First, some shoes.
Knar school is an hour away from Siem Reap in a very poor area. I will tell you more about the school at another time. Today, I took three boys from the school to the children's hospital with Lori. They have all been complaining of hearing loss and saying that they did not want to go to school anymore. As an Audiologist in a former life it was hoped that I would be useful.
None of the boys had been to Siem Reap before and coming to the big city (actually small town) was a major event. None of them speak any English. Their teacher, who does have some English came with them and helped to translate. They came to the house first; the youngest boy did not have any shoes on. So, first we got him some new flip flops. He beamed when he realised that they were for him. Newly shod, we set off in a tuk tuk for the hospital They all looked rather frightened about being hauled off in the big city they had never seen and in a tuk tuk they had never been in by two barang (foreign) women.
So, we got to the Children's Hospital. There were crowds of people waiting patiently with their sick children in a semi-open space, we found it a little confusing. We were given a number and had to wait. Eventually we were called for registering. There was a desk, a few dirty boxes with random stuff in and a thermometer that was being stuck under all the kids arms. There was a filthy bit of cotton wool being used to wipe things. There was some confusion about one of the boys ages, he is 15 - too old for the children's hospital here. These boys were presenting with hearing problems and everyone who spoke to them was wearing a face mask. When they when they did not hear the question ans said 'what' the nurse just wrote down a question mark and moved on to the next question. I find it hard to convey to you how awful it all was. You were supposed to take off your shoes to enter the hospital, something Lori and I refused to do. At one point I said 'this is a hell hole' Lori told me that the real hell hole was the General Hospital for adults. There are people lyng in corridors with i v's with blood and excrement all over the floor.. She said that if she was ever unfortunate enough to find herself in there she would pray to God for death..
The boys were then weighed in another place and we were told to wait again. At this point we decided to go out and get the boys some lunch as they had probably not eaten all day. We went off to a restaurant and got lots of noodles and rice with chicken, pork and vegetables. We also got cans of mango juice for them In the very poor villages kids exist on rice with nothing else we wanted hem to eat well. When we got back I foolishly asked someone if the boys had time to eat before they were seen. Silly me, several hours later we were still waiting. The waiting would have ben alright if we thought that there was any hope of them getting some decent care at the end of it; fat chance. Nothing was clean enough. You got the feeling that if you went there healthy you would almost certainly contract something just by being there. You didn't want to breath the air. If there had just been a sink and soap it would have been a huge improvement. Some of the babies, especially, looked very sick. One in 5 children die before their fifth birthday often from illnesses that could be prevented by access to clean water and basic hygeine.
Our boys had particularly dirty feet, not surprising when you don't own shoes. It was the sort of dirt that looks totally ingrained. They walk through the rice paddies, get small cuts that get infected and they never really heal. Their homes have no soap and no clean water. The foundation has put a new well in the school with clean(ish) water and started a foot washing programme. The next job is to put in a facility for the kids to shower. One of our boys today had a large area of sores on one leg.
Eventually, after several hours we were called in to see the Doctor. Another Cambodian rule is that you do not ask the Doctor questions about anything he does or says. It can piss them off and work against you.
It's not their fault but the standard of diagnosis and level of training here is diabolical.. During the KR regime all the hospitals were blown up. Anyone known to be or foolish enough to admit to being a Doctor was killed. A whole generation of knowledge and skill was lost, The Doctor's are all very young and there is no one with experience to pass on any training. Facilities are poor and our boys got shoddy diagnosis, were given appalling advice and offered no treatment other than a course of antibiotics that everyone comes out with whether you need them or not. I was fit to boil, I wanted to scream out loud but I could not question the Doctor. At one point when I suggested that one boy, who was mouth breathing and has chronic otitis media might benefit from and adenoidectomy he said ' but he needs to have a runny nose before we would consider it' I said, I thought very mildly, but he has a hearing loss what about that. Immediately another Doctor appeared to see what was going on. I though we might get thrown out. I had to sit on my hands and bite my tongue but I was at boiling point about the futility of it all. He did a useless test with a broken tuning fork on one boy and declared that he had 50% hearing - nonsense. He came up with rubbish that he had obviously read in a book that had no relevance to the conditions that our boys had. It was all so upsetting because in the west these children could be treated successfully so easily. Here there is no treatment.
The consequences of all this are that a young child gets an untreated acute ear infection. Then another and so on. The infection becomes chronic and still there is no treatment. The hearing loss means that the child looses interest in school. He probably stops going and so ends up with no education. He becomes withdrawn and is just known as the deaf one. He job prospects are very limited, he certainly cannot move out of the cycle of poverty. His life is blighted all because he got something that 1 in 5 children all over the world get and that, certainly in the west ,is so easily treated. It makes me feel so impotent that such small things present such huge obstacles here.
The boys were scared. We were doing everything we could to try to get some help for them but, ultimately, we did nothing. There was nothing that we could do. It was all for nothing except a decent lunch, an ice-cream and some new shoes.
It has been a totally shitty day. After showering away the filth of the hospital Lori and I went to Raffles and sat in colonial splendour and had a cocktail. It was lovely and we felt that we deserved it. We are lucky that we are able to do that- it helps to make it all a bit more bearable. All we could do for our boys was to send them home. Back to their village hut with no electricity, no clean water and very little hope and that hurts.
None of the boys had been to Siem Reap before and coming to the big city (actually small town) was a major event. None of them speak any English. Their teacher, who does have some English came with them and helped to translate. They came to the house first; the youngest boy did not have any shoes on. So, first we got him some new flip flops. He beamed when he realised that they were for him. Newly shod, we set off in a tuk tuk for the hospital They all looked rather frightened about being hauled off in the big city they had never seen and in a tuk tuk they had never been in by two barang (foreign) women.
So, we got to the Children's Hospital. There were crowds of people waiting patiently with their sick children in a semi-open space, we found it a little confusing. We were given a number and had to wait. Eventually we were called for registering. There was a desk, a few dirty boxes with random stuff in and a thermometer that was being stuck under all the kids arms. There was a filthy bit of cotton wool being used to wipe things. There was some confusion about one of the boys ages, he is 15 - too old for the children's hospital here. These boys were presenting with hearing problems and everyone who spoke to them was wearing a face mask. When they when they did not hear the question ans said 'what' the nurse just wrote down a question mark and moved on to the next question. I find it hard to convey to you how awful it all was. You were supposed to take off your shoes to enter the hospital, something Lori and I refused to do. At one point I said 'this is a hell hole' Lori told me that the real hell hole was the General Hospital for adults. There are people lyng in corridors with i v's with blood and excrement all over the floor.. She said that if she was ever unfortunate enough to find herself in there she would pray to God for death..
The boys were then weighed in another place and we were told to wait again. At this point we decided to go out and get the boys some lunch as they had probably not eaten all day. We went off to a restaurant and got lots of noodles and rice with chicken, pork and vegetables. We also got cans of mango juice for them In the very poor villages kids exist on rice with nothing else we wanted hem to eat well. When we got back I foolishly asked someone if the boys had time to eat before they were seen. Silly me, several hours later we were still waiting. The waiting would have ben alright if we thought that there was any hope of them getting some decent care at the end of it; fat chance. Nothing was clean enough. You got the feeling that if you went there healthy you would almost certainly contract something just by being there. You didn't want to breath the air. If there had just been a sink and soap it would have been a huge improvement. Some of the babies, especially, looked very sick. One in 5 children die before their fifth birthday often from illnesses that could be prevented by access to clean water and basic hygeine.
Our boys had particularly dirty feet, not surprising when you don't own shoes. It was the sort of dirt that looks totally ingrained. They walk through the rice paddies, get small cuts that get infected and they never really heal. Their homes have no soap and no clean water. The foundation has put a new well in the school with clean(ish) water and started a foot washing programme. The next job is to put in a facility for the kids to shower. One of our boys today had a large area of sores on one leg.
Eventually, after several hours we were called in to see the Doctor. Another Cambodian rule is that you do not ask the Doctor questions about anything he does or says. It can piss them off and work against you.
It's not their fault but the standard of diagnosis and level of training here is diabolical.. During the KR regime all the hospitals were blown up. Anyone known to be or foolish enough to admit to being a Doctor was killed. A whole generation of knowledge and skill was lost, The Doctor's are all very young and there is no one with experience to pass on any training. Facilities are poor and our boys got shoddy diagnosis, were given appalling advice and offered no treatment other than a course of antibiotics that everyone comes out with whether you need them or not. I was fit to boil, I wanted to scream out loud but I could not question the Doctor. At one point when I suggested that one boy, who was mouth breathing and has chronic otitis media might benefit from and adenoidectomy he said ' but he needs to have a runny nose before we would consider it' I said, I thought very mildly, but he has a hearing loss what about that. Immediately another Doctor appeared to see what was going on. I though we might get thrown out. I had to sit on my hands and bite my tongue but I was at boiling point about the futility of it all. He did a useless test with a broken tuning fork on one boy and declared that he had 50% hearing - nonsense. He came up with rubbish that he had obviously read in a book that had no relevance to the conditions that our boys had. It was all so upsetting because in the west these children could be treated successfully so easily. Here there is no treatment.
The consequences of all this are that a young child gets an untreated acute ear infection. Then another and so on. The infection becomes chronic and still there is no treatment. The hearing loss means that the child looses interest in school. He probably stops going and so ends up with no education. He becomes withdrawn and is just known as the deaf one. He job prospects are very limited, he certainly cannot move out of the cycle of poverty. His life is blighted all because he got something that 1 in 5 children all over the world get and that, certainly in the west ,is so easily treated. It makes me feel so impotent that such small things present such huge obstacles here.
The boys were scared. We were doing everything we could to try to get some help for them but, ultimately, we did nothing. There was nothing that we could do. It was all for nothing except a decent lunch, an ice-cream and some new shoes.
It has been a totally shitty day. After showering away the filth of the hospital Lori and I went to Raffles and sat in colonial splendour and had a cocktail. It was lovely and we felt that we deserved it. We are lucky that we are able to do that- it helps to make it all a bit more bearable. All we could do for our boys was to send them home. Back to their village hut with no electricity, no clean water and very little hope and that hurts.
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