Battle of the Balance

Only in the past few years have I come to appreciate that I was born on the lucky side of life.  Not only do I have enough food, love and shelter but I have the ability of having experienced going on an aeroplane, visiting towns and countries beyond my home, obtaining a first class education and many, many other things which most in the world cannot even imagine.

A friend’s son is doing a project on Cambodia with his primary school class in Australia.  When the class learned that I live in Cambodia we tried to work out a meeting of some sort.  With various protections in place through the school, Skype and other meetings were not approved.  So the children’s teacher filmed each of them asking me a question about Cambodia which was then emailed to me.  For the past few weeks I have been working on a filmed response.

Some of the questions were far easier to answer than others.  Compare “what is the main form of transport?”, with “do you have fidget spinners in Cambodia?”!  One child will get a range of short clips showing motorbikes in their various forms of hard labour.  The other was more challenging but I managed it.  One of our doctors, who looks about 12 years old, was interested in the question and she went out and bought herself a fancy metal fidget spinner.  I filmed her responding to Ben’s question with “you asked if we have fidget spinners in Cambodia and yes, we do, and in fact I also own one <as she pulls it from her white coat pocket and spins it>, but to be truthful, I don’t really know what is the fun thing about this?”.  It’s cute.  But it is brief!  After a few days I came up with a solution.  Today I am going to Siem Reap to work on Project Rav (the tuk tuk website we are designing).  Yesterday I bought 4 cheap fidget spinners to give to Rav and Seth’s 4 boys.  Ben’s video will show the boys receiving / playing with their fidget spinners, with the message that these children have almost no toys so I bought them a fidget spinner each on your behalf.

Over the next few days in Siem Reap, as well as photographs for the website, I will be video-replying to the last few questions: “what are your houses made out of?”, “how many ruins are around your place?”, “how many rice paddy fields are around your place?” and “is most food imported or grown there?”.  All much easier to find relevant video footage of in a rural area, than in the city.

Last night I wandered around the busy market local to my home, taking video footage for the question “do you have supermarkets or do you have to go fetch your food?”.  Dying fish laid out on banana leaves streetside made their last few leaps of death beside rows of unpriced shoes.  A mother with two school boys on one moto pulled up at a vegetable stall and leaned out sideways to sort through the cucumbers and choose a few of the best, her sons both bored to tears and unaware I was watching them.  A woman with a large flat tray of food perched on her head and a small red stool hooked on her arm spotted me videoing her and stopped to pose for me.  A man with small twisted, twig legs sat on the ground, obviously placed there by someone who I wondered about (could they love him or could they be a pimp?) with a hat held out for donations, telling me that he comes from Prey Veng (a province bordering Vietnam).  A woman in pink pyjamas and a massive floppy brimmed sunhat poured fish cake batter onto a pan over an open fire burning inside a tin box attached to the side of her moto, at one of the many mobile takeaway joints.  Next to her a young woman in a wheelchair sat on the corner begging.  Motos crawled slowly through the sauntering crowds on this busy street which is really an al fresco drive-through supermarket.

Closing my $1000 iPad, the umpteenth moto-dup driver asked “Madame?”, hopeful of a fare.  I shook my head and the look of disappointment on his face suggested a stressful existence.  I walked over to the ATM, aware that the crowds all around me neither have bank accounts, nor anything to keep in an account.  Then I walked into a trendy, dim-lit bar to join a friend for drinks, aware also that the crowds outside neither know that this bar with it’s unassuming frontage exists, nor could afford to enter if they did.

The next few days will be spent with Rav and Seth, getting the final photographs for their website organised.  Yesterday Rav’s sister who lives in a $30/month rented room smaller than my bedroom with her mother and three small children, called me to say that she is in hospital with the 2yo (on a general ward) and 6mo (in ICU).  Our language barrier means that I remain unclear of what is wrong with either of them but the Kuntha Bopha Hospital offers free treatment which is less than adequate to western expectations, but more than she could otherwise afford.  Unable to offer any practical assistance, I sent some money instead, to help reduce her stress at being away from work (selling rice cakes wrapped in banana leaf at a local dust-tracked market) and unable to continue the daily loan repayments she must make to her loan shark.  When I told her I will be in Siem Reap for a few days she asked, was I going for work?  No, holiday.  Oh so lucky Helen.  Yes, I KNOW.  I really DO know.

Recently on a car trip to a work training session, our new translator asked me “have you ever been to Angkor Wat?”.  Without thinking I replied with an enthusiastic “Yes!  Many times!”.  An ensuing silence brought to mind Sam, my tuk tuk driver who has lived his whole life only 350km from Angkor Wat but has never been there.  Could Sam be the norm?  Can most Cambodians not afford to visit their nation’s most famous attraction?  I asked the translator, “have you been to Angkor Wat?”.  He paused and seemed to compose himself before giving an awkward “no”.  After another pause I said to him “I think most Cambodians cannot afford to go to Angkor Wat?”.  He nodded and I said, as much for my own sake as his because I never want to be a bombastic foreigner, “there are so many things that foreigners don’t understand”.  Again, he nodded in silence.  That day we visited his family home, a sprawling wooden shack in a square of mud surrounded by verdant rice fields which at this time of year, he spends his weekends ploughing.

On that note I now have to get showered, dressed and packed for a $40, 50-minute flight to Siem Reap.  Because that’s the life I was given.  There is no way to express my gratitude for this fact.  Except to share in some small way, what I have, with those who have-not; and to share some of what I know of their stories.

Attacked by a chicken

About half a million of Cambodia’s 15 million population are employed in the garment factory industry.  These workers make around $80 per month.  Export from this industry earns the Cambodian economy around $5 billion per year.  In recent times garment workers have been lobbying for a pay rise to $160 per month.  Today at least five Cambodians lost their lives over the issue.

Demonstrations have been occurring around the country for some weeks now.  Here in Kampong Cham military police have been heavily present outside a government building very near our office and while I haven’t seen any demonstrators, I have heard their chanting from a distance.

The Prime Minister of Cambodia, Hun Sen, is from Kampong Cham and the town despite it’s visible poverty also has a small amount of extreme and conspicuous wealth.  Hun Sen was a commander in the Khmer Rouge but he fled to Vietnam in 1977 during some internal regime strife.  In Vietnam a rebel army was formed in which he became one of the leaders.  This army was sponsored by the Vietnamese government who liberated Cambodia in 1979 and installed the new government, of which Hun Sen was initially Deputy Prime Minister.  Since this time he has maintained leadership in the country under a number of different titles, but for almost 30 years as Prime Minister.  This has been a hotly challenged position with accusations of ballot corruption as recently as last year following the July election.  Demonstrations are a frequent event across Cambodia, but particularly in the capital of Phnom Penh.

It was with apprehension that I read in yesterday’s newspaper that the government warned of “consequences” if garment workers continued their demonstrations.  Yesterday’s apprehension was followed today by great sadness at the news that military police opened fire on striking garment workers in Phnom Penh, with at least five dead and an unknown number wounded.

While this was happening in the city I was having a very peaceful and interesting day visiting patients in the countryside of Kampong Cham.  Patients with Drug Resistant TB are required to take their medication by DOTS (the acronym for Direct Observed Treatment, Short Course).  When a patient is diagnosed with DRTB, our DRTB nurses travel to their home and identify someone willing and able to take on the role of directly observing every dose of medication.  Usually this also involves administering at least one medication by intramuscular injection.  On a regular basis the team travels out to perform “surprise visits” on both the patient and their Home Based Care Nurse (HBC Nurse), to ensure that everything is happening as it should with no complications or problems.  The medications cause many side effects and require a reasonably strict regime, which if not followed well can result in poor outcomes for the patient as well as placing their household and close contacts at risk.

We arrived at the office early and piled into the car.  A driver, a social worker, a nurse and myself.  We left the city and headed south on the main road, as always past many sights including ox-drawn carriages piled high with hay, trucks almost doubled in height by their produce, with sometimes dozens of workers seated atop the produce at dizzying heights.  Long wooden carriages being towed by motorbikes or bare tractor engines carry groups of women to the garment factories for a day’s labour.  Tuk tuks and mini vans overloaded with people or produce, motorbikes carting whole vegetable stalls with produce held between the knees of the driver, piled up against the drivers’ back and stretched across the back of the bike in cane baskets.  None of these things are of interest or concern to the locals I travel with but all continue to make me wide-eyed and agog.

Recently the most common sight in front yards has been rice drying on canvas tarpaulins in many front  yards, but this morning rice had been replaced with the white chopped roots of cassava much like the photograph below, stolen via Google.

cassava

A moderate distance out of town we pulled into a small concrete roadside home.  Reminiscent of a quaint old colonial cottage, with widely spaced metal bars behind wooden shutters in the window space; an adjoining thatched lean-to, dirt floors throughout and the tin roof reinforced with dried palm leaves.  Next door a family were sitting on the grass in a circle, I guess eating something together.  Chickens pottered about, puppies played, and a fence of bamboo was suspended across a space of about two metres with grass sheaves crossed over the fence, drying for an unknown but no doubt productive purpose.  The closest image I can find of this scene is these sheaves of wheat.

Sheaves of wheat

With hammocks slung between anything vertical that is strong enough and bamboo-based day beds always situated in outdoor undercover spaces, the family appeared and perched in various locations to join us as we spoke with the young patient about her medication regime, side effects, concerns about not yet being allowed back to her job at the factory, etc.  Without a translator I rely on snippets of information from my colleagues, who very kindly always include me in the conversation whenever possible.  A lively and jolly conversation transpired while a young man approached a large ceramic tub, collected water from it with a handled plastic pot, transferred a trickle of water into a smaller tub and washed himself before disappearing into the house, reappearing in a smart shirt and trousers, and driving off on his motorbike.

From this house we visited four more locations including a home I had visited previously, where I was welcomed with greetings of familiarity and many smiles.  It was here that I was motioned to sit on a plastic chair which was brought downstairs from the house, to the breezey dirt floor space underneath the house.  Children appeared from all angles and stared at me, laughing whenever I made eye contact with them and otherwise smiling gently as they observed my every move.  As I watched the pet chickens pottering around I suddenly found myself in the path of a retreating chook as she hurried to escape from an attacking rooster and landed noisily almost in my lap, creating a brief din of shock and hilarity as my colleague shouted “sorry!” at me and brushed some wayward feathers off my t-shirt!

At another elevated bamboo home I was invited upstairs and inside.  At the top of the stairs I hesitated as I looked down and through the gaps in the bamboo to the ground about 3 metres below and wondered if this precarious looking floor was going to hold my weight.  My two colleagues and the two residents were already inside sitting down and all encouraged me in with assurances.  We sat on a floor mat near a mosquito net covering another mat used for a bed, in a setting very similar to this image stolen from the internet.

Bamboo floor home

Everywhere I have been, people have very little materially but much to give in the form of welcoming smiles, reassuring gestures and inclusiveness towards the obvious foreigner who doesn’t even know how to walk on the floor of your home.

After our last home visit we drove back to the town of Skun which is best known in the travel books as the place where tarantula spiders are deep fried and served as a snack.  I’ve been through Skun a number of times now but had not seen the spiders.  Today we stopped at the side of the street market in Skun to drop someone off.  Immediately the car was surrounded by vendors offering us various dishes being held up to the windows.  As I looked up at some chunks of pineapple and tried to absorb the scene before me, a big plate of fried tarantulas appeared at my window with a pair of hopeful eyes trying to tempt me!  Needless to say she received a categorical shake of the head in response before we drove off to escape the hopeful masses.

Fried tarantula in Skun (courtesy Google)

Fried tarantula in Skun (courtesy Google)

We pulled into a local outdoor restaurant for a Khmer lunch and I got to know my colleagues a little more.  Khmer food is delicious but nothing goes to waste, so eggs are eaten complete with shell, chunks of meat are interspersed with chunks of offal, the rice is bottomless, and chunks of tropical fruit come on large wooden sticks for dessert.  Many of my colleagues are not from Kampong Cham and spend days or weeks at a time away from their family in order to support them with the small but reliable wage that MSF can offer.  Stories are commonplace, of fathers who live away from home except for one or two weekends per month, mothers who work seasonally in the rice fields (hard physical labour) near their children, but after harvest season travel to the city, leaving the children in the care of elderly grandparents for prolonged periods so that $80 per month can be earned in the garment factories.

Back at the hospital I attended an education session with my translator.  Everyone in the room except me was Khmer.  The presenter asked was he to present in Khmer or English?  The room remained silent.  I suggested it should be in Khmer as I was the only non-Khmer person there.  He replied in Khmer, that he would present in Khmer but that it was important for everyone to practise their English and learn to understand and speak it well because “when you use English you will understand the world much better and have many more opportunities”.

That is no doubt a true statement.  But Cambodia and Khmer speakers are opening my eyes to the real world, too.