Boat Baby Update

He lives in a home with walls constructed of bamboo, elevated on wooden stumps ten ladder steps from the ground.  I have cycled or tuk tuked along this track which runs parallel with the Mekong countless times over the past four years.  The track passes through many impoverished communities, an interweave of Buddhist and Islamic villages living side by side for at least 50km.  About twenty metres from the road, a large expanse of open flat delta leads to the front steps of his shack.  With Wet Season in full swing, this land is currently a muddy swamp.

Yesterday was nine weeks to the day since Boat Baby arrived on the floor of that wooden boat.  Dan pulled the tuk tuk in at the roadside and pointed the house out to me.  Looking across the quagmire between us, BB’s mother waved from the front door as his grandmother bounded down the ladder and immersed herself in the mud, striding deftly through the swamp towards us.  I registered the depth by the mud marking  her legs.  Dan asked me, is it okay for you to go there?  I replied I don’t like it but I’ll do it, should I take my shoes off?  No, keep them on.  He informed grandmother of my reply.  She took a firm hold of my elbow and guided me to the bottom of the ladder.  With my thongs jamming in the mud I removed them and now there was mud to the top of my ankles and on my left hand, holding the rubber strips as daintily as I could.  Parasite OCD kicked in and I concentrated on shaking it because BB was waiting to meet me.

Grandmother bounded back up the ladder and returned a moment later with a plastic pot of water.  I swished my feet around in the brown water at the edge of the ladder to soften the mud, then she poured clean water over them and I stepped onto the dry first rung.  Up ten ladder steps, a red hammock was swinging between two wooden foundation poles, tiny Boat Baby snoozing as he rocked.  Mum picked him up and handed him to me.  Tiny, but fat and perfect.

Only about ten minutes ride from The Eyes family, I was shocked to hear that Mum, who is about 20yo, does not work because she also has vision problems!  She has had three operations on her eyes so far, all at the nearest District Referral Hospital, who operate at no cost and offer transportation fees.  My limited knowledge of the way the health system works here confirmed that this family fit the criteria of poor enough to  warrant financial assistance when they engage with hospitals.  This is not a guarantee however and when they registered at the maternity ward the day Boat Baby was born, they were not deemed poor enough and charged $40 for an overnight stay – money that they did not have.

Boat Baby’s father, who was on the boat with us the day  of his birth, moved to Phnom Penh a month ago to wait tables at a restaurant, to earn money for the family.  He has been unable to return home at all – a bus ride costs $7 one way.

This area was heavily bombed during the Vietnam War.  Agent Orange was sprayed across the region by US forces to kill the foliage, making the bombing campaign more efficient.  Could it be that the common vision problems apparent through my own small anecdotal experience of this one small village, are connected to the use of Agent Orange less than 50 years ago?  Local doctors apparently claim that babies in this area are 50 times more likely to be born with disabilities than in other parts of the country.  Little or no research has been undertaken.  Research is another example of privilege preserved for wealthy nations.

We said our farewells, Grandma holding my hand tightly as if to let me know of her hope for a connection between her family and this mysteriously lucky foreign woman who can travel far and wide and wants for nothing.

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The Only Thing is Kindness

Kindness is a free currency from a well that will never dry up,”
“The most efficient way for you to act with young people is to be a calming force
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”                                                       ~ Lady Gaga

The United States Conference of Mayors (USCM) is the official non-partisan organisation of cities with populations of  30,000 or more.  There are 1,408 such cities in America today.  Each city is represented in the Conference by its chief elected official, the mayor.

Last year, at the US Conference of Mayors, Lady Gaga spoke with the Dalai Lama to an audience.  Her words were full of kindness as the only thing.

We need to shift the perspective.  The solution is that we need to build a kinder and braver world.  Get rid of those labels.  These different factions; Gay – Straight – Rich – Poor – Mentally Ill – Not Mentally Ill – Gun Owner – Not Gun Owner.  None of this can matter anymore.  We are unified in our humanity and the only thing that we all know, we all appreciate in one another, is kindness.  So this has to come before all things.  And you must operate relentlessly this way.  With everything you have.

Lady Gaga on Kindness as our Solution

Join the movement and commit a random act of kindness everyday.

 

Heart Strings 02

Heart Strings 02

The congested, hot, overstocked and fascinating Phsar (Market) Tuol Tom Poung, or Russian Market as it’s known in English, takes up a full block of the Phnom Penh neighbourhood I live in.  From the top floor of my apartment building we can see the rooftops of the Russian Market – a patchwork of multi-coloured, rusty tin roofs pressed up against each other to form one massive block-sized square of roofs.  One street along the northern edge of the market turns into a fresh food bazaar every evening.  Vendors set up on their paid plots of verge or stroll around with produce in trays balanced on their heads, a stool crooked in their elbow for a quick seat if they happen across a customer.  The crush of stalls narrows the bitumen thoroughfare to maybe 2 metres wide along which crowds of motos, pedestrians, cyclists, beggars, tourists and locals wend past each other.

Boxes of fresh green vegetables are positioned in a tight square around their seller, beside which a canvas is laid to present many dozens of pairs of shoes, beside which another canvas acts as a death bed for fresh fish laid out to die in the open air, occasionally making a last ditch jump off the edge of the canvas, onto the bitumen.  Large tin bowls filled with water hold live crabs crawling around on each other, beside mobile restaurants frying pancakes, dumplings and various other fast foods.

It’s not unusual to see a moto with one child perched up against the handlebars and two perched behind the adult driver.  Mum will pull in at an open air vegetable stall, lean across to choose her vegetables, pay for them, hang them from the handlebars and slowly drive off while all three kids stare blandly as though it’s all very ordinary and boring.  The disabilities on show here can be distressing and I always wonder about one young girl in a wheelchair who is sometimes pushed through the streets and at other times, left alone on a corner to beg.  She is not the only one apparently being managed by external parties for the purposes of organised begging.

Interspersed with these very local experiences are many western style cafes, bars and restaurants catering to the foreign and wealthy Khmer populations residing in or passing through the area.  Fashionable, understated boutique eateries are a theme of Tuol Tom Poung and after six months living here I still haven’t tried every establishment.  Good food, charming ambience and specialty menus all come at extremely reasonable prices if you are earning a decent salary, which makes them inaccessible to a large proportion of the people passing them by everyday.

Tonight I walked down the street to find dinner and stock up on a few groceries.  The side streets intersecting with main roads around Tuol Tom Poung have a village feel in the middle of this busy city.  Neighbours perch on chairs at front gates nattering, people play cards on the floor of a wide front room opening out onto the street, children kick a ball in the middle of the street, the barbecue meat patty guy fries up on his open fire at his front gate.  Moto dups approach pedestrians from behind to offer “moto, Madame?”.  Tuk tuks on every corner chat on their phones, listen to music or convene in one cab to have a drink together, all ignoring me as if I’ve become a regular who they know not to hawk business from.  Popular franchise Brown Cafe opened down the road within the past month and suddenly that corner is crammed with parked cars jutting out onto the busy road, adding even further to the traffic congestion of the main street.

Our own street is a charming little village in it’s own right, especially on cool evenings like tonight.  Our corner tuk tuk guys always stop us to have a chat in broken Khmer about where we’ve been or where we’re going.  The local shop keeper sits in his wooden recliner at the doorway of his little wooden hut watching the world go by.  Families appear from behind tall steel gates to socialise in the street together.  Mobile restaurants pull their carts through the street and stop as neighbours come out to order dinner, cooked and packed on the roadside before the vendor moves on to find their next customer.  Our apartment security guy, his shirt tucked up around his chest to cool off, wanders away from the street party and back into the property as we approach, to make his presence known.

Observing all of these sights tonight was an especially happy time because while I was at the grocery store Sokum’s husband called me.  “Helen?  I have happy news.  Now she already surgery and the doctors said it is success”.  It’s early days and even with the most successful operation she will be on medication for the rest of her life, among other considerations.  But surgery was a success and the road to recovery has begun.

Heart Strings 01

Heart Strings

When I first heard about Sokum’s condition, her husband called it “corollary heart disease”.  Obviously he meant “coronary artery”, but why would a 20 year old already have coronary artery disease?  It had to be Rheumatic Heart Disease.  When I visited last week I wrote “Rheumatic Heart Disease” on a scrap of paper for her husband and told him how to pronounce “Roo-matik”.  He would ask the doctors.

Surgery was supposed to happen sometime last week but for some reason it was delayed.  She has transferred to the surgical hospital and yesterday I went to visit.  A rumbling thunderstorm had rolled into town and the storm drains were pouring out into the roads.  The heavenly deluge soaked motorists from above as their tyres drove whitewater at them from below.  I was perfectly dry behind the waterproof tarpaulins that my tuk tuk driver had tied down, turning the open air carriage into a car-like cabin, minus ventilation.

Husband came out to meet me with a large umbrella.  My tuk tuk parked outside a large open walled building with shining white tiled floors, brilliantly clean whitewashed walls and evenly spaced, equally clean white fans dotted across the unmarked white ceiling.  Was this a Cambodian hospital?  Entering the main building my astonishment continued.  The walls and floors were clean!  The staircase was light and spacious.  We walked past patient rooms with uniformly black mattresses on the beds.  Staff in scrubs were seated at a desk with computers.  Only two things distinguished this place from any western hospital – the beds, albeit clean and furnished with mattresses, had no linen; and large oxygen tanks were lined along one wall, indicating that there is no piped oxygen available.

In a five-bed room I met Sokum, her mother, her aunt and a young friend.  Family and friends have attended the National Blood Bank en-masse, donating blood so that all blood transfusions Sokum needs during and after surgery are replenished.  The blood bank relies on this system of a donation from the patient’s network in exchange for each transfusion.  Husband informed me “surgery will be tomorrow at 1pm because they said it is urgent”.  A team of doctors including at least one from Korea will be operating today.

When I asked Sokum how she was feeling, husband translated “after the doctors explained about the surgery, now she feels better”.  The doctors were happy to answer their questions and had confirmed that her diagnosis is Rheumatic Heart Disease “that she got when she was a child” (RHD results from Rheumatic Fever which occurs primarily in childhood and primarily in impoverished environments where the Streptococcus bacteria is able to thrive).  The air was sharp with smiling anxiety from everyone, including her very bright-eyed father who came out to the tuk tuk to meet me as I was leaving.  Patients in the beds around her stared and smiled at me and as I left some of them expressed “oor kun chiran” (thank you very much) at me.  I wondered at their stories, aware that you don’t end up in a Cambodian hospital without a story of struggle and debt to tell.  This shifted my thoughts to an American patient I know of who has been billed $63,000 as the “gap” between his insurance cover and the missing costs of surgery.  This is no way to treat our sick and most vulnerable, regardless of which borders they live within.

At 12:20pm today husband called me to talk.  Except he didn’t really talk.  I did elicit from him that there are a lot of people with them now at the hospital – family and friends have come to lend support.  Sokum is scared, her mother is crying and husband obviously escaped to make a phone call in hope of reassurance.  All I could say was that it is normal to be scared, normal to cry, normal to feel worried, and that I would not say “don’t worry” because it is okay for them to worry.  He said “the doctors say don’t worry”.  I said that’s because they are not worried, they know this operation and they know that they can do this, but the family do not know it, so it’s okay to be worried.

He will call me again when she returns from surgery later this afternoon.  In honour of Sokum I am posting this blog at 1pm just as I imagine she is being wheeled into the Operating Theatre.  As to my earlier blog post, This Thing We Could Do.  It seems we did it!

What is Rheumatic Heart Disease?

A short, touching article from Professor Chris Semsarian, an Australian cardiologist who spent a week on a research project in Cambodia:
While rare in affluent countries, RHD is a major public health problem in the developing world in populations living in poverty with low socioeconomic status and limited access to adequate healthcare.

RHD Australia’s Website:
RHD is a chronic, disabling and sometimes fatal disease. It is 100% preventable.

Culture Clash

Anyone else with a tendency for writing would have blogged ceaselessly had they lived the month I just lived.  Midway through my one year assignment in Cambodia, I traveled home to Australia and New Zealand to visit family and friends, visiting two major Australian cities, the Australian outback and various locations around the south island of New Zealand.  From a desert in bloom to towering snow topped mountains, a hillside harbour view villa to a waterfront city condominium, any decent travel blogger would have spent a month writing fervently.  Two road trips, shopping, scenic walks, soaking in hot pools, sipping wine and dining out were all on the agenda.  Where once Australia and New Zealand were ordinary places that I called home, they are now strikingly special places that I call home with a sense of awe at my fortune.

Nevertheless that is as much as I am inclined to write about my holiday, which would rank as the “trip of a lifetime” for many, because I have now had about 15 hours back in Cambodia, catalyst to my writing impulses.  Friends and family at home express problems such as waiting for an expensive dress to go on sale before being able to afford to try it on; needing to work full time to pay the mortgage and whether to stay in the current job or look at other options.  There are always other options.  The main topics of conversation at home revolve around issues that sit at this comfortable level of lifestyle in a robust and functional economy.  I couldn’t see three friends whilst home because one family were road tripping interstate; another were holidaying in Singapore and a NZ friend was on a long weekend in Brisbane.

In contrast, when I ask my Cambodian contacts if they have traveled, most admit to never having ventured beyond their small hometown and almost noone has been to an airport let alone on an aeroplane.  Finding the next meal is the focus of millions.  This is an observable phenomenon everywhere in Phnom Penh if you understand what you are witnessing as you travel the bustling roads past street vendors, hawk-eyed tuk tuk and motodup drivers, trolley-pulling scavengers, disabled beggars and more.  Most wealthy world witnesses, speaking from my own experience, actually don’t comprehend this fact, rather seeing the sights as intriguing and exotic.

With the contribution of many, including two considerably large donations, it appears that enough funds are going to be raised for 20 year old Sokum to have the heart surgery that should save her life.  Had I not traveled home when I did, this would likely have never happened.  Asking for money (my most loathed pursuit), even in a case of the life or death of a young person, is an almost guaranteed flop when you do so from afar, eg via online communication.  Speaking to people in person has a slightly better strike rate although it is an excruciatingly awkward activity which I feel risks friendships.  Many are already giving generously to their own causes and “my” cause does not ever have to be anyone else’s cause.  Yet it is an interesting phenomenon because while it’s so difficult to engage people in something such as Sokum’s fundraiser, the challenge is trying to connect people to the cause as I know that if people met her, they would give generously.  Those who do engage get an extraordinary amount of joy from the experience.  An example is my friend’s teenage daughter who wrote to say that she had decided to forego her 16th birthday present in favour of sending the money to me “for Cambodia”.  My friend wrote last week to say “She has also inspired some of her netball team and they want to donate as well“!

Last week I informed Sokum’s husband (the only English speaker, who has been actively pursuing all limited avenues to raise the money) that we look to be able to meet their target amount.  It has not happened yet, but we have surpassed the halfway mark and have enough pledges on promise to bring us to the mark.  He thanked me immediately and asked when I was coming home to Cambodia.  A few hours later he informed me that they were bringing his wife to Phnom Penh on 25th September, to meet the doctors.  After a 14 hour day of travel yesterday, this morning I was woken by his call that “we are at the hospital now“.  I dragged myself out of bed and called my days-off tuk tuk guy before walking to three different ATM machines to withdraw the money already received (which can only be withdrawn in $400 amounts).  Passing one of our two workday tuk tuks, I stopped for a quick chat and gave him the Sydney Australia t-shirt I bought for him, before heading across town to the hospital.

At the hospital I fell in love.  Yet again.  The most gentle, humble, smiling, beautiful young couple, with her equally charming mother, were sitting in a stuffy waiting room, waiting to see a cardiologist who would be available sometime after 2pm.  The hospital is privately funded by a multitude of NGO partners, aiming to serve Cambodia’s poorest with quality care that is otherwise unavailable to the population due to the lack of resources and regulations within the government’s seriously under-funded Ministry of Health.  In a sea of deficit there are occasional islands of hope, and while not coming anywhere near the quality we take for granted in the wealthy world, this seems to be one of them.  Nevertheless, cardiac surgery does not come free and with no health insurance of any kind in Cambodia, the only way for this to happen is via a user-pays system.  Sokum’s husband explained that the surgery is offered to them here at half the cost it would otherwise be.  Still an inaccessible amount when you earn $100 per month.

After about an hour sitting together, talking about Sokum’s health, writing “Rheumatic Heart Disease” on a scrap of paper for them to ask the doctor if this is her diagnosis, photographing the medical information they had with them to send to a cardiologist in Australia who offered to assist if possible, answering questions about life in Australia and New Zealand and why I am in Cambodia, talking about her husband’s job and looking without success, for their tiny remote village on Google Maps, I left them with the funds received so far.  Our farewell included promises to stay in touch and it seemed she will likely have surgery sometime later this week, but so far I haven’t heard the outcome of today’s consultation.

During our time together they informed me at least three times that “you can be our grandmother”.  So now, at 48 years old, I find myself grandmother to adults in their 20s?  It was spoken with such a tone of respect that I knew we were having a culture clash and that I was being granted some sort of honour, rather than being labelled an old hag!  En route home we approached the corner of our street and there was my tuk tuk friend perched on his moto with no customers but looking very Australian in his new t-shirt.

After an outstanding holiday at home, the best day of my month off work was, of course, Day One back here in Cambodia.

Unconnected Connections

Fundraising for the 20yo woman with (probable?) Rheumatic Heart Disease needing urgent heart surgery continues.  A friend asked me to prepare a Powerpoint presentation for a fundraiser she is organising and I thought I would share it here as it summarises some of the stories I’ve spoken about disjointedly.

Story One: An Inconceivable Connection

In May 2014 I met a 25 year old Islamic woman from a rural village in Cambodia who had been told she had terminal cancer.  Surgeons in Cambodia operated twice to remove the “cancer” from her abdomen, first forming a colostomy as they removed some bowel.  The diagnosis came purely from the doctors opening her abdomen to investigate the pain she had been experiencing since pregnancy with her now-8yo son.  They based their diagnosis on what they could see – inflamed lymph nodes in her abdomen.  There were no resources to take a biopsy or other investigations which would give a proper diagnosis.

Surgical practices are basic at best and often dangerous without good equipment.  When her pain persisted, they performed a second operation which damaged her bowel, causing a second opening on her abdominal wall to form (a fistula).  She now oozed faeces from two sites on her abdomen.  This caused acidic burning of her skin and she was unable to absorb food so she became severely malnourished.  Doctors finally told her she should go home to die.  A short time later she developed a chronic cough and was diagnosed with lung TB.

Although it was thought she was dying, her TB needed to be treated for public health reasons.  Constant abdominal pain, oozing faeces which burned her skin and severe malnutrition were her main physical problems when she was admitted to the MSF program I was working on, with drug resistant TB.  We were unable to find any muscle mass to inject the second-line TB drugs when she was admitted to us, and she was unable to stand up without assistance.  She weighed 20kg.

After a few weeks on the right TB medications her cough eased and her abdominal pains ceased and I was sure that she had abdominal TB rather than cancer but there was no way of confirming this.  She continued to ask us if we thought she was going to die and we had no way of knowing the medical answer to this question.  She stayed in hospital for two months before we discharged her home.

My nurse team visited her at least once a month and I visited her either with them or at weekends, multiple times but I was at a loss to help in any meaningful way.  She needed colostomy bags and protective dressings but they were unavailable in Cambodia.  When I came home to NZ and Australia  I tried to source them but they were expensive and I was not able to supply more than a few weeks’ worth, so I did not supply them.  She had to wipe the openings with tissue or gauze many times during the day and night.  All I could really offer was a little financial help to the family for food, school fees and gauze, and some emotional support.

El Pais 009

Waiting to die from surgical complications related to undiagnosed mesenteric tuberculosis (2015), photograph courtesy El Pais newspaper who visited the MSF TB project

Her other problem was the debt her family had accrued trying to find a diagnosis and treatment for her.  They sold their house.  Her father had moved to Malaysia where he could earn a slightly better income selling food at a street stall.  Her grandfather had taken a loan out with his house as collateral.  Her younger brother, a very eager student, had been told once he turned 15yo that he would have to leave school and was thinking of moving to Thailand to work on unregulated fishing boats.  They were financially desperate.  Her mother stayed at home to nurse her daughter’s wounds and care for her 4yo son.  They were living in an extended family home in crowded conditions.  Laundry is done in the nearby Mekong and I was constantly astounded that the open, oozing wounds, had not become infected.  This was testament to the family’s extreme care.

In June 2015, a year after I met “Paula”, I was on holiday with an American friend in Provence in the south of France.  She invited me to a lunch at a beautiful medieval homestead with some wealthy Americans at an exclusive cooking class.  During conversation some of the Americans were very interested in Cambodia and asked me to explain what I meant when I used the word “poverty”.  I tried to explain Paula’s situation and the health care system.  I described her sitting on her death bed in a wooden hut beside the Mekong as we sat at this lush table with so much more than we needed.

Three American women sitting opposite me were on holiday together.  They were especially interested and one of them cried as I told Paula’s story.  Another asked me so many questions that I thought she must be a doctor or a nurse.  But she eventually told me that her husband is one of America’s leading gastro-intestinal surgeons and he would be fascinated by Paula’s story and would want to treat her himself!  When I explained that this was a nice idea but completely impossible, she assured me that it was perfectly possible.  She and her husband sat on the hospital board and could influence them to agree to a charity case for free surgery.  Someone else at the table was so inspired that she offered to pay for all other costs if the medical costs could be covered.

IMG_5042

A very memorable lunch

I returned to Cambodia almost immediately, cutting my European holiday short to organise a million details including passports, American visas, air travel for a critically unwell passenger.  She fainted at the photograph store when we took her for her passport photographs; fainted between the tuk tuk and hotel a number of times; fainted twice inside the American Embassy in Phnom Penh during her visa interview.  My life from July 2015 until early October 2015 was filled with taking this dying woman to various appointments and helping her fall to the floor as we challenged her to travel and walk distances she was not in any position to tolerate.

In October 2015 I travelled with her, her mother and a Cambodian nurse who acted as our translator, from Phnom Penh to Seattle.  A local Imam met us at the airport and drove us directly to the hospital.  En route, with the skyline of Seattle ahead of us in the distance, I heard her speaking Arabic to him from the front passenger seat.  Some time later he informed me that she had said to him “I can die now, because look at the experience I have had”!  She was admitted to the surgical ward and immediately began receiving the type of health care that we in New Zealand take for granted.  Within days her nutrition had improved and within two weeks she was deemed nourished enough to undergo surgery.

During our first 24 hours I found myself responsible, as the only native English speaker, for finding Halal food for her and her mother, which was quite a feat in a wealthy inner city area of one of America’s most prosperous cities.  After some time searching the streets I found a Vietnamese restaurant and ordered takeaway.  When I arrived back at our hospital room, a group of Islamic people were visiting.  They approached me eagerly to ask “are you the Australian doctor who brought her here for surgery?”.  Errr… no?  “Yes you are, it’s you who did this for our sister!”.  From that moment for the following two week stay, I was overwhelmed with attention from dozens if not more than 100 Cham people, mostly refugees from Pol Pot’s Cambodia in the 1970s, who have a strong community.  I never went looking for food again, as we were inundated with home cooking multiple times per day.  I was invited to stay at a family’s home where dozens of Cham Cambodians came for dinner to meet us.  The next morning the teenage son of our host family found a shoe box, cut a hole in the lid, taped the lid to the box and said he was taking it to mosque to raise money for Paula’s family.  He returned a few hours later with US$3,000.  The money was given to me and I was told “you must tell them what to do with it”.  I carried it back to Cambodia and gave it to grandad, who took it on the back of Paula’s sister’s motorbike, straight to the debtor, at my request and with me following in Chom’s tuk tuk!

Within two weeks of our arrival in USA an eight hour operation rejoined Paula’s bowel and closed her wounds.  She remained in America for five months to recover and to cut a very long story short, this is a photograph of her at home in Cambodia taken last week <not shared online to protect her privacy>.  She remains impoverished but she can care for her son and she works, selling homemade rice cakes from outside her house.

Story Two: A Fishy Connection

In February 2017 after more than a year away I returned to Cambodia and am now working on a project with Medecins Sans Frontieres, based in Phnom Penh.  The rich-poor divide in the city is visible and extreme.  The poor have few options and I can probably count the list of their choices for income on ten fingers.  One of them is to run a mobile “restaurant” from a trolley on a bicycle, cycling the streets hoping to find someone who will buy your fried banana.

Inequality in a pic

Searching the streets for recyclable tin, plastic, paper and cardboard is another common income generator and you see very young children and very elderly people pulling trolleys through the streets, as well as parents with children in the trolley with their collection of rubbish.

Phnom Penh Scenes 01

Last year when I came home to visit I landed in Christchurch at midnight with no way of making my way home to Mum until my uncle insisted on driving the almost three hours one-way to collect me and taxi me home in the middle of the night.  This uncle fishes off the shores of New Zealand’s picturesque South Island almost daily.  He took me out in his boat to pull up some craypots, and we swam in the open ocean in wet suits.  He dons goggles and swims with a long spear, catching butterfish.  He has regular close encounters with fur seals and dolphins and has even been up close and personal with Orca.  He refused to accept anything from me in thanks and so I promised that I would fix a fishing boat in Cambodia on his behalf.

Across Cambodia and in a particular location near Phnom Penh there are many landless communities of Islamic Cham people who live on boats or, when the river water is low enough, build makeshift shacks with any material they can find, on the riverbank.  A friend of mine volunteers with an organisation who work with one such community of about 500 people, ensuring the children have birth certificates, pay the school fees for families who fit their criteria (agree to keep their children in school and not make them work on the boats), work with families in need of health care etc.

For at least part of the year the community live on their boats as the riverbank disappears underneath the rising waters during Wet Season.  In April this year a particularly strong storm swept through Phnom Penh.  Even from my fifth floor apartment with it’s double glazed windows I could hear the torrential rain and winds.  That night one family’s boat sank to the bottom of the Mekong leaving them without their only source of income – access to fish which both feeds their family and gives them something to sell.   When I told the organisation a few weeks after this storm, that I had a donation to use on repairing a boat, this was the family they identified.

The family bought a new boat and when I visited about eight weeks later, it was upside down on the riverbank being waterproofed.  They told me via a translator that “we do not know how to thank you, there is no way to tell you how much thanks we have for your help”.  I also learned on that visit that they could not live on their boat as they had no roof for it.  The parents and two youngest children were sleeping in a tiny shack, two other children with a neighbour on their boat, and two children in a land based shack with another neighbour.  The wrong (cheaper) roof could potentially pull the boat over in strong winds and they could not afford a better roof.  When I asked how much a decent roof would cost they showed me a roof that was for sale at a boat nearby, for $60.  We funded this roof for them immediately.

046 Cham Visit

035 Cham Visit Roofs 13

The $60 (unaffordable) roof for sale, in front of the neighbour’s boat.  The neighbour has a newer roof (on the boat behind), hence the older roof for sale.  This “quality” roof can last for about ten years.  The family are able to live together again on their little boat.

Story Three: The Rheumatic Connection

Or so I think.  It could be another disease, but it’s most likely Rheumatic Heart Disease, a condition of poverty which occurs at very high rates in impoverished populations, including Central Australia’s indigenous communities.

Last month a friend told me about Sokum, a 20 year old woman dying from heart failure.  She could live if she could access the cardiac surgery that would treat her condition, but cannot afford the $6,000 needed.

Her family have no way of raising the funds to pay for her surgery and an American student working with Sokum’s husband started a fundraiser to help them.  So far we have raised just over US$3,000 but donations are drying up.

The family went into debt to organise a cardiologist review some months ago, and were told that she will be too unwell for surgery if they wait too long but without the money for hospitalisation costs, they have no choice but to watch her fade away.  Without access to her cardiologist I can only guess that her most likely diagnosis is Rheumatic Heart Disease, which is common in populations living in poverty.

When I asked her husband to say something for fundraising purposes in New Zealand here’s what he wrote:

My wife’s name Sokum and 20 Years old.

Before her parents take her go to meet traditional doctor but she is not better and then my parents continue to take her go to public district health hospital a doctor said that lung failure. The doctor provided a lot of medicine but feel not well more serious ill so, my parents continue to take her go to referral provincial the doctor said that can not treatment here need to send Phnom Penh city. In the Calemet health hospital doctor asked her about situation and check with x’ray so the doctor tell her truth about heart problem.  need to make surgery very soon.

Before we don’t know but when we were to Calemet hospital and know about her heart problem 1 year.

Now she doesn’t work because too sick of her. She stay at home right now can’t do hard work and can’t eat with salt food.

Before she is works at factory worker 3 years and during work with factory she working hard to find money to support the family.

Thank you helen
If you have more question please feel free let me know.

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I should be in a position to provide an update on this fundraiser in a week or two.  Things are moving slowly but surely and Sokum had a cardiologist appointment in Phnom Penh today.  Some incredibly generous gestures have been made on her behalf which I look forward to speaking about once everything falls into place.  All donations continue to be warmly welcomed, either through Go Fund Me or by contacting me directly.

Update on Being Twenty

Yesterday I received this message from Sokum’s husband. It’s not a good medical description of her condition but it’s an excellent description of what she and her family are experiencing right now and of why I’m hoping along with them that the money for her surgery can somehow be raised in time. Anyone touched by this with any small amount to give can donate at the GoFundMe page Here  or contact me privately for other options.

 

I’m good, Sokum very thin and often sick because she eat a little bit and take medicine more than eat. The blood of her body difficult to control that’s make her often sick and heart unusual very fast that’s cause make her tired.

Doctor said that can’t waiting to much time if keep a long time will dangerous and can’t treatment.

So, my family and me trying to working hard to find money to support for surgery that’s sooner.

We will do surgery for her in early October. Surgery will organize at Calemet Health Hospital in Phnom Penh City, Cambodia.

Best thanks and gratitude to you helen and your team very working hard to support us. ❤

We hope to see and to say something with you when you come back to Cambodia..💑

See you soon❤