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.

Far Flung Fishing Friends

When I first met Paula and her family, her father invited me to visit their village with the offer that he would take us out on his fishing boat.  Now that I know them well, he lives in Malaysia in order to earn enough money to continue paying off the family’s debt, incurred throughout the five years of Paula’s illness.  So the offer to go out on his fishing boat remains on hold for now.  When I last visited Kampong Cham, Paula’s brother rang me on the Saturday morning to enquire of my whereabouts.  I was able to say that I planned to visit the next day, but unable to give any detail due to our language barrier.  Dan and I arrived unannounced at about 9am, having left my fellow expatriates at the bottom of 200+ stairs leading up to a temple complex at a nearby hilltop.  A few kilometers later, a newborn baby boy was one of the first to greet me along with various villagers who I am often unsure if I’ve met before, due to the volume of people who always form my welcoming party.  It was a happy visit as always although they were disappointed that I couldn’t stay for a meal and I had to repeatedly insist that my friends were waiting for me at the nearby temple.

Dan makes a quiet and unassuming translator, quite different to Chom’s style of doubling as the paid entertainment!  I am often unsure of exactly what I am being told, usually because the assumptions behind peoples’ stories are laden with histories and perceptions that I don’t fully comprehend.  Paula and her mother talked about their memories of America, that they really wanted to stay but they could not.  Her mother said that “we travel with nothing but you travel with many bags and even your children have bags at the airport”.  A poignant observation of wealth from impoverished eyes.  Her neighbour told me that her husband works as a fisherman on boats off the Thailand coast which is “very dangerous” but he has no choice because they need to eat.  These are just daily conversations, not requests for help or for pity.

Whilst in the village I visited the parents of a young Cham woman who I met in Seattle.  She met her husband when he returned to Cambodia for a visit and she now lives near Seattle with him.  When I met her in Seattle, the conversation was amazing for both of us, as I asked where she was from?  Cambodia.  “Yes, but where in Cambodia?” Oh it’s a place called Kampong Cham.  “I know Kampong Cham, where is your home?”.  When she named Paula’s village I was surprised beyond belief and when I claimed to know this village, she was equally surprised.  Recently I told Paula’s family via Dan, that before I came to Cambodia I had never heard of Cham people, but now I feel very connected to them.

On return to the temple to meet the others, my bag fell off it’s perch behind Dan’s moto and was hit by the tuk tuk wheels underneath my seat, veering us off course so that for a moment I thought we were going to drive over a bluff into the rice fields below the elevated road.  Thankfully a small tear in my case, salvaged from the roadside a short distance behind us by an apologetic Dan, was the only damage done.  We picked the others up at the bottom of the stairs, filled with excitement at the Khmer New Year ceremony they had gate crashed by chance, on the mountain.  They had photographs galore showing hundreds of people dancing and making offerings to dozens of processional monks.

Back in Kampong Cham town we had another delicious and inexpensive market meal before our hired van met us for the drive back to Phnom Penh.  Within 2.5 hours we were arriving at the apartment gate.  That night we headed out for dinner to the historic Foreign Correspondents’ Club, an open air restaurant on the trendy tourist strip river front.  Not far from the Royal Palace, the FCC as it’s known, overlooks from its first  and second floor terraces, the massive new Sokha Hotel on the opposite shore of the Tonle Sab river.  If you had not been to that shore, which most tourists and expatriates have not, you would not know that the Sokha rises above a community of Cham fisher people, who live on small colourful wooden boats which double as their livelihood, allowing them to fish and therefore to eat, as well as to make a small income if they are lucky enough.  You also may not know, that the promontory it sits on is the junction where the Tonle Sap and Mekong rivers converge.  During the wet season, the Mekong delta floods push the Tonle Sap river flow backwards into the lake which swells to four or five times it’s usual size.  This is the largest freshwater lake in southeast Asia, feeding some of the largest freshwater fish in the world.

Cambodia map showing the Tonle Sab and Mekong rivers meeting in Phnom Penh

Tonle Sab flow reverses into the Tonle Sab Lake during the wet season

River catfish in Cambodia, 2002. Photograph courtesy Zeb Hogan, University of Nevada

Sokha Hotel as seen from the city side of Phnom Penh

On May 24 last year I wrote a blog called Pay It Forward in which I talked of my uncle, an open sea fisherman in New Zealand who refused to take anything from me as a thank you, insisting that I “do something for Cambodia” on his behalf.  Maintaining fishing boats in a place like Cambodia is a constant challenge for their owners who need to work the boats everyday and rarely have enough money to keep them maintained.  Determining to offer repair of a fishing boat on behalf of my uncle, Bree who works with the Cham people living on the shores of the Mekong/Tonle Sab confluence, was my obvious contact.  She tells tales of severely disabled children living on these small wooden boats and spending hours everyday on the river while parents fish; of boats sinking with whole families on board; of a vigilant community constantly looking out for each other due to the dangers of their worn out boats.  Yesterday, a year after my promise to my uncle, I finally organised a boat repair on his behalf.

My day started with breakfast at Brown, a trendy coffee shop in a trendy area of town, where I met Bree who had arranged for us to meet up with Ben, the CEO of Kung Future.  We caught a tuk tuk across the river, where we met up with Ny, who had been informed of the boat repair plan and been scouting the community to determine who was most in need.  Somewhere between trendy Phnom Penh and the Mekong/Tonle Sab confluence shoreline, your perception of the world is thrown into turmoil.  When I first visited here with Bree three years ago, there was talk that the Cham people would be forced away from this shore once the hotel was built, to keep them out of sight of tourists.  The fact that the hotel remains largely unoccupied may be the reason that this threat has not been carried out.  Many dozens of empty rooms with running water and ensuite toilets watch down on this active community where dozens of families live without a single toilet.  Among their many useful interventions, Kung Future have supplied water filters so that families can drink the river water safely.  If the community move too far uphill, they are moved back down by police.  When the river waters rise, they are forced to dismantle their huts and pile the materials onto the boats.  Bree talks of visiting the community during the wet season, stepping warily on tiny patches of mud or balancing one foot in front of the other on narrow wooden planks to reach moored boats.

Life in the shadow of a near-empty hotel

Boat repair at the Tonle Sab/Mekong confluence

Bree and Ben thought we might end up visiting a community on the Tonle Sab shore, where many more boats are delapidated.  The Tonle Sab waters are calmer and less rippling than the Mekong, so once your boat becomes dangerously ramshackle it is safer to fish on the Tonle Sab.  However Ny already had a plan for a family living in the shadow of the Sokha Hotel.  On 8 April an early monsoonal storm hit Phnom Penh.  The family consisting of Mum, Dad and six children were on shore in their tarpaulin-covered bamboo hut.  The next morning Dad walked down to the water’s edge and his boat had disappeared, along with all of the paraphernalia they had stored on-board.  The story of retrieving the boat made no sense to me, as Ny tried to describe, with accompanying photographs, the lowering of large water drums which in some way helped to raise the boat off the riverbed and haul it to the surface.  It has been sitting on the shore for a month now.  The family are impoverished but functional, their children have good school attendance, thanks to their fees being covered by Kung Future.  Their parents generate a small income by selling produce from the so-called house, but without the ability to fish they have been forced to live on little else but rice for the past month.  Ny told me their story before walking with me down a packed-mud slope to the boat, filled with gaps in the wooden panels and holes in the strips of glue holding the panels together.

When she was comfortable that I agreed to this being the boat we repair, we went to meet the family.  Dad was sitting under the shade of his tarpaulin roof, on a bamboo floor suspended about 60cm off the ground.  One hand rocked a hammock hiding a sleeping baby and the other hand rested on the edge of a broken foam eskie with smoke wafting out of it’s open top.  When I looked closer, an open fire burned on stones inside this eskie, on top of which a pot of rice boiled!  When I expressed my concern at the peril of a fire in such flammable surroundings, Ny explained that it was okay as long as he did not move away and this was why he was leaning on the edge of the eskie.

Ny introduced me and talked to Dad about my uncle, who fishes in very cold sea water, jumping off his boat with a long spear and swimming around, spearing fish.  Dad listened with a smile, nodding occasionally and I wondered if he thought I was spinning him a tall tale.  We explained that my uncle wants to help a fisherman in Cambodia and that repairing the family’s boat was the choice we’d agreed upon.  This led to a photograph session just as Mum arrived on a clackity motorbike from the market.  Except the two youngest, their children were all at school.  With Mum and Dad as witnesses, I handed my envelope containing the donation to Kung Future.  Ny asked Dad to make a list of the supplies he would need so that they could go shopping together this week.  He can repair the boat himself so there will be no labour costs and he predicts it should take about a week.  I asked if I could return to see the boat once it’s fixed, and Ben announced “we can do better than that!  We will go out on the boat with him!”.

From here we wandered through the community, visiting young families, tiny stunted and malnourished children, elderly women lying down under tarpaulin shades, grandparents pulling potatoes from the ground with infants at their ankles and men working on their wooden boats.  I was a sweltering mess but it was the best morning I’ve had in ages.

Harvesting potatoes

Destined to be back on the water very soon

Standing On The Outside, Looking In

It is much more difficult in Phnom Penh, to find the impetus to write.  My accommodation is a fifth floor apartment overlooking rooftops for as far as the eye can see.  This removes me from community life somewhat although I’m slowly starting to recognise the neighbours beyond our apartment block.  We recently relocated our office to be near the clinic, in another part of town.  Now we drive to and from work in tuk tuks.  This puts us on the bustling city streets for half an hour each morning and evening, with many fascinating sights and sounds.  In work hours I find myself walking the short distance between office and clinic a number of times each day, again putting me on the always-intriguing streets.  Still, a significant amount of my spare time is spent suspended in the sky, disconnected from the community I live in.  This is not a complaint – I love the apartment and am enjoying my expatriate colleagues / housemates.  We arrive home before 6pm, I go for a swim, share a drink and meal, then hit the sack in time for another work day.  Our location and routine diminish the inclination to write.  Perhaps once I get a weekend routine going this might change.

According to The World Bank four million people were lifted out of poverty between 2005 and 2015 due to positive developments in the Cambodian agriculture sector.  Most of these people remain poor and vulnerable with a loss of US70c per day being enough to drag poor families back into poverty.  Defining and measuring these categories is a complicated discipline which I am not equipped to explain here.  My observations on poverty are that it is not always, or solely, about individual income.  Rather, there are many factors at play.  Someone with a home and secure and livable income who lives in a place where access to education or health care is limited, is still affected by poverty.  Nowhere is this more obvious, than in many of Australia’s remote indigenous communities where public facilities such as education and health care are often insufficient and people experience social and economic challenges which affect their well being and contribute to the indigenous health crisis.

An extremely common Cambodian story is that of families separated due to work commitments.  Twice a year the nation celebrates important national holidays which routinely see economic activity grind to a halt much like Christmas or Easter in western nations.  My tuk tuk friend in Siem Reap, who I call Rav here, had not seen his mother for three years despite living a mere 320km away.  His sons are now 5yo and 6yo, significantly different to the tiny boys their grandmother last saw.  Rav is probably “poor”, rather than impoverished.  He pays $40 a month for a small rented room (literally a room with a bathroom and a kitchen bench with running water on one wall).  Driving tourists to the temples makes this rent and the family’s other short term expenses do-able if he is careful, except in low season when the lack of customers turn an already competitive market into a very tight squeeze.  His income doesn’t stretch to taking time off or to the cost of tickets to travel away.  When I saw him in Siem Reap in February Rav was very low, feeling trapped by his economic circumstances and worried about his mother’s ill health.  I have regular donations from a number of friends and family and so I told him that I had some donor money I could contribute to get the family to Phnom Penh to visit his family.  At first he was reluctant but as Khmer New Year drew near, he agreed to my offer and brought his wife and sons to Phnom Penh for a three day visit.

The family met me for lunch oneday.  Rav said that his mother could no longer walk and they did not know what to do for her.  He did not know if her feet were swollen, but both feet were causing a problem.  My suspicion was liver or heart failure, which lead to fluid retention and immobility; or uncontrolled diabetes, which can lead to loss of feeling in the feet due to a build up of sugar in the bloodstream.  I suggested that she should go to hospital but they were reluctant due to hospital fees.  70% of Cambodia’s health care costs are paid for out of pocket by patients, with many thousands of already-poor people going into debt or selling assets to cover the cost of medical needs.  A large portion of the country’s population are considered vulnerable to these “health shocks”.  Paula’s family, who sold their house during her illness and whose father now lives permanently in Malaysia in order to earn enough money to continue paying off their health care debts, are an example of this cycle of poverty connected to medical care.

With their hesitance about hospital I suggested to Rav that I visit his mother.  That night at dusk, after a half hour tuk tuk drive to the edge of town, I arrived at her tiny rented room.  Rav’s two sisters with their partners and children, his mother, and he with his brood were all apparently occupying this tiny space.  Perhaps another reason that Rav doesn’t make regular visits to the family?  Lying on a bamboo mat on the floor, his mother sat up while I found a space to sit beside her.  With Rav’s translation she proceeded to give a very clear description of sciatic pain radiating from her right buttock into her groin and down the back of her right leg, with some lesser pain in the left leg.  Astoundingly I had just been discussing sciatica with a family member who had been given a low dose of Amitryptilline which alleviated their pain almost immediately.  With the assistance of a physician friend I was able to recommend the medication.  Darkness enveloped us and Rav suggested that I needed to go, as though he was concerned about my safety in his overcrowded little laneway.  The assumption of people like Rav, is that they have nothing to offer when in fact, their small acts of caring and of sharing their lives have a big impact.  It is amazing to me, to be so warmly welcomed into the homes and lives of people living so differently from me.

With many thank yous and goodbyes, the tuk tuk wended down the dirt lane and out onto the main boulevards towards home.  Phnom Penh’s outer suburbs at night are an experience unlike the Phnom Penh expat night life where well lit pavements are lively and fun but removed from the grime, congestion and poverty which most expats, despite living in this city, are far removed from.  Elsewhere in the same city, public squares are unlit and dirt-floored, chickens saunter through crowds as their cousins rotate on spits, open fires grill all sorts of meat, you inhale a fluctuating mix of barbecue smoke and exhaust fumes, markets heave with people, motos and the beat of popular music and traffic regularly grinds to a halt.

Traveling through these bustling, dimly lit neighbourhoods I pondered, as always, on the difference between my privileged and egocentric experience of the world, which comes with it’s own set of complicated disadvantages, and the world as it is experienced by most humans.  The more I see my birth entitlements, the more I see that others are no less deserving than me and that my so-called successes were really more a matter-of-course related to my privilege, than indications of real success.

Success in Life 02

Thoughts from Alice Springs

For thirteen days in Cambodia I was very busy.  I visited the MSF project I will be working on from February, a similar public health program as I currently work on here in Australia but with many more issues to contend with.  No doubt I will blog on that as and when I become involved.  My old translator picked me up on the back of his moto and took me out for dinner one night in Phnom Penh, after which we picked up his tiny son from English school.  I visited a number of other colleagues, some of whom I will be lucky enough to work with again next year; some of whom remain unemployed since the previous MSF project closed; and some of whom are working elsewhere.  All of whom treated me with generosity and hospitality that I know involved effort and sacrifice.

As usual, I grappled with my own existential issues constantly as I lived in nice hotels, ate good food, sipped wine, and had no discomfort (with the exception of humidity-and-afro-wings), whilst surrounded by fellow humans who have nothing like the luck I happened to be born into.  Phnom Penh, where I will be based at least some of the time, is busy, noisy, crowded, disorganised, with roads that turn into lakes.  Sitting in the back of a tuk tuk ploughing through deep brown puddles and afraid we might tip over, we passed children walking knee-high through the same muddy quagmires.

I told a Cambodian friend that I once found the traffic sights in his country very funny, for example, the people who sit on roofs of vans and trucks, or travel in/on overcrowded vehicles, but that I have realised it is not really funny because it means they are poor?  He replied “yes it is not so funny because they have no choice, it is the only way that they can travel”.

It’s easy to claim that indigenous people “have it lucky” compared to places like Cambodia, where hunger and destitution are inescapable.  Khmer people are on Khmer land, dominated by Khmer language and culture.  Being a visibly and culturally different minority in a place where the dominant population rule over you, own the land, own the systems, language and culture, can make for a highly diminishing existence, irrespective of the wealth of the nation you live in.

Yesterday morning Mathew’s sister and her two young children came with me to visit Matthew at our local jail.  As they talked together in language I reminisced about the time we spent together ten years ago.  In the space of eight months both of their parents were killed in violent situations.  Matthew was 11yo and his sister, witness to her father’s stabbing, was 13. That was, for me, only the beginning of what followed.  For the first time in my life I was exposed to issues around family and community obligations that don’t exist in my culture, chaos and overcrowding that are rare to my experience and understanding of the world.  Foreign child rearing practices, family disruption and an incompetent departmental response to orphaned children all became new and unfamiliar territories that I unexpectedly had to navigate, sometimes without even knowing so.  I was suddenly exposed to the effects of drug abuse, domestic violence and sexual assault, attended criminal court proceedings, stood up to inept social workers,  spoke out to prosecutors and magistrates, and most significantly, became an unintended foster parent to a child who foisted himself upon me when the system failed him dismally.

It is no surprise to me at all, that these two siblings, who were so forsaken, yet resilient and independent, now have struggles as young adults that someone with my privilege in life can only imagine.  There-but-for-the-grace-of-fortune-go-I could be my life’s motto, whether I think of Cambodia, East Timor, Central Australia, or many other places and situations.

My flight home out of Phnom Penh departed at 5pm.  That morning Samantha and Chom, two of my best friends in Cambodia, joined me in the luxurious foyer of my hotel where we sat on red cushions underneath ceiling fans surrounded by green gardens, marble floors, tropical timber ceilings and a pool beside the open air restaurant.  They were visibly dazzled by the lavish setting and shocked by the menu prices (about $7pp, per meal).  Samantha brought her two children.  She expected 3yo “Adam”, severely incapacitated by his terminal genetic neurological condition, to be irritable and unhappy away from home.  Instead he lay silently for hours, settled and comfortable.  The hotel staff spoke to us at length with a lot of questions about and interest in Adam.  When I went to pay for lunch they gave me a 10% discount.  Upon asking why, I was informed “because you look after Khmer people, you are our special guest”.  Again Cambodia, with the generosity and kindness!

We Can Survive Another Day

When you get as old as me everyone starts to look young.  Over 50% of the Cambodian population are under the age of 24 years old.  Coming from a country where 40% of the population are over 50 years old, it is no wonder that I spend my life wondering why I’m surrounded by twelve year olds.  These are typical demographic differences between the rich and the poor world.

The American hospital have agreed to cover the costs of Paula’s charity care!  Now we are at the nitty gritty stage – where will she stay during her convalescence, is there a Cham community who we might connect them with, how can we provide a guarantee to the hospital that they won’t be held responsible for any non-treatment expenses.  Once these details are nutted out we will move to the passport/visa stage.  It continues to seem as though she could be looking at an unexpectedly hopeful future.  Although life is dicey in her frail and vulnerable state – yesterday she attended an appointment in town but was dizzy and unwell and had to leave quickly to get home and lie down.  Anything could happen before she reaches the treatment which could save her.

Yesterday morning Chaz and I ate breakfast together.  As we finished off our eggs he said “we can survive another day now”.  I assumed he was referring to our attending another work meeting and muttered something about how we’ll be done by lunchtime.  He realised my confusion and said “In Cambodia this is what we always say to each other.  We ate a meal so now we can survive another day.  Tomorrow we will look for more food”.  Not a phrase my food-overloaded perspective could have understood without his translation!  We attended our final meeting at a city based organisation before he headed home on the midday bus in time for work today.  The tuk tuk dropped him off at the bus before delivering me to my hairdresser.  Only the salon was locked up.  So I popped into the cafe over the road and asked the waiter if said hairdresser (who I haven’t been to in almost a year) was still there.  The answer, “Yes!  But he open at 10 o’clock.  But now is 11 o’clock.  Because last night he was too much party”.  Hmmm…. perhaps not the best day to have my hair done?  I sat in the cafe for a couple of hours hoping he might show, before deciding to try again today.

Last night I arranged to meet up with Dara’s parents who I’ll call Rita and Nathan.  They are now working on a large building site in Phnom Penh.  Dara was recently in town for a hospital appointment about his leg, but has since returned home to his grandparents’ village.  As I walked out of the hotel, at the corner 100 metres away a young guy in a red t-shirt appeared, raised both arms into the sky as though he was surrendering to an army, and shouted “Tuk tuk Madame?”.  While I focussed on ignoring him, he disappeared around the corner.  A few seconds later he reappeared, chugging towards me in his tuk tuk, beaming a bright smile.  We negotiated a deal including to wait for me at my destination and bring me home.  I rang Rita’s number and he spoke to her for directions, before putting out into the harmoniously unharmonised traffic of this city of extreme contradictions.  Wealth mingles with poverty, designer motorbikes burn past hand pulled trash carts, guards walk into the middle of busy roads and blow whistles at oncoming traffic to give right of way to massive SUVs, beggars bow their heads humbly at patrons in expensive restaurants hoping to scrounge enough to buy a morsel with.  This city is a microcosm of everything that is wrong in today’s world.  As many battle to survive, others battle to make a dent in the injustices, while a few powerful individuals appear to have lost their hearts in favour of their egos.

Last week an Italian tourist sat with me at wine o’clock and bored me to tears about the destruction he believes immigrants are wreaking on Europe.  I listened in silence, wondering at the mentality of such thinking as he droned on about having been in the military and where he’s travelled etc.  Chai, the blind amputee, arrived on his nightly rounds and Chom joined us to have a quick talk with him about 2 metres from where Mister Italy was sitting.  I returned to my seat and without so much as drawing a breath, he returned to his monologue about himself.  There is no point arguing with an ego I will never see again, so I sat silently and thought about just how much he had in common with Chai, who sustained his injuries as a soldier at a time when they would have both been in their respective military jobs.  But being poor, foreign and visibly disabled, Chai was immediately beneath Mister Italy to even warrant a mention of interest.  His loss in my view!

As we approached the general vicinity of Rita and Nathan’s abode, a tall construction site came into view and Tuk Tuk Madame (TTM) spoke to them again.  For a surprisingly long period of time.  When he finally handed my phone back he explained that Rita was not able to tell him her location and had taken the phone to Nathan, who had a better idea.  Neither of them were able to give clear directions, which I explained was because they moved to Phnom Penh for work about a month ago, they are not from the city and do not read or write.  Nevertheless, we found ourselves on the right road and a young man who I recognised as Rita’s young brother, waved us down.  I’ll call him Phil.  He was standing beside the pitted bitumen track over the road from a multi-storey construction site with an older man who also seemed to recognise me, I guess because I only ever saw him from underneath his krama as he worked along the riverside in Kampong Cham.

The construction site over the road from us was alive with workers milling in and out under dim lights.  Thankfully, noone appeared to be working on the upper levels of the building framework.  On our side of the road a tall, makeshift fence of corrugated sheets obstructed the view of the corner block.  An opening between two of the iron sheets provided an entranceway through which workers were coming and going, obviously in and out from some sort of living quarters.  Via TTM the men said Rita was “at the bathroom”, so we waited for a while before TTM said “You can go in there if you want, but they said it is very dirty”.  No problem.  I followed them in through the opening, Phil lighting our way with his mobile phone.  A long muddy path was laid with wooden planks acting as bridges over the soggiest patches.  About halfway along Rita appeared, her hair wet, hugging me as she motioned that she had rushed home from work and washed as quickly as she could.

At the end of the path I entered another Shackville, only this temporary city of squalor, obviously housing hundreds, made Kampong Cham’s Shackville look positively swank.  Men and women wrapped in kramars were bathing at an open air communal “bathroom”, consisting of wooden platforms over the mud, large rainwater tubs and hand held plastic pots.  Below is the closest photograph I can find on the internet to show how people bathe at these open air public water supplies.

Cambodian bath

Past the “bathroom”, the “housing” began.  A busy estate of makeshift shacks made from various combinations of tin, plywood, wood and anything else that can provide shelter and privacy, all raised one high step above the muddy ground.  I was guided into an area underneath a large tin-roofed structure similar to, although much longer than, the open-air shed-like frame in the photograph below (sourced from the internet).  Instead of housing park benches, the shelter has been converted into many dozens of cubicles divided by thin walls of plywood, plastic sheeting and tin.  A muddy path runs through the length of the structure, like a tiny street dividing it down the centre.  On either side we passed many doorways opening into cubicles of about 2 metres squared with walls ending about halfway to the tin roof.  About halfway along we climbed into the little cubicle where Rita and Nathan now live.  A television blared in one corner, a rice cooker sat beside it and above us a square plank of wood balanced on the edges of the walls, taking up half of the overhead space just above head-height, used as a storage shelf.  They sleep on the plywood platform floor a step above the dirt.  In the dark I could not see beyond the dimly lit cubicle we sat in, to tell where the electricity was sourced from but I doubt it’s permanent or safe.

tin roof shelter

Nathan joined us for a while before returning to a group of men perched on a wooden log near the door just outside from us.  He reached up to the overhead shelf and pulled out Dara’s hospital appointment card and leg x-rays, pre-and-post his operation, to show me.  Phil and another young man sat in the doorway with their eyes glued to the television, listening in on our conversation occasionally.  A young woman joined us from one of the nearby cubicles, beaming at me and saying something I didn’t understand.  Eventually I rang Chom to get some translations of the conversation and it turned out the young woman was saying “I came to meet you because I never met a foreigner who can speak Khmer”.  Funny that, given that I had no idea what she was saying because I DON’T speak Khmer!

At one point they were talking about their work, climbing a ladder onto the multi-storey building frame and I was horrified at the image of them all those storeys up with no safety equipment to protect them.  I made a stupid joke with my hands, showing someone falling from a height and landing on the ground below.  They laughed but with a certain awkwardness.  Rita showed me her calloused hands and nodded when I asked if she wears her thongs up the ladder.  Later in the night I learned that so far, three people have plummeted to their deaths from this one construction site alone.  Part of my shock included the bad taste of joking about such a thing when I should have known better.  They earn $5 per day for their efforts – 7am until 6pm, seven days a week.  A friend in Kampong Cham tells me that “some offical people” use very bad words “against poor people”, calling them names which are “not even fit for humans”.  It’s difficult to grasp where such mentality comes from but seems to be a common human phenomenon to value human beings based on their status in society.

While he was on the phone I asked Chom to check if Rita wanted to come and eat something with me and her reply “Dov!  Dov!  Dov!” translated as “she really really REALLY want”.  Nathan stayed behind to watch over their cubicle of possessions which are safe during the day when most people are working, but more vulnerable at night to theft.  Phil came with us.  Walking out through the mud tracks, I was surprised to see young children and babies living in this workers’ slum and wondered many things, from how they manage to look so clean in such dire living conditions, to if and how they get their vaccinations.  A public health nurse would have a field day providing basic services to these people!

We reached the street and TTM jumped to attention.  I climbed aboard but Rita and Phil waited in the distance until I waved them over.  Giggling and whispering to each other, it became apparent that going to a restaurant in a tuk tuk was some sort of treat.  I assumed they would lead us to a nearby restaurant but when TTM asked where we were going they said they did not know any restaurants.  They eat rice out of the rice cooker in their cubicle for every meal and do not go out to restaurants.  I wonder if they have anything with their rice?  We did a u-turn and a couple of blocks away found a local corner restaurant to eat at.  TTM asked “It’s okay for you to eat this food?”.  Yes, no problem!  TTM sat on his tuk tuk waiting and we went in.  None of us able to read Khmer, I pointed to the only photographs on the menu and ordered – frog, pork, quail and rice.  Followed by an inward sigh of relief when they said they were out of frog!  We shared a happy, broken-Khmer meal together before dropping them back at Slumville.

The trip home was filled with contemplations and a very enjoyable chat with TTM, about many things including his baby son (“I VERY love him!”), the state of inequality in Cambodia between the super rich minority and super poor majority, his aspirations for a decent future, etc.  I returned to my boutique garden hotel with it’s private pool, ordered a red wine and spent the rest of my evening trying to come to terms with this world of haves and have-nots.  My sleep was disturbed by nightmares of Rita plummeting to her death after I made that stupid-stupid joke.

Worlds With, Worlds Without, Worlds Apart

Despite having worked with Tuberculosis for many years now, my world is very largely without Tuberculosis courtesy of the luck which I was born into.  TB exists in Australia at an annual rate of between 5 and 6 cases for every 100,000 people.  In 2013 Australia, with a population over 23,000, notified 1,256 cases of Tuberculosis.  Many, though not all, of these occur in immigrants from high prevalence countries.

For over a year now, I’ve been living and working in Cambodia which is mostly a country of “withouts”.  In reference to TB, the tables turn and it becomes a country of “withs”.  The annual rate per 100,000 people is 715, which translated in 2013 to over 39,000 cases for a population of slightly more than 15 million people.

Before leaving Kampong Cham one recent Sunday, Bea, one of the doctors and I were out on a bike ride through the rural villages.  En route home we visited the young girl whose father had reported his concerns to me over his daughter’s regular migraines which have not resolved after some years.  During the informal clinical assessment he presented us with her health documents, which included a TB treatment card showing she was diagnosed and treated last year via her local village health centre.  Finding someone in Australia who was ever treated for TB, let alone in such recent times, whilst out and about on other matters, would be an incredibly rare find indeed.  Here, it is par for the course.  This is a practical example of the difference between TB rates in the two very different countries.

Today, 24 March 2015, is the 20th anniversary of World TB Day which was initiated in 1995 by World Health Organisation and has been recognised annually ever since.  Needless to say, Cambodia and countless other places have been alive with TB health promotion activities.  Teams were in market places and on the streets, delivering messages related to this year’s theme, of reaching the estimated 3 million people thought to contract TB disease each year without ever being diagnosed or treated.  This theme was started last year, and continued this year to promote it’s significance.

My old team have apparently had a fun day, out and about at various locations spreading the message about TB.  I was highly amused to find a photograph on Facebook of Chom, my tuk tuk friend, standing in this year’s green t-shirt alongside a dozen or more of my old team, at my old office!  His services were recruited to hang one of the canvas banners from his tuk tuk, with a loudspeaker attached to his roof, playing messages about TB as he putted his way through town all day.  That’s a solid day’s work for someone usually reliant on the rather unreliable tourist population, in competition with any number of other tuk tuk drivers.  About three years ago his father in law, Microphone’s grandfather, died of TB.  Another example of the fact that in Cambodia you don’t have to look far, to find connections with TB.

TB Day 2015

Cheung Prey TB Day pic

Cheung Prey World TB Day

In 1993 the United Nations instigated the first annual World Water Day, which is now held on 22 March every year.  On Sunday organisations throughout the world promoted messages about water and sustainability.  Thankfully I had already left Kampong Cham when their water supply shut down, which occurred sometime last week, continued over the weekend including throughout World Water Day, and remains in progress as I type.  Some areas are now into their second week of having no water at all.  None of MSF’s staff have access to running water, all are bathing by hurling pots of water over themselves from remaining tank water which is also running dangerously low.  Apparently it is a very uncomfortable state of affairs.  I left town at the exact right time!

MSF is currently supplying the hospital with two truckloads of water each day to keep things operational until the town supply is recitified.  This will probably be done by pumping river water directly into the town wells as a temporary measure.  A combination of no rain for months and high temperatures causing rapid evaporation has caused the town’s well water to dry up.  Locals report spending $2.50 per day on bottled water just to survive.  This is unaffordable to many if not most and no doubt contributing to the overburden of illness which already exists.  Many, such as Dara and the others in Shackville, are unaffected because they already live without proper access to water.  Shackville’s water supply is a homemade pipe system made by Dara’s father and colleagues, which extends from the Mekong, up the bank, over the road, and down into the concrete tubs sitting outside their tin shacks.  Every evening during the sunset traffic cruise which brings Kampong Cham alive, thousands of bicycles and motos drive over these pipes, which are protected by strips of wood placed parallel against the hoses as they pass over the bitumen.  Vehicles make contact with the wood sitting alongside the hoses, rather than the hoses, keeping them from traffic damage.

The point of recognition days such as World Water Day and World TB Day is to raise public awareness of their respective issues.  For those of us from the wealthy world it is extremely easy to incorrectly think that neither of these subjects pose a risk to us.  As an example, a very commonly held myth in Australia and New Zealand is that “TB was eradicated”.  For those in the poor world, promotion of accurate messages about both issues is a difficult and complicated thing to achieve.  Low literacy, stressful living conditions, mixed messages and priorities related to immediate survival make the delivery and processing of messages convoluted and difficult.  This is hardly surprising given the low levels of informed opinion which exist in the developed world.

On Thursday I’m leaving Phnom Penh for some time to visit friends and travel in Europe.  My excitement is tinged with flashes of the young blind woman in her remote village, who has fallen out of two elevated houses already.  When I return later in the year, the Mekong will be flooded and there will be no way of visiting her.  During recent visits to Dara in hospital I’ve met a number of other patients including a 12yo boy who is currently hospitalised with a deformed arm, which he broke falling out of his house.  This seems to be a common phenomenon in a country which requires houses to be elevated for the flood season.  It is connected to another common phenomenon – drowning.  Last year at a work conference held at a resort I had a really fun time swimming with my Khmer colleagues.  Young and fit, none of them swam as fast as me, which was clearly related to the fact that I received training as a child and have a proper swim stroke.  One of my colleagues asked me if I had taken swim lessons as a child and when I replied affirmatively he said “we don’t have swim clubs in Cambodia.  In Cambodia, if we don’t swim we drown”.

Yesterday I picked up Dara and his mother in a tuk tuk I negotiated for the day and we traveled to the city, spending about seven hours sightseeing together.  Mum, who cannot recharge her mobile phone because it requires reading numbers and instructions, had her phone in her hand all day and took more photographs than me!  She pointed to Phnom Penh’s tallest skyscraper (there are only two) and explained that she had been a construction worker on this site some years before Dara was born.  I took some photographs of her with this building in the background.  Below is a photograph of the same skyscraper, taken from a friend’s apartment a couple of weeks ago, with a construction worker on another site, in the foreground of this city landmark.  Clearly being a sightseer instead of a worker in the city, was a remarkable and new experience for her and it was special to share this time with her.  Inside the Royal Palace grounds I joked that I was staying in one of the fancy apartments across the manicured gardens from the Silver Pagoda.  She believed me!  Which is very similar to the perceptions that my Central Australian indigenous friends have of “whitefellas”, who they seem to imagine have no limits either financially, nor regarding possible high-falluting connections.

As we walked through the Royal Palace yesterday, Dara hopped along on his crutches with his one leg and I pondered about Tuberculosis, drowning, unsafe water, falling, traffic accidents, landmines, disease and all the other “withs” which accompany Cambodian life.  While I flit off to the other side of the world at great expense, the only “withs” in my life being privilege and advantage, what delights will Dara and so many others I know and love, face during (but regardless of) my absence?  Why do I get so much while others get so little?  As an MSF colleague who is currently in Sierra Leone on an Ebola assignment says, we have to make the most of our privilege whilst at the same time helping those who weren’t born into our extremely fortunate circumstances.  The problem for me is finding a balance between decadence in my favour and basic assistance in others’ favour.  I want to enjoy the decadence my lifestyle affords me but forevermore it will be tinged with flashes of Dara, the blind lady, Kim in Siem Reap and his extreme struggles, and so many others who cannot even imagine the “withs” in my life and their opposite connotations to the “withs” in a world that is “without”.  Life is certainly not black and white and I hope that upon return to Australia I can retain the insight I have developed of my infinite advantages in life.

Phnom Penh Construction Worker

Construction in the foreground of what are currently Phnom Penh’s only two skyscrapers.

 

Fifty Ways to Leave Your Lover

The problem is all inside your head, she said to me
The answer is easy, if you take it logically
I’d like to help you in your struggle to be free
There must be 50 ways to leave your lover

~  Paul Simon

The market town of Skun in Kampong Cham province, Cambodia, is one of my all-time favourite places in the world.  It has absolutely nothing going for it.  Unless you like busy, overcrowded third world markets filled with unfamiliar smells and fresh produce, including fish still wriggling in a struggle for life.  Or eating at open air restaurants where pots sit atop flames contained by circular stones and meals cost 75c per person.  Or watching mini vans packed so full that the frame sinks precariously close to the ground, with people on the roof and fare spilling out of the roped-open back door.  Or you like to marvel at plates overbrimming with fried tarantula, fried cricket, fried red ant, fried water beetle, fried cockroach and various other fried-exotic-insect-species, sometimes carried on the head of their vendor.  Or maybe to walk through puddles of brown sludge which sit stagnant for weeks on end after the slightest rain.  Or to see fluorescent green rice paddies dotted with tall coconut trees and white oxen.  Or breathe more dust in a day than you cumulatively breathed before in your life.  With so much character, I guess it’s not surprising that this is the place where some of my most fun, hilarious and adventurous experiences seem to have taken place.

Leaving Kampong Cham was one of the hardest things to do, made easier by the fact that I will return later in the year and by the drawcard of another dance party in the red dirt of Skun, which was my first overnight stop.  MSF will leave Skun soon and a few nights ago held their program-closing party.  As expected, the Khmer team floated like angels around the dedicated pot plant placed centrally in the dirt area of the front yard nominated as the night’s dance floor.  While their arms gracefully flowed in rhythm with their buoyant bodies, we clumsy expats followed in our dust-soaked thongs, “freestyling” in pursuit of the impossibly graceful and synchronised moves of our national colleagues.   We also drank beer poured around huge blocks of ice which allowed one can to be shared amongst many plastic cups, laughed, gossiped, eyed off the gorgeous 20-something dude coordinating the sound system, and ate a delicious buffet Khmer meal of spicy salads, soups and noodles.  The neighbours seemed to know when the formalities were over, appearing in their floral pyjamas and party moods carrying plates of fried duck and pork, cans of Angkor beer and plastic bags filled with ice.  The “duck killer” and “pig killer” were identified amidst shocked laughter.

One young man half-danced-half-limped through the gate, seemingly already intoxicated until we learned he was lame from a moto accident, introducing himself to Bea as though he already knew her.  To my query about how she knew him she replied “I don’t”.  He sat down making a concerted effort to talk with her via translations from national staff sitting nearby.  He then limped away, returning a few moments later with a large watermelon which he presented to her with a short speech about how grateful he was to her for coming to his country to help his people and an apology that he had nothing else to give to her.  It seems he has watched her walking to and from the market, past his house, many times.  I suggested that after living for a year as the only foreigner in this remote town, she is probably known by many who she thinks she’s never seen before.

The following morning I turned up at the bus station, headed for Phnom Penh.  After my last visit to a bus station in Skun, I was wary and so I decided to go with another bus company.  A few days earlier Chom said he’d call and book a ticket for me.  He appeared to do so.  When he hung up from this call he told me that “if you know the place on the road where they can pick you up, that is good”.  I said I knew it and tried to describe the area.  He said that I should give him the name.  I didn’t know the name.  Then we had other things to talk about and changed the subject.  From Skun I called to ask if he’d booked my ticket?  “No because you didn’t know the name of the place to pick you up and they said you can get it at the restaurant in Skun”.  Okay, no problem.

A tuk tuk parked at the front door on what had been a packed dance floor a few short hours earlier.  My bags were piled into the cab, I climbed in beside them, and off we putted.  Pulling into the bus station I asked Tuk Tuk Madame to wait while I bought a ticket.  Well, that’s what I thought I was saying.  Apparently what I actually said was, can you come with me to buy a ticket.  The ticket seller, identified by the fat wad of tiny-value notes in his hand, turned as TTM spoke to him and pointed towards the road.  We followed his finger and watched as the bus drove right on by.  Amidst a blurry haze of dust, malnourished beggars and Khmer conversation with strangers, someone said “Phnom Penh?”.  Yes.  A finger pointed at a car parked in front of the tuk tuk and Khmer riel was translated to “five dollar” in English.  Done deal!

My bags were loaded off the tuk tuk and heaved into the back of this new-ish SUV.  Treading in foreign waters I watched the driver closely.  He leaned into his door to switch the ignition on.  An elderly man appeared from the restaurant and climbed into the front passenger seat.  The driver opened the back door and motioned me in.  I sat beside the window, smiled at the young man seated beside the opposite window, and reached for my seatbelt.  The driver, holding my door open, seemed to say that I shouldn’t use the seatbelt.  Soon enough I shuffled over to allow two more passengers in.  Four people across a seat built for three is very mild by Cambodian standards.  I texted Bea to let her know I was in a car with five other people.  A moment or two later I texted her again, correcting my mistake.  There were six of us.  My western brain was slow to recognise the extra passenger.  The driver’s head was positioned excessively central to the car and he was reaching in a twisted position for the steering wheel.  Wondering why, it took a few moments to notice the second head, belonging to a body positioned on his seat, between him and his door!

A two hour lumbering bus ride from Skun, we made it to Phnom Penh in just on an hour.  Approaching Central Market the usual array of moto drivers surrounded the moving car, peering in one window at the passengers, then manouevering through traffic around to the other side, peering in from another angle to select their preferred customer.  This seems to take place at all bus stops, with a coordinated tag system between moto drivers and tuk tuks.  When buses pull into the smaller market towns, moto drivers literally run to the door of the bus in an apparent race, with the first to touch the bus having first dibs on their choice of passenger.  At the bigger stations a more sophisticated “Hello Madame” approach is employed, with a line-up of offers from motos, tuk tuk drivers and placard-holding hotel reps.  It’s an experience we don’t face in wealthy countries, where we telephone taxis or approach them in their orderly queues, with meters calculating the fare.  In my culture, this passenger and fare bartering process is non existent which explains why until recenty, I found it so stressful and dreaded arriving anywhere.  I now see that it’s an informally well-coordinated system between people who have no other income source, no pension, no paid holidays and who rely on the cash in hand from this work to feed themselves and their families.  Perhaps the sense of desperation was the source of my stress because now that I am consciously aware of what’s going on, my stress levels have dissipated.

Saying goodbye to Kampong Cham the previous day was a mixed experience of excitement and sorrow.  Drama at Phter Koma with a misbehaving teenager stole my final morning from me, but proved an interesting problem-solving experience reminiscent of times with the misbehaving Mathew a few short years ago.  My boxes and bags disappeared from my room in a single convoy down the stairs and out the door, courtesy of the typical Khmer team approach.  The number of jobs in need of hands always equals the number of hands that seem to materialise from nowhere.  Chom’s tuk tuk was transformed from empty to piled high in the space of two minutes.  A row of young staff waved us off with promises to “wait for you”, referring to my planned return.

A few detours through town included a stop at the second hand bicycle shop where Chom chose a small bike for Microphone as my way of thanking him for his help over the months.  In the crowded aisle between hundreds of bikes, two young men worked simultaneously.  One removed training wheels from a nearby bike and attached them to the back wheel while another attached a basket to the handlebars.  The tyres were pumped and the bike was squeezed into the tuk tuk atop my gear.  We delivered everything to Chom’s house, farewelling a confused Microphone who woke to the image of Dad wheeling a bike towards him after months of discussion about why he can’t have a bike yet.  During more farewells, my bags were heaved between one MSF car and another amid discussions about how many staff were coming, requiring which vehicle.  Soon enough we piled into the troupee and made our way south to Skun.

Anticipations of the party and knowing that I will be back in about five months helped my departure out of town, but saying goodbye is never easy.  Now in Phnom Penh, Bea is joining me tonight for a final weekend before we both leave the country.  Other friends are or will be here and Dara, who I farewelled at Shackville on Monday as he boarded a moto with Mum to travel to the Children’s Surgical Centre at the National Rehabilitation Centre in Kien Khleang, is a tuk tuk ride away.  His amputated bone was surgically shortened two days ago and he should have a few years now, free of complications from the bone until it grows through the stump again.

Wooden slat beds are lined up in rooms housing adults and children together, all of whom have had some form of surgery in recent days.  Babies and young children in visible/audible pain, some with deformities, cry intermittently while bandaged adults lie quietly.  All are tended to by at least one family member, sharing the crowded beds under squeaking ceiling fans revolving at various speeds depending on their level of disrepair.  I did not see a nurse or any equipment during my hour-long visit yesterday.  The best on offer post-operatively for anyone in Cambodia is an intravenous line for fluids and some oral pain relief, unless you can afford to purchase the very rare supplies of parenteral analgesia, which most cannot.  Dara was unhappy but his “need” for a new balloon was satisfied by the loan of my iPhone to watch music videos, so he’s okay.  Mum appeared to explain that the money I’d given her to cover food and transport for the duration of this hospital stay was already spent, apparently during a single visit to the market!  I didn’t plan that assistance well – it’s a lot of money to give an illiterate rural villager visiting a city without anyone to guide and advise her.  Today I’m visiting again with a friend so will get more detail and try to ensure they can eat for the remainder of their time here.

All of this appears to be my final days in Cambodia for the next five months.  As yet I have no onward travel plans or bookings.  The Hot Season is upon us, my visa is about to expire and MSF have been unsuccessful in matching me to an assignment thanks to my limited availabiity.  This once-in-a-lifetime year-long holiday has been years in the making and resisting all temptation, I must not spend it’s entirety hanging out in Cambodia.  Many options are floating around in my head, amidst the hunger and need and all the small differences I could make if I wasn’t leaving.  Travel is not as interesting or exciting to me now, as the rewards I can reap by being in Cambodia.  But I will leave Cambodia because I feel I must, at least for a short time.  When, how and where to remains to be seen.