Until We Meet Again

It’s my last day in Cambodia after a whirlwind final week.

By the time I returned from the US last weekend, Chom hadn’t seen his family, including his new baby, for five weeks.  We made arrangements for an overnight visit to them a few days later.  We traveled almost three hours upstream on the western shore, crossing to his mother in law’s village by ferry, and the following day almost three hours downstream on the eastern shore, in effect doing a full circle through remote Kampong Cham.  It was a humdrum journey for Chom who has been travelling this route, sometimes at the helm of a wooden fishing boat on the river, since childhood.  For me however, it was one last (for now) intrepid adventure into a peculiar, foreign and fascinating world.

Our first stop was the market for a stock of noodles and soy sauce.  Balanced on top of our bags, a handlebar-high pile sat between Chom’s legs.  Passing another moto with a couple of 50kg bags of rice between the driver’s legs, upon which a small child was perched, his legs swinging over the front of the handlebars, we looked very ordinary in comparison.  Nevertheless, with a middle aged white female pillion passenger, we seem to draw much more attention than the various and often hilarious scenes of innovative transport which are ignored as everyday sights by the locals.

Second stop, about 30km upstream, was a shack on the riverbank where Chom introduced me to the mother of a young impoverished fisher family with two of her four children at her ankles.  The youngest could only have been about 7 or 8kg, the size of a six month old, but walking confidently so probably at least 16 months old.  In the rich world a toddler in this condition would be hospitalised for feeding and have a team of social workers and health professionals case managing them.  In the poor world no such support exists and in Cambodia almost 50% of children suffer from chronic malnutrition.  Between passing the noodles and soy sauce from moto to mother, Chom fished into my bag for my camera and instructed us into a pose “because you have to show everyone in Australia what you do for the poor people so that they give you more money”.  Okay, does she understand why you’re photographing us?  “No problem, no problem!”.

Continuing on past the shining pagodas and mosques central to each wooden village, surrounded by rice and corn fields busy with people and ox-driven carts, we arrived at Paula’s home where the family were expecting us.  Appearing from all corners of the village, a small crowd instructed us over the wooden plank bridge above the mud brown pool at the front steps, and into the large, wooden room that is their home.  Paula’s stretcher bed is conspicuously absent from underneath the barred hole in the wall which has provided her only connection with the outside world for almost five years.  The empty space felt somehow exciting and frightening at the same time.

A bamboo mat was rolled out onto the wooden floor slats and we sat in a circle around it.  “Cambodian Cake” (sticky rice and banana steamed inside a bamboo casing) and bottled water were placed in the centre.  I dished out a small token from America for each of the younger family members as well as something for grandad, as head of the family.  The photographs I had taken in America were keenly passed around and I talked about the hospital, her surgery, the Cham community, our flight and other relevant details of what has happened to her since our airport farewell in Phnom Penh.  I tried to explain a photograph of her neatly meshed abdominal wound but Chom refused to translate this for me, telling me later that my lack of warning as I passed the photograph to him, had made him suddenly nauseous!  I gave them the envelope of cash that I was entrusted with from the Cham community in USA and Chom counted it with grandad, confirming the amount matched the count Samantha and I had done with Paula’s mother in the hospital room a few days earlier.

Grandad and Paula’s younger sister then led us on their motorbike past crowds exiting the mosque.  Boys and men in colourful long tunics with patterned skull caps; women and girls in black niqabs, only their eyes visible, slowed down to watch us as I stared back in equal fascination.  Down the road we turned onto a dirt track towards the riverbank to enter another elevated home.  Fried banana and more bottled water were presented on another bamboo mat in the middle of a large wooden floored room with barred holes in the wall framing the tops of trees against a blue sky.  I sat beside the door as bodies seemed to appear from nowhere.  Children stood on the top step staring at me and at one point I counted sixteen women and five men sitting before me.  Most of them were related to people who I had spent time with in USA not even a week prior.  A long conversation ensued, much of which wasn’t translated to me because Chom was too busy enjoying himself!  With a crowd of smiling faces all staring at me warmly,  it felt like an experience in it’s own right!

After about half an hour we continued in our two-moto convoy, following Paula’s grandfather and younger sister to the nearest town, where we pulled in at the bank.  They were there to deposit the cash, paying off almost half of their previously-crippling health care debt.  We said goodbye outside the bank, thinking we would not see each other until next year.  With tears in Grandad’s eyes, Chom said “I don’t know how to say in English because it means he thanks you a LOT, impossible to say”.   Back on the road towards Chom’s little family, through fields of cashew and rubber plantations, red dirt and rice fields, we continued on for about another two hours.  At the ferry crossing we joined a white Brahman rope-led by his human escort, motorbikes galore, a homemade truck with an open-air lounge chair perched at the steering wheel, and any other number of interesting sights which were all ignored in favour of smiling stares at me!

Through the grounds of a riverside pagoda, passing underneath the golden gates onto a shady tree lined dirt track, we reached Chom’s mother in law’s home where his new son was sleeping to the rhythm of a swaying hammock tied to beams under the elevated house.  Mum and grandma were busy at pots sitting atop open fires in the dirt and big brother was playing hide and seek from the wooden stairs leading inside the house.  We wiled an afternoon away sharing a delicious meal, before lazing in swinging hammocks underneath a hay shed.  Throughout the afternoon and evening we were visited by a steady stream of neighbours.  In the early evening we took a motorbike cruise to a nearby pagoda complex where we photographed each other standing inside a forest of trees smothered in ribbons and flags and beside various Buddhist statues.  Driving through a hive of early evening activity in the nearby Cham fishing village, I wondered if the crowds we passed by were related to any of the many people I met in America.  Back at the house various visitors sat with us underneath the house, amused at me photographing the neighbours as they steered their oxen home after a day ploughing the fields.  From groups of children to families a range of people cruised by on motos, boats returned home with the day’s catch and a million other sights typical of rural Cambodia kept me interested during an evening of conversation that I mostly didn’t understand.

After a “shower” at a concrete tub with a plastic pot, I was guided to “the bedroom”, a walled-off corner of the large open-plan wooden-beamed upstairs room.  A bamboo mat was unfurled onto the floorboards and a green mosquito net tied from each corner to a beam in each corresponding corner of the room.  Similar mats and nets were set up in each corner of the large open plan room over the wall from me, housing Chom and his little family under one, his mother in law in another, and her father in another.  I climbed into my private little sanctuary and soon dropped off to sleep, smoke from nearby fires wafting up through the floorboards, the baby cooing from under the family’s mosquito net nearby, roosters crowing occasionally and by morning, the hum of motorbike and boat engines alerting us before sunlight, that day was about to dawn.

Another “shower” with the plastic pot refreshed me for the day ahead.  I took an early morning walk through the village, accompanied by Chom’s 4yo son and 7yo nephew whose incessant chatter made no sense but sounded intriguing nevertheless.  Fish twitched on lines of string as they were delivered to doorways from the water’s edge by men who returned to their wooden boats to continue collecting the day’s breakfast.  Women with baskets of produce on the carriers of their bicycles asked my small bodyguards where they were going and were informed matter-of-factly “we are walking with Helen”.  Motorbikes purred past, slowing down to wave and say hello.  At the nearby pagoda the boys showed me the newly-painted long boat sitting outside of it’s wooden shed in preparation for the upcoming Water Festival boat races.  School children were crowded inside the forested area of the pagoda complex, apparently cleaning the grounds.  Later Chom informed me that cleaning the yard was a usual start to the school day in Cambodia.  We took his moto to a nearby village where I purchased some checked krama scarfes to take back to Australia as gifts.  They were cut and hemmed while we waited.  After mid morning brunch with the family we said our farewells and made our way back downstream.  Another three hour journey through mixed Buddhist and Islamic villages, I tried to memorise a thousand sights which I will not see again until I return to Cambodia next year.

The rest of my week has been spent visiting people to say farewell.  En route to Dara’s village we visited “Toilet Two” where a pinwheel for their 4yo daughter elicited a super cute response of delight.  Chom informed them that Sally and Jack, the chickens they gifted to him in thanks for the toilet, were no longer with him.  Sally was run over on the road outside the house and Jack, missing his wife, had wandered away and settled in at a neighbour’s house where he has a gaggle of girlfriends.  This caused a big debate and eventually Chom agreed to accept three more chickens from them.  A farewell visit to Dara’s family where a frisbee and some balls caused wild commotion.  We returned to Toilet Two briefly to pick up the chickens.  This time housed in a rice sack with manually-ripped ventilation holes, my newfound chicken-grip skills were not required!  A visit to Phter Koma with a new ballgame from America, where we spent a few hours playing games with the children.  These and various other brief farewells have kept me busy all week.

Yesterday an expat friend suggested we take a tour somewhere as a final outing.  There is a beautiful hillside pagoda complex above the Mekong river not far from Paula’s village.  After breakfast of “bowng dea drey brawmar” (fish omelette with fresh vegetables and rice) at Central Market with Win, we headed off in Chom’s tuk tuk with two of his young female hotel staff.  A Seattle contact had emailed me asking if I would visit a sick woman in Paula’s village.  Aware of the perception that may have developed in a village where the rich world must seem mysterious and inaccessible, and where everyone knows of Paula’s miracle treatment in America, I said I would visit on condition that everyone understands that what happened for Paula was a unique situation which I would never be able to replicate.

Happy to see grandad again, earlier than expected, he and Paula’s younger sister accompanied us to the house of their unwell neighbour.  Shoes off, up the wooden stairs into the big open room again, this time I was greeted by the sight of a small bag of bones lying alone on a bamboo mat in a corner of the room. Unable to move her legs, she has been paralysed for twenty years and noone knows why.  I am not qualified to diagnose her and explained this.  Chom and I had an argument when he told them that she “probably carried salt” after giving birth to her now 20-something daughter, evidenced by the fact that she became unwell when her daughter was about ten months old.
“What do you mean?”
“If the women carry salt when they are pregnant or just gave birth, they will get sick”
“No they won’t?”
“Yes they will”
“No.  That is not correct”
“In Cambodia this is correct”.
Trying unsuccessfully to hide my frustration, while Chom tried unsuccessfully not to seem startled by my reaction, we agreed to continue our debate on this surprising and confusing topic later on!  I have since learned that a universally held belief here, is that women should never carry salt or rice, especially not heavy bags, and especially not during their child bearing years.  Women who fall sick during this time of their life often blame it on contact with salt!  Chom’s own sister, when pregnant and with a newborn, would not touch salt except to eat, so that if she needed to sprinkle it on her food, someone else would have to do this for her!!

I explained to the family how and why they should access a wheelchair from Handicap International in Kampong Cham town.  Otherwise powerless to really help, I promised to visit again when I return to Cambodia next year, feeling aghast at yet another person in the very same village, with yet another debilitating disease, helplessly and invisibly waiting to die.  Simultaneously, the meticulous care she receives from family was evident in her clean and well presented appearance, the unified replies to my questions about her clinical condition, and her basic but decent level of comfort.  As we left, Chom informed me later, she had asked if it would be possible for someone to sponsor her with a monthly stipend.  Outside the house Paula’s grandfather apparently told Chom of another unwell person they wanted me to visit.  With three friends waiting in a hot tuk tuk, Chom said no to the request without telling me, so we headed off to our afternoon of playing tourist.  Grandad also invited us to join him for a meal “because I want to kill one cow and sit with you to eat beef”.  I had to decline, promising to return next year for this novel experience and telling Chom the cow needs to die before I know it exists!  Today I received a message from the US-based daughter of some villagers that “my mother and father waited for you since yesterday, they prepare food and so I told them you already been and cannot go again because you have no time”.  It doesn’t help my constant underlying thoughts of how to possibly stay, when all of this unfinished business lies in wait for me!

The French founder of Phter Koma is currently in Kampong Cham and this afternoon, after I said goodbye to the children, she cycled past with fourteen children following her on their bicycles.  About half an hour later we had the first tropical storm since I returned a week ago, and she and her small horde appeared underneath the verandah cover of our shared hotel, drenched and looking for cover.  With thunder and lightning blasting out of the densely white sky, we stole a final few moments together.  Breakfasts, lunches and dinners have kept me busy all week and now, just over 12 hours before I leave, I have a final dinner and drinks and am yet to pack my bag.  Obviously blogging about my week took precedent over departure preparations.  But now a quick bag-pack is in order and so I am publishing this without any proof-read.

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A Cross Cultural Islamic Experience

I had been in Cambodia about a week when one of the MSF expats announced excitedly that on a bicycle ride that day, she’d cycled through an Islamic village with a mosque and many people dressed in Islamic attire.  Islamic people in Cambodia seemed a curious thing to our uninformed minds.  Since then I’ve learned a little about Cambodia’s Islamic population, the Cham, particularly since becoming involved with Paula’s family and fellow villagers during the preparations to get her to America.

Paula remains hospitalised after surgery five days ago.  Apparently she spent a night in ICU at the weekend but has since returned to the surgical ward.  At this stage we still don’t know when she can be discharged from hospital.  Upon discharge she will need to stay nearby for at least a month or so, to receive appropriate follow up before returning home to Cambodia.  The wound is expected to heal only gradually, hindered at least in part by her poor nutritional status.  A plastic surgeon has been added to the medical team caring for her.  Surgery last Wednesday was a six hour affair involving two highly experienced gastro-intestinal surgeons and their team. The following night at dinner Sean (not his real name), the surgeon, talked about the operation.  Paula’s digestive tract was, in his words, “a monumental wreck” and she would have died within the next few months without corrective treatment.  They were nevertheless, able to patch the various anatomy together again and he believes she will make a slow but full recovery, returning to a normal life within the next few months.

Last week was highly emotional for all of us.  There were tears as Paula was wheeled away from her mother to the operating theatre early Wednesday morning.  It was a long and anxious day for those of us waiting in the wings.  Sean knew this and we received the occasional phone call from the theatre, to let us know that all was going okay but taking longer than hoped.  There were more tears on Thursday when Samantha and I met with an American paediatrician organised by Sean, to discuss her critically ill son.  At two years old, he has an undiagnosed neurologial condition.  Based on photographs and the story of his clinical picture, the paediatrician was able to deduce that he has some sort of progressive genetic condition which is slowly causing deterioration in muscle tone.  That there is no cure and the condition is terminal was tragic but not unexpected news.  To have an informed clinician speak at length with knowledge and empathy was an entirely different experience compared with the lack of care or attention he receives in Cambodia.  This stems from an under-resourced system in which staff are so often powerless to help.  Prior to last Thursday noone had spent more than a few moments at a time filling in scripts for this boy with a mysterious condition, during episodes of acute illness.  One Cambodian clinician told his mother, when he presented with probable pneumonia, that there was no point treating him “because he is disabled”.  So the time spent with a first world paediatrician, offering her advice free of charge, was a bittersweet pill for Samantha.

On Friday Samantha and I made the return trip home to Cambodia.  There were many tears and tight, persistent hugs as we left the hospital, especially with Paula’s mother.  She is nearing the end of a very long journey, having spent years caring scrupulously for her no-longer-dying daughter, while maintaining a semblance of family life for her other offspring and Paula’s son.  She has also continued to run a small local market stall while her husband and oldest son are overseas earning what is for rich-world-citizens, very small amounts of money to send home.  All because of the debts incurred by Paula’s medical needs.  Paula and her mother remain in the capable hands of a first world medical team and a strong, supportive Cham community who I spent only a brief but very impressive time with.

SE Asia Maps

Historic and current day maps of mainland South-East Asia

What we now know as South-East Asia is made up of a vast and diverse number of ethnic groups.  According to UNESCO there are at least 25 ethno-linguistic minorities in Cambodia alone.  The dominant Khmer population makes up about 95% of the country’s more than 15 million people.  The biggest minority outside Khmer is Mandarin Chinese, consisting of around 440,000 people.  Next in line are the Cham, at over 200,000 people.

The history of Cham people is long, involved and complicated, so I cannot do it justice here except to provide a brief history as I understand it.  They probably travelled to what is now the central coast of Vietnam sometime before 600BC, from Malaya or Borneo.  Developing from smaller tribal groups and growing out of a preceding Kingdom known as Lin Yi, the Kingdom of Champa, as seen in the historic map above,  existed from around the 7th century AD until it was completely annexed by Vietnam in 1832, finally rendering the Cham a stateless people.  At this time many, following their last King, fled to Cambodia.  Here they settled in communities across the Mekong Delta but most predominantly in the province of Kampong Cham, which literally means “Cham Landing”  or “Cham Harbour”.  Today most of Cambodia’s Cham population live in the provinces of Kampong Cham and Tboung Khmum.

Originally Hindu and Buddhist, the Champa Kingdom began to be influenced by Islamic merchants from the Persian Gulf as early as the 9th century AD.   Today most of Vietnam’s Cham people remain Hindu whilst most of Cambodia’s Cham are Islamic.  They speak and write their own language, living in their own distinct villages where mosques and goat herds replace pagodas and pigs.  Cham villages are interspersed between neighbouring Buddhist villages and Cambodian Cham speak Khmer as their second language. As with so many minority and landless populations across the globe, Cham of both Vietnam and Cambodia have a history of persecution.  Half of Cambodia’s Cham were annihilated between 1975 and 1979, targeted specifically by the Khmer Rouge.  Many more escaped during or after this brutal period.  This exodus from Cambodia saw Cham people scatter far and wide and there are a number of Cham communities across the western world including USA and Australian cities.

After spending so much time with Paula and her mother, as well as other members of the family more intermittently, I have had some interesting experiences.  During one of their recent hotel stays in Kampong Cham town, I knocked on the door of their room, opening it to the sight of Paula on the bed against the far wall and an eerie sense of another presence in the room.  Kneeling on the white floor tiles, wrapped in white prayer attire from head to toe with only her face visible, her mother was deep in somyang (prayer).  Her face appeared at first sight, to be suspended in mid air and I literally jumped out of my skin.  At other times, preparing for prayer, she washed her feet in front of me, or had to explain to me why she was fasting (a cultural practice upheld during times of anxiety, such as on the day of Paula’s surgery).

Since the day we met I have known that Paula and her family are Cambodian Cham.  Only recently did I realise how strong the cultural implications of this fact were.  When we embarked on our “mercy mission” to the USA, I had no clue that I was travelling towards a much more significant Cham encounter in the USA, than I had experienced to date in Cambodia.  This lack of experience on my part is entirely due to my “stranger in a foreign land” existence.  I am surrounded by Khmer and Cham culture in Cambodia but I see it through western eyes, which very often means I don’t see it at all, short of noticing a beautiful mosque, colourful Islamic clothes, or understanding the occasional superficial observation unique to Cambodia such as the way people greet each other.  During our travel preparations Sean’s wife, I’ll call her Cate, located a local Khmer person in USA, who in turn located a Cham Imam.  They both picked us up at the airport on arrival and transported us straight to hospital.  During this journey we discovered that the Imam grew up in the village directly opposite the shore from Paula’s village.  Last week I showed him a photograph of myself standing with an elderly Cham man in this particular village, who he recognised as his neighbour!  His parents remain in this village and he visits home with his young family every few years.

I lost count of the number of Cham visitors who appeared in Paula’s hospital room during the two weeks we were with her.  We bought almost no food during our time in the US because bowls, containers, pots and pans filled with various home cooked meals, rice, fruits and snacks appeared on a daily basis such that we filled both the hospital and the hotel fridges.  My plan to purchase warm clothes for Paula and her mother was cancelled when bags of second hand clothes appeared from multiple sources.  My plan to purchase a sim card so I could have telephone access was cancelled when a telephone was loaned to me.  As the person acknowledged by Paula’s family as making her mercy mission happen, I was overcome by the fuss that was made of me by everyone coming to meet us.  Such that some claimed they had travelled to meet me rather than Paula.  An undeserved amount of praise was heaped on me.  Statements such as “even though I never met her, she is Cham and so she is my sister and you have saved my sister’s life”, “I have lived in US for 35 years and never once seen a Cham able to come to America for treatment, it is truly amazing”, “every night when I close my eyes all I can see is your face”, “you must be the famous doctor who brought our Cham sister to America”.  Every day tears were shed, amazement was expressed, gratitude was articulated in words and gestures.  It was flattering, humbling, bewildering, confusing and overwhelming, all in one hit!

At no time during our preparations within Cambodia and journey to America had I remotely anticipated that I would even meet Cambodian Cham people, let alone from villages I know and visit.  Some of the conversations were hilarious, along the lines of me looking at a Cham person who in turn was looking back at an Australian who asked:
“Where do you come from?”
“Cambodia”
“Yes, but where in Cambodia?”
“A province north of Phnom Penh called Kampong Cham”
“I know Kampong Cham, where are you from there?”
“It’s in <specific district>”
“Oh, you’re not from <village name>, are you?”
“Oh!  How do you know my village?!”

Beyond my initial sense of neighbourly welcome, we were in effect adopted into a large, strong, collaborative extended family.  I greeted the first invitations to spend time with people in their homes, keenly.  But my western brain expected these invitations to dry up after one or two meals.  Instead, the invitations escalated to the point that it became impossible to see everyone who wanted to meet us!  People continued to send home cooked meals, phone calls from strangers seemed relentless, asking when we were free to eat at their home or at a restaurant, insisting on paying for everything and transporting us etc. Samantha, a Khmer nurse, was not only accepting, but very welcoming of the constant array of attention and invitations.  Her only regret was that the local Khmer community were not extending the same open arms to her as Paula’s Cham commuunity.  She wondered aloud, if she was the patient and not an escort, would the Khmer community have rallied in a similar way for her?

At the same time I began to wonder constantly, when I would possibly get some time and space to feed my western need for solitude and independence!   It was only when I began to recognise the slow sense of suffocation that enveloped me, that I was able to reflect and realise I was in the midst of a very affable, yet intense, culture clash!  My attempts to step away from the attention were met with more determined invitations, which in turn increased my own determination for some solitude.  I didn’t understand why I was being so hotly pursued, and my increasing dissociation from such warm and friendly people, who I liked a lot, was causing an equal amount of confusion.  About a week ago I declined an invitation for lunch and received a telephone call from the would-be hostess trying to persuade me to change my mind.  Tired and confused, I announced that I was starting to get stressed by the constant intrusions into my time and could they please let me have some time off.  I was astounded when she replied with a very kind and gentle tone, “we thought we could share a meal with you.  Are you too busy to come today?”.   It struck me that as much as I needed some space, this community needed to extend their generosity and friendship to me.  I was only in town for a short time, which for me made my time and space more precious, while for them it made their need to see me more urgent!  It was perhaps one of the most awakening moments of my life, to be able to visualise my own cultural norms as compared with those from another world view.

Back in Cambodia for a week before winging my way home to Australia, my first mission was to visit Chom’s wife and children at her mother’s village about a three hour motorbike ride from here.  He hadn’t seen his now-six-week-old son for five weeks and was waiting for me to accompany him.  The journey took us through Paula’s village, where we stopped of course, and many Cham villages I now know a little more about.  Chom’s wife is from a village with a pagoda which divides two distinct village populations physically, with Cham homes upstream of the pagoda and Khmer downstream.  We took a drive through the Cham side of this village the other night.  Looking at the villagers in their Islamic attire, who stared back at me, I ruminated on how I could be in prosperous America one week, socialising with people from this very place and days later find myself driving through their impoverished home town exchanging glances and smiles with their family members.  This trip was an adventure in itself and I’ll blog about it later.

Cambodia In America

Existence would be intolerable if we were never to dream
~ Anatole France

These words could have been written specifically for Paula.  After developing severe, chronic abdominal pain during pregnancy in 2011, her interim years have been a living hell.  We met on one of her most wretched days, approximately 16 months ago.  She had already undergone five surgeries and her gaping wounds, oozing faecal liquid onto her abdominal wall, have caused constant pain, immobility and severe malnutrition.  The family spent thousands of dollars seeking medical care for her mysterious abdominal symptoms.  They sold their home and later, their grandfather mortgaged his home so that it is currently owned by the bank.  With over $5,000 owed, her father moved to Malaysia and her brother to Thailand.  Both send their wages home to cover the repayments.  The family (Mum, seven children and Paula’s son plus various other extended family) live in the home of Paula’s aunt while she too, is in Malaysia where she can earn more than is possible in Cambodia.  When she returns, the family will be rendered homeless and do not know where they will live.  The debt will take them three years more to repay before they can begin to think about re-establishing a new home.

Not long after Cambodian surgeons informed Paula that there was no hope, and that she should go home to die, she was diagnosed with pulmonary tuberculosis.  She began standard TB treatment, which in a “dying” patient is more a public health protective measure, than a life saving intervention.  A few months later culture results from her sputum specimens confirmed that her TB was resistant to one of the standard drugs, and she came to us in order to begin a drug resistant (DRTB) treatment regime.

A beautiful young woman with a dedicated and loving family, her story seems to have evolved into a very rare instance of DRTB actually saving a person’s life.  Without the TB diagnosis she would have remained at home waiting to die.  Instead, she came to the attention of people with “outside connections”.  A rare and unlikely opportunity for an impoverished rural villager from Cambodia.  She has featured in two separate reports on TB in Cambodia by Spain’s largest newspaper, El Pais and also in a fundraising brochure for a European branch of Medecins sans Frontieres.  She’ll never know the existence of such paradises as the hillside home of Patricia Wells in Provence, near the medi-eval village of Vaison la Romaine, with it’s clifftop castle and ancient cobblestone laneways.  Yet it was in Patricia’s beautiful garden of lavender, herbs, vineyards and summer blossoms, where Paula’s fate changed dramatically, one sunny day in June this year.

Since that astonishing day when I heard the words “my husband could probably fix her”, followed sometime later in the same conversation with “if her husband treats her for free, I will cover the additional costs”, I have had many doubtful moments.  Awaiting confirmation of charity care from the treating hospital in America; sending Paula, her mother and our Khmer translator (my ex-colleague, “Samantha”) into the US Embassy in Phnom Penh to obtain visas; seeking medical clearance from the airline and many other stages in the process of getting her here.  Amazingly, almost a week ago we did get her here.  She is hospitalised and investigations all show that her condition is operable and she should return home in good health, to a normal life, reasonably soon!

The astonishing coincidence of happening to have lunch with the very people who could make this happen for Paula, and happening to mention her miserable existence to them without knowing of their connections and abilities in this regard, appears to have set a  pattern for Paula’s continuing good fortune.  The long haul flight from Cambodia to America was challenging to say the least.  She travelled the almost four hour journey to Phnom Penh airport in a minivan with at least 30 family and neighbours.  I have no idea how they crowded in together, with Paula lying on a stretcher bed in the same vehicle!  By the time we (Samantha and I) arrived at the airport, in our own minivan with Samantha’s hordes, the Paula hordes were already there, crowded around her stretcher bed which they’d positioned outside the main doors.  It was amazing to be a part of the excitement and I have never been the subject of so many photographs as I was that night before check-in.

We made it across the Pacific Ocean with her, a 25 hour journey in total including 14 hours of flying time broken by an 11 hour stopover.  The excitement of going on an aeroplane was slowly overshadowed by her progressive exhaustion.  By the time we boarded our second, much longer flight, she appeared more like a little old lady than the 25 year old beauty that she is.  Pushing her tired little bones through Customs and Immigration made for an expedited entry into the USA, with officials showing nothing but compassion and respect.  There is a large and tight-knit Cham community here and an Imam met us at the airport with his wife.  As they drove us into the city to the hospital we discovered via conversations in Cham and Khmer, that he comes from a village on the opposite shore of the Mekong from Paula.  In fact, I believe he comes from the village where Chom and I rolled in the tuk tuk!

This week the world has shrunk even further as a steady stream of Cham visitors have appeared daily, some of whom even come from Paula’s actual village!  Their stories seem to be a mix of escaping as refugees during and after the Khmer Rouge era, or more recently, being sponsored by wives or husbands already living here.  Their immediate connection with Paula, especially for those who know them as neighbours and extended family members, but even as strangers meeting for the first time, is surprisingly strong, based on a mutual language, religion and culture originating from a distinct area of the Mekong Delta.  It has been amazing as an outside observer, and also a little overpowering as someone from a very individualistic culture, to find myself embraced by this community spirit.  Karen, paying for the out-of-hospital expenses, has so far had a very tiny food bill because home cooked meals are arriving daily from the community.  The hotel we had booked for Paula and her mother post-discharge until she is deemed fit to fly home will probably be cancelled.  A choice of family homes are earnestly offered for them to move into for as long as they need.

On Thursday I was asked to spend the night at a family home with Paula’s mother and Samantha, who is also having a very awesome first-overseas experience.  We were picked up and transported about an hour from the city to a large family home where extended family and neighbours were either waiting, or joined us later.  A large meal was simmering on the stove, conversations flowed in Cham, Khmer and English, beds were organised, a neverending supply of food was served, children played at our feet and talk of Cambodia, America, food, religion, health care, poverty and wealth kept us awake until after midnight.

Yesterday morning we were taken on a tour of the area after breakfast.  We were due to attend the mosque and talk to the community about their Cham sister/daughter’s plight but information arrived that Barack Obama was coming to town for dinner and traffic delays were expected.  Paula’s mother stayed behind while Samantha and I were driven back to the city in time to avoid the traffic and ensure Paula was not left alone for another night.  As we approached the city a phone call arrived to say that the community had raised over $1,000 towards the family’s debt!  This morning a follow up phone call has placed this at $2,000!  Equally surprising is the information that Paula’s mother, 2 years my senior, has told the community that “my mother will decide what to do with the money”.  Naiively accepting this comment, as I vaguely wondered who she meant as her mother died during the Khmer Rouge, I was then informed “you are the mother, so it is your decision”.  Brain whirling in horror, I maintained some telephone composure and discussed how the money can best be utilised – by paying it towards the family’s debt, and how to best ensure this happens.

In the early days Paula regularly asked “do you think there is any hope for me?”.  My colleagues and I reassured her while in private discussing whether these reassurances were the right approach given her utterly hopeless condition in a country where a prolonged and miserable journey towards death is accepted so often as normal.  To have dreamed that an outcome such as this was remotely possible, would have been ridiculous.  Yet, the utterly ridiculous appears to be taking shape!  If only she were not just one of many thousands with equally harrowing existences.

Not Out Of The Woods Yet

But it seems that the remaining project now, is to cram my belongings into a case and meet my travel companions

~  Famous Last Words By Me
A Couple of Hours Ago

Proof reading the final version of my last blog post less than two hours ago, this happened.

Finding the words for a blog requires silence, peaceful frame of mind, a little comfort and few interruptions.  There’s a cafe nearby with air conditioning and today is particularly hot so I was hiding away in the cool, writing.  Unexpectedly a Khmer friend opened the door and began waving in an elderly woman who I often see around town with a sack on her back, searching for cans and bottles to sell.  An American couple had given my friend some cash for her and he had come looking for them to show them she had received their donation.  They were not here but I was.  I’ve often watched her and wondered.  Why are her legs deformed?  Why does she scavenge, surely she has children who could look after her?  He encouraged her in and asked me to photograph her with the money, as evidence to the Americans.  She removed her krama which sits curled around her head as she wanders the streets and smiled for a couple of photographs.  I offered her a drink and she asked for Coca Cola!  A seventy two year old Cambodian woman sitting across from me drinking Coca Cola – that’s another “first”!

As she sipped her Coke, my friend translated for me.  Her husband died during Khmer Rouge.  They had three children.  Her sons were called to military training in the 1980s and were both killed by landmines at that time.  Eight years ago a motorbike crashed into her while she was out scavenging.  Three bones in her legs were broken and she was hospitalised.

Her daughter had just given birth to a fourth child.  Worried about her mother, she walked with the baby to visit her mother in hospital.  With assurances that she was fine, her mother sent her home to care for the four children.  She walked the 3+km home again.  The next day she was dead, I guess from a post-natal haemorrhage exacerbated by the long walk?

With no way of feeding the baby, she soon became unwell.  They took her to a doctor who offered to adopt her.  She has not been seen since.  The children’s father left to marry another woman, leaving his remaining three children in the care of their grandmother.  He has since also died.  To feed her three grandchildren aged 6yo, 10yo and 12yo, she walks the streets scavenging.  She is indebted to a villager who provides her with rice.  She takes the sacks of bottles and cans to this villager as repayment.

We went in the tuk tuk together, picked up her two bulging sacks of recyclables, and drove her home.  I will repay the debt for her and bought her a 50kg bag of rice, which will last the family a month.  I asked for her expenses which come to $85 per month.  Sending each child to English classes would be an extra $12 per month at $4 per child.  We left with the promise that I will try to find people in Australia willing to sponsor her so that she doesn’t have to walk the streets scavenging anymore.

If you are interested in helping this family, it would only take four people to donate US$30 per month (to cover bank and GoFundMe fees) allowing this tiny beautiful woman some security and dignity in her final years.  When I am not in Cambodia this can be reliably entrusted to one of my loyal Khmer contacts, with regular updates.

The same crowdfund page will work for this:
Help a Cambodian Family

It may not work but given the achievements we’ve had so far with so many projects, it’s worth giving this a go!  I promise that my final project is now definitely just to pack and leave.

Meanwhile, correspondence with a friend in Australia is also worth sharing:

I reckon we can do better than this. I’m reflecting that cuts to Australia’s aid budget are implicated in sad stories like this… my own offer to volunteer in Cambodia through Red Cross was turned down because Australia couldn’t afford to let me volunteer through Australian Volunteers in International Development (AVID – AusAID funded).

Most Australians don’t realise how little we spend on foreign aid, and how much it can achieve. Personal stories like this might help not just your poor lady but thousands of others.

Interestingly we donate much more personally than we do as a country, yet a co-ordinated aid program sounds so much more valuable than each of us forking out a little bit for this lady who had the good fortune to meet you.

How about an open letter to (politicians).

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Trying To Be A Noisy Neighbour

poverty and privilege silent neighbours

Mornings in Kampong Cham town and across Cambodia come alive the moment the first ray of sunlight blazes it’s long sharp streak through the fading night skies.  The first market sellers start to appear on their motos piled high with what would, in my world, be truckloads of produce.  When I appear a few hours later, the streets are humming and I have never lost the sense of fascination I feel with sights that the locals consider “normal”.

Yesterday I made the maddest dash I’ve ever made, 30km to Paula’s house on the back of a motorbike, to get her signature on what was  hopefully the final of many forms needed to make our pending journey possible.  En route we pulled over so I could answer my telephone.  As a herd of cows sauntered past, motos weaving around and through them honking their horns in warning, I explained to the airline representative that I understood the urgency and was onto it.

A yellow pool of slush and water has settled around the base of their house, with a long wooden plank poised as a bridge from solid ground to the first dry step.  After an excitement-filled conversation about meeting at the airport in a few days, signed form in hand, I crossed the bridge towards the moto and stood still to take this photograph.  The moment obliged dozens of small red ants to attack me from toes to ankles.

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Both Paula’s and Samantha’s families have a minivan booked each, to transport their respective hordes to the airport for what I expect may be an overwhelming send-off .  I will be there, foreign, alone and unloved, which is sure to elicit plenty of sympathy from those sending us off!  I am mostly looking forward to the excitement of traveling with three Cambodians who never dreamed of going in an aeroplane before.  My spare moments are spent trying to anticipate how best to prepare them for their rich world experience, plus practising my poker face.  I expect to be the reference point for three of them during turbulence so straight faced and calm will be the only expression I share.

This morning after smothering tiger balm over my itchy feet, I hit the road on my bicycle to do a few chores.  When the ATM thought too long about my requested withdrawal before changing it’s mind, I immediately suspected the money which had not been dispensed had probably made it’s way out of my bank account.  Walking into the bank on the first of any month – public servant pay day – is to be avoided whenever possible.  Unless you’re a foreigner.   I was asked to take a seat at the counter, immediately ahead of the crowds in the seated queue behind me.  Conversing in English, a phone call was made and moments later I was informed that the withdrawal would be reversed by tomorrow.  I cycled over the road to another ATM and made the withdrawal I needed.

Served in my native tongue, ahead of everyone else, without concern for the missing money because I have enough in the bank, in a country where only 3% of the population even have a bank account, I cycled through the market contemplating.  My Cambodian days cause constant inner turmoil.  My own freedoms and privileges, being treated “like a King”, and then witnessing such extreme hardships in the exact same moment, is the most confronting experience.  Even having this exposure to “the other world” gives me a privilege that others, safe in comfort zones, miss out on.  I deserve no more than the next person, yet I have immeasurably more than most who share my world and I know this through personal observation, not from statistics, other peoples’ accounts, photographs or videos.  Until very recently I had no real clue that this was the case despite “knowing” it in theory.

Inner turmoil is described as “the mind’s way of destroying the perception of what you are”.  Only now, in middle age, have I learned that on a global scale I am far more entitled and powerful than I ever had a clue of being.  My previously held self perception of being a “global average” has turned on it’s head.  The only way to respond to this revelation is to use my power and privilege to the benefit of others.  This also seems to have become the only way I feel I can personally benefit any further from my over-entitled life.  I seem to have transcended previously held aspirations for material possessions and international travel, in favour of helping others.  It doesn’t make me anything but the same selfish person I’ve always been – my aspirations have simply changed.

Any praise for helping others belongs fairly and squarely to those around me, who face their own hardships yet help others, often with great personal sacrifice.  Among so many, “Rav”, my friend in Siem Reap, is a fine example of this.  A young man with a wife and two small children, he was born just after Khmer Rouge were ousted by the Vietnamese and grew up in troubled times.  He doesn’t speak about himself much but I know life has been a constant challenge.  While I was jumping on trampolines, going to swimming club and boarding school, he was simultaneously fishing in rice fields for the family dinner and often going hungry.  When I arranged to help “Kim”, the landmine victim who I support with a small amount each month, he brought Rav with him to assist with translation on our first encounter.  On that occasion I purchased a sewing machine for Kim’s wife, which led to the placement of a photograph of myself and my mother in a frame on the wall of their tiny home, above the old machine!

As so often happens in this country, upon meeting Rav I immediately warmed to his quiet, unassuming, helpful character and we have remained in touch ever since.  Despite it becoming apparent over almost two years, that he lives an impoverished existence himself, he has only ever assisted me in my attempts to support Kim, often saying “at least I have an ability to work but Kim has no hands and no leg, his economic is much worse than mine”.  Most recently I learned that he sold his telephone – one of their only assets – to pay a hospital bill after one of his sons became unwell.

Before leaving Cambodia I really wanted to help him in some way.  Ways which are small to me, can be significant here and I knew he wanted to send his sons to English school but it was unaffordable.  Aware of his pride, I broached the subject vaguely and suggested he talk with his wife about my offer to sponsor this.  Some days later they accepted the offer and last week I arranged to visit Siem Reap for the final time this year.  Courtesy of the nearby temples of Angkor Wat, Siem Reap is an incongruous place.  Rich with tourists and the money they bring, and poor with impoverished beggars and low paid workers, attracted by the pull of a possible income.  Despite being the richest town in Cambodia, the province of Siem Reap is one of the poorest, showing that the spoils are not distributed.  Rav lives in a small bedroom, a kitchen sink with running water on the back wall and a bathroom walled off in a corner.  No bigger than my bedroom, this room with one double bed houses six people – Rav and his wife, their two sons and two teenage girls from a remote village whose family are facing starvation.

Siem Reap’s economy supports English schools of a much higher calibre than the dirt-floor basement areas of private homes which make up the majority of English schools in the country.  Rav picked me up and we met his wife, two boys and one of the teens, before heading to an English school of my choosing, found on the internet.  Unlike most schools which are run by a single Khmer teacher, often as a supplement to their public school employment, the children will be exposed to a combination of salaried native English speakers and Khmer teachers.  They will also receive half an hour per day of Chinese language lessons.

The young couple were visibly surprised by the well resourced classrooms, library and play areas.  Their small boys ran excitedly between one room and the next, full of wonder at the toys, books and colour.  The fees are beyond their budget but well within mine, so I agreed to sponsor them.  Rav taught himself English by talking to tourists and was able to complete the enrolment forms independently, in a shakey but legible English – far more astonishing to me than the fancy school!  The boys started on Monday and Rav has called me a number of times to express their joint astonishment that their children are attending a school where the other students all come from families who own cars!  “Our economic is not changed but my children’s luck is very changed now and I think they can have a good life”.

The oldest teenage girl staying with them, 16yo, has found work at a nearby soup stall.  Her 14yo sister wants to stay in school but Rav was told it would cost money to transfer her enrolment from the village government school, to their local school.  I asked him to find out about this so I could help if possible.  After speaking to the teacher he rang to let me know “the teacher will do it for two boxes of beer”.  So I am stocking a village teacher with two boxes of beer!  Ironic given that a 28yo man in the same village died yesterday from “stomach bleeding because he drank too much rice wine”.

The school enrolment created a new problem and Rav said he would sell his wife’s sugar cane juicer to get the deposit for a loan so that they could purchase a motorbike.  Their only vehicle is his tuk tuk which he needs to transport customers in order to make their only survivable, albeit unreliable income, except the sugar cane juicer when there are enough tourists to warrant setting up a stall.  The thought of selling another asset sent my first world brain reeling (yet again) and I asked him to put the idea on hold until I could think about it for a while.  That night I started an online crowdfunder and advertised it to friends and family.  In only three days we raised enough for them to buy a near-new, excellent condition motorbike!  His wife can now transport the children while Rav works.  Life just got a whole lot easier for one small family who deserve an ounce of luck, courtesy of people in France, US, England, Australia and New Zealand.  I do get a thrill connecting these two worlds – thanks everyone, from an overwhelmed Rav in Siem Reap!

The Eyes came to town yesterday because they were both complaining of red, sore eyes.  When they called and described their symptoms to Chom I felt slightly mortified that I had refused to pay for post-operative antibiotics on the grounds that the surgery was falsely advertised as “free of charge to patients”, while costing hundreds of dollars.  However, when they turned up yesterday all was not quite as it had been described.  We spent a morning at the local Ophthalmology Department to be informed these were normal post-operative symptoms.  A prescription for eyedrops and paracetamol was given.  We went to the market to pick up the medications and they informed me along the way that they needed new shoes.  So a trip to the shoe stall was included in our tripping-about, which Chom suggested may have been the main reason for their “symptoms”!  Just when I think I’ve completed my final Cambodian project, something else crops up.  But it seems that the remaining project now, is to cram my belongings into a case and meet my travel companions at Phnom Penh Airport for two weeks hanging out in North America.