A helping hand in Cambodian slums

New Zealand Doctor
http://www.nzdoctor.co.nz

22 APRIL 2009
AnneMarie Tangney

In September last year I took a month off from my normal routine of playing doctor, mother and wife and went to live in the slums of Phnom Pehn, Cambodia. I stayed with a family in a slum situated in the southeast of the city. Of course, I paid for my keep so as not to be a financial burden to them.

The idea behind going to Cambodia was for me to get out of my comfort zone, to experience real poverty firsthand and see what impact a group called Task (a local Christian organisation, funded by charities such as TEAR Fund) was doing through their various aid projects.

My host family did not speak any English and so out of sheer necessity I managed to learn more Khmer language than I would ever have dreamed possible. I started by learning to count, name everyday foods, say please, thank you and basic greetings. Then I added some adjectives and more nouns to my vocabulary.

I was surprised my ageing brain was still elastic enough to cope with language acquisition at such speed and marvelled at the value of total immersion for learning a new language. By the end of the month, in fairly basic Khmer I was able to chat and joke with my host family, teach them some card games such as Last Card, which they loved, and felt I had a meaningful relationship with them.

It was an unforgettable month. Each day started with me rising at 5.30am to the sound of the neighbourhood getting into full swing of the morning routine, which consisted of television or pop music at full volume, people washing clothes in large metal bowls and breakfast preparation. The coolness of the early morning made it definitely the most pleasant time of the day, as generally after 8am the temperatures would start to climb to levels such that I would start perspiring from then until night time. I had no real way of knowing for sure but guessed the temperatures to be about 35 to 45°C between 8am and 8pm.

After breakfast, which was rice every day, I would usually get a motorbike ride into town. It was a challenge both haggling in Khmer with the motorbike driver as to what the fare for each ride would be and holding on for dear life as we negotiated some of the most incredibly dense and chaotic traffic I have ever seen.

After surviving the ride to the city, I would meet up with someone from the Task medical team. The medical team consisted of a doctor, a nurse, a medical student (a man putting himself through medical school on the weekends) and a midwife. I would tag along with one of them as they visited various aid projects. The three projects I most frequently attended were AIDS home care which involved regular supportive home visits to people diagnosed with HIV/AIDS, a clinic for prostitutes and a women’s general clinic.

September was still the rainy season and the unbelievable rainfall along with non-existent drainage meant we were often wading through flooded alleyways of warm, blackish water to access many homes. Upon arriving at a patient’s home, I sometimes had a bit of difficulty getting up the thin wooden ladders to the rickety houses on stilts. I was sometimes worried I would break the flimsy floors made of split bamboo with my weight but luckily they seemed to be sturdy enough to cope, despite the fact I was roughly double the weight of an average Cambodian woman.

The most common medical problems I encountered when visiting people with HIV/AIDS in their homes were activated TB, dysentery, thrush and skin sepsis. A lot of emphasis went on encouraging patients to keep going with their TB treatment, to start or continue with their anti-retroviral therapy and sorting out everyday issues such as access to food and basic items such as cooking pots, blankets and mosquito nets. There was a real sense of satisfaction felt by myself and the Task team for their work. Without such work the majority of people they help would have no hope of access to medical care and basic items. It’s a pity there is so much work to be done among the very poor of Cambodia and a finite amount of time, money and man power to do it. Nevertheless, to be part of this was terribly satisfying indeed.

It was lovely getting back to my family in Dunedin and going back to my usual routine has not been as weird as I thought. I realise I tend to live in the present and try to make the most of the opportunities of the moment. Still I hope my month in Cambodia gets to have some impact on my present and future, but I am still trying to figure out how.

AnneMarie Tangney is a Dunedin GP