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! 

All is still well in Cambodia! I have finally become adjusted to the time and sleep (almost) through the entire night. There is this dog next door that I am not too fond of and he always barks at 3 am. Then, at 5 am Phnom Penh is pretty much up and at ‘em! This means lots of motorcycles, cars and selling carts (with really annoying horns) to keep me up.

Last weekend we went out on Friday night for Chelsea’s last night. We had a delicious Italian dinner on Friday, which included pizza and wine. I would compare it to Dante’s pizza at home and it was delicious! Our cook here is amazing, but it is nice to have a meal every once in awhile that consists of something other than rice and vegetables. In case you were wondering, I usually have toast with peanut butter or a banana for breakfast with coffee. For lunch and dinner, it is white rice and vegetables. For dessert, we get watermelon, pineapple or whatever other fruit they bought for the week. The meat here isn’t my favorite so I usually save that for when we are at a restaurant. Sometimes our cook, Nay, will prepare fish or eggs and they are both great!

On Saturday, we went to the market to get some DVDs to watch in our room. They are very, very cheap here! That evening, we went to a place called the Latin Quarter and they had wonderful food, live music and dancing! The rest of the week has been pretty much the same. Last night, Nina and I went for night shift at the hospital. We were in surgery until about 1 am and then went upstairs to sleep. We only had two twin size beds so Nina, the doctor and I pushed them together and slept sideways on them. To put it nicely, it was not the best sleep I’ve ever experienced! But, the bathroom had a flushing toilet and I remembered my bug spray so I couldn’t complain! We slept in our scrubs and were able to sleep through the night. We were there in case there was an emergency surgery that was needed in the middle of the night.  The hospital has been great and this is my last week in general surgery and I am excited to go to pediatrics on Monday. This weekend, Steph and I are thinking about going to Kampot to enjoy a nice little weekend away and go have some fun on the beach!

The first week is almost over! I still can’t sleep in for the life of me so I am up at about 6 am each day. I usually go across the street to skype with my parents, check my email and drink coffee. At about 8 am, Richard (my driver) comes to get me and we make the 15 min ride to the hospital. He takes me on a motor bike (sorry mom and dad), which sounds more dangerous than it actually is. The streets are full of moto drivers and it is chaos. All of the traffic makes for a pretty slow ride to the hospital so any accident would be more comparable to bumper cars instead of an actual accident!

Once I get to the hospital, I just head up to the general surgery floor and wait for one of the surgeons. Nina, the Scottish girl that does medicine with me, and I usually just observe consults and rounds until a surgery is scheduled. On Tuesday, we saw a cholecystectomy. On Wednesday, there wasn’t a surgery scheduled so I was able to come home at noon and relax. On Thursday, a total gastrectomy was scheduled but once the surgeon was able to open him up, he noticed that the cancer had spread beyond the stomach and it was inoperable. We were also able to head into the next OR after the gastrectomy patient was closed up and see a little bit of a brain tumor removal. The hospital has been a great experience and each day is different, which is great! The doctor that I met on the first day asked me where I am from in the US and I told him Nebraska. Since Cambodians aren’t familiar with this, I just say that I lived in Texas for a bit. They know that one!! Now, this doctor refers to me as a cowboy and says I am “Leslie, with the big hat, boots and guns”. Silly man!

Since I am usually only at the hospital until about 1 each day, I get to do a lot of exploring in the afternoons and evenings. On Tuesday, I went to the Russian market to buy surgical caps and then Steph and I went to riverside to hang out before we came home for dinner. On Wednesday night, we went to a spa here called “ONE”. It is a really nice and more expensive salon here in Phnom Penh. By the way, “expensive” means $12 for a 90 min massage and $10 for a 60 min pedicure. Usually, a manicure and pedicure adds up to be a whole $2! ONE is a spa that trains young girls on various spa treatments and keeps them employed. The girls all live together in an apartment. We read each of their stories and they all come from very rough, poverty-stricken backgrounds (like many Cambodians). I read a variety of stories including one being abandoned at a young age and starting to work as a housekeeper at 9 years old. Another woman was married at 19 but then went to school outside of Phnom Penh. She came back a year later to find that her husband had married her cousin! She ran into her husband (with her cousin) in a club about 2 years later where he beat her with a board. She suffered many internal injuries and spent the next year in the hospital—the same amount of time he spent in jail. The stories go on and on. It was really interesting to spend some time with these amazing women, learn about their past and then sit with them and just observe how far they have come!

On Thursday, I was done at the hospital at around 12:30 so I came back for lunch and then spent the afternoon with Steph and Amy at their orphanage. The orphanage has about 20-30 kids ranging from an itty bitty baby to a 21 year old. I had so much fun holding the little babies, playing soccer with the young boys and helping Steph use lice shampoo on the kiddos. The stories of these kids also have a wide range. Some of the kids were found by the river or in a dumpster while some of them still have parents, but the parents don’t have enough money to take care of them so they live at the orphanage. Nonetheless, they are all just full of joy and are wonderful to spend time with! After the orphanage, some of us went to meditation at the temple and it was exactly how you would imagine it! Bald monks walking around with their orange, draped clothing while people silently sat Indian-style on cushions. It was a really interesting experience and I plan on going each Thursday. I am not really great at the whole “thinking about nothing” idea they have…but it is a wonderful time to just reflect on my time in Cambodia and be thankful for the opportunity to be here. They gave me a little book on meditation to coach me through my first time there and it talks about “loving-kindness” and its importance in our lives. It was really great to read so I thought I would share it with you guys! It explained how it is important to practice loving-kindness towards others and ourselves. This includes forgiving ourselves for certain things and forgiving others. It also includes just loving ourselves while we love others. We can’t practice loving-kindness towards others without practicing it towards ourselves and vice versa. We were supposed to think about this and the people, things and experiences in our lives. I couldn’t help but think about everyone at home when I read “May all beings in this world be well, happy and peaceful”. So I hope everyone is well back in America and I think about you all often! Until next time!

Home Sweet Cambodia

I have arrived in Phnom Penh and everything is great! It is a chaotic city with crazy driving, a wild nightlife and TONS of people. My roommates are great girls. One is from Australia and the other is from California. I arrived at the apartment at around 10:30 pm and we were out shortly after. On Sunday, we woke up and went to get some coffee, went to the market and then took a tuk tuk out to the countryside. We were able to go see Prasat Taprom Tonle Bati (http://www.leisurecambodia.com/news/detail.php?id=110). The little kids here are adorable and the ones that get to go to school love to practice their English with us. I told a little girl that her English was very good and she said she learned it in school. We were standing next to a cow and she goes "the cow doesn't know english because he didn't go to school". Cute little kids!! I will have orientation tomorrow and go meet the doctors at the hospital where I will start on Tuesday morning. Can't wait!