Pessimism and Privilege

Pessimism and Privilege

Partners in Health was formed by Dr Paul Farmer and some peers including Roald Dahl’s daughter Ophelia, in the late 1980s after Farmer became determined to make a difference to the people he met in Haiti as a medical student.

The success of Partners in Health in places as far flung as Haiti, Russia and Rwanda, is proof that optimism combined with love, focus and action, makes incredible difference.

Global health statistics available through many organisations such as The Gates Foundation and UNICEF confirm that to be on the right side of history, you really need to take an optimistic and informed view of what is actually happening in this era of progress.

The same can be said for indigenous health here in Australia.  When a colleague said recently “what is the point of what we do because nothing is changing”, I was surprised and a little disturbed, as I pondered on the information available to us through many sources that in fact, as difficult as things continue to be, strides of improvement are well documented, well known and deserve to be celebrated.

If you’re privileged enough to express pessimism about the point of helping others, you’re privileged enough to access the plethora of information that justifies optimism.

This I Believe – Dr Paul Farmer:

I believe that health care is a human right.

I have worked as a doctor in many places and I have seen where to be poor means to be bereft of rights.

I saw early on, still just a medical student, the panicky dead-end faced by so many of the destitute sick.  A young woman dying in childbirth.  A child writhing in the spasms of a terrible disease for which a vaccine has existed for more than a century.  A friend whose guts were irreparably shredded by bacteria from impure water.  An 8 year old caught in crossfire.

“What a stupid death”, goes one Haitian response.

Fighting such stupid deaths is never the work of one, or even of a small group.  I’ve had the privilege of joining many others providing medical care to people who would otherwise not be able to get it.  The number of those eager to serve is impressive and so is the amount that can be accomplished.

I believe that stupid deaths can be averted.  We’ve done it again and again.  But this hard and painful work has never yet been an urgent, global priority.  The fight for health as a human right, a fight with real promise, has so far been plagued by failures.

Failure because we’re chronically short of resources.

Failure because we’re too often at the mercy of those with the power and money to decide the fates of hundreds of millions.

Failure because ill health, as we’ve learned again and again, is more often than not, a symptom of poverty and violence and inequality.  And we do little to fight those when we provide just vaccines, or only treatment for one disease or another.

Every premature death, and there are millions of these each year, should be considered a rebuke. 

I know it’s not enough to attend only to the immediate needs of the patient in front of me.  We must also call attention to the failures and inadequacy of our own best efforts.  The goal of preventing human suffering must be linked to the task of bringing others, many others, into a movement for basic rights.

The most vulnerable; those whose rights are trampled; those rarely invited to summarise their convictions for a radio audience, still believe in human rights, in spite of or perhaps because of, their own troubles.

Seeing this in Haiti and elsewhere has moved me deeply and taught me a great deal.  I move uneasily between the obligation to intervene and the troubling knowledge that much of the work we do, praised as humanitarian or charitable, does not always lead us closer to our goal.  That goal is nothing less than the refashioning of our world into one in which noone starves, drinks impure water, lives in fear of the powerful and violent, or dies ill and unattended.

Of course such a world is a utopia and most of us know that we live in a dystopia.  But all of us carry somewhere within us, the belief that moving away from dystopia moves us towards something better and more humane.

I still believe this.

 

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My Privilege

This working week while visiting Baby 1 at his home, it transpired that another baby (Baby 2) who I had been looking for without success, was known to Baby 1’s family.  When I explained that I’d been reliably informed that Baby 2 is not in town, Mum 1 argued with me.  Amusingly in hindsight, I argued back a few times before Mum 1 suggested that she take me to Baby 2.  With the baby seat sorted, Baby 1 excitedly let me strap him in, his long black eyelashes open wide, laughing excitedly when the car started to move as Mum explained to me “He really love to cruise around”!  We drove through town, onto and along a dirt track, up a hillside through scrub and over dry rocky streams.

Above town, sitting in the dirt near an open fire beside a group of rusty tin sheds with doors but no windows, I finally met Baby 2 and her mother.  I never would have located them without Mum 1’s generous guidance.  With children running about our ankles, Mum 2 explained why she could not come with me immediately as other Mums asked did I also need to see their children?  There is no electricity and no water supply at these tin sheds they call home, and Mum 2 needed to visit a shelter in town to shower first.  This year I am working in Australia, not in Cambodia, in case this story is disorienting.

Working with indigenous people has always been an honour to me, for a number of reasons including the generosity I regularly encounter despite such marginalisation and hardship; and working with another culture where values of sharing and participation quite foreign to my own dominate strongly.  It is not too far removed from similar experiences in Cambodia.

These experiences never fail to remind me of my own privileges and how important it is to me, to use my privilege in useful ways.  Recently someone suggested to me that actually my life has not been very privileged and I shouldn’t suggest that it has been.  But referring to my privilege does not mean I am unrealistically optimistic.  I belong to the working class and grew up with various challenges that will always walk with me.  Yet compared to many, I do have privileges, that I recognise and appreciate.

Jerin Arifa is a young Bangladeshi woman described in one website as “an award winning trailblazer in women’s rights”.  Now an American citizen, she grew up in Bangladesh where her activism began in childhood.  Amidst protests from neighbours who profited from cheap child labor, Jerin and some other young people taught reading and writing to homeless youth in a park.  I can’t find how or why she made her way to America but she was an undocumented immigrant for some years, during which time she won a number of impressive academic awards.

A few years ago I first heard the term “intersectionality”.  Today I heard Jerin Arifa speak on the subject in simple and easily-understood terms.  Working with other cultures and societies, I often reflect on the social injustices I witness and am even a part of because of the systems that I belong to.  Hearing Erin speak today, intersectionality seems an articulate and essential philosophy to share.  It describes the ways in which oppressive attitudes and systems of power such as xenophobia, sexism and homophobia are inextricably linked.

Intersectionality has its roots in the feminist movement.  When the suffragettes fought for equal political rights, black women (in fact, black people), were not represented.  As one example, women in South Australia gained the right to vote in 1895, yet indigenous Australians only earned the right to vote in 1962.  Historically, intersectionality disputed the idea that gender is the only thing to determine a woman’s fate in male dominated society.  For example, women of colour, different religion, different sexual orientation, living in poverty or with disability, are not represented by the same inequalities that white women living in the mainstream middle class may experience.  The philosophy has since evolved to include inequalities and injustices beyond only those endured by women.

Jerin Arifa talks about the issue eloquently in this four minute video.

Jerin Arifa Talks Privilege and Justice

Every Time I Go On A Plane

Kung Future is a tiny NGO working in Phnom Penh off the smell of an oily rag, with landless Cham people who live on their boats at the conflux of the Mekong and Tonle Sap rivers.  This week Kung Future reported the death of a two year old boy who fell off the boat he was living on and disappeared, despite the efforts of many who tried to find him by diving into the muddy waters.  His body was found some days later.  Kung Future do a lot of work in this community including organising birth certificates for children who would otherwise officially not exist; enrolling children whose parents cannot pay the fees, to school; some health care support when possible.  They also provide upkeep for boats in disrepair, which often leaves families with no choice but to try and fill holes with whatever they can find, even rolled up paper!  The community’s needs are high and the resources to meet their needs are extremely limited.

Cham fisherman painting his newly repaired boat, courtesy Kung Future

Meanwhile back in Australia, I feel a world away from all that.  The Project is a current affairs entertainment show airing here on weekday evenings.  One night recently, musing on a news item related to our national airline Qantas, one of the commentators said “every time I go on a plane…” as if it was the most ordinary statement, along the lines of “every time I eat breakfast…”.  As ordinary as they may have seemed to most Australians, these words revealed the extreme privilege that simply being born in Australia bestows upon us.  Our privilege is so normalised to us that we don’t see it.  Not every Australian can speak so casually about plane travel, but every Australian can hear it with a feeling of mundanity.  In contrast, I have lost count of how many seemingly worldly Cambodians have asked me with genuine fascination, about flying on an aeroplane, or how many countries I have visited.

Almost daily someone currently asks me if I find it difficult to settle back in at home.  The biggest impression I have on my return is our normalised privilege.  I don’t struggle with it at all; I am merely returning to my own normal life.  However I do have a very heightened awareness of it after moving rapidly (in the space of a 10+ hour flight), from a place where survival and limiting hunger are the focus for a large proportion of the population, to a place where liberty and comfort are central to our reality.  My friends and family here are securely employed, living in homes with solid roofs, paying off affordable and regulated mortgages, driving safely maintained cars, with opportunities to travel and the right to hold political opinions without fear.  My friends in Cambodia have between none and a few of those things, on a much smaller scale and in a suffocating economy where poverty is a highly visible feature of everyday life.

Something else many people ask me is why I would choose to follow my plans to return to Cambodia rather than stay in Australia.  A Cambodian friend suggested that maybe I don’t really love myself, that I would choose to live there rather than be among the comforts of my first world existence.  Friends in Australia frequently suggest I need to focus on settling down / building a nest egg for the future.  To the contrary, these quotes speak the most to me:

~ Jim Carrey

In The powerful way that normalisation shapes our world, Jessica Brown comments that “our grasp of normal is an entanglement of objective and subjective, moral and social judgements, prone to changing for the better and for the worse“.  She highlights the complex nature of normalisation, in that it can easily change (eg the normalisation of various previously unacceptable behaviours during the era of Trump) but can also be very fixed (eg ideas on female beauty).  It is an intricate phenomenon that most of us probably never really think about.  The reason I think about it is because what seems normal when I am living in Cambodia, is very different to what seems normal when I am living in Australia and these differences are particularly heightened for me now, as I settle back into a six month stay in Australia.

As one of many examples, I am staying with friends at the moment, who due to some veterinary visits, have spent more on their pet dogs in the last two weeks than most Cambodians can spend on themselves in a year.  These friends are living well, but they are not wealthy by Australian standards.  Yet to my adjusting brain, sharing their lifestyle for this short time highlights how extremely privileged we in Australia are, with very little recognition of the fact because it is merely normal to us.  It gives me some context to refer to, when trying to understand the complex nature of my relationship with impoverished villagers in Cambodia, who see me as infinitely wealthy.  My existence is beyond their normality, for the sole reason that I have enough money to appear in, and disappear from their lives, seemingly at whim.  Most of these are people who have never traveled away from their own village.

Before leaving Cambodia I wanted to visit Boat Baby, who I “caught” when he was born on the small wooden boat over the Mekong Delta in August.  About six weeks ago now, I spent a weekend in Kampong Cham, visiting various people with Dan (tuk tuk driver), to say farewell.  Boat Baby lives in the village next to the blind family who I have often talked about, so we added him to our itinerary in that direction and picked up an extra bag of rice for his family.  Five months old, he was swinging in a hammock inside the family’s elevated bamboo shack as we arrived.  He appeared to be asleep and I tried to stop grandma from waking him, as she bent to pick him up.  As she did so, I realised he was awake, but with semi-closed eyes.  A short conversation with Dan ensued, who then turned to me and with a tone of surprise said “Helen he is blind”.

Yet another vision impaired person in the same village?  Can this really be just coincidence?  My thoughts keep reverting to the knowledge that this area was heavily sprayed with Agent Orange in the 1960s.  We will never know because this is not a place where researchers will spend money or time investigating, and even the American veterans exposed to Agent Orange, still reporting high rates of disability in their offspring, have had limited recognition.  There is almost nothing written about it, but according to this article from 2008:,

Kampong Cham, Cambodia | The proportion of babies born with disabilities in eastern Cambodia is more than 50 times higher than in other parts of the country, according to local doctors.
While the reason for the higher rate has not officially been confirmed, it is generally believed to result from the use of Agent Orange, a dioxin-containing defoliant, by U.S. forces during the Vietnam War.

I was predictably horrified at the news and wanted to help.  His grandmother was forced into the jungle in this area during the Vietnam War and remembers living as a soldier alongside the country’s Prime Minister, who also comes from this region.  When I asked via Dan, does she know if they sprayed Agent Orange in the area, I understood her swift answer immediately – a very normalised “yes”.

The family had returned days prior from Phnom Penh, where doctors had already advised them to go to the paediatric hospital in Siem Reap where surgery may help.  Having just traveled to Phnom Penh, they did not have any money for this and would have to wait.  I gave them US$200 for the purpose of having him seen immediately but they could not leave now due to harvest commitments.  Last week they finally took him to the hospital, a day-long bus trip, and were given a planned appointment for the end of this month.

My communications with Dan following this trip to Siem Reap not only saddened me but also highlighted the complexities of relationships such as mine with this family.  A return bus trip and 1 or 2 days’ stay in Siem Reap would have cost a tiny portion of the $200 I had given them.  So I was confused by their request via Dan, for more money to attend the next appointment.  Dan never says anything bad about anyone, yet his reply to me when I asked why they needed more money already, implied that they had spent the money on other things assuming my money was free flowing, and that “everything not good” (ie he is unhappy with them).

Obviously I won’t continue to support the family in these circumstances.  Which means the baby will either not receive any treatment for his congenital blindness, or his family will have to go into debt for the purpose.  Health care debt is a normality in Cambodia where all health care works on a user-pays system.  Poor families may receive discounted or waivers if they can produce a “Poor ID” card, however these cards are notoriously provided by village leaders to their own family, leaving the poorest in communities with no evidence that they need support.

In my world, people do the wrong thing all the time but they don’t have to pay for it with their health, the health of their children, or as is so often the case in Cambodia and other poor places, their lives.  I feel very disheartened by this little boy’s circumstances and his family’s inability to understand the risk they took by making assumptions about my perceived wealth and perhaps my perceived obligation to him.  Finding a balance in this situation is going to take some time, patience and soul searching.

IMG_5024

Boat Baby at home with Mum and Grandma

World Wealth Distribution

From Pew Research Center http://www.pewresearch.org/fact-tank

Anyone interested in where they fit into this scale of global wealth can enter their basic information into the calculator at GivingWhatWeCan.org.  Despite my exposure to poverty which I think is probably more than most Australians, my hunch about my own wealth was completely wrong and I am far wealthier than I would have thought.  That’ll be normalisation playing games in my head!

Miracles, Swallows and Amazons

Just over two years ago, during a boat cruise on Lake Windermere in north-west England, a small island in the lake captured my imagination when the guide described it as the place which had inspired Arthur Ransome’s children’s adventure series, Swallows and Amazons.  Tonight at a hotel in Siem Reap I turned on the television and correctly guessed the film as Swallows and Amazons, based on the English accents and unmistakable scenery.

Yesterday I woke with abdominal cramps and diarrhoea and had to call in sick.  Bed bound with frequent rushes to the toilet, by mid-morning something had taken its hold on me and I wasn’t sure whether to sit on or put my head inside the toilet bowl.  Either option was only a 50% solution.  Shivering cold and feeling like I might faint at any moment, I dragged myself into the main part of our apartment to let a Khmer colleague, working in the kitchen, know that things were not going well for me.  She followed me to my bed and as I flopped face down she said “Oh you have a lot of rain”.  Peering through one half-opened eye at her, I asked “rain?” and she motioned towards my head.  Sweat was raining off me!  She then suggested she should call the doctor.  Unable to imagine how anyone would get me off my bed let alone out of the apartment and into a tuk tuk to hospital, I replied “I have to stay here”.

I asked for a vomit bowl and she returned hastily, rubbing my back as I heaved spasms of clear water into the bowl.  The force of heaving caused a panicked rush to the toilet, with my colleague leading the way, holding the vomit bowl at my chin before passing it to me and leaving me to my devices.  Flopping back on my bed, she returned with a small pot of tiger balm which she proceeded to rub all over my abdomen.  Amazingly, it did help the nausea and drooping consciousness.

Within about half an hour whatever it was had expelled itself from my system so I must have looked fraudulent, propped up on pillows sipping water, when my housemate rushed through the door, stethoscope and thermometer in hand, on her emergency rescue mission!

Plans to travel to Siem Reap for a long weekend were not easily cancelled so I monitored myself all afternoon and determined by mid-evening that I would be safe to travel.  After a quick tuk tuk ride to the bus station I was horizontal on the cushioned floor of my own roomette on the Night Bus.  Eight hours of mostly-sleep later, we were pulling into Siem Reap.

International Children’s Day is a public holiday in Cambodia and I’d promised a lunch time swim at the hotel for Rav and Seth’s families.  Four very excited small boys arrived with two babies and four parents in tow.  The boutique hotel likely didn’t know what had hit them but we all need to be taken out of our comfort zones from time to time and a splashingly fun time was had as staff looked on wide-eyed at the commotion.  Tonight Seth, whose English is entirely self-taught, wrote:
Hello Helen how are for today now you get for dinner , and my family thank you also and very very happy swim and for lunch time, this is my first time for my family to swim pool thank you so much for today
It’s hard to imagine living in a resort town such as Siem Reap which must have hundreds of swimming pools at it’s hundreds of luxury and middle-range hotels and hostels, and never having been in a swimming pool.

The two hours-or-so of lunchtime excitement saw me nana napping this afternoon when my telephone woke me.  A Khmer friend in Kampong Cham who never calls, had also sent a private message on Messenger.  I clicked on the 12 minute video he shared to me, watching a small boy speak in Khmer to the camera with English subtitles, describing his dream to go to school and help his mother and younger siblings. Instead, he is forced to spend days and nights selling ripped banana sugar, ripped potato sugar and dry freshwater clams from a hand pulled cart in the streets, in order that the family can keep a roof over their heads.  At the end of the video I learned that he lives and works within a five minute walk of my workplace.  Not knowing this, the Kampong Cham friend had contact with what he called “a tycoon” in Kampong Cham who watched and was moved by the video, wanting to help the family.  My friend called me in hope I might be able to help locate the family.  As it turns out, I probably can!

So on International Children’s Day I reflect on my own childhood summers, spending hours everyday in New Zealand’s public swimming pools or crystal clear rivers and beaches.  Unaware of my childhood fortunes, I transitioned into an equally oblivious adulthood of visiting or living in places that most people may never even know exist but which I can frequently recognise on the privileged television channels I get to watch.  In comparison, two families splashed today in a pretty blue swimming pool for the first time in all of their lives.  Meanwhile a distressed family in Phnom Penh may be about to have a new lease on life thanks to an uncanny series of connections.

Abacus 03

The Frangipanis Above Me: Part 2

Giving is the essence of Abundance

It’s a five hour bus ride from Kampong Cham to Siem Reap.  I was the only Barang on the bus which is a reasonably unusual experience, especially on a route to the very touristic town of Siem Reap.  Seat 29 was my allocation but someone had already taken it.  One of the many young men surrounding me asked as I stood in the aisle, “excuse me madame, what is your number?”.  I showed him my ticket and a reshuffle ensued on my behalf, despite my protestations that I could take one of the vacant seats near the back.  A short way along, the young man in the aisle diagonally opposite me began taking selfies.  When he positioned himself to get a selfie with me firmly in the background, I gave his telephone a smirk.  A few moments later, admiring his shots, he spotted my photo bomb and turned to smile at me.  From then on I was included in his crowd of friends.  When he turned to offer his mates some bread, the first overture was made to me; when he offered everyone a piece of fruit, it came via me first.  It’s hard to imagine such geniality being extended to an old girl from a twenty-something young man in my world, but it’s considered normal here in Cambodia, I suspect as a consequence of the communal living experience.  They were en route to a friend’s wedding together and there was a very definite feel of celebration in the air.

Rav was at the station to pick me up just after lunch.  In the afternoon we sat for a drink together, joined by an apologetic Seth, who should not have told me his problems, etc.  To cut a long story short, Rav has a decent tuk tuk with a decent moto meaning he can attract better paying passengers.  Both of these vehicles were given to Rav by grateful and generous customers in the past year or two.  Nevertheless he also struggles with many tuk tuks competing in a tight market of tourists.  Many days pass with no income and on a good day he can hope for $15 to $20 for a full day’s work.  Prior to his good luck, he also had a worn out moto, attached to a rented tuk tuk.  Seth, despite his good English, cannot attract the same passengers or income because his tuk tuk is run down and his moto is so archaic that it cannot travel as far as Angkor Thom, the walled city of temples.  He is restricted to taking people around town or as far as the airport.  He has four children and their living conditions are much more dire than Rav’s, mostly because of his severely limited income.  This was difficult to imagine because I’ve been to Rav’s little room where he and his wife share a bed with their two children inside four walls.  During our discussion I scored an invite to Seth’s home and he picked me up this morning.

Last week his 6yo son was playing near the front of their so-called home, a series of home made shacks put together on his brother in law’s land, when he was attacked by wasps.  Looking up into the palm trees, the little boy spotted a nest and decided that throwing stones at it would be fun.  Multiple stings later his mother rushed him to hospital with an anaphylactic reaction. I saw the tree, wasp nest and shacks that they call home, this morning and again, it unraveled me.  This young, strong, healthy, well dressed guy who interacts so competently with tourists from across the globe, lives like this?

Bitumen turns to muddy streets which turn to muddy lanes leading to a muddy little driveway where I walked up a muddy single lane path along the side of the palm leafed shack in the front, belonging to his brother in law.  Brother-in-law has agreed to Seth, his wife and their four sons, living on a raised platform behind the shack, rent-free.  They’ve been here five years but will have to find alternative accommodation next year when the in-laws plan to build a home and will not have room for so many extras.  The family eat, sleep, shower and live on a square of wooden slats about 3m x 2m, about 1m above the muddy ground below.  Their allocated section of platform is between Seth’s parents’ share of the platform further inside the enclosure, and the open air entranceway.  All of it is covered with tin and tarpaulin, beside an ice-making factory over a brick wall which growls constantly from 3am to 9pm daily.  I side-stepped around the back to view the little open air toilet between their platform and the ice maker’s boundary fence.

It became a no-brainer and I explained that while it is not possible to help everyone, I wanted to help Seth.  However, I needed him to have a plan so that I can attract donations because noone donates if you ask for “free money”.  His plan was expressed immediately – he needs a decent motorbike so that he can take customers to Angkor Thom.  I then explained that I don’t have enough money to buy a motorbike but I do have access to a loan from the bank, so rather than wait for donations, I would take this money and buy him a motorbike.  Rav, in his ever-modest style, replied “congratulations”.  I’d asked him earlier how he would feel if I helped Seth, and was told without hestitation that “the more people who you help, the better it will be for everyone including me.  I don’t get jealous, and if my friends can have customers then when I have money problems, there are more people I can ask to help me”.

We traveled back to town over the jarring muddy roads, Rav shouting out to Seth “wow your road is very bad!  My heart fell out to the ground!”.  We stopped at a number of different motorbike shops over the course of about an hour.  With no interest in motorbikes and their various dimensions or features and aware that my presence would require everything to be translated, plus risk an automatic rise in assumed price, I left the boys to shop while I waited, a dissolving lump of lard on the synthetic tuk tuk seats.  Eventually we came across a shop with a motorbike in our price range and of an acceptable quality to pull a tuk tuk for long distances.  The next chore was for me to find enough ATMs to withdraw the money I needed, which was complicated by one machine only dispensing riel currency; three machines not recognising my card and another machine wanting to charge an excessive withdrawal fee.  Finally I had enough $ in my possession and we made our way back to the motorbike shop.  Seth invited me in to pay but I declined, passing the money to him without even thinking about it, and asking him to check it.  He stopped to count it slowly in front of me.  During lunch Rav laughingly announced that Seth took a photograph of the motorbike money when he took it to the shop counter.  Seth added “because I never touched so much money in my life”, before pulling his phone out to show me the fanned-out crisp $100 notes sitting on the shop counter.  More unraveling of my world perceptions courtesy of these composed young people who have not had a fraction of the advantages that I take for granted.

With Rav riding Seth’s new wheels beside the tuk tuk, we lurched our way back to the shacks where I was invited to lunch by an overjoyed family filled with thank yous.  We ate on the platform where all of this family’s life plays out.  Rice with fish soup cooked on an open fire in the mud.  A conversation ensued between Seth and his wife about whether I would be okay to eat this food, but Rav assured them that “she is not like the tourist, she lives with the Cambodian people, it’s okay”.  He also translated at another point in the mostly-Khmer conversation, “you came from Australia and brought some Australian lucky with you for all of us”.  During the conversation I mentioned that I like Bowng Dea Drey Broarmar, a fish-pancake served with fresh vegetables and rice, which it turns out is Mrs Seth’s speciality.  Tomorrow night we’re sharing another meal together on the infamous platform so she can share her culinary skills with me again.

After lunch Seth drove me home to my hotel.  This afternoon I lay for hours on my back in the hotel pool, looking up at the cloudy sky through blooming frangipani flowers hanging from branches peering over the fresh blue water.  I get to sleep under a solid roof tonight, unaware if it is even raining outside my sound proof walls.  I handle $100 bills with an air of irritation because they need to be changed to smaller currency.  And when I look to the sky, where so many see wasp nests, I get to view flower blossoms.

Seth Family Blog

Seth and family on the platform they call home. The children to the right are trespassing on grandma and grandpa’s territory. Seth and his wife share the small square they are sitting on with their children, as a bedroom, dining room, bathroom and lounge.

Seth Family Blog 02

Taken from Seth’s section of the enclosure, looking inside at his parents’ section and out of the open entranceway at the mud track below.

Good Riddance For 2017!

New Zealand’s South Island is a panorama of tiers stretching in a lengthwise direction roughly parallel with the coastline.  Most prominent, at least initially, are rows of alpine summits piercing into blue skies or disappearing into woolly clouds.   Dizzy heights descend into rolling forests and grassy slopes, which in turn meander into a patchwork of green and gold valleys where sheep graze beside vineyards and other plantations.  Snaking across this landscape are braids of emerald rivers flowing from icy altitudes towards the glassy Pacific Ocean which wraps the nation’s coastline for 14,000 kilometres.

south-island

Satellite image of the South Island

Thanks to a destructive earthquake last month in which the seabed rose by more than 1 metre during two minutes of terror, the roads into Mum’s hometown were closed when I arrived last week for Christmas.  Being, as I am, from this abundant life, my perfectly feasible solution was to take a light plane, turning the 2.5 hour drive into a 35 minute flight over fertile, clean, affluent territory.  Most of my week was spent admiring panoramic views.  I kayaked in a crystalline blue bay, waved and shouted out to cruise ship passengers making their way to shore for the day and enjoyed the guarded attention of playful fur seals agile enough to keep themselves at arms’ length while showing us their tricks.  Meals were prepared at home some days and other meals were shared in local restaurants.  Gifts were exchanged.  Extended family visited from near and far.  Today I was chauffeured back to Christchurch by a convoy of generous family in time for tomorrow’s early morning flight home.

This time next month I will be en route to Cambodia.  Every moment that I reap the benefits of my lucky existence, I am aware that within my social circle now, are people who can only dream of having even a smidgen of what I have always taken for granted.

Samantha writes regularly about 3yo “Adam” and the slow, miserable progression of his genetic disease in a land where paediatricians have little to offer him whilst needing to charge money for what services they are able to provide, immersing the family into more debt in their desperate bids to find help for him.  Some doctors and nurses have turned him away in blatant discrimination against his visible disability, claiming “there is no point”.  He continues to beat the odds through repeated bouts of pneumonia and diarrhoea which we have been known to diagnose amongst ourselves, guessing at how to treat his symptoms, sometimes with the help of a local paediatrician in Australia who has generously offered advice from afar.

A child with his condition in “my” world would also be disabled and terminally ill, but unlike Adam, would have options for nutrition, appropriate comfort measures and medical care.  At 3 years old Adam remains the same peak weight he reached at about 12 months old.  With each inspiration the skin on his torso sucks in between his tiny ribs.  His twiggy arms and legs are stubbornly twisted and curled in a gridlock.  He can’t turn his head but his deep dark eyes follow conversations alertly as he lies passively observing the world around him.  He cries every night in apparent anxiety attacks, probably combined with hunger or pain.  Not all of the medications he needs are available in Cambodia, and only available by prescription in Australia, meaning he will never be made as comfortable as he needs and deserves to be.  Every medication Samantha obtains is purchased at retail cost via private pharmacies, helping her family to remain impoverished.

Adam is only one example of what it means to be unwell in a poor country.  The latest stories from Joe’s village are that he probably won’t be alive by the time I arrive in just over a month.  His story is for another blog.  Without the means to obtain medical care due to his immobility, the remoteness of his home and the family’s complete lack of funds and health literacy, guesswork is all that is available.  My guess is that he is dying of Post-Polio Syndrome about six decades after his (probable) Polio infection.  I keep picturing him lying in his hammock at the top of the wooden ladder leading to their front doorway, unaware of why he’s sick.  Lack of personal funds is one aspect of poverty.  Lack of health care is a less visible, much more significant aspect.  Most of us from “my world”, where sickness is less common but health care is accessible, abundantly resourced and subsidised or free, find this impossible to fathom.  Had I not seen it for myself, I could not have imagined it either.

Meanwhile, I get occasional messages from various corners of Cambodia, often with at least some intent related to practising English.  Today I had the following conversation with one of Paula’s brothers:
Hello, how are you?
Hello, I am fine thanks, and you?
Me too.  Where do you live now?
Now I am in Australia but in February I will come to Cambodia and so I will see you soon.
Good riddance then.  We will wait for you in (their village).

With the same intent, I wish a very good riddance for everyone reading this.  May 2017 provide you with enough and may you appreciate every moment of it.

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Love Your Luck

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Yesterday I resigned!  After eighteen years of owning a permanent position with the same organisation, I bit the bullet.  I will soon say goodbye to my salary, superannuation, annual leave, long service leave and an accumulated 34 weeks of sick leave.  Those are the benefits I can think of immediately but there are various others, such as 10% extra pay during holidays, the right to complain to and disagree with management without fear or favour, professional development allowance, and so many other first world privileges.  I have owned the same permanent position for sixteen years, in that time taking four years of special leave to work elsewhere including a year in London, a year in Cambodia, and time with other organisations.  Each time I went away, the security of returning to my permanent position was something I gave no thought to.  For most of the time I owned this position, I truly had no idea that it was anything particularly special.  I trained as a nurse and I held a nursing job – big deal?  I have always loved my job and appreciated that this is not necessarily a common experience, even in the privileged world.

Only recently did I spend time in a country where nurses earn $100 per month, not paid reliably, working inside a system that is so horrifically deprived that you could call it almost non-resourced.  Throughout my year working in Cambodia, my first world brain grappled with so many outlandish experiences.  Hospital waste management problems, including seemingly uncleanable dirt throughout patient areas, stockpiles of refuse, rat infestations, sewerage leaks, the smoke from burning medical waste wafting through patient areas.  Patient meals were cooked by homeless domestic staff in the dirt behind the MSF laboratory, on open wood-stoked fires.  Most significantly, patients suffered and died in situations that do not exist in my world.  I had tiny insights into systemic corruption which filters down from the highest echelons to directly affect both patients and staff.   This blog is testament to the struggles I continue to have, coming to terms with the inhumanity that so many face on a daily basis due to the vicious cycle of poverty and corruption.

The biggest impact all of this has had, is to accentuate my own intense privilege.  It is the epiphany of this privilege that has inspired me to leave some of it behind.  Most people my age are committed to all sorts of things which mean they can’t do what I am doing.  Many probably would not want to if they could.  Without the encouragement of my friends working in East Timor who spurred me to join them there in 2012, I likely would never have known either, about this other world, where such big differences can be made with such small effort, and where your own life, world view and source of fulfilment, change so dramatically that things can never be the same again.

A friend in Cambodia, connected to both Wat Opot and Cambodian Childrens Fund, recently wrote this anecdote which resonated with me, prompting this latest rant.

Tonight I had one of the most humbling experiences of my life to date. I really don’t like public speaking, even to small groups – it’s something that I’ve always put up with but avoided where possible…

… and so tonight I found myself talking about my life to a room full of young teenagers. These guys and girls are this years top 15 students from the CCF Leadership program, having made it through several rounds of an intensive training and selection program. 10 of them, after this round, will attend the incredible Global Youth Leadership Summit, hosted by Tony Robbins in California.

The reason I was sitting in on the class was to hear *their* life stories, with the hope that I could use them on social media at some point. After stumbling through my own story, I sat back and listened, and was blown away. Their stories were heart wrenching, some couldn’t contain their tears and raw emotion, and I found myself embarrassed at how privileged my story was in comparison. The incredible power of CCF – and the Leadership program in particular – to change lives never ceases to amaze me. These amazing young people are the future of the country, and it is in good hands.

The point is not that you should go to a remote place and live an alternative existence.  The point is that those of us born into the privileged world, deserve to know, to appreciate, and to share, our good fortune.

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