Cambodia Clinic Day 5 and wrap up

Hands on the shoulder of the one in front of them, they moved in a line through nutritional assessment then waited to be seen by a medical provider. Each had a different expression, some smiling, some not so sure of what to expect, some showing nervousness, some taking everything in and some just looked like they had been through this before. I remember one little boy in particular. He was shy, eyes downcast, hands twisting inside of each other, and feet moving from side to side. I watched him as he went to get weighed and then measured for height. He never looked up, obeyed instructions and moved from one station to another. One always questions coincidences or at least I do. Out of the 15 medical examiners, the hundreds of children we were seeing, the line moving at a pace that resembled a quiet chaos of order, he was brought to me. Coincidence, I think not. He sat down in front of me, eyes diverted, ignoring my smiles, my hand on his, and my gentle assurance that all will be well. Sitting back, I looked at him and stayed silent for a moment. I did not have an interpreter, so I took a chance.

 

“Do you know who I am?” I asked in English. He did not reply.

 

“Do you know why you are here?” He didn’t look up. I thought how silly of me to expect him to understand English and to respond. I tried another approach.

 

“Can I hold your hand? Will you let me listen to your heart?” He looked up making contact with my eyes. He reached out his hand. I took it. We sat like that for a few moments, not saying anything. I held his hand and smiled. And he smiled back. I leaned in and put my stethoscope on his chest and I heard his heart beating fast, and as I listened some more holding his hand, I heard his heart beat slow, his breathing more regular and his hand resting comfortably in mine.

 

I asked an interpreter sitting at another table to ask this little boy if he spoke English. The little boy when asked shook his head no. He smiled at me, and reached out for both of my hands now and held tight. I held tight too and then asked him if I could finish examining him. He said nothing but let go of my hands. I finished examining him, the whole time of which he look at me and smiled.

 

When I was done, I filled out his form, gave him his plastic bag that he would use to get his vitamins, his tooth brush, a small gift, stickers, and an antibiotic I prescribed for his ear infection. He stood, started to walk away then stopped. He turned, looked at me and smiled. I smiled back. I watched him for a long time as he made his way in the line through all the rest of the stations. As he came to the last one, he turned around again and smiled at me one more time. I smiled back. He was 5 years old. How did all this happen? Did he understand English? I’ll never know. But all that is a never mind. I remember what I told the team the first day about expectations and that it is all about what we leave behind. I’ll never forget him, and I hope he never forgets me. I have no reason to try and figure this whole thing out, to dwell on the whys and the how’s, because for me the expectation on this trip was that I would see God’s hand touch those who we came to see and I did. I believe that He gave that child a listening heart that understood me and He gave me a patient heart to trust that He would be there for all of us. I saw it all during the week. A team of 31 servants who had listening and patient hearts, giving of themselves to the 1500 children who we saw this week.

 

Until our next trip in October to India, in all things give thanks,

 

David

Cambodia Clinic Day 4

So help me out here. Another day at a school, hundreds of children seen, most with an illness or 2 overworking our pharmacy with dispensing medications. We are working in tandem and moving at a quick pace, seeing 220 children in about 2.5 hours. Do the math and you’ll get an idea of how we did in a 6 hour clinic day (okay I’ll tell you…534 children seen today). But that is not what I need help with. This morning I gave a talk on child abuse, one of the several clinical pearls I do each morning while we are on a medical mission trip. We talked about presentation, suspicion of, treatment of and protection of the child. We also talked about the cultural differences when it comes to parenting and what we consider child abuse. Do we impose our cultural standards of child protection on other cultures or do we try to understand the other side and look the other way when a child is being hit with a stick which they consider accepted discipline? What about the medical side? “Coining” is when a coin is rubbed hard on the skin making significant red streaks over the back and the chest. Purpose? To rid the child of fever and bad humors and is common here. But what about something more disturbing. Placing a burning ember on the skin in a pattern described by a local medicine man to rid the body of, again, bad humors? And on a child. Held down and burned. We saw such a child today. The picture clearly shows the scar of the burn mark. When the Cambodians who were working with us were asked about it, there was a shrug of the shoulder and a general acceptance that is a cultural norm. Not so with us. We struggled with it and wondered how we could teach the sensitive and true side of caring without harming the child. The answer wasn’t simple. They don’t see it as harmful, but truly a caring nature to help cure their child of disease. A parent’s love, genuine no different than our own desire to protect our children from illness, but to us incomprehensible as to how they did so. So, we shook our heads, and hoped that some insight to what child abuse is would cross all cultural boundaries one day. What say you? Other than that, we had a wonderful day…

 

In all things give thanks,

 

David

Cambodia Clinic Day 3

The clouds turned black, blocking out the sun and it began. The torrential rain fell and fell some more, drowning the country and all who lived in it. The rainy season was here. People looked up and continued to live life thankful for the rain, undeterred by the flooded streets, the humidity and the dampness. They waited for it. It would last a few months, giving life to the dry arid land that Cambodia had become just a short while a go.

 

The sun struck the ground, scorched it, and killed all that lay in view. Hot air circulated around the barren ground, taking with it the water that had filled a lake just a few months ago. People looked up and continued to live a life hampered by the arid and dry heat and waited for the rain. The dry season.

 

That is how it is here in Cambodia, flipping from one season to the next, and today we saw and lived in the dry season, crawling along a shallow river of water to a shallow lake where about 200 families lived on floating bamboo and wood houses, floating with the ups and downs of the lake. In the rainy season the lake is huge, with a water level that is 30 feet above the current riverbed. Today, the floating village lay close to land both to the side of them and underneath them. There are about 300 children there in a school that was built for them by One Child Matters, and we were there to see them. We set up clinic on the banks of the shallow lake and watched as the children came to us in small skiffs. We too had traveled several miles in small skiffs to get there. Right here in the middle of a shallow lake in the boonies of Cambodia, working under tarps and with a generator and a router, we saw a couple of hundred children using our electronic medical record system. Technology in a place barren of anything that would resemble comfort and modern. The school has outhouses that empty right into the lake where the children swim. There is a cell phone tower just a few hundred yards from the floating homes and the school placed on a small patch of land in the lake, but they don’t have electricity or running water. The living conditions were evident in the health of the children. Many chronically malnourished children with chronic infections. There is much to do and much to address. But wouldn’t you agree that even if we are successful in treating the malnutrition, the chronic infections and more, the swimming in the polluted water, the bathroom residues going directly into the lake and the overall life lived without running clean water, electricity and more would trump anything that we could ever accomplish? Not so fast. We are gaining ground since we were here last. Teaching the children about hygiene, bathroom protocol, and more has made a difference. Yes, we saw some sick children, but they are better than what we saw several years ago. So, give us time, and let’s continue to see how it all plays out. It is playing out, granted slowly. No giving up just yet…

 

In all things give thanks,

 

David

Cambodia clinica Day 2

Sometimes we can’t hide from the truth. The truth therefore is…we didn’t see many patients today. I could be a great wordsmith and write around the fact that we waited and waited and waited some more for patients to arrive without really saying so, but that would just not be right. So I openly declare that we sat around, getting to know each other, seeing maybe 100 patients, ate lunch, went on a walk, visited a silk farm, and wondered what happened. What we were told was that the children knew we were coming but they were all adolescents and self disciplined. It was thought that since it was so hot, the adolescents were probably not keen on riding their bicycles in the heat and would maybe, just maybe, come by around 4 or 5pm. Really? Yes really.

 

What do you do when you sacrifice your time to come and do a medical mission trip and you wait for someone to show up so that you can help? You question if this was a bust and a waste of time. Truth be told (yep, the truth again), we all thought that. I could show a picture of us sitting around fanning ourselves, drinking liters of water and talking or I won’t. So I won’t. But here is a picture picture of us getting ready to leave in the morning. Little did we know…

 

Transparency is what we are all about. Truth telling and honesty. Some people just can’t handle the truth (you remember that line from a motion picture). We can however and we aren’t ashamed of it. So, here is a little bit more of the truth. It was a relatively restful day, needed and appreciated. Tomorrow I can assure (truthfully), will be very different. Just wait and see. A floating village is where we are going. We won’t be sitting around, oh no. We’ll be busy. And that is the truth and nothing but the truth.

 

In all things give thanks, 

David

Cambodia Clinic Day 1

As the warmth of the early morning sun broke through the waning darkness of the night, we drove 180 kilometers from Siem Reap to Battambang. Salaa Hope School was our first stop and our first grouping of our medical team in action. Not to worry. Within 30 minutes we were up and running seeing about 100 patients in the first 1 and a quarter hour. The children all looked healthy and in fact they were. Salaa Hope is the school where we built our first medical clinic in 2004 and is staffed by Chhaiden who is our country medical director. In 2005 I trained 15 teachers to be healthcare workers, and Chhaiden showed a unique knack for the vocation.  We sent him away to medical school. A physician, who had traveled with us several times, sponsored his medical school tuition and today, Chhaiden is responsible for the healthcare of the 3000 One Child Matters children in Cambodia. From 2004 until now, a medical clinic, over 8 Medical Mercy trips, 15 healthcare workers trained (9 who are still here), and a Country Medical Director are in place: true sustainable care.

 

In the afternoon we went to Prey Dach School where there were another few hundred children to see. No electricity, sweltering heat, some minor technical problems with our new electronic medical records, led to some delays, but once we got going, we got going.

 

So what about a story? Well, sorry, there isn’t one. But there is an observation. Lots of smiling faces, lots of laughs and lots of love…from the children and back at them from the team. Remembering that the expectation isn’t what we bring, but what we leave behind, I looked at the team and the children throughout the day, and saw much of what we left behind. It’s always the little things that bring the biggest rewards. Despite the heat, and I mean heat, I think we accomplished what we came here to do. Perhaps one day I’ll be able to verify that, but for now, I’ll just go with my heart.

 

In all things give thanks,

 

David