A Tale of Two Cities

Best of Times
In 1843 a survey was conducted in London which found that only 26 of the city’s 2,400 hospitalised patients were children.  Yet in the same year, of 51,000 deaths recorded in London, 21,000 were children under the age of ten and one third of London’s children died before their first birthday.  Clearly there was a need for paediatric inpatient care, but children were generally kept at home even when seriously unwell.  In 1848 Dr Charles West published Lectures on the diseases of infancy and childhood which remained an authoritative medical reference for the next fifty years.  A powerful orator and renowned physician, he fundraised the money to establish ten hospital beds dedicated solely to the inpatient care of children, opening in 1852 at 49 Great Ormond St in Bloomsbury.

London teemed with the poverty, inequality and injustice chronicled so potently by Charles Dickens, who was publishing novels such as Bleak House and Hard Times at the same time as Dr West was treating the poor.  Almost all of Great Ormond St Hospital’s patients came from the surrounding slums of Clerkenwell, Holborn and St Pancras.  Charles Dickens was a staunch supporter and benefactor of Great Ormond St Hospital, acknowledging that it was the only public institution dedicated to saving the appalling waste of human life suffered by London’s children.  His public reading of A Christmas Carol at a festival dinner in 1858 raised enough money to purchase the house next door, allowing the hospital to increase it’s capacity to 75 beds.

Since that time, Great Ormond St Hospital (GOSH) has grown exponentially, opening it’s own School of Nursing in 1878 and a Medical School ten years later.  Many pioneering medical researchers and practitioners lived their careers out at GOSH.  JM Barrie, author of Peter Pan, donated the rights of his famous book to the hospital in 1929, claiming Peter Pan had been an inpatient there and “it was he who put me up to the little thing I did for the hospital”.  Princess Mary, the only daughter of King George V and Queen Mary, completed her nurse training at GOSH, as did Princess Tsahai, daughter of Haille Selassie, after fleeing Ethiopia when Mussolini invaded in 1935.  Princess Mary became the President of GOSH some years later.  Princess Tsahai returned home in hope of using her skills to develop child health services, but died from meningitis at the age of 24.  Britain’s founding child psychiatrist, Mildred Creak became GOSH’s first female medical consultant in 1940.  Many firsts have happened at GOSH since that time, including the UK’s first Paediatric Neurosciences Unit in 1959, the UK’s first Leukaemia Research Unit in 1961, the world’s first heart and lung bypass machine for children in 1962, the world’s first successful bone marrow transplant on a child in 1979 and numerous other pioneering interventions.

Princess Diana became President of the hospital in 1989 until her death in 1997.  I traveled to London for an interview at the GOSH School of Nursing in August 1997.  During my two week visit Diana was killed in Paris.  My interview and pre-admission exams were some time before the funeral.  We were taken on a tour of the hospital which included the hospital chapel where an arrangement of lilies with a message from Prince Charles, William and Harry to staff and patients sat poignantly near the altar.  After being accepted into the year-long Registered Sick Children’s Nurse course at GOSH, I learned some months later that visa entitlements meant I could not undergo the training as planned.  This was devastating at the time, but I likely would have followed a very different career path and perhaps never experienced Timor and Cambodia, which have been so dramatically life changing.

Today GOSH is infamous as a leading world paediatric treatment and research centre.  The GOSH Facebook page is filled with features on sick children, often with rare conditions, receiving world class care and attention.  In mid July when video footage of this sculpture hooked to a crane, flying in the London skies and landing on the roof of a new state-of-the-art facility at the GOSH site, appeared in my news feed, I felt at once heartened – for those able to receive the care they deserve; and saddened – for those who will never experience such care.

GOS swan

Today a beautiful swan sculpture created by artist Chris Brammall ‘flew’ into place on top of the Premier Inn Clinical Building, part of the Mittal Children’s Medical Centre at GOSH. The 4m long steel sculpture is the first artwork to be installed in the building and will be visible from patient bedrooms when the building opens next year. The sculpture is dedicated to children and families affected by Syndromes Without a Name, commonly referred to as SWAN, and echoes the building’s natural world design features.

In particular, I thought of Samantha’s almost 3yo son in Phnom Penh.  He probably has a known genetic syndrome, but because there is no way of diagnosing him in Cambodia, it remains unknown, putting him into the same classification as a child affected by SWAN.  Rather than receiving state-of-the-art care, at times he has been turned away from receiving any care at all, in an underfunded and resource-starved system which allows discrimination and neglect, relying on the individual standards of health professionals who receive varying degrees of training and supervision.  Deprived of the most fundamental resources needed to provide a basic level of care, people’s energy is spent resolving a multitude of complex structural problems.  In my own experience, when in a single day at work there is no running water, no way to fix sewerage leaking out of the ground near your patients, and no oxygen supply for patients with respiratory disease, your ability to care for patients is reduced and you develop a level of powerlessness.  Contending with a barrage of such problems on a daily basis can erode your spirit, although it offers the opportunity to develop keen problem solving skills which are redundant in the comfort of first world health care settings.

This week’s news from Cambodia included a broken hearted email from a Khmer doctor involved in an advocacy capacity with HIV+ children who I know and have worked with.  The adults caring for these children are not medically trained and have naturally put their trust in the medical staff dealing with their HIV treatment.  The children are being taught to be independent in their daily medications and so it took some time for an adult to notice that the tablets in one of the children’s bottles were broken roughly into halves, quarters and crumbs!  This caused the carer to look closely at the other children’s medications, finding another child has been taking already-expired tablets.  Thankfully, with a doctor advocating for them, the carers are empowered to speak with the treating doctors and ask for rectification.  But how many children in impoverished places are not in the care of literate adults who would notice a problem in the first place, let alone feel confident to question or challenge health professionals who sit in positions of power at clinics and hospitals?  It would be easy to think that this somehow reflects the character of Cambodian health professionals but I disagree.  Over the years I have worked with hundreds of nurses and doctors and it is only the well resourced standardisation of our system with it’s protections and quality processes, which shields any of us from the same flaws which exist in any group of individuals.

Had Charles West and Charles Dickens been alive in today’s globalised society, the unequal status quo of the world’s children would have been unacceptable to them.  The poorest of the world’s poor may no longer be London-based, but they are still afflicted by appalling suffering and loss of life, which ultimately hurts us all.  In this age of cutting edge innovation and prosperity for those of us living in the best of times, those experiencing the worst of times are no less deserving.  Former US President Ronald Reagan advocated for international aid as a way of promoting economic growth and democracy.  The aid America provided to Germany and Japan after World War II stands as an excellent example of two potentially unstable nations becoming important allies and trading partners, whose prosperity has in turn benefited the rest of the world.  International growth and development, particularly the small investments needed to make significant change in the poor world, serves us all.

My observations of local life in Cambodia have regularly evoked comparisons with what I know of Dickensian London and it’s disparities between a powerful minority and the vulnerable teeming masses.  The difference today is that the wealthy minority is just as likely to be foreign onlookers of poor nations (in person or via the media), as it is to be that nation’s local elite class.  We – including those who consider ourselves common battlers – are today’s “high society”, purely thanks to the systems that work in our favour to ensure we  have shelter, food, education, opportunity and services.

Doctor Charles West, in his everyday approach to other people, showed us how we can capitalise on our privilege for the benefit of everyone.  Small sacrifices at both national and individual levels can make the biggest difference to those in need.  The alternative seems to be, to take on the role of Ebeneezer Scrooge, Dickens’ cold-hearted moneylender who despised the poor and approved of their suffering.  Even Scrooge eventually realised the selfish benefits of generosity and changed his ways.

In commemorating the 200th birthday of Charles West on 9 August 2016, GOSH said:
Today we’re celebrating the bicentenary of our founder Dr Charles West. Dr West was driven to found a specialist children’s hospital in the 1850s after being appalled by the extent of sickness among children of the poor in London. Dr West was loved by the patients he treated – he never prescribed a foul tasting medicine, always ensured his instruments were warm before using them, and had a drawer full of toys in his consulting room that was ‘accidentally’ left open. Happy birthday Dr West!

Giving to end poverty
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Imperfect Equals

In October I wrote about the elderly woman caring for her three orphaned grandchildren, who walks the streets scavenging for recyclables to sell in order to feed the family.  I will call her Belle.  Back then I shared this photograph of her at home with the children.

Belle and Kids

Since then a friend has been donating AU$35 per month to my account on behalf of his adult children, in lieu of sending them Christmas presents, which I send to Belle.  Last week I sent money to Chom, who today sent me this euphoric message and photograph of himself with Belle, reminding me of the allure of Cambodia.

Hello Helen Belle she laughing very much make me very funny too. she wish to the God bless you I gave 50$ to her. Please say thanks to your friend for me hope to see him in Cambodia one day thanks again Hellen take care see you.

Belle and Chom

Clearly Chom continues to get a thrill out of helping people, and I feel a pang of jealousy to see him enjoying the experience without me.  He recently made an impromptu visit to Paula to see the transformation he’d heard about, with his own eyes.  Again, I was envious to see the photograph of them together, with Paula standing straight and strong.  For the whole time I knew Paula, she spent her life lying flat, sitting up for short periods or walking with assistance for very short distances.  It will be an incredible day when I finally get to see her in good health.

Maintaining alliances with Cambodia is not always easy sailing, however.  Kim, the landmine victim, was in touch very soon after I mentioned him in my blog on June 4.  At that time he had written expressing concern about paying his rent.  A few days later he tagged me in a photograph on Facebook, apparently unaware that it would lead me to the connected Facebook page.  It came as a shock to see a page dedicated to raising funds for Kim, his family and their rural village!  Kim had never so much as implied that anyone else was involved in helping him on a regular basis so it took me some time reading through this page, to make sense of it.  I located the contact details of a guy who I’ll call Bob, an Australian tradesman who spends significant periods of time in Cambodia and has been involved with helping Kim since 2012.  We had a long telephone call together and among other things, I discovered that he has paid Kim’s rent through to October.  The message from Kim expressing concern about paying his rent, was a lie!  The majority of Bob’s help, however, has been building toilets and water wells, supplying bicycles for children to travel to school, and supplying school equipment, for families in Kim’s village.  He does it all with donations made from family and friends.

I asked Rav, our mutual tuk tuk friend/translator, did he know about Bob?  He replied “yes, he also help Kim”.  I then wrote to Kim that I knew his rent was paid and I was very disappointed to learn he had lied to me.  Instead of apologising, he denied the lie.  We had a brief to-and-fro about this before I told him I was not going to help him this month as I needed time to think.  For two years I have been sending him money each month with no strings attached and at no time did I link these payments to rent.  His message to me last month was merely a reminder that my monthly donation was due.  His life is challenging and impoverished and his English is very limited, particularly in written form.  I have been to his home, spent hours with the family, and I know their situation.  Still, he felt a need to deceive me, which I suppose is his perception that I may not understand, with my rich-world-eyes, if he told me someone else was also helping?  I spent a few weeks processing the situation and wondering if I would continue to help someone who thought it was okay to deceive me?  It’s also possible that his use of the word “rent” was his way of saying “expenses”.  I’ve spoken at length with Bob, who has also had problems with Kim, who at times resents that Bob helps his village instead of helping Kim and his family directly.  Bob and I have agreed to communicate regularly and to form a united front with Kim.  I have also decided to continue helping Kim despite this hiccup.  The fact remains, Kim’s life happened to Kim and not to me, through sheer fate.  Just because he’s poor, does not mean he has to also be perfect to earn the help he needs, anymore than I must be perfect to earn the life I was so thankfully born to.  Which is just as well because I am not.

Kim and I are equals, with the irrelevant exceptions of his disability and poverty which make him no less human than me.  As with all relationships, we are humans interacting with each other as the imperfect and contradictory beings that every one of us is.

Charity vs Solidarity

Speaking of Charity

Charity-begins-at-home

The English word charity has a long and ambiguous history, depending on the source you refer to.  It stems from the 4th century when St Jerome translated the Christian bible from Greek to Latin.  He used “caritas” in place of “agape” which is referenced over 300 times in the Greek version and is said to mean “the highest form of love”.  There are Jewish, Islamic and other translations, all with similar meaning, about caring for or giving to, the poor.  The different cultural / religious connotations are interesting to note.  Christian implications of charity are said to include the virtue of wealth and the free will of the virtuous to give, or not.  Jewish charity, known as tzedakah, stresses an obligation of the wealthy to give, the right of the poor to receive, equal social status of both and an ultimate intention of wealth redistribution.  The Islamic equivalents are zakat (compulsory giving) and sadaqah (voluntary giving).  Buddha taught that all giving should be free from attachment to either the gift or the recipient, and that generosity leads to freedom.  All religious interpretations have humanitarian and spiritual implications.

The phrase “charity begins at home” also has a long and evolving history and is today, said to be one of the most frequently misused expressions in the English language.  The phrase was probably first coined by Sir Thomas Browne, in a literary work called Religio Medici, published in the 1600s.  The literal interpretation of his meaning is that being caring towards ourselves and those around us, sets the scene for being generous on a wider scale.  As with so many phrases and philosophies, it has become misconstrued, with many using it today as a warning against being too generous, particularly to people in far away places!  The inference seems to have become, that charity actually ends at home.

Yet in an unintentional way, charity actually does travel full circle and end up back at home.  An awesome example of this is the case of Julia Wise and Jeff Kaufman, a young Boston couple who have given away 40% of their pre-tax earnings every year since 2008.  They are putting into practice what various studies have shown – that high levels of giving actually enrich our lives.  One study concluded that donating to charity has a similar correlation with happiness, as a doubling of household income.  So giving to benefit others actually benefits the giver.

Not unlike the sense I often have here in Central Australia, living amongst a marginalised indigenous society, my first few months in Cambodia, surrounded by extreme and often shocking poverty, perturbed me.  Living in comfort alongside hunger and destitution challenged my sense of justice and equality.  Also my sense of self, as I came to a realisation of my excessively entitled life.  I slowly resolved this inner dilemma by learning to connect with people from vastly different worlds, and offering help where I was able to.  Not only did this alleviate a small amount of the suffering I witnessed, but it was personally fulfilling to see the difference I was able to make in others’ lives.  I feel honoured to have made this discovery and to have had the adventures of a lifetime along the way.  This all stemmed from my having the time to help a few people out in ways that most fortunate people never experience.

I’d already had many unusual adventures here in Central Australia, which were a prelude to what lay ahead for me in Cambodia.  I wondered how I would feel returning home.  It has been surprisingly easy, helped by returning to my furnished home, familiar workplace, welcomed by neighbours, colleagues and friends such that it felt as though I’d merely been away for a long weekend.  However, I feel like a different person courtesy of the soul searching about both myself and the world, visited upon me during my two years away.  This morning alone, I watched “news” of Justin Beiber posting selfies of his bare chest on Twitter, heard that Australians are the “world champions in taking Ecstasy”, seen morning TV presenters ziplining through treetops, riding rollercoasters and jumping out of aeroplanes, and watched snippets of the weekend’s live concerts across the country.  Taylor Swift in Sydney, Ed Sheeran in Brisbane, Sam Smith in Perth, with some tickets selling for up to $500pp.

Where once these “news” items would have interested and entertained me while seeming fairly normal, it all now seems incredibly self-indulgent.  That is not to say that I would not love to see Sam Smith in concert or enjoy various other luxuries, because I would and I do.  I’m going to have to buy some “rich world” shoes because I can’t get around in thongs at work or social functions any longer!  I’ve just spent an amount on my hairstyle which I know could feed a family for months.  The list of luxuries I am slowly surrendering to as I settle back into Australian life goes on.  But our rich world indulgences should be interspersed with charity towards those in need, both because we can and because it is a very healthy endeavour for us to engage in.

Thankfully I’m not alone in my epiphany about the rewards of giving.  There are many movements today, involved in encouraging and supporting people who wish to give.  One of my favourites is the Bill & Melinda Gates Foundation.  They use their money to do the most good for the most people and they often talk about what I know and try to impart in this blog: the fact that with so many people in the world existing on almost nothing, those of us in the “rich world” do not need to make big sacrifices in order to have a big impact on lives of the extremely poor.  To quote Bill Gates, people living in rich nations are in a unique position to make a real difference to the lives of the most impoverished people on the planet. Not only does our money go much further in the developing world than it does at home, but we also now have access to the technology and understanding to allow us to target our resources effectively.

If you are someone who argues that you shouldn’t give to charity because you can’t trust where your money will go, think again.  There are many organisations such as GiveWell and GivingWhatWeCan, devoted to evaluating and promoting the most effective charities.  Most reputable charities have their own websites and implement economic transparency so that donors know where their money will be spent.  Your money does not have to disappear into a black hole, and if you do a little bit of research, all available online, it probably won’t.

Strikingly inconsistent with the difference we can make in the “poor world”, it is estimated that last year Australians spent over $520 million on unwanted gifts.  It’s hard not to imagine the good that could come from such wasted money.  There are so many organisations offering a charitable alternative to this waste.  Check out Care Australia’s Gifts that will never go unloved or Plan International’s Breakfast at school for a year as two examples.  Even Mahboba’s Promise, an Australian-Afghani charity, are marketing Christmas Gifts That Will Change The World.  My own Go Fund Me is also still open, currently with only $100 not yet given away, at Help A Cambodian Family.

[A quick update on Paula for those wondering.  She remains in the USA with her mother, staying at a hotel covered by my friend Karen and under the watchful friendship of the local Cham community who embraced us all so readily.  Last week she was discharged from the care of the surgeon who cured her and recent photographs show a strong, healthy and beautiful, transformed young woman.  She remains in the care of a plastic surgeon and her healing wound now looks quite superficial.  She will probably return home in the next month to six weeks].

We in the “rich world” have inherited phenomenal advantages.  We are an entitled global minority.  By giving small amounts of time, attention or money to effective causes we can make a serious difference to some of the world’s poorest and most distressed people.  Charity does begin at home.  It also ends at home, but not in the commonly misinterpreted meaning of the proverb.  For the most selfish reasons charitable acts towards the needy, no matter where they might be, are a highly desirable venture.  Do it for Christmas!

Sharing makes us free

So Many Worthwhile Causes

There are so many worthwhile causes in this world.  I find myself saying “no” to requests for donations to all kinds of charitable organisations who approach via door knocking, mailouts, emails and telephone calls.  It seems overwhelming sometimes.  Only recently have I realised that the reason “we” in the western world are so inundated by requests for philanthropy, is because of the global imbalance between rich and poor.  While poverty in Australia is defined as any single adult living on less than $358 per week, elsewhere in the world 1.2 billion people continue to survive on less than $1.25 per day.  From what I saw in Cambodia, many of these people actually earn nothing at all.

There is a calculator at https://www.givingwhatwecan.org/get-involved/how-rich-am-i where you can work out how rich you are in comparison to the rest of the world.  According to my calculation I belong to the richest 0.3% of the world’s population and if I give 10% of my income away, I remain in the top 0.5%.  Amazing stuff!

Another excellent reference is this four minute video infographic displaying global inequality and outlining the causes.  https://www.youtube.com/watch?v=uWSxzjyMNpU .  The richest 2% of people in the world have more than 50% of all global wealth.  The richest 20% have 94% of global wealth while 80% of the world have only 6% of the world’s material wealth.  Is it any wonder that we, at the upper end of this scale, find ourselves being highly sought after?!

Only 200 years ago the richest nations in the world were about 3 times richer than the poorest.  Today we are 80 times richer.  This has happened mainly by material wealth being removed from poor countries, by corporations and wealthy countries, which occurs at a rate many hundred times higher than the rate of aid injected into these countries.

I’m currently visiting family and traveling in New Zealand, where the wealth of our small nation has never seemed so visible to me as it does on this holiday.  Looking at the infrastructure alone we are clearly well resourced – even the most rural country roads are almost all bitumenised, potholes are almost non-existent, roads are well marked, road signs are clear and standardised, roadworks are staffed, signposted and extremely safety-conscious, hospitals and schools are clean and organised with modern conveniences unseen in most of the world.  It’s so far removed from the world I became used to for a year, where waste disposal was erratic, sewerage leaking on the grounds of a public hospital was considered unfixable, patients often sleep on floors in walkways of hospitals, roads were mainly pothole-ridden dust tracks, schools were bare concrete buildings with ancient wooden furniture and no reading resources, etcetera.

This leads me to the reason for this blog post!  As someone who says “no” to donation requests almost daily, I recognise that this is just “yet another cause” which most will not feel able to assist with.  I also know that in order to want to contribute to a cause, we need to feel connected in some way to the cause in question.  When we are detached from the concern at hand, we are less inclined, or not at all inclined, to feel a need to involve ourselves.  Being involved as I am, is why this is a cause I want to mention.

When I first arrived home a very good friend of my mother announced that she was coordinating a fundraiser for me and that I would need to present to a public audience!  She and Mum worked together at a nursing home in the town where I spent my teenage years and the event was held at this home / hospital last Wednesday afternoon.  The audience was quite a mish-mash!

An artist of considerable talent, she donated a beautiful acrylic painting of red poppies which was raffled alongside a book written by a local nursing friend and a brass door knocker which were both also donated to the cause by separate donors.  She recruited an audience from far and wide, produced and distributed a written invitation to the event, baked cakes, enlisted others to assist with catering, networked at various social gatherings, promoted raffle tickets all over town and I probably don’t even know what else, towards hosting the event.  It was a real “kiwi” experience, reminding me of the community spirit that exists here in spades.

Mum and a couple of other family members, many of Mum’s old work colleagues, an old high school friend of mine, a boss from my first out-of-school job and various others joined interested nursing home residents and staff in the large ocean-facing lounge room of this beautiful nursing home.  I put together a powerpoint presentation titled “A Year in Cambodia” and picked some of the stories which had touched me the most to share from a large projector screen on the wall of the residents lounge.  Standing not 20 metres from the Tasman Sea which rolled and broke into white fringes out of the panoramic window beside me, I spoke for 45 minutes about my experience and my hopes to assist the Children’s Home with much-needed funds.  The assumption that I would be nervous, stemming from jitters which surfaced days prior when I gave the same presentation to a group of  aunties and other extended family in Mum’s lounge room, turned out to be incorrect.  Despite a number of the audience nodding off to sleep before me!

I also gave a similar presentation to a Year 6 class upon request of my good friend’s 11yo daughter which was a highly entertaining exercise.  After speaking semi-regularly at schools and universities in Cambodia, the small classroom with comfortable desks and chairs, a computerised presentation system, children all speaking confidently of their overseas experiences and extra-curricular activities could not have been more different to the classes I spoke to in Cambodia.  Since I’ve been home others have also generously donated, either to Phter Koma or to individuals they know of through this blog.  I am so grateful to many for their eagerness to contribute, which is not just about the money but also the big hearts of many of my family and friends.

Until now I have not named the Children’s Home I regularly mention.  But they have a public profile and the Board of Directors have farewelled me on a holiday to Australia, New Zealand and America in the hope that during my travels I might manage to raise money for the home, so I guess it’s time to name them here and outline what we do.

Phter Koma Children’s Home in Kampong Cham Cambodia currently cares for 12 children between 6yo and 16yo who are HIV+ and have lost one or both parents to AIDS.  The home is licenced under Cambodian law for 15 resident children but currently does not have the budget for more than the existing 12.  I am the only Australian member of the Board of Directors at this home which was established by a group of doctors and social workers who came to the realisation whilst working together on an HIV program, that many of their clients were dying and leaving behind HIV+ children with no one to care for them.  This placed the children at high risk of health problems related to poor HIV treatment as well as many social risks including homelessness, neglect, abuse, child trafficking and prostitution.  The children all come from families who are unable, for various and often shocking reasons, to provide them with proper care, in a nation crippled by poverty.  They are beautiful children, keen students who attend school daily and extra classes whenever possible in order to try and catch up after losing out on schooling due to circumstances including ill health, poverty and chaotic home lives.

The home is 100% Cambodian managed, with a Manager, an Educator and two carers who rotate in shifts to provide general care to the children including cooking, housework, coordinating the children’s activities and health appointments and ensuring care and routine in their lives.  In order to function at a basic level, Phter Koma needs a minimum of US$2,500 per month which covers accommodation (they rent a house near the children’s school), staff salaries, food and clothing for the children, transport, school fees and other general costs.  The carers earn around $100 per month in salary and all staff earn less than $400 per month, so most costs relate directly to the care of the children.

Cambodia is renowned for it’s “orphanage tourism” which corrupts children in care for the purposes of fundraising for personal gain/profit.  Phter Koma is a genuine, licenced and ethically managed not-for-profit association with processes in place to ensure the protection of their resident children, whose best interests are the association’s only concern.  The Children’s Home website is at www.phter-koma.org .

The role of the Board of Directors is to provide technical advice and oversee budget implementation, as well as to raise funds to keep the home functioning.  Most funds currently come from France where one of the home’s founders, a French social worker, spends exhorbitant amounts of time and energy sourcing private donations.  We have a provisional budget of US$30,000 for the following year, but currently only have US$26,000 available (almost all from French donors), so we are looking for an extra $4,000 to ensure the home remains operational into the following year.  If we are able to raise more funds we will be able to increase our resident children from 12 to 15.  There are many HIV+ children in the region who fit the criteria for admission to Phter Koma and have an immediate need for residential care to protect their health and improve their future chances at a decent quality of life.  We also have a currently-unaffordable idea that we would like to separate the children into two separate homes, by gender, as they move into their teens.

Both France and USA have tax exempt connections to Phter Koma allowing their citizens to make donations to us as an official charitable organisation.  I am currently working towards obtaining this status within Australia, which is a complicated and lengthy process.  All donations are warmly welcomed by anyone interested in contributing to a highly worthwhile cause but permanent donations which can ensure continued income for the home are most valuable as they mean we have a better chance at maintaining operations into the long term.  For more information or to make contact, refer to www.phter-koma.org or feel free to email me privately at hjtin@yahoo.com.

Millions of Monks

Cambodia has an impressive total of 28 national holidays per year.  That’s another 5+ working weeks of days off added to the annual leave people can take.  Not that most people are entitled to annual leave given that less than 20% work in occupations which follow the labour laws.  Most people work seven days per week, 52 weeks per year, just to feed themselves, many managing this in a less than adequate way.

Yesterday was not a public holiday but provincial towns including Kampong Cham held a big annual event of dragon boat racing.  Between 40 and 50 rowers per massive canoe raced on the river outside of our house during the day.  This was a lead-up event to the famous Water Festival which has it’s main celebration in Phnom Penh in November.  Unfortunately I only saw a very brief glimpse of the racing en route to work.  Over my year here I have seen many of these beautifully decorated boats sitting under shelters as we’ve cycled through their owner villages.  The purpose of yesterday’s event was to put the boats and rowers from these villages onto the water in preparation for the bigger event in Phnom Penh, where they will all travel downstream in about a month’s time.  It was quite a sight, with dozens of oars on one boat moving in chorus, propelling the boat at some speed over the current of the Mekong.

In the evening small homemade boats decorated with food and candles were floated onto the river, apparently in order to send the ancestors back to their other-world after they visit as ghosts during the observance of the two week Pchum Benh festival.  It was a big and busy day for Kampong Cham, followed by a big and busy evening.

I went out in the evening to check things out, starting at a riverside restaurant where the young wait staff were busy decorating their paper and banana leaf boats and preparing to join the procession to the riverbank.  Variously adorned skiffs appeared from behind the bar amidst a lot of excited commotion.  At one point a young waiter appeared with a ceramic dinner plate bedecked with a bunch of bananas and a candle in the centre, which sent his workmates into spasms of laughter.

Processions began to make their way along the promenade, including one large ornamental boat carried on the shoulders of a crowd of men who chanted as they marched along.  Most others were small and humble, but there were swarms of people everywhere, both on foot and oozing out of vehicles which purred along the crowded esplanade at snail pace.  I found a place on the walled embankment to sit and watch the full moon rise as these symbols were released onto the water, enjoying the sight of two big boats cruising nearby, one of them a new riverboat with fairy lights and light music playing to a subdued crowd who I imagined probably had champagne flutes in their hands; the other a big old wooden barge with a crowd concentrated on the bow, clanging steel on steel in rhythm and shouting out boisterously.  As the symbolic boats were released some people were jumping into the muddy water to swim them out into the current; other groups were on small fishing boats, collecting the rafts wafting on the shores and transporting them into the middle of the river to release them again.

It was a busy, interesting event to be amongst and as I was sitting enjoying the spectacle, Chom called me and shouted into the phone “I am at the front of your house!”.  I shouted my location back to him and he said he’d join me.  Moments later he appeared with his wife and son and we sat for about an hour watching the small and large boats, swimmers etc in the river under the moon’s reflection.

This morning a million monks weaved their way in single file through the busy streets of town, collecting alms from shopkeepers in a slow procession which stretched for many blocks.  The sight of monks collecting alms is not unusual but I have never seen them in such numbers before.  Apparently during the Wet Season (which has been disappointingly dry this year), monks stay at the pagodas and do not seek their regular donations from the general public.  This gives farmers and others reprieve to grow crops or save their produce without having to make regular donations from crops which are not yet ready to be harvested.  Today was the beginning of the new season in Buddhism and so the monks appeared in full force to begin their alms collecting again.

Monks collecting alms in Kampong Cham today

Monks collecting alms in Kampong Cham today

Yesterday while cycling through town to get Dara his daily treat I noticed a woman I have seen before in the same spot, sitting quietly with two naked children.  Clearly hungry, I bought them a fruit shake and took it to her.  Ineptly I asked if she had clothes for the children and she indicated no.  She then lifted her sleeve and showed me a badly infected, cellulitic arm.  Horrified, I asked if she had been to the hospital and was told no.  Payment of user fees in the health care setting here is an issue which keeps many Cambodians indebted and I understood why she was wary of my suggestion.  I said I would return in the afternoon but by then it was raining heavily and she was no longer there.  Meanwhile I recruited Win who provided me with some hand-me-down clothes from his son and I had these in my bag ready to clothe the babies.  Today at lunchtime I managed to locate her and she immediately clothed the children who were rapidly transformed – it’s amazing how good a clean pair of shorts can look on a little grubby, raggedy street-dwelling body.  I rang Chom who agreed to join us and while waiting for him, I cycled to the market and got some fried rice and coconuts for them.

As I arrived back at their tree Chom pulled up alongside us at the same time as a man on a bicycle who parked up and joined her on her park bench.  The ensuing conversation revealed this was her husband and they had four older children who were in the streets with sacks on their backs, scavenging for recyclables.  Chom explained that we knew somewhere she could go to have her arm seen to and when she initially declined, we explained that there would be no cost attached which immediately changed her mind.  She left the 3yo boy with his father and boarded Chom’s tuk-tuk with the baby.  We traveled in tandem, bicycle and tuk tuk, and made our way to a clinic where she was able to see a doctor who dressed the wound and provided her with antibiotics as well as de-worming tablets for herself, her husband and their six children as a precautionary measure due to their living conditions and the childrens’ malnutrition.

We all returned to the same park bench about an hour later and the older children appeared, two stunningly beautiful girls and two stunningly handsome boys aged 13yo down to 6yo, all dressed in filthy rags.  Dad immediately dispensed the de-worming tablets to each of his children and they dished out the two serves of fried rice between them.  Chom talked to me about his perceptions, which were much like mine, that this was an impoverished and uneducated village family eking out a form of a living by scavenging in the city.  As I am leaving next week there is little I can do for them and I am learning that there are very few NGOs here who can help in any meaningful way.  I am also learning that this is not an unusual situation for people to find themselves in, as I realise that there are hundreds of sack-bearing scavenging children on our streets.

Children scavenging along the embankment during a tropical downpour, yesterday.

Children scavenging along the embankment during a tropical downpour, yesterday.

Around 4pm this afternoon I was in a meeting when a text arrived from Chom “How are you?”.  I replied “Fine thanks and you”, to his “Me too, no customer and lonely”.  I suggested a 5pm drink together and we met at a riverside restaurant to catch up.  We spoke at length about some of the things we’ve done together, helping Dara and his family, the lady who sold her hair, and the family we saw today.  He said “I feel like my life is really changed now.  Before I thought so much about money and how I want the car and I want the nice things, but I don’t think about that anymore, I just think about my family and my friends and I really like having you as my friend and to help people with you”.  Doch knea – same here!  He then told me that his mother-in–law’s neighbour was widowed recently and has no way of feeding herself and “I told her that maybe you can help”.  To which I agreed and with a grand total of $10 we were able to ensure she has a stock of one month’s worth of rice, soy sauce and other extras including some eggs and fish for protein.  He rang her to tell her and there were tears and many thank yous.

I think about the charity Cambodian Childrens’ Fund a lot, as they are doing such remarkable work in Phnom Penh with families and individuals such as those I encounter here.  Interventions such as ensuring children attend school while giving their parents alternative choices, caring for the elderly and widowed, providing much-needed health care, etc.  How amazing it would be to come up with a plan to implement something similar for the people of Kampong Cham and other provincial towns, who have so little with no alternative but to live on the streets, begging and scavenging.

Meanwhile, these are all little things I am going to miss being involved with over the next few months while I catch up with family and friends and take a holiday back in the parallel universe that I call home.

Angkor Athletes and Apsara Angels

Angkor Wat is the biggest of many historic Khmer temples situated near the tourist resort town of Siem Reap in Cambodia.  It is the largest religious monument in the world and has been ranked as one of the Seven man made Wonders of the World.  Khmer civilisation came into it’s own and thrived here for centuries through the Middle Ages.  Yesterday the inaugural International Angkor Empire Marathon was held, with a starting point at the entrance gate into Angkor Wat Temple and a course encircling the World Heritage listed site, including through the ancient walled city of Angkor Thom and past many other temples.  It was an exciting event and registration fees will be divided between a number of local hospitals and charities.

There are currently eight expatriates living and working together with MSF-France in Kampong Cham, a diverse but well-matched group of people from all over the world who socialise and work as a happy (and incredibly lucky) team.  We hired a driver and mini van for the weekend and on Friday afternoon headed off with stocks of wine and snacks for the five hour journey to Siem Reap, for a weekend together.

Despite a fun journey along rural roads with many interesting sights, luxurious boutique hotel accommodation and decent tourist-friendly shopping and restaurants in Siem Reap, where I now know people who I enjoy catching up with, the highlight of my weekend was definitely the 0430am start four of us made yesterday morning. We reached Angkor Wat in time to watch the sun slowly rise behind the famous ancient temple spires before cheering on the race starters for the 21km half marathon at 6am, followed by the 10km competitors at 0610am, then lining up for my own 3km fun run take off at 0620am.

On previous trips to Siem Reap I’ve mentioned Rav, the affable young tuk-tuk driver who translates for me with the landmine victim whose family I support.  We visited them on Saturday for our usual encounter at their little single room accommodation sleeping a family of four and serving as Mum’s workplace with the sewing machine set up in one corner.  Yesterday at 0500am Rav was waiting as arranged and runners were already on the unlit road outside our hotel, 5km into the 42km full marathon which had started half an hour prior in the dark, their silhouettes silently pounding the road as policemen lined the streets to mark their route.  We packed into the tuk-tuk, the two serious competitors who were about to run 21km and 10km respectively, full of nerves and excitement.  The tuk-tuk made it’s way out into the road, crossing in front of runners in the usual Cambodian style of casual but polite rule-free road-sharing which I have become awkwardly familiar with and which makes me worry for my return to Australia where road rules and road rage will be unfamiliar and alarming!

Sunrise at the temple was a spectacular array of slowly-evolving colours, with a DJ on stage spurring the crowds, calling for competitors to make their way to the start line, appealing for cheers according to the nationalities he was naming randomly, playing loud beat music and rousing applause for the competitors at each take-off.  Our Slovakian colleague left first in the half marathon, full of nerves but no doubt stimulated by the adrenaline rush the crowd and atmosphere generated.  Ten minutes later our Australian colleague took off in a similar rush of excitement for the 10km race, followed ten minutes later by myself and our American colleague for the 3km fun run.  Unlike my American friend who planned a stroll, I was determined to run the distance despite my similarly inappropriate attire and utter lack of athletic desires or talents.  I started at a slow pace which I correctly thought I could maintain for the duration.  Surrounded by a mixed and happy crowd of joggers and walkers, and inspired by the beautiful tree-lined route in such a magical site, I mused about the historic events preceding my own footprints on this patch of land over many centuries as I ran to the beat of the tunes on my newly-created “Angkor Marathon” playlist.  Plenty of interested local people lined the route going about their usual daily business of selling to or cleaning up after tourists, with lots of staring, waving and smiling as I plodded past, helping me to maintain my pace so that within 20 minutes I had shuffled my way back to the finish line, feeling quite accomplished.  After all, I can now say that “I ran in the inaugural Angkor Empire Marathon” – with the subtle distinction of adding the word “in” to my sentence making all the difference to the truth of my statement!

Just as I was reaching the finish line a very fast and fit male runner strode past me, giving me the extremely false impression of competing in a serious race – the difference being that I shuffled across a white chalk line in one direction as he veered the bend and bounced energetically underneath the red banners of the serious finish line.  Rav found me a few moments later and we stood along the edges cheering in the approaching serious competitors.  Green cardboard squares attached to plastic ice cream sticks were being handed out and we waved these at ourselves to cool down in between using them to cheer on the athletes.  Our walking MSFer was next over the line, strolling casually along in her thongs!  About twenty minutes later Bea appeared, crossing the 10km finish line in good time with a beaming smile.  About an hour later our Slovakian 21kmer strode in looking like she’d just taken a walk in the park!  The serious runners received a medal while the 3kmers received a certificate with space on it to complete our names and finish times.  Along with the green cardboard fans and after taking some photos for evidence that we did get a finishing certificate, Rav’s children inherited these.

After cooling off, rehydrating and soaking up some of the race atmosphere Rav pulled in alongside Angkor Wat’s moat and we piled in again for the return journey to the hotel for breakfast, a shower and a much-deserved rest.  Rav parked himself across the road from the hotel and waited, the standard pastime of thousands of tuk-tuk drivers throughout Asia!  A few hours later we gave him some more custom, heading into town and then to visit the two year old I spent time with in April whose tracheostomy has been removed and is healing well, before returning to town for lunch while Rav sat patiently once more in the back of his own tuk-tuk.  After lunch I needed to stop at the bank so we parked and I jumped out and ran into the ATM.   Stuffing my money into my purse I turned around to the sight of my three housemates madly fanning themselves in unison in the back of a parked tuk-tuk with three green cardboard fans which Rav had obviously retrieved from under the seat amidst complaints of “many sweats” in the still and steamy air.  It was a quintessentially Asian-hilarious sight.

This morning I arrived at work and negotiated the discharge of a 64yo patient who is ready to return home where she has her own business which she created with $100 borrowed from a neighbour.  She has been hospitalised for a month now and her business and the repayments have all been on hold.  When I told a friend in Australia her story, which involves existing as subsistence farmers in a home made out of bamboo and banana leaves, with malnourished children in the house including a 7 month old who weighs 4kg, they sent me $100 to pay off the loan.  Today with my translator back at work after two weeks away, I was able to communicate this news and give her the money to pay off her debt.  She listened to my translator explain my possession of $100 intended for her, and nodded quietly before announcing that she was very excited to finally be going home.  We returned a few moments later with the money in an envelope.  She appeared from the bathroom with a krama wrapped sarong-like around her chest.  She slowly and demurely changed in front of us, into a white laced pyjama-like top before calling her husband in from the undercover pathway outside where he had been chatting with some other patients.  He then changed into a pair of black pyjamas and sat next to her.  I held the envelope as Win explained that they should be discreet about it as it was not possible to do this for the other patients.  They agreed quietly to this and I placed the envelope on her wooden bed base.  Via Win I then asked for a photograph to send to the donor and they agreed.  The envelope sat on the bed untouched, and so I sat down on top of it to have my photograph taken with them.  Without any verbal recognition of the money, the patient placed her hands on my arm and stroked it repeatedly, saying I had beautiful skin, and that I looked healthy.  I looked at Win, suspicious that he had substituted “healthy” for “fat”.  Reading my mind he said “she means that you are very healthy, it is a very positive thing in Cambodia”!  Against her 40kg frame which knows both hunger and tuberculosis intimately I do look gigantic, so I can accept this “compliment” without too much torment!  We did argue back and forth a bit as she said she wished she had my “health” and I replied in jest that I wished I had her slim figure, eliciting a more forceful “but I really wish I was healthy like you”.  I let her win the battle, realising that my luck at birth means I already won the war.

Making the most of my translator we then cycled to Shackville (as I have dubbed it) to visit the mother of the 6yo amputee boy.  I met her this morning on my way to work and we conversed as we always do – with much laughter and little understanding of what each other is saying, so I told her I would return “with Khmer” (the only way I know how to say “with my translator”).  Her son came to the Night Market with us a few Sundays ago, when we took the orphans to a Childrens’ Fair event.  I had managed to communicate to her earlier that day, my request that he join us at the Fair and she had conveyed her understanding and consent.  When I returned that afternoon to collect him as arranged, he very slowly put his prosthesis on, looking nervous and slightly confused the whole time.  With his growing bone protruding through the skin of his stump, the prosthesis is uncomfortable and he is only wearing it at the moment for aesthetic reasons.  I carried him to my bike and put him on the carrier, cycling away with a very anxious boy watching his mother disappear into the distance behind us.

When we arrived at the Fair his nerves slowly dissipated as he played with the other 6yo in our group, hopping along behind the other children or asking the older ones to carry him.  Apsara dancers and children juggling featured at the fundraising event and we bought the children an ice cream and some fried noodles to share.  After two hours he announced that he was ready to go home (via the Cambodian Orphanage Director who was with us).  So I picked him up and carried him home as he nodded off in my arms.  When we arrived at Shackville he opened his eyes and suddenly became very animated, shouting out to his mother, pointing towards the Night Market excitedly and talking at high speed.  His gut busting enthusiasm told me without understanding a word, that he had enjoyed the excursion.

Today thanks to Win, his mother was finally able to relay his version of events.  He told her that he ate a lot of different foods and he “even saw many angels”!  It took me a while to process what he could possibly be speaking about.  The “lot of different foods” were an ice cream and a small plate of fried noodles divided as a snack between three children.  The angels were Apsara performers!  He is staying with his grandparents at their village seven kilometres from here because Mum has to work and she doesn’t have enough money to feed him, which is why he was crying the last time I saw him.  I cycled by and waved out, aware that he was in Mum’s arms crying but because I was late for work, didn’t stop.   Mum speaks to him everyday on the telephone and in every conversation he asks “did My Barang come to look for me today?” and tells her “Mum, please don’t abandon me”, as his way of pleading to return to Shackville!  The kid is a heart breaker!

These are his angels performing for him!
Childrens Fair Night Market 9 Aug 036a

Imperfect Souls

African-proverb-sleep-with-mosquitoMosquito killer

When I was about ten years old I used to visit a young mother because I liked playing with her baby.  I don’t remember how I came to know her but she lived in a house on a street between my house and St Josephs Primary and I remember stopping in to visit them on my way home from school.  It was quite a surprise to me when Mum told me oneday that this woman really appreciated my visits and that they always cheered her up.  Looking back now, I realise that she was an impoverished single mother who probably had little to no support, so an older child taking the little kids off her hands occasionally made a difference.

Ten years later as a student nurse in England, I nursed a frail, elderly woman who lived at home with her equally-elderly sister and would come to hospital for respite care once every six weeks.  Her sister had long-ago retired from a senior nurse position at the same hospital and I loved to hear her stories about working in our hospital during the war years, when the hospital was bombed and regularly dealt with war wounded citizens and also soldiers who were transported from battles across the English Channel.  When the frail sister was admitted into a nursing home her respite care to hospital ended, but I stayed in touch with them occasionally.  Oneday I phoned to say hello and the healthy sister was very upset because she was not well and could not visit for her nightly routine tending to her sister at the nursing home.  I offered to go in her place and for about a week I visited the nursing home, put her sister’s slippers on for her and fed her dinner.  I was also able to pass messages between them both so they did not fret for each other until they got back to their normal routine once the second sister was well again.  It was around the corner from my home and took me less than an hour, so it was no effort and in fact an enjoyable interlude for me.  But again, something so small in my mind surprised me when it transpired that it had made a difference to both their lives, to the extent that when the last sister died a decade later, she left me an inheritance.

I’m no angel though, with plenty of faults and mistakes to my name.  With the recent headlines about Robin Williams’ suicide after years of torment, I wonder what failings haunted him so badly that he couldn’t forgive himself?  It would be so easy for hyper-sensitive and self-critical people to suffer terribly in the face of their own faults.  Tracy Chapman’s lyrics At This Point in my Life say it well – At this point in my life, I’ve done so many things wrong, I don’t know if I can do right…. I’ve been climbing stairs, but mostly stumbling down, I’ve been reaching high, but always losing ground, I’ve conquered hills but I’ve still got mountains to climb…. but right now, I’m doing the best I can.  She describes so well, the state of being human – the struggle of being an imperfect soul.  Noone in this life is faultless and it’s okay to work towards making small differences in the world, which will always be imperfect differences coming from an imperfect soul.

These are all reflections I made as I listened to Scott Neeson speak about how he transitioned from tycoon to philanthropist extraordinaire a decade ago.  His story is quite incredible and anyone interested in charity will really enjoy hearing him speak at this TEDx lecture delivered in Hong Kong in 2012.  I think his life story sums up the Anne Frank quote perfectly, that “Noone ever became poor by giving”.  Not that anyone, least of all Neeson, thinks we should all sacrifice everything and move to a third world garbage dump.  But pioneers like him are turning outdated negative attitudes towards giving to charity on their head and showing that individuals actually can make a difference in situations that seem hopeless.  And that being a “do-gooder” is not a one dimensional concept but is full of imperfect nuances implemented by imperfect souls.

https://www.youtube.com/watch?v=_tJK6R2y0bk

I follow Scott Neeson on Facebook and another reason to admire him, is that he never shows concern for others’ criticisms, he just gets on with doing what he does.  There are so many people who prefer to cast aspersions and yesterday a wise friend emailed me following some trouble she faced from detractors on a public website with over 20,000 members which she administers.  Her words about it were Some people are put on this earth purely to be destructive of anything built by someone else so why would I get upset by them?  Their words mean nothing to me.  Her wisdom is inspiring, and so on I shall blog!

Audrey Hepburn character