Closing in on the last couple of Cambodian weeks...

I am sorry that my blog posts have been few and far between these days! Sometimes I get into such a routine here that I forget that I need to update this! After I recovered from being sick, I headed back to the hospital! I have been spending the past few weeks in surgery and the past week has been a mix of the ICU and surgery. While I was in the surgical rotation, I took for granted the fact that things went relatively smoothly. Well, as smoothly as it goes in Cambodia. Things get a little bit lost in translation sometimes and so it appears to be fairly unorganized around here. Usually it is actually the fact that everything is more laidback and slightly chaotic in Cambodia, but I have also found that things would be discussed in more detail if I spoke Khmer. I observed a few weeks worth of surgeries and enjoyed learning from the surgeons. We had a bunch of random public holidays where we didn’t work so the weeks would fly by! I changed into the ICU department last week and it is fairly emotionally draining. The doctors are very helpful and some of the medical students speak English very well! I asked one of the students why the charts (and everything in the hospital) are in English, French and Khmer. Why don’t they just pick one language? He explained that some of the doctors/students study at private universities and some at public. The private school students learn medicine in English and the public school students learn it in French. Some things are written in Khmer, such as prescriptions, because a lot of the patients and their families only speak Khmer. I find this to be fairly confusing and complicated…but then again I only understand about 1/3 of what is going on! The key to surviving as an English-speaking intern in the hospital is finding an English-speaking medical student to translate for you, download a LOT of apps on your iphone and wear comfortable shoes!

The ICU was very different from pediatrics or the surgical floor. Unfortunately, most of my patients were moto accident victims. On my first day, one of them went into a coma and passed away the following afternoon. The other 28 year old man is really struggling to hold on. A lot of them are conscious but incredibly beat up. Most of them wear were wearing a helmet but sometimes that isn’t enough. I see some women after they have a C-section and I also saw one woman who had complications after her thyroidectomy. One older man has been in the ICU for one week after removing a portion of his colon because of a tumor. I have also seen a young man who came in with a knife in his head because a gang member stabbed him. I also saw a man that was doing some work and fell down 30 feet onto the cement. His swelling made him unrecognizable but he is lucky to be alive. We will see if he makes it. The doctor told me today that his body was going into shock and it isn’t looking good. Today I saw a man with a “ruptured intestine” from being kicked by a cow. I was told that he had to travel 500 km on a motorbike from his province to get medical attention. Since the main method of travel is a motorbike, I always think of how terrifying and painful it must be for some of these patients to get on the back of a motorbike to the hospital in their condition. Needless to say, it’s been a heavy couple of weeks and I can’t wait to come home and hug each and every person that I love! I know I take my health, and the health of my friends and family, for granted. On a lighter note, I got to scrub-in on a surgery! I was able to help take a kidney stone out of a young woman. It was about the size of an almond and the surgeon said he has taken stones the size of coconuts out of bladders! I can’t even imagine how horribly painful that must be.

We have been having so much fun with our time off of work and with our weekends. The group of people that is here now is so wonderful and I know I will be devastated when we all part ways. We have become a little family and although it’s an incredibly diverse group, everyone adds a little something to make it great. We eat all of our meals together and usually spend our evenings in the main area of one of the apartments to watch a movie. The picture on the screen is really shaky, it’s incredibly hot and mosquitoes eat us but we’re used to it by now! A few weeks ago we all took a cooking course together on a Saturday. Last weekend, the Peace Corps volunteers were in town so some of my friends were excited to meet them. It’s always fun to meet other Americans! Travelers from the United States are very rare around here.

I am technically done with my projects abroad work today, the 16^th, and was supposed to move out of my apartment and stay in a hostel until my parents get here. I woke up really sad to be leaving my friends and although I would still see them, I would miss our time in the apartment together. So, I made a few phone calls and have extended my time in the apartments and I am very excited about it!

I found a restaurant in Phnom Penh that will serve an actual Thanksgiving dinner so we have a group of 23 volunteers going! Since I am the only American, I am excited to share this American holiday with all of my friends from all over the world. I have plenty to be thankful for this year! One thing I am VERY thankful for is that Mom and Dad arrive in less than 2 weeks! I can’t wait to show them around and have them see where I have spent the last 3 ½ months. I can’t believe I will be returning to America in less than 5 weeks! Can’t wait to see everyone and Happy Thanksgiving!  

Hello! I am sitting here getting eaten by mosquitoes so let's make this short...I started back in the hospital this week and Monday and today (Wednesday) were fairly brief. They are both public holidays so we didn't have any surgeries scheduled. Yesterday, I was with Dr. Rasmey in the OR and observed his cholecystectomy. Today, I started my day visiting with Dr. Oukreth. He is a great man who is always smiling. He barely speaks english but is fluent in spanish so we get by pretty well speaking spanish to one another. He explained to me that he went to med school in Cuba and so that's how he learned spanish! We visited for about 45 minutes this morning and there was something in our conversation that I found to be wonderful so I wanted to share it with all of you. You see, Cambodia is a very poor country. There are also ways to make a lot of money...I saw a Rolls-Royce outside of the market the other day and everywhere I look in Phnom Penh, I see a Lexus. But, we are surrounded by a lot of poverty as well. The hospital that I work in is affordable for a lot of Cambodians but I was told during my first week working there that this is the "hospital for poor people". While talking with Dr. Oukreth, he told me that the ICU is full of patients that have complications after surgery. A lot of people experience infections or are in need of medications that the hospital can't provide. I expected these type of conditions but what really surprised me is that he explained that a lot of the problem is the nursing staff. They're underpaid (they make $100 per month) and can't afford food a lot of the time. Since they aren't getting proper nutrition, they run out of energy and this affects how well they treat their patients. I asked what a doctor makes at this hospital and he said $200 per month. I knew this couldn't be accurate because most of the doctors drive nice cars and have iphones and ipads. I asked how they afford their nice things and he explained that at this specific hospital, they make $200 per month. They work there in the mornings/early afternoons and in the evenings, they work in private clinics where they can charge more and that's where they make good money. I asked him why they work in the hospital when they are making such great money elsewhere. Dr. Oukreth sat back and smiled. He responded "Leslie, it's because we have a conscience. We need to take care of our Cambodian people. If we worked in private clinics all of the time, who would take care of the poor people here? So, I work some of the time in the private clinic to make money to pay for my family and my things and then, I work here to help my people. If they can't afford treatment or surgery, that's okay! We will do it anyways." I thought that this was a great way to start my day! We all work hard and make money to live our lives and support our families. It's well-deserved and hard-earned money! But it's also so important to take some time out of our days and reach out to the people that need a helping hand every once in awhile. In a country that has a huge gap between the wealthy people driving a Lexus and the poor who are malnourished and begging for food, it was encouraging for me to meet a lovely man that counts his blessings and uses his knowledge and skills to help those in need.

Lately

Life has been a little strange and I've been a little bit "off" lately. After I returned from Thailand, we had public holidays on Monday, Tuesday and Wednesday. It was like a ghost town around here because everyone returns to their home province to be with their families. I was supposed to return to work the following Monday but instead, I was sick for the entire week last week! After a couple of days, I decided to get some antibiotics. This is always an interesting process in Cambodia. I went to the "pharmacy" that ended up being a small stand on the side of the road. I bought the amoxicillin from a girl that couldn't have been more than 10. For 7 days worth of medication, it was 6000 riel or $1.50. Well, I finished my meds and am still fighting the sickness so who knows what is wrong! I am feeling ten times better than last week, though, when I started crying on skype with my parents. Ha! Last Saturday I felt good enough to go to the "dirty weekend" hosted by Projects Abroad. This is an event that happens once a month and we go to an orphanage or school to paint the walls and jazz up the place. We had a great time (other than the terrible heat) playing with the kids and painting. The kids loved to help us! This morning, I went back to work even though it is a public holiday again. I assumed that people were still sick and surgeries still happen on holidays, silly me! I was there for one hour and the on-call surgeon came up to me and explained that we didn't schedule any surgeries and I should return tomorrow. Then, he returned to his bench to nap. Oh well, I tried!

I am never quite sure as to what these holidays entail and I'm so confused with things most of the time here. The King's funeral procession was on the 17th (the day after the 3-day holiday a couple of weeks back) and so everyone was back in Phnom Penh but a lot of things were closed for the funeral. Then, from what I understand, there is supposed to be 7 days of mourning and "happy" things cannot occur. Music can't be played, bars are closed, restaurants are closed and everyone wears black ribbons on their clothing. Each night, everyone gathers at the Royal Palace to mourn the death of the king. I really don't understand much of this because more than 7 days later, these things still occur. I attended the gathering at the Palace last night and although many people were praying and mourning, the people in the back were on the grass and it looked more like a social event. People were selling light-up toys and having picnics. It reminded me of a community park on the 4 of July! One day I will figure this place out...

Painting outside of the orphanage

Playing at the school in the slums

The tribute to King Sihanouk at the Royal Palace

Kids outside of the palace showing me what to do with my candles and incense

Outside of the Royal Palace

There isn't much else going on over here but every day is a new adventure! I am seeing pictures of Husker tailgates on facebook and you all look SO COLD but of course, you're having so much fun!

2 Week Holiday to Thailand

Hello!! We survived our two week trip through Thailand! (We decided to skip Laos because our bank accounts were depleting rapidly). I have no idea where to begin to explain everything so I will give you guys the highlights and some pictures. We flew out of Phnom Penh on September 26th. We had a layover in Bangkok before we flew to our destination in Koh Samui. I was incredibly sick this day and quite miserable on the planes...and for the next couple days in Koh Samui, I spent most of my time in the quite LUXURIOUS (not) bathrooms of Thailand. It was definitely God's way of testing my patience and tolerance of challenge. Koh Samui is a beautiful island with some great beaches but the rainy season stole a lot of our sunshine! After a few days on Koh Samui, we took a ferry over to another island called Koh Phangan. We stayed in a beautiful resort with a big, warm shower and unbelievable view! I spent most of my time walking the beach, laying in the sun and reading. We went to the "Full Moon Party" and that was a great time. I met some Americans on the ride over to the other side of the island where the party was so it was fun to talk to them! It was a little strange to be talking about Husker Football and I heard the word "Creighton" for the first time in a month! After a couple of days on the island, we took a ferry back to Koh Samui where we caught a bigger boat to the mainland. We then had a 4-hour bus ride to Phuket and we arrived fairly late at night with tired bodies and hungry stomachs. We had some McDonalds when we arrived and one may assume that I would be really excited to have some "western" food but it was quite the opposite. All of the food in Cambodia and Thailand is so fresh and "natural". It was a little bit nauseating to go back to processed foods and especially fast food. We get fruit straight from the market and one morning in Cambodia, I saw the waitress walk across the street from the restaurant to a lady with chickens to get my eggs for breakfast. It’s a little difficult to go from that back to McDonalds! In Phuket, we spent a day on a boat tour to Phiphi island and that was beautiful. We were able to go snorkeling, visit three islands and play with monkeys. After another day in Phuket, we caught a quick flight back to Bangkok where we spent our first night in a terrible hostel! We should have known since it was only about $7 a night…but since we were exhausted, we spent one night there and then changed hotels after the first night. Bangkok is basically an Asian version of any big city in America and to be honest, we were quite disappointed. We did go shopping in a few markets, found some great restaurants and I spent one day in an AMAZING spa for a massage. It was very zen and the women that work in the spa were so kind and gorgeous! After a couple of days in Bangkok, we caught a 14 hour night train to Chiang Mai and this was my favorite part of the trip! We spent time at Tiger Kingdom and took pictures with tigers. The tigers aren’t sedated and since they were fed right before we came, it’s safe to touch them and be near them. We also spent a day in the Elephant Nature Park which was by far one of the best days ever! These elephants are rescued from abusive situations or they were abandoned. This amazing woman, Lek, buys the elephants from the owners and brings them to her “Elephant Heaven”. Go to elephantnaturepark.org to learn more about this wonderful woman and place. We were able to feed them and bathe them in the river. They eat whole pumpkins and watermelon, which I find fascinating! They’re big animals but they are so gentle and happy! On our last day in Chiang Mai, we visited a temple and had one last meal before our 14-hour train to Bangkok. We arrived at about 7 am and caught a flight back to Phnom Penh and it was GREAT to be home! We were back to the world of cheap food and drinks, friendly people and familiar surroundings. I was also very excited to have some clean laundry! Monday through Wednesday of this week is a Khmer holiday so we don’t have work and most of everything is closed in Phnom Penh so it has been a little bit quiet and lonely. A lot of the volunteers in my apartment went to the beach so it’s quiet around there. I will return to the hospital on Monday and I am anxious to get back to work!

Bathing the elephants at Chiang Mai. This one helped me out a bit!

Full Moon Party in Koh Phangan!

View from our resort in Koh Phangan

Bangkok Market

Tigers in Chiang Mai

Beautiful view on our ride to Phi Phi Island from Phuket

Buddhist blessings in the Temple in Chiang Mai

Train back to Bangkok. The Thai Countryside is unreal!!

Killing Fields at Choeung Ek

My friend, Kim, and I on the beach with the bartender, Camera, and two local girls.

Hello from Phnom Penh!! The past couple of weeks have been crazy! I am officially done with the pediatric ward. I really enjoyed working with the children and since I love kids and have a heart for the HIV positive population, it was a great fit for me. It was a little bit slow and I usually didn’t have much work in the afternoon but this made for a great opportunity to explore a little bit more of Phnom Penh. I went to the killing fields last week and it was a very interesting experience. It is about 30 min outside of the city and since I love the countryside of Cambodia, I loved the drive out! I spent about two hours wandering around the killing fields by myself. Signs and a headset explain what everything is and what happened there. It is heartbreaking to think that the sweet Cambodian people experienced such a hate-filled time in history. I found that the most bone-chilling part was the tree that they beat babies and children against before throwing them into the mass graves. Visitors leave bracelets around the posts of the mass graves and on the trees to show respect, support and love. On the way out, you can buy flowers and incense to leave after you pray for the victims. Some say to not spend time at the killing fields if you visit Phnom Penh but I disagree. I think it’s an important experience!

I spent this past weekend in Sihanoukville. I took the 6-hour bus ride down on Friday afternoon. I still can’t get over how absolutely beautiful Cambodia is! I never sleep on the buses…mostly because it would be nearly impossible due to the cramped conditions, obnoxious khmer karaoke videos and uncomfortable seats…but also because the countryside is so gorgeous! I feel like I’m in a movie!  We got there on Friday evening at about 8 pm. We went out for some Indian food and then wandered along the beach. We stopped in some bars and listened to music and made new friends. We made our way to the hostel pretty late and were greeted in our room with a bed full of bed bugs. Three rooms later we found one without bed bugs! Luxury! On Saturday, my friend Kim and I were going to take a boat to the islands but the weather was a little sketchy so we ended up having breakfast and taking a tuk tuk out to the waterfalls. It took about 1 hr to get there and we spent some time swimming in the water and exploring with a little Cambodian girl. We spent the rest of the afternoon on the beach and playing with the little kids that sold stuff along the water. Once they get over the fact that you’re not going to buy something, they’re a lot of fun and so adorable. Our evening was once again spent in the bars on the beach meeting new people and even seeing some people we knew from Phnom Penh! We got a bus back on Sunday and I will now prepare for my long backpacking trip. For every 10 weeks that you work with Projects Abroad, you get to take 2 weeks of vacation. So, I’m taking my vacation time with my friend Steph and backpacking through Thailand and Laos. We are catching a 6 am flight on Wednesday morning to Koh Samui and starting our adventures! I won’t have a computer with me so I won’t be able to update my blog but I am keeping a journal so I won’t forget any fun details.

I feel so lucky to be able to experience southeast Asia. The people here are so wonderful and of course, I’m obsessed with the little kids. It’s a beautiful area of the world!! I can’t wait to explore it further and then return to Phnom Penh and head back into surgery!!

The past week and a half in pediatrics has been a lot of fun. All of the kids that I see are HIV positive and I usually help with physical exams. Sometimes the patients just come in because they need a refill on their HIV meds but sometimes they have other problems too.

Last week, a little boy named Prathana came into our office. He is 10 years old, HIV positive, has TB and severe malnutrition. He was only 33 pounds! He has avoided staying in the hospital because he is scared. The last time he was told that he needed to be admitted, he would have had to stay alone in the hospital so his parents could go home to work. I would be scared too! When the doctor told him that he needed to stay again this time he was incredibly sad. There really wasn’t any other option for him because if he didn’t stay this time, there is a good chance that little Prathana would die.  Staying in the hospital means that he will get regular medicine and meals, which is something he isn’t getting at home. Apparently his mother, also HIV positive with TB, is very forgetful due to her medications and so she often forgets to give Prathana his HIV meds. They’re incredibly poor so they’re lucky to get one good meal per day. Prathana’s lack of proper nutrition and regular medication has led to him developing AIDS. He has chronic abdominal pain as well. He has been in the hospital for 6 days now. He is dealing with some constipation and of course, malnutrition. His meals (although he is now in the hospital) consist of white rice and some green beans. I went to visit him in his room on Monday and met his two sisters and father. His mother, father and sisters are also HIV positive. He has one oldest sibling (14 years old) who is HIV negative and is staying at home. His two little sisters are adorable and the smallest one, Vanchhy, is especially full of energy and joy! She loved playing and getting her picture taken. I spoke with the doctor and asked what I could get Prathana to help him while he was in the hospital. We decided that he would really benefit from Pediasure and prune juice (I think this was the dietitian in me…). On Tuesday, I was able to bring his family those two things along with some other food, toothpaste, toothbrushes and toys for the kids. Vanchhy was especially excited for the crayons and her new princess notebook to color in! Keep the Chharn family in your prayers—they are very sweet people!

I have a few days left in pediatrics and I am thinking I may stay for next week as well. I have a new favorite part of the day--stopping by the NICU and visiting the tiny, tiny babies! 

Tonight I’m going to go to a yoga class with a few other girls and just seeing if we like it! We are pretty excited so I hope it isn’t a flop! On Friday, I’m going with my roommate to take some of the kids from the orphanage to a water park (this should be an exhausting experience…). We plan on taking a cooking class on Saturday and then next weekend, I’m going with a couple of girls to Sihanoukville for our 3-day weekend! So much fun ahead! 

Tiny little pre-mature baby!

The Chharn family

Vanchhy with her new Princess Book!

Hello! It has been another wonderful week in Cambodia! Last week was my last week in the General Surgery department. On Friday morning, Steph and I took the bus to Kep. It was a 4 hour bus ride from Phnom Penh. Departing the city was a little bit chaotic (of course) because of the huge bus trying to maneuver through the moto-filled traffic and lack of organization in the transportation system here. We made some stops along the way to pick people up and drop people off. I am still a little bit confused about how that system even works but in the end, we made it to Kep! We arrived and got a tuk tuk to our hotel that we had previously booked for the weekend. It looked very nice from the outside but we were a little confused because it seemed to be a bit isolated. As we made our way to our room, we noticed that there was a lot of construction going on and we were the only people, aside from the employees, that were there.  We asked where the pool was and they told us it was under construction.  Then, we looked across the street to our “private beach” which was also under construction. We decided to take a look around Kep and find somewhere else to stay and the tuk tuk driver took us to this beautiful, natural resort up the mountain. We were lucky enough to get the last room available at the Veranda Resort for the weekend! It was a beautiful place with a comfortable bed and…a WARM SHOWER! I honestly haven’t really minded cold showers the past few weeks but a warm shower was quite nice.

We spent Friday evening at the crab market and had some squid and crab for dinner. Kep is known for its seafood and now we know why!  Then, Steph and I returned to the hotel to have a drink by the pool and then were in bed by 10 pm. Kep is really quiet and relaxing town so if you’re looking for wild nights, it is not the place! Saturday we woke up at 8:30 for a wonderful buffet breakfast and then spent the day just relaxing by the pool. It was so nice to get out of the busy city for the weekend and in some fresh air! We had another great seafood dinner at Kimly restaurant then another early night.

On Sunday we had a bit of a rough time getting a bus. The language barrier really was an issue for this. We bought our bus tickets at the front desk of Veranda and were 20 min early for our 12:30 departure. It had been raining all morning so delays were expected since the roads are mostly dirt. At about 2:00 (and a few phone calls later) we found out that our bus had given our seats to two Khmer people who didn’t have tickets. The front desk of our hotel called a bus that was about 40 min outside of Kep and told them to stop the bus and they would send us by tuk tuk to meet them for a ride to Phnom Penh. (Actually, I am just assuming that this happened because nobody really explained anything except that we were supposed to get into the tuk tuk that arrived). Usually, being potentially stranded in a small town of a third world country would be a little bit of a stressful situation. How it was solved ended up being one of my favorite parts of the weekend! The tuk tuk drove us through the countryside and on some back roads through rice farms. It was absolutely beautiful. The farmers out in the fields with their cows reminded me a little bit of home. Well, if Nebraska had more Asians, palm trees , mountains and skinny cows. Regardless, it was a beautiful drive. We made it back to Phnom Penh safe and sound!

I started my two-week rotation in pediatrics this morning. The doctor that I will be working with barely speaks English and I don’t speak any French or khmer. This will be a struggle. I sat in on her morning consults and a family of four came in first. There were three children (ages 11, 14 and 16) and a mother.  I just observed their conversation, which consisted of the doctor asking the mother questions, and then the mother counted how many pills were left in each of the prescriptions in her purse. After this, I decided to ask if there was a medical student around that could speak English. She brought in a very sweet girl named Sophie and she helped me communicate with the doctor. I found out later that the whole family I had seen was HIV positive. All of the outpatient work that this pediatrician does is either an HIV positive case or just simple cough and cold check ups (these are rare because of the cost of a hospital visit). The pediatric ward has about 4,000 outpatient, HIV positive children and they see about 30-40 children per day. They come in for prescription refills and frequent blood work. She went on to explain what labs are needed to be eligible for antiretroviral therapy. I asked the doctor if all of the children have HIV from their mother and she said no. Although most of the children have the virus from their mother, a lot of them have it from a blood transfusion. I was so confused by this. She said that private clinics would sometimes test blood donors for HIV before they donate blood but not always. Public clinics do not test the blood they receive. Either way, blood is donated to the hospital and there is not a way to trace it back to where it came from. They explained that blood is needed in the hospital, even if it is HIV positive. Clearly there needs to be a system implemented here! It broke my heart to think that these little kiddos are HIV positive and it is even more terrible that it could have been prevented.

Working in Pediatrics is so much different from surgery but I think I will learn a lot! Sophie said she would be there for the entire two weeks that I am there so she will probably help me out immensely.

Loved seeing all of the Husker posts on facebook—GO BIG RED!