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!