum repaired yesterday, but today her deformed ear lobe, which causes her great embarrassment, will also be repaired.   News such as this washes away my First World Problems every time!  The Children’s Surgical Centre are to be thanked for this.  Another great NGO doing valuable work with vulnerable people.

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Falling Through Gaps

Falling through gaps

While it’s not health systems that save populations, but healthy and equitable economies allowing a decent standard of living for most if not all, I still like this quote by Dr Paul Farmer.  He is the founder of Partners in Health (PIH), a Non-Government Organisation who work in the poorest parts of the world, having begun from humble beginnings in Haiti after he visited there as a medical student in the 1980s.  As well as being a Professor at Harvard and working out of the Brigham and Women’s Hospital in Boston, he is the Director of PIH, a physician, medical anthropologist and humanitarian.  PIH are now one of the best known international medical NGOs, known especially for their philosophy of health being a right for all, which sees them bringing high quality, modern medicine, to poor populations in places such as Haiti, Rwanda and prisoners in Russian jails.  Tracy Kidder’s biography of Dr Farmer, “Mountains Beyond Mountains” goes into more detail and is worth a read.  Partners in Health work in collaboration with Medecins Sans Frontieres, for example the Tuberculosis Control Guidelines which guide MSF’s day to day TB work were written in partnership between both NGOs.

Yesterday Chom picked me up and we made our way to the blind lady’s village, via a warehouse for 50kg rice which Chom heaved onto his shoulders and dumped onto the floor of the tuk tuk amidst a lot of chatter and laughter.  I must get a photograph next time.  It was about a half hour journey on beat-up dusty roads through many villages and we had to call a few times for directions.  Upon arrival the whole village had a “poorer than most” feel to it.  The pagoda, usually a bright and well maintained centre of community life, was dull, dusty and in some disrepair.

My phone but his language skills - getting directions as we approach the village entrance

My phone but his language skills – getting directions as we approach the village entrance

Village barber shops are almost always shacks under trees.  Often the only place where you can find a mirror too!

Village barber shops are almost always shacks under trees. Often the only place where you can find a mirror too!

We parked on the dust track outside their bamboo shack of a home as two excited children, their mother and her parents all approached to meet us.  Her parents are 62 and 63yo.  Her gentle faced, very thin father walks on his right leg, but his left leg is a useless, wasted pin which serves solely as a crutch to anchor his next step.  He swings it forward and the misshapen foot hits the ground, allowing him to take his next step forward.  Sometime into our visit I asked what happened to his leg and the answer was “He has been like that since he was 4yo”.  I asked why and the reply was “Back then there were not many doctors.  He got a fever and then his leg stopped to work”.  My educated guess is Polio but I could be wrong.  He greeted us warmly, wearing just a checked kramar like a skirt around his naked waist.

More hilarity as Chom heaved the sack of rice over his back and lumbered his way to the house and up the stairs like a hunchback, groaning with each step up to the front door and dumped it on the bamboo planks at the door about 2 metres above ground.  We then sat together on a bamboo bed base under the house, watching a chook sitting on her “eggs for babies” as others bwarked around our feet and the children poked and prodded me.  Their mother, who I will call Mini, disappeared into the house briefly and returned with the two My Little Pony toys I had brought back from America in January and we played with them together as the Khmer adults chatted and Chom occasionally gave me snippets of what they were saying.

After telling Chom the story from Mark that maybe her husband had been murdered, he spoke to her and relayed to me that her husband was “very older than her, 53 years old but she is 30.  It’s so old!”.  He traveled by moto to a specific place where he sold his moto and gave the money to a friend, telling the friend “Use this money for my ceremony because I am going to die”.  He was then found drowned in the river so it seems suicide is the general consensus.  Nevertheless, there are no laws in place to investigate such things and as Mark pointed out to me “she is very poor and too afraid to talk to the police”.

We also got a more accurate story about the fall she had.  She was staying with someone in another village, when the wall of their house fell down and she fell out, hurting her back. Her daughter also fell out of the house.  Her own house is a bamboo shack sitting next to (on the same land as) her parents’ home, where we were sitting.  She does not stay at her home anymore and Chom pointed out to me “there are no stairs, she cannot go inside”.  I am unsure but perhaps the stairs were removed to stop the children or unwanted visitors from entering the empty shack?  Chom explained that she has noone to look after her, so she has to stay with her parents now that her husband is dead.  He also explained that her sister works in a tobacco field and earns $95 per month and “she helps everyone because they cannot work”, motioning his hands in a circle to include Mini, her daughters and parents.  How does $95 feed six people when a 50kg bag of rice costs $30?  As an outsider I don’t know, but speaking to Chaz later in the day about this, he told me that most people “like this” forage for leaves that they can eat, and fish in nearby waterways.

It became slowly apparent that the help she had called me for, was food.  I asked Chom a number of times “When she called us the other day she said she wanted help?” and he replied “I think for food”.  I asked a couple of times more and got the same reply.  We stayed for about an hour and I had no idea what was being said for the most part, as Chom laughed and chatted animatedly, offering me rare snippets as the non-translator that he is!  As we were preparing to leave I asked again, saying I want to be clear about what she meant when she asked me to help.  Chom laughingly said “Oh! I forgot to tell you!  She said that sometimes she is bored and she want to ring you and sometimes they have no food.  So I think it’s okay that you gave some rice and a little bit money”.

On our way home Chom shouted from the moto at me about other parts of the conversation I had missed out on.  “I asked her mother, why do you marry this man when he cannot walk?”  Predicting my horror he shouted “In Cambodia we think this is funny, because I say it in a friendly way, not a mean way, and they laugh too because they know it is funny.  But she said another man wanted to marry her but she didn’t love him, she loved her husband”.  Then “the husband already had three wives, she was the fourth wife for him and he was 53 years old.  I asked her, why do you marry a man like this?  She said, because she needs someone to look after her.  I told her, a man like this will not look after you, that is a bad idea to marry him!”.  His insights are simultaneously wise and hilarious!

As we drove there we stopped in a Muslim village to find some children I had photographed on a bike ride at the end of 2013.  Chom located the neighbours who recognised the children and promised to give them the photographs.  On the way home we stopped at another house to give some photographs to a young family who I had similarly photographed about eight months ago.  They remembered me and were happy to see the pictures.  They took three plastic chairs and placed them under a tree, wanting to tell me that their 13yo daughter “always get headache”.  Since the age of 9, two or three times per month, this young girl has severe headaches.  They have taken her to various hospitals including as far away as Siem Reap, but had no luck with a diagnosis or treatment and do I have a friend who is good with “head medicine”?  I will ask one of the doctors and see but something tells me it won’t be something we can easily help with.

Days as interesting, challenging, rewarding and heartfelt as these seem to be glueing me to Cambodian soil.  Chom texted me last night to say “Dara he staying in Kg Cham now I saw him sit with his Papa”.  When I visited Shackville this morning Dad was cooking up a storm in the kitchen, which is just outside the bathroom (rice porridge with loads of vegetables).  I’ve promised Dara a treat for dinner this afternoon, perhaps fried rice at the Night Market and a ride on one of the bumper cars.  The conversation with Mum appeared to be that his leg is painful and he is on medicine for it – another infection I guess.  Which as you can see, is not exactly surprising.

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The Year of the Sheep

Chinese New Year is a fairly big celebration in Cambodia.  The streets come alive with (illegal) fireworks which have frightened me out of my skin a number of times today.  The funniest of which was as I was cycling down the street after this morning’s English class and a young boy stood in the road, pointing his hands at me in imitation of two guns.  Watching him and wondering what he was up to, I nearly fell off my bike as some of the loudest crackers I ever heard blew up on the road right beside me at the same time as laughter seemed to erupt from around the neighbourhood.

Tonight there seemed to be more sex tourists in my face than I am used to.  Old fat white men with young thin Cambodian women.  I wouldn’t mind if there were no children involved but tonight at a popular riverside restaurant, a very young girl of about 10yo was floating around her mother who was sitting with a particularly sleazy “boyfriend” who looked like he should be in a nursing home.  Creepy to say the least.

Last Friday, one of our first stops en route to Kratie was a sand bank where a ferry transfers people between either side of the Mekong, on the border between Kampong Cham and Kratie provinces.  Microphone and his mother traveled on this ferry to their family’s village home.  Upon arrival at the informal “terminal” (for want of a better word), I received a missed call from the number of the blind woman whose husband drowned in the Mekong while I was away at the end of last year.  I asked Chom to call her back.  He had just driven for three hours after next to no sleep the night prior and was cranky at me for no apparent reason, other than he didn’t want to translate for me.  He’s not a good translator at the best of times (translation skills and language skills are two different things – he has great language skills but limited translation skills, with translation something he openly admits he does not enjoy).  So I understood the crankiness and handed him my phone to call her anyway.  A reasonably long conversation ensued, followed by a much shorter translation that “it was very windy.  The wall of her house fell down and she fell out of her house.  She asked can you help.  I told her you are going to Kratie now and you will call her back on Sunday”.

On Monday I held him to this promise and we called her back.  The wall of her house fell down and she fell out of the house.  She thought I might be able to help her.  She is not badly hurt but she has no food and her daughter fell out of the house too.  Last week she met some people from the hospital who visited her village and she asked them if they knew the Barang who once gave her some rice?  They asked her was the Barang a little bit fat?  Yes.  Oh that must be Helen!!  We arranged to visit her sometime soon, which will depend somewhat on Chom’s availabililty as it is particularly busy right now with tourists.  He knows the general vicinity of her village and with her phone number we can easily navigate our way there.

I was already interested in her situation when today I visited my old team at the hospital to say hi.  One of my nurses, I’ll call him Mark, told me he was at a village last week where he met a blind woman who described me and wanted to know if he would call me for her.  He told her that “she rotates, sometimes she is in Kampong Cham but she goes to Phnom Penh, Siem Reap and other places and now she is in Kratie”.  He didn’t want to call me in case it wasn’t appropriate.  She actually has my number and hence called me herself the very next day.

The story from Mark elaborated on what I already knew.  She is very poor.  Her house is very small, made from bamboo, and it cannot stay still in the wind.  One wall fell down on a windy day and she fell out of the house because she could not see.  She has nothing to feed her children because her husband drowned.  He drowned in the river but he could swim and they cannot find his motorbike so maybe it was a robbery?  Noone will know “because she is very poor and she did not complain to the police.  But if he drowned they would find his moto, and his moto is missing so it must be a robbery because he would swim if it was not a robbery”.

So that’s how I’ll remember the first day of the Chinese Year of the Sheep.  Assaulted by anklebiters with fireworks, and learning yet more horrific details of what it’s like to be disabled and impoverished in the Third World.  Something tells me that Andrew is about to buy a blind Cambodian widowed mother a new wall for her bamboo shack!

Different Degrees of Broke

I have European friends in Phnom Penh who went broke helping people.  They are closer to retirement than away from it and they are in debt with no assets despite having well paid jobs as professionals with international organisations for many years.  They have lived in a few different developing countries over the past twenty or more years, and have devoted their lives to helping people who would have otherwise either existed in misery and pain, or died.  This has been an incredible education for me.  Two years ago I honestly did not appreciate that there are millions of people in the world who succumb to death because they are not able to survive problems which simply do not exist in my reality.  Problems of starvation, deprivation, preventable disease and violence which are not seen in my world.

The desire to help people who are visibly destitute is often very strong but I realise, observing the situation my friends now face, that there is little point in sending yourself broke.  The only real way to help others is by looking after yourself to maintain a position of being able to help where possible.  This means finding a balance between having too much and losing everything.  It’s a fairly tight rope sometimes and I can see how my friends tripped and fell.  Despite their current situation being fairly stressful, they still live a comfortable life with enough food, a nice rented apartment, and some locals they are able to support through employment such as a tuk tuk driver who works for them on a small daily wage.  They are from a country with a social security system where they can retire to with supports in place.

Their version of “dire” contrasts strikingly with the version of “dire” that exists for so many in the world, including those they’ve helped over the years.  Today alone the stories I heard left me reeling in dismay.  That’s on the exact same day when I examined my bank account and pondered on how I am going to do everything I would like to do on my nine remaining months of holiday?  It won’t be possible to hit New York, the UK, Europe and Latin America as I had hoped and I sadly have to reassess my plans.  I even had some pangs of self pity as this reality hit me.  That was after I’d heard some of the stories I am about to share here.  Perhaps this is a good sign, that I won’t be going broke dedicating myself to the service of others, anytime soon?

As I mentioned in my previous blog, we spent last weekend in Kratie, the province north of Kampong Cham known for it’s small endangered population of river dolphins.  We saw the river dolphins from a boat on the tranquil waters of this very unique part of the Mekong, cycled on Koh Trong Island, drank cocktails each night, lunched on a bamboo floored platform above flowing waters of the Mekong  upstream from the dolphins, and many other very touristic experiences.  But the biggest and most delightful experience was the magical time spent with my two expat friends and Chom, plus Chom’s wife and 3yo son who stayed at the family home in a rural village, while we continued on to Kratie town.

After a weekend of exotic experiences, we thought it had come to an end as we boarded the tuk tuk and made our way south on the highway, past village after village of thatched wooden cottages and all the rural scenes that accompany them.  Chom suggested we could have lunch with his wife’s family and so we shopped at Kratie Market for beef and vegetables, piling them into the tuk tuk with the rest of our hilariously huge load.

Vegetables at Kratie Market

Vegetables at Kratie Market

Two hours later, our feet resting on luggage or poking out over the side of the tuk tuk for want of space, we approached their rural village, stopping in at a local pagoda to admire the golden reclining Buddha and other structures in the typically beautiful, spacious and leafy grounds.  We laughed heartily with a couple of elderly gentlemen sitting under a tree who enacted to Bea and I, the motion of pulling down their strides and squatting over a toilet and pointing to the room where this could take place should we be wondering.  Chom engaged with them animatedly before explaining that they had just returned from his brother in law’s engagement ceremony where they had seen Microphone.  Back on board, we drove through the pagoda to an adjoining road, exiting on a shady country lane above the Mekong.  Within moments Microphone came into sight, playing on a bicycle in the dust outside his grandmother’s elevated wooden home.  As we parked various family members appeared, their hands joined respectfully at their chins in Chum Reap Suor gestures towards us.  We were ushered out of the tuk tuk and into the dusty open basement area under the house to sit on the standard bamboo table which furnishes every home in Cambodia and serves as a combined table/chair/bed.

Our bags of market fresh food were immediately spread out at one end of this table and a team work immediately ensued with vegetables washed by one, chopped by another, garlic crushed by one, beef rump sliced by another, all amidst animated conversation, debate and demonstration with the knife about how best to perform each task.  Neighbours arrived to watch and chat, children played amongst dogs and chickens at our feet and at least four adults worked together, talking about how to cook and serve the food and only proceeding once an agreement was reached on every detail.  I for one, felt totally awestruck at the rich family-community life I found myself immersed in.  Between watching the children, animals and team of cooks, I wandered over the road and rubbed the head of an ox who looked at me with the longest, prettiest eyelashes, leaning into my fist in cooperation at the head-rubbing on offer; photographed a boat through the trees on the Mekong below; watched the various moto-driven mobile shops honking to announce their proximity, waved down by consumers along the way.

Two hours later, filled with rice, beef and vegetables enjoyed with four generations of Chom’s famiy in-law, we hit the dusty tracks again and travelled another three hours south to Kampong Cham.  Arriving home, I jumped in the shower and as I watched the bright orange, dust-drenched water wash down the drain, savoured the memories of perhaps the most enchanting few days of my life.

This morning I spent some time with Chaz at Phter Koma.  He met the HIV+ mother and her two children  yesterday to organise some of the paperwork.  She returned to Kampong Cham to make herself and her children available for the recruitment process.  There is no guarantee we can take them and they will have to meet various criteria before we can promise the children a place in our home.  Aware that she was under great financial strain, I asked Chaz to let her know that I would support her with a small amount of money to finance her trip.  She is living in a remote area though and it was not possible to get any money to her.  As such, she relied on my promise of assistance and arranged a loan with a farmer.  Rather than return with the cash she owes him, she is obliged to work in a rubber plantation for a month now, to repay the $25 loan.  But she has enough money to feed herself and her two children for about a month while she labours through her latest debt.  She is in very poor health and probably performing this hard labour whilst living out her final months.

Chaz told me that she had a lot of stories to tell of hardship and I asked him for detail.  He said “for example” before relaying that she often cannot feed her children, and is often weak and bed-bound.  Her ten year old son goes out searching for edible leaves which they cook and eat.  He has told his mother not to worry about him or his sister, that he will look after them.  He often goes without food, insisting that his mother eat what he has managed to find for them.  She is in her mid 30s and preparing to die from an AIDS related illness related to her inability to access the anti-retroviral treatment she needs due to her poverty stricken circumstances.  Chaz quoted her as saying, among other things and apparently in tears many times during their meeting, “I don’t know how much longer I have to live and I want my children to be safe and get an education and other opportunities I did not have”.  As I have said before, her husband who is HIV negative, abandoned the family when he learned of their infection.  As a young girl she was involved in a traffic accident and received a blood transfusion which she believes is how she contracted HIV.

Horrified at the stories Chaz was delivering to me in his calm, accepting manner, I said that in Australia I never met even one person who experienced such hardship, yet in Cambodia it seems that everyone can tell me similar stories from some time in their life or another.  Chaz agreed, pointing out that he also has similar stories.  His family were relatively prosperous (as with “broke”, “prosperous” also comes in varying degrees!), until his brother had a traffic accident and they had to go into debt to pay for his treatment.  The doctors wanted to amputate his leg following the injury and instead of agreeing to this, his parents turned to a traditional healer.  Chaz said “In Cambodia the doctors always want to cut and we do not trust them, and now my brother is okay and  he can walk”.  But at a price, as the family spent all of their money on hospital bills combined with costs of a traditional healer.  Sometime after this his mother developed breast cancer and after having both breasts removed, died a painful death from what sounds like metastastes (“the lumps were everywhere”).  He remembers her crying every night from pain.  His father remarried very soon after Chaz’ mother died and he has had a very strained relationship with his family since that time.

Living in his village, Chaz worked as a labourer building wells, digging in deep trenches, breathing dirt and moving large rocks which were lifted out by ropes above him.  A very risky business with nowhere to go if a rock became dislodged from the rope it was tied to.  After a few years of this existence he moved to Phnom Penh in hope of finding better opportunities.  He worked very long days at a family owned restaurant, earning $25 per month plus accommodation and food, and was entitled to two hours per day to attend classes such as a computer course he enrolled in.  He remembers eating yellow (instant) noodles every single day and being very hungry all the time.  He also had many gastric problems, including a bout of Typhoid.  After a few years he realised that life was no better in the city and returned to his village.  It was upon returning to his village that he met a foreigner who recognised his situation and ability, returned to Europe and located enough donors to support Chaz to attend university.  He moved to Kampong Cham to attend university in 2007.  Growing up under hardship in a rural village he had no vision at all that his future would improve as much as it did “and this is why I always want to say thank you to the people who helped me.  Now I have a Masters degree and I can work here instead of labouring in my village.  I am very lucky”.  He earns an executive salary of almost $100 per week.

These are just a few of the most recent harrowing stories I’ve been told in the past day or two.  The saga of recruiting children based on criteria and whether these criteria have any room for flexibility is another story altogether, involving a lot of very strong discussion between France and Cambodia and my learning curve is so steep it is almost going backwards on itself!

A close family friend Andrew died last week in New Zealand.  He was not only involved in the fundraising that his wife coordinated on behalf of Phter Koma, but he had Mum and I to stay for a week in November, during which time we held the fundraiser.  We had the most relaxing visit with this big gentle giant of a man who read every book under the sun, remembered details that would not even enter my consciousness, made us laugh and cried with us too.  In his memory some money was put into my account by Mum and one of my aunties “to go to a good cause in Andrew’s memory”.  So far he has provided food for this woman and her children for a month.  Their situation is by no means going to have a “happy” ending, but with Andrew’s help it is eased significantly and sometimes that is the best any of us can do for each other.  Rest in Peace, Andrew.

Insidious Power Play

The way that Cambodians name their children can be really amusing to a westerner.  One family of five children I know are named Danay, Danneth, Panneth, Panna and Dany.  The girls are “D” and the boys are “P”.  When I met them I was seeing them everyday and it took me a month, first to hear the names, then be able to say the names, and finally remember which child owned which name!  Coming up with aliases for the people I write about is becoming increasingly more difficult as I try to keep my aliases “western-friendly”!  The Executive Director of Phter Koma needs an alias for this story so I’ll call him Chaz.

The beginning of this post is not about Chaz though, but my hilarious mate Chom.  He’s a young, goofy, kind hearted, intelligent, fun guy who would do anything for anyone.  He has a pregnant wife and a 3yo child and he works hard to support them as best as possible, often lamenting that he cannot do more due to his circumstances.  His parents died from two different types of cancer within six months of each other when Chom was 12 years old.  Within the space of a single year his life transformed significantly for the worse.  He was the youngest son of a doctor with loving parents, seven older siblings and plenty of hope for his future.  A year later he was an impoverished orphan being brought up by older siblings who had to struggle to find his school fees.  They tried to place him in an orphanage to guarantee regular school attendance but because he had grown siblings, no orphanage would accept him.  His education was limited and he left school at a young age to work as a security guard.  He realised early on that English fluency could improve his chances and so he spent as much time as he could with English tourists and bought himself a Khmer-English dictionary.  Self-taught English seems to be a very common theme throughout the poor world.  The widowed teacher I know in East Timor told a very similar story of how she taught herself English (speaking with soldiers, not tourists).  Now, some years later, Chom continues to practise his English with tourists but also on his mobile phone.  I often catch him lying in the back of his tuk tuk waiting on customers, listening to his English app.

Before I left Cambodia in October Chom wanted to take me on a holiday to visit his wife’s family.  Unfortunately we ran out of time and it didn’t happen.  Today it’s happening – Chom, his wife, their son, myself and two expat friends are heading 120km away on his tuk tuk for a couple of nights!  I’ll write more about it when we get back.  From 3yo Microphone, to the 40-and-over expats, there is a lot of excitement about this Khmer-French-Australian mini holiday.

Two days ago I took my laptop to a local restaurant to do some lesson planning.  Upon arrival there was one other customer, a well dressed Khmer man, sitting at a table, who ignored my arrival and presence with an air of arrogance.  I sat down and texted Chom to let him know where I was, as we had some trip planning to do together.  A few moments later he arrived and sat with me.  He was trying to call a specific hotel where we want to stay tonight but we couldn’t find the correct number.  While he was on the first call I heard a noise from nearby which made me turn my head.  The Khmer man sitting near us was looking at Chom’s back and “ssshhh”ing him.  He then looked at me, “ssshh”ed and pointed to Chom, by way of instructing me to tell Chom to be quiet.  Shocked at his arrogant attitude, I looked away again.  Chom had not heard him and didn’t change his volume, which was perfectly acceptable.  We then found another number for him to call.

When he hung up from the second call the man addressed him in Khmer.  The only parts of his sentence that I understood were the informal name he gave Chom, which translates loosely to “young brother”, and something to do with “outside”.  I was looking at him wondering if he really just told Chom to go outside when he turned his attention to me, saying “you need to be quiet or go outside”.  An exchange ensued where I disagreed, noting that he was in a restaurant with seven other tables which could just as easily have customers making much more noise than two normal-volumed people, and that if he needed quiet he should find himself an office.  He argued back that we were not being polite, speaking and making phone calls in his presence.  I pointed out that we were customers in a restaurant and this was not his office.  It was brief and ended unresolved.  I was infuriated with the attitude of this obviously wealthy man speaking to Chom in such a belittling way.  Chom turned away and stared out of the window, before saying to me in almost a whisper, “shall we go outside?”.  I replied in a normal volume “No, I am not going outside, I am sitting here”.  I then tried to get a conversation moving but Chom sat staring out of the window, answering me quietly but obviously feeling very uncomfortable.  Within about ten minutes the man organised to get the bill (also speaking poorly to the wait staff), a car pulled up and he and his leather briefcase were chauffeured away.  He did not look at or acknowledge us as he left, but a few moments later his car drove back past the restaurant and his driver slowed down, staring in at us, in what appeared to me as a gesture of possible intimidation.

As soon as he left, we relaxed and Chom said “the Cambodians with money, they treat other Cambodian people like we are animals”.  I joked “We should have told him, if you give us $10,000 we’ll go outside”, to which Chom replied “I am a poor man but even if he gives $1 million I would not take it because I don’t want corruption money”.  The man has been dubbed Mister Corruption Upstart.  Hopefully we will never see him again!

Moving onto Chaz now, recently I have been working closely with him on various Phter Koma projects and come to know him.  He is from an impoverished rural background and also lost his parents as a child.  When he was young Chaz met a foreigner who returned to Europe and sought assistance for Chaz, sponsoring him to attend university which would otherwise have been beyond his means.  He is a kind, hard working and ethical young man who talks openly about the lucky chance he had which changed his life.

Yesterday Chaz and I took one of the Phter Koma kids to an appointment in Phnom Penh.  I went with them because Chaz had to submit some reports to two different Ministroy offices while he was in the city, so I agreed to look after the teenage girl while he was doing that.  We brought the midday bus home again, arriving late afternoon.  On our way to PP we were talking and Chaz said almost the same thing as Chom had said the previous day, that “rich Cambodians, they treat their own people who have no money, like they are animals”.  I asked Chaz if he had ever felt directly affected by the corruption he mentioned during this conversation.  He gave me the example of being unwell in hospital and his parents needing to have money in their pocket to pay the nurses “because unless they get the pay, they will just walk around and not give me the treatment”.  I explained that in Australia behaviour such as this was not tolerated and nurses seeking favours from patients could lose their jobs and even face criminal charges.  Chaz said “yes, in your country the people are much nicer”.  I argued this, saying that in my country we do not have the history of terror and twisted corruption that Cambodia faced for many decades, and this allowed us to establish systems which protect our people and ensure that corruption, which we do have, is not able to take hold the way it has in Cambodia.

My understanding of Cambodian history is that the people have been tyrranised for so long that this tyranny is well entrenched, currently in the form of a Communist government so focussed on looking after itself that it promotes corruption in order to remain powerful.  The Khmer Rouge were much the same when they came to power in 1975, although they were far more psychotic in their behavior towards the populace.  I’ll write more about that another time as the history of that era in Cambodia is unbelievable.

All of this in the same week as Korea’s “nut rage” court case.  The daughter of an airline owner, enraged that staff in the First Class cabin of her flight served her nuts in a bag instead of a bowl, insisted on the plane, taxiing towards take-off, return to the terminal so that the attendant serving her could be removed from the flight.  She has thankfully been made to answer to her behaviour in a criminal court in which the judge stated he did not believe she was particularly repentant and thus ordered a one year jail sentence.  Her father was in the same court in the year 2000 facing charges of tax evasion.

Corruption, power, wealth and arrogance.  They love to hang out together.  In the developing world it seems to be so much more visible and conspicuous than in the lucky countries where we have protective systems in place.

Carrying the Stigma of HIV

HIV rates in Cambodia peaked in the late 1990s at around 2%.  This was one of the highest rates in Asia and was considered to be a burgeoning epidemic which could easily have progressed in the same way as epidemics seen in many sub-Saharan African countries where rates have soared to as high as 20%.  In 2003 almost 4,000 new HIV infections occurred in Cambodia, reducing by 67% to 1300 new cases in 2013.  This suggests a successful public health campaign.  The overall prevalence rate of 2% in the late 1990s dropped to 0.7% in 2013, partly due to these public health interventions but also in part due to AIDS deaths of many infected individuals.  Death to AIDS in a country with very limited resources is an intolerable, painful and highly undignified experience for the dying victim as well as their family and the staff trying to provide some level of care.  It is made worse by the stigma often shown to these patients by family, community and even health care workers.

In mid December 2014, routine HIV screening of a few community members in a rural commune of Battambang Province saw some surprising positive results in people with no risk factors.  This motivated other family including spouses and children to undergo voluntary testing and further surprising results came to light.  Ultimately 1940 people were tested, 212 returning positive results.  In a country with an HIV rate less than 1%, this specific population have a prevalence rate of almost 11%.

As well as the very high prevalence rate, those testing positive are unusual.  For example, very young people with HIV negative mothers including 4yo twins, only one of whom tested positive.  The usual transmission routes of sexual contact, mother-to-child-transmission and injecting drug use have been ruled out.  Initial epidemiological studies have shown statistically significant high rates of injections or intravenous infusions having been administered to the HIV+ cohort.  This appears to be connected to a particular unlicensed doctor in one specific village, where 82% of all positive cases come from.  He allegedly told police that he sometimes reused needles and other equipment two or three times before disposing of them.  With a transmission risk of only 0.5% if exposed to an HIV infected needle or other hypodermic equipment, this does not explain the very high rate of infections in this population, even if every reused needle was tainted with the virus, which is highly improbable.  The doctor has been arrested and charged with murder (although I have not read that any cases have actually died yet), while investigations continue.

According to media reports this story has understandably and unsurprisingly left the community reeling in shock.  What I had not considered, was the possibility of repercussions beyond the community affected.  There remains a lot of stigma attached to HIV around the world and Cambodia, with it’s low health literacy particularly in rural populations, is no different in this regard.  It is very common for HIV+ individuals to hide their HIV status in order to avoid negative repercussions such as being shunned by family and community, losing employment and education opportunities, and facing prejudice in the health care and other systems.

I have mentioned previously that Phter Koma is in the throes of recruiting three more children to our home which currently accommodates 12 children while licensed with the relevant ministry to accommodate 15.  This is a lengthy process involving official processes and documentation to be submitted and approved.  Two of the children identified for recruitment are siblings currently living with their HIV+ mother who has no family of her own and has been shunned by her husband and his family.  Her own family with the exception of one brother have all died.  When we identified her children as needing our support she was living in a nearby district and very keen to send her children to us as soon as possible because of her difficult social circumstances.  Unemployed and reliant on casual work wherever she can find it, her children are unable to attend school as they follow her from one community to the next, looking for work in order to feed them all, and for somewhere to sleep each night.  Their treatment adherence is very low and they are at risk of developing AIDS.  Their mother has contacted us independently to beg us to take the children but we have to follow the correct protocols and have had to ask her to wait.

Most recently we approved the process to begin recruiting these children.  Subsequent telephone contact with their mother informed us that she has now moved to a distant province, looking for her brother.  This makes the recruitment process even more complicated than it already was, as the correct provincial departments must be involved.  Without having undertaken all of the formal assessments we cannot guarantee her the children will be admitted to Phter Koma.  But the only way she can justify returning to Kampong Cham Province is if we can give this assurance.  She moved because the community she had been living in, hearing of the Battambang HIV cases, became fearful and suspicious of how the virus might be transmitted and asked her to leave their community.  Obtaining anti-retroviral medications from the local clinic is likely enough to have alerted community members to her HIV status.  She again begged us to please take the children, citing intolerable living conditions, but until all requirements are met we cannot do this.

This is the practical reality of the stigma and adversity that Peope Living with HIV (PLHIV) face across the globe.

Cambodian Rosë

Just a quick funny to demonstrate the service you sometimes receive here.  Most if not all of the wait staff in restaurants along the riverfront in Kampong Cham are young villagers who have been employed because they have some level of English, which can range from a skerrick to fluent.  They earn between $80 to $100 per month plus tips, which I am sure often surpass their actual salary.  Most of them have limited training, often nothing other than what they learn on-the-job.  They certainly don’t have experience being a customer and combined with the English they are required to make sense of in all kinds of accents, I am sure it can be very daunting for some of them, particularly those starting out in their mid-teens.  Some of them have disabilities which are very common here, perhaps due to the subsistence lifestyle and also the fact that there is no disability support so you have to make a living no matter what.  Given this overall picture, the service is usually not of a westernised standard and it is often very entertaining.

One of the funniest service events I have had came about a week ago when some of us turned up for a wine in the late afternoon.  I ordered a white wine and waited to see what would come of it.  This glass was presented to me.

Haematuria coloured white wine

Haematuria coloured white wine

As nurses our immediate observation was that my wine looked like a glass of haematuria (bloodstained urine).  I held it up to the light and put my nose into it.  We were busy commenting about the highly unusual white wine when the waiter, who had noticed our observations, returned and said “Sorry Madame.  You said white wine but I put red wine first.  Sorry!”.  Oh I see!  I have a Cambodian-style glass of rosë vino!  Without further ado, we got on with drinking what had been served to us!

A few other photographs from around town in the past week:

Seven on a moto

Seven on a moto

For a year we’ve been in competition at who can count the most bodies on a single moto.  Last night we beat our own record with seven!

Monks strolling in the evening

Monks strolling in the evening

In the mornings monks are seen visiting businesses around Central Market and beyond, collecting their daily alms.  Recently I was having breakfast at the market when a group lined up at my outdoor eatery so I made a donation and was told to wait “because I will give you a blessing in English.  I wish for you good life, good work, good luck, good money and good boyfriend”.

In the evenings the purpose of their presence in town is usually walking to or from one of the many schools offering lessons in Korean, English and various other disciplines.  Cambodia’s most educated appear to be these young men who live inside the grounds of the many pagodas.

Blind amputees and other disabled people often have to beg for survival.

Blind amputees and other disabled people often have to beg for survival.

Scavenging for survival is a commonly observed occupation, in both the very young and the very old.

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Cambodians regularly ask me, do I prefer to stay in Cambodia or Australia?  For the moment, my answer is Cambodia.  I am always greeted with “For me, I want to stay in Australia”.  An understandable desire given the extreme difference in lifestyle and choices!