Mission to Cambodia: Third Clinic in Poipet and Traveling to Siem Reap

My roommate and I woke up this morning convinced that the world was ending. Music and yelling from the streets outside our hotel was so loud that we could feel the entire building shaking. Turns out it was just a parade because of the upcoming election that was casually going on at 6:20 AM. Cambodians are early risers, that’s for sure. Once we were assured that the world would in fact go on, we got up and got ready for the day. After a breakfast of noodle soup and iced coffee with sweet milk, we were off to our third clinic around Poipet.

On the bus in the morning, Dr. Massie led a devotional and prayer. She spoke about how we are all broken in our own ways, but that God uses our brokenness and our differences for the good of his Kingdom if we come to Him as we are and allow Him to work through us. If you are interested in the story that she shared with us this morning, google “Indian cracked pot story”. Unfortunately, the parades for the election caused a lot of traffic buildup and we were a bit late showing up to the Vision of Hope Center, a small Christian school that opened its doors for us to set up our clinic. Our lovely translators and other friends from Freedom’s Promise met us there. The building was small but we made it work as usual. Today was a short day due to both showing up later than planned and also because we had a three-hour bus ride from Poipet to Siem Reap, where we will be staying until Sunday morning. Despite only lasting a little over three hours, we were able to see a good number of patients. The nursing students switched roles a little bit so that we were all able to have multiple experiences over the three days. Kim and Paige soldiered on assessing and diagnosing, and the pharmacy team did an amazing job working together and working with what they had to provide the best care that we could for these people.

Last clinic in Poipet with all of the wonderful missionaries and translators who partnered with us to make these clinics possible!

I had the opportunity to be at the education and prayer station, which was the last table that the patients would go to before leaving. This was a difficult but really great experience for me both as a nursing students and as a Christian. A huge part of nursing is patient education, but I have not had many opportunities in nursing school so far to put that into practice. I found myself drawing from things I have learned in nursing school so far and being so thankful to Belmont and the wonderful education that I am so blessed to receive there. I spoke to patients about things like how and why to take the medications that they were given, different diet and lifestyle changes for things like diabetes or hypertension, living with asthma, relaxation techniques for anxiety, proper hydration and nutrition, and more. My heart went out to each individual that I spoke with, especially when it was clear that they were in need of the kind of medical care or

Getting fruit off the trees outside the school

education that we simply could not provide them with. After asking if they had any more questions, I would ask if it was okay if I prayed for them. Almost all of them said yes, and this was a special time to call on the Lord and ask for healing and safety for these people who we have grown to love so dearly in our short time here. Many of the people who I prayed over today were most likely Buddhists, but I was amazed at their reverence while praying and the kindness that they showed to me during our brief but hopefully meaningful interactions.

Around 1 PM, we packed everything up and ate a lunch of peanut butter sandwiches and some delicious fresh mango from right off the trees outside the school. The translators and everyone from Freedom’s Promise showed us so much love and kindness during our three days here, and they gave each of us a gift of a beautiful Cambodian scarf. After a prayer, lots of photos and hugs goodbye, our group of 20 piled into our bus and headed to SIem Reap.

Views from our hotel in Siem Reap

The bus ride was about three hours long and the other undergraduate nursing students and I we passed the time telling gross and funny stories from our experiences in nursing school. We were stuck in traffic once again in Siem Reap because of the election. Once we arrived to the hotel we were greeted with cool towels and tea. We ate dinner at a rooftop restaurant on the top floor of our hotel. The hotel here in Siem Reap is very nice and we are all so excited to have a break from working hard in the clinics and for the opportunity to tour the temples around Siem Reap tomorrow! Everyone is going to bed early because tomorrow we leave at 4 AM to catch the sunrise at Angkor Wat!

 

 

 

 

 

Mission to Cambodia: Second Poipet Clinic Day

One of our translators Sarah!

Today, we held our second day of clinics in Poipet. We started off the day with leftover, cold pizza for breakfast because we needed a pick me up from yesterday’s breakfast. Our group had ventured out and we were served Khmer porridge with chicken liver and some were adventurous than others. A woman from the community opened up her home so we could use it as the clinic. It was a smaller space with an open patio and curtains to block out the sun (we greatly appericiated this). It was amazing this woman who didn’t know us would offer up her home so we could run the clinic in her village. We didn’t know where we were going to set up clinic, but we trusted God would provide and He did. We saw around 70 people that day of varying ages. We saw several babies and children and it was sad to see what they were going through, especially the malnourished children and scabies wounds.

One of our practitioners, Kim, assessing this sweet baby!

This is such a huge problem in all third world countries, but it never gets easier to see children suffering from it. The children are still so joyful and want you to play with them despite them not feeling their best, which is very inspiring. Our translators from Freedom’s Promise were outstanding. There was no way we could do our job without them! We all worked with the same translator for the 3 days of clinics so we got to know them really well and enjoyed spending time with them.

From the outside looking into the clinic, it looked like mass, unorganized, chaos, but on the inside everyone had a place and job. We had nurse practitioners, undergrad nursing, and pharmacy all working together to make the clinic run smoothly. We functioned extremely

Some of the sweet children we were able to take care of

well together, especially since it was our second day understanding how the flow of the clinic should be. The most incredible part of the day was watching our entire team work together and really see all of the nursing & pharmacy skills we have learned put into practice. It was like it finally clicked with us how much we truly knew and have learned. This was a neat experience because we all had different moments when we realized this. Several of us shared stories that night during our highs and lows about those moments. Highs and lows are something we do (attempt) every night where we can share moments or stories from the day with the whole group. Even though we were together all day, we all had different experiences and enjoy hearing our different views. IMG_7055.MOV (click on link to see video)

Later tonight, we went to dinner and then came back for praise and worship with Freedom’s Promise. We sang and worshiped together and it was truly amazing to see just how powerful God’s love is. His love is not just in our Bible belt of the South, but across the entire world. It is very powerful to watch Him work in everyone’s lives and see how much impact God has had in Cambodia and in our lives the short time we’ve been in Cambodia. After we worshiped, Freedom’s Promise brought out handmade bags, wallets, and other little items for purchasing. Our group swarmed at them because apparently we can’t pass up a good Cambodian deal. Dr. Massie was the first one there and just about everyone in our group bought something! We had a great day and tomorrow we are doing another clinic in Poipet before we head to Siem Rep for temples and being tourists!

 

 

CHS Faculty and Staff Perform to Raise Money for Charity

CHSN faculty and staff group perform for charityDr. Natalie Michaels, associate professor in the College of Health Sciences and Michal Christian, program assistant in the School of Nursing, continue to make music together in an effort to raise money for the Down Syndrome Association of Middle Tennessee. With the addition of Dr. Mark Christian, adjunct professor in the College of Theology and Christian Ministry, the group played everything from “Misty” to “I Will Always Love You.”

Michaels has been singing and writing music since she was 10 years old. She also plays piano and the flute. Michal Christian is a classically trained ballet dancer and musician, and Dr. Mark Christian is a professional guitarist.

Mission to Cambodia: On the way to Poipet we go!

After nine hours of riding in a bus that reminded me of the Taj Mahal (purple curtains included), our entire team has finally arrived in Poipet, Cambodia. The bus ride started out a little rough. Unfortunately, the fire extinguisher fell from one of the overhead shelves and exploded as soon as it hit the ground. The white fumes started spreading everywhere, so we quickly pulled over to air the bus out. After that little hiccup, we were smooth sailing. And by that I mean the bus ride felt much like a wooden roller coaster at an amusement park.

When the fire extinguisher broke – note the purple curtains and seat covers.

Meat market at one of our stops

After arriving in Poipet, we checked in to our hotel and headed straight to dinner. We were all starving and in desperate need of some nourishment. One of our hosts took us to a casino on the Thailand border and we ate at the restaurant inside. For the past week, I’ve been on a hunt to find something green to eat (coming from the girl who eats spinach out of the bag like chips). Lucky for me, the restaurant had broccoli! I was on cloud nine to put something green and tasty in my mouth.

Casino on the Thailand border

On the way back to the hotel, our host and a few of the translators that will be working with us at the clinics tomorrow told us about Poipet. We drove by a street that had building after building of massage businesses with young girls sitting out front. I thought to myself how strange it was to have so many places to get a massage all lined up together and how it seemed awfully late to be going to get a massage. A second later, our host turned to me and said that the girls sitting outside were probably somewhere around my age. He added that the store fronts say that they offer massages, but their real business of prostitution is in the back of the building.

At first, I didn’t really comprehend what he was telling me. How could these young, pretty girls be caught up in such a horrible cycle like human trafficking and how did they get into this situation in the first place? It hurt my heart knowing that these girls were around the same age as me and didn’t have an escape route from their present reality. As I thought more and more about it, I started to realize a few different things. Human trafficking effects all countries and it does not discriminate against race, ethnicity, or socioeconomic status. There are many factors that perpetuate the cycle and a few that are especially unique to Cambodia. The country continues to rebuild itself after the mass genocide that occurred in the 70’s under the Pol Pot regime. With high levels of poverty, few job opportunities, and a broke justice system, trafficking and exploitation in this vulnerable country continues to persist.

Over the next couple of days, our team will be working with an organization called Freedoms Promise as we set up clinics and see patients in different provinces around Poipet. Their mission is to free those who are caught in the cycle of human trafficking by restoring communities, empowering leaders, and sharing their vision of freedom from oppression through the love of Jesus Christ. Please continue to pray for our team as we treat and educate patients over the next couple of days and love on the people of Poipet.

Mission to Cambodia: Hope Hospital and Preparing for Poipet

By Tessa Collier, Undergraduate Nursing Student

Today, the undergraduate nursing students went back to Hope Hospital here in Phnom Penh while the graduate nursing students went on home visits in the area. This morning eleven students and our three professors piled into the hospital van with several huge, military green duffel bags full of supplies to donate to the hospital. Dr. Massie led a Memorial Day themed devotion en route. When we arrived, we walked into the lobby to take a group photo with all of our donations. I have noticed that so many people want to take photos with us, and I have not encountered that on previous study abroad and mission trips I have been on.

Our group of eight students split into two, and we were led on a tour of the hospital. We were informed that Hope is known throughout the country for providing excellent care, and Cambodian nursing students love having the opportunity to learn at the hospital. Our guide explained to us how the hospital used to take pride in providing completely free healthcare to its recipients but decreased funding has forced it to start charging (albeit minimally) for services. We were led through the different departments, such as the Emergency Room, a minor procedure room, and Radiology. These are among the few of the only air-conditioned rooms in the entire facility. Instead of indoor waiting rooms, patients wait outside because the sun kills Tuberculosis. We walked through the beautiful courtyard with a large mango tree into a clinic and the lab. We finished our tour by visiting the medical and surgical wards on the second floor. Each ward has about 12-13 beds; there are no individual patient rooms. If a patient needs privacy while a procedure is performed, curtains are pulled around his/her bed. There are no patient care techs or nurses aides. Family members help move the patient from stretcher to bed and are taught by the nurses how to help in managing the care of the loved one. Coming to this hospital also makes me realize how much we waste in America’s hospitals. They do not dispose of chest tubes or other small things that we usually take for granted.

We dropped off five students to shadow local doctors and nurses. Two other students and I followed Dr. Massie, Dr. Taplin, and Dr. Wofford to the medical and surgical wards to look at charts. Charts here are still done through card copies. Dr. Taplin told us that every hospital in the country is required to chart in either English or French (two of Cambodia’s official languages, after Khmer); this particular hospital uses English because it was founded by English speakers. In the medical ward, Dr. Taplin opened the chart of a patient with abscesses in his spleen. They had found growths of what are called Burkholder’s pseudonomas (a term that was not even in Stedman’s Medical Dictionary) which is a type of bacteria common to this region. We then looked at the chart of another patient with Cirrhosis who had come to the hospital with ascites, which is fluid that has shifted into the abdomen. The doctors had just finished performing a paracentesis, draining 1.5-2 liters of fluid from the man (this is the maximum amount that can be drained per day.

We then went to the surgical ward where Dr. Taplin went over the chart of a woman who underwent a mastectomy to remove a huge tumor that had been growing for three years. She had not had access nor the education to wellness check-ups or cancer prevention that we have in the States. At this point, the woman was put on palliative (comfort) care because there is nothing more that can be done for her. There is no chemotherapy in this country. People who have the money can go over to nearby countries, such as Singapore, for treatment, but for the poor there is no such luxury. Dr. Taplin, Dr. Massie, and Dr. Wofford led the three of us students in a discussion about how care differs in this country compared to the States. Again, this hospital is known for providing quality care. So while there are many differences between the two systems, just because they do things differently here does not necessarily mean that it fails to provide great care to patients. It was a very informative and thought-provoking discussion.

We later regrouped with the other five students and went to lunch at Flavours Restaurant, where we went for dinner our first night here. We are now preparing for our nine-hour drive to a province called Poipet tomorrow where we will set up clinics.

 

 

Mission to Cambodia: “The Killing Fields”

Many people in many different countries around the world have been affected by genocide. When most people think about genocide they think about World War II and the Nazi’s decimation of Jewish people. Many people think that genocide is a thing of the distant past, but in Cambodia it is all too recent. From 1975 to 1979, only 38 years ago, Cambodia was thrown into chaos, by a radical regime, the Khmer Rouge and their leader, Pol Pot. Pol Pot saw hardships faced by people living in provinces outside the cities and blamed it on the people living inside the city. He saw education and wealth as a selfish and destructive nature that needed to be eliminated. Yesterday myself and others on the trip visited a cite where his radical ideas became a reality, and what a disgusting and horrific reality it was.

Upon arriving, the first thing you notice is an articulate archway, created in the traditional Cambodian fashion, as well as a tall building built with the same beautiful architecture,  about 100 yards away from the entrance. After we walked inside the camp we dawned our headsets and began the audio tour. Another student on the trip, David, explained an interesting view of this after the tour stating that it felt odd to him that we had the privilege to listen at our own leisure and pace while we were walking on the souls of thousands. As we walked towards the first checkpoint, we grew nearer to the large ornate tower in the center. As we came closer the beauty of the architecture fades away as you notice the thousands of skulls and bones displayed inside; it was truly perturbing.

Entrance

Entrance

tower in center

tower as we came closer

I won’t go into every detail of the audio tour, as it would take up too much time and my memory would not do it justice. As I began to walk around one of the things I noticed was birds singing and wildlife in full bloom. It was an oddly peaceful and almost tranquil place to be; almost as if it were a place to meditate and relax.

The path we walked and the audio tour portrayed a very different more terrifying realization. As you walk down the path there are sometimes fragments of bone and teeth scattered on the ground. There are dozens of pits and small mounds where mass graves had been excavated and the horrible reality hidden beneath brought into light for all to see. On the tour there were signs with descriptions of each area and recreated pictures of what the place was like while the killings were happening. Death and despair was everywhere and you could feel it.

The mass graves have been decorated by tourists with bracelets as a sign of respect and sorrow for the victims, two places in particular had many bracelets; the mass grave of women and children and the child killing tree.

As the tour moves on. It brings you to a tree titled “The Magic Tree” that is explained to be the same species of tree under which Buddha found enlightenment. However this specific tree is ironically called this and was used to hang tools of massacre as well as lights and speakers that blasted revolutionary music to drown out the screams of agony. The audio tour provided a music clip of the music combined with a diesel generator recreating the noise the victims last heard. This was the hardest part of the tour for me and many others. The noise was terrifying and seemed to bring up the emotions of the anguished souls. There are no words to describe the feeling.

At the end of the tour we were allowed to visit inside the tower, I think it was called the Shtupa but don’t quote me on that. As we entered, we took off our shoes out of respect and were offered to buy incense or flowers to leave for the memorial. Inside the tower were many skulls and bones as well as the killing tools. Each skull had a different marking describing how they were killed.

This place is rough on the conscience and for religious people can be a place of questioning. If there is a God how could he let this happen? How can the world be so cruel if there is an almighty? Many people would answer different things, but none of them can take away the heaviness of the reality. After leaving this place I felt I will never be the same. It is hard to go on living the privileged way we do when you know there was and still is so much hardship for others. This place and this country makes me feel ashamed of my fortune and ashamed of my trivial worries. There is nothing left to do but give back as much as I can and try to better myself and the people around me one action at a time. Let this place be a reminder to all of the terrible possibility of genocide. It could happen anywhere, but when the time comes we must make an effort to prevent catastrophes like this to ever happen anywhere.

Mission to Cambodia: Freedom’s Promise School Clinic

Today (Thursday, 5/25) was the fourth day of our trip, but with travel was our second full day in Phnom Penh, Cambodia! After spending yesterday exploring the city and learning more about the history, we were going to engage in the community around us through a variety of ways. Following breakfast at the hotel, our group of fifteen split into three different groups. One group went with a Social Worker to do HIV home visits and another group went to a local hospital to assist with check-offs for their staff. The group I was with was six of us going to a local school through the organization Freedom’s Promise. At the school we would be holding a clinic for Well Child Checks.

As we arrived in the area with the school, the van dropped us off across the street and walked through a small street, similar to an alleyway. The bleak reality of these peoples’ living conditions shook me. Small rooms, which consisted of little more than dividing walls and a cover were homes for families. Running water and simply a place for trash were non-existent. After walking along the row of homes, we were then in the area with the school. It consisted of several classrooms, an office, and a library. A teacher directed us to their covered play area with tables and chairs to use for our clinic. Lauren and I, both nursing students, set up to do height, weight, vital signs, and an eye chart. The two Doctorate of Nursing students, Kim and Paige did thorough assessments. Dr. Wolford and Dr. Massie were assisting anywhere and everywhere – from aiding in assessments to helping prescribe to keeping kids entertained as they waited.

A health issue noticed in nearly every child was tooth decay. This may seem somewhat insignificant to us and an easy fix, but for these kids it can be so much more. If further decay occurs, they could end up without teeth or an infection. While the United States has fluorinated water to help prevent this, these children come from families without running water (and Cambodia’s water isn’t drinkable, much less fluorinated). For the most part, brushing their teeth isn’t a priority. A toothbrush here costs $1, which seems insignificant to us. Yet, for many of these families, that is a day’s wages – not to consider the need for toothpaste or the lack of access to clean water. This simple issue made me realize even further how we take so much for granted back at home.

Dr. Wolford, a pediatric nurse practitioner, made an important point at the beginning of the day. She said that “Kids were kids, wherever you go.” This simple statement eased some of the nerves about not speaking the same language, as I found this reminder to be so true. Smiles, laughter, and even many games are so universal. Even if it was after a little misunderstanding, we learned their games as they did cartwheels over a string made with rubber bands. They learned limbo and we played their version of jump rope. As they waited for the next part of the assessment, Lauren and I were taught some of the shapes in Khmer. We sang “Head, Shoulder, Knees, and Toes” and taught some boys how to flip a half full water bottle to make it land correctly and cheered after many attempts for each of us. These kids were full of joy, despite their circumstances and I think that was the most powerful part of the entire experience.

Mission to Cambodia: First Day

Today was my first day in Cambodia. My group and I woke up early, had breakfast, and walked through the city to the river. Most notably it was hot, and I sweated a lot. The city was pretty and the people were nice, so that made the heat slightly more bearable. Later on in the day, I went with a group to visit the S-21 prison museum. S-21 was first a school before the Khmer Rouge took power. The Khmer soldiers decimated the school and turned it into one of many torture camps used by the Khmer Rouge during the Cambodian genocide. Their prisoners were held in hardly livable conditions, tortured daily, then killed slowly and painfully after they had given confessions to crimes they never committed. In each of the buildings, there were pictures of the prisoners and the cells they lived and died in.  The whole experience was hard to swallow, but I forced myself to look at the pictures, the torture devices, and the bones of the prisoners. I forced myself because it’s easy to look away, to not think about it and forget it happened – especially to an American. However, I see it as the least I can do for the people who can’t look away, and who can’t forget no matter how hard they try. They people who died there had no rights, no freedom, and no say in what happened to them, but I believe they have a right to be remembered; and I believe that it is our duty to remember them and the injustice of the Khmer Rouge so that those injustices will not be repeated. I think S-21 is a perfect example of what the Khmer Rouge did to Cambodia: destroy education, replace it with misery and death, and then leave it to be forgotten. There was a monument constructed at S-21 declaring that the information there is the right and property of humanity as to not forget the cruelty we are capable of.

Mission to Guatemala: Last days

Today, the nursing/pharmacy team had the privilege of traveling to a prominent coffee plantation and offering a hand. We focused on providing health screenings and education to the plantation workers and their families. We were also able to hand out dental hygiene kits to all the individuals we crossed paths with. One thing that we have really learned on this trip is the value of teamwork. The nursing students, pharmacy students, and a Guatemalan doctor all worked hand in hand to provide this community with access to healthcare. We also got the opportunity to see how this plantation prepares their coffee products. Now not to brag, but if this healthcare stuff does not work out, some of us may have a future in the coffee industry. The highlight of our day was definitely towards the end. As we were passing the horse stables, we saw one of the young boys we had seen on day 1 of this trip. When we first saw him, he was the picture of discomfort and pain. Today, when we asked him how he was feeling, he responded with the biggest smile and an endless amount of gratitude. This was a reminder that all our hard work here was making a difference.

The PT/OT team spent our last workday back at Keramion, the school for special needs children that we visited on Monday. The day began with a bit of dancing, followed by receiving gifts from the children. We were so amazed by the generosity that we were shown and will treasure the gifts as well as the hugs we were given. Afterwards, the OT team saw one more child with autism who had some behavior issues that the mother and teachers wanted to discuss. We were able to provide education on different calming strategies such as deep pressure, bouncing on a ball, and slow swinging. His mom was present and was really interested in learning, and some of the other OT team members also had the chance to interact with child’s younger sister. Following this, the PT and OT students set up a small obstacle course for the children. Due to rain, we had to move it inside, but it still worked! The staff was excited to learn about new ways to engage the children in purposeful play that would encourage practicing different skills such as crawling, jumping, and grasping various objects.

The children headed home after completing the obstacle course so that the afternoon could be used for a staff in-service. Griselda, the school’s founder, also shared more of her incredible testimony with us, and we were able to pray for her which was a very moving experience for everyone involved. The PT students on the team also worked with Griselda on different exercises and were able to give her advice on managing her back pain. It was amazing to see how much she had improved in only a few days! For lunch, Belmont team members treated the staff to spaghetti, and the rest of the day was spent training the staff on specific topics such as sensory integration, proper lifting techniques, and behavior management. All of the staff members were extremely grateful for our help this week. After spending so much time together, it was hard to say goodbye, but we know that the children are in good hands at Keramion and that God is definitely at work there. It was such a blessing to bear witness to this incredible ministry this week.

Written by: Anais, Emily, Alicia, and Hope

Mission to Guatemala: Mother’s Day

Today was Mother’s Day which is a major holiday in Guatemala as many of the mothers had the day off work. We wanted to help serve the community by helping them prepare for the special celebration.  We enjoyed helping the students decorate and pick flowers from the field for the mothers. The PT/OT team also supported the nursing and pharmacy students stepping in as needed to assist with orthopedic and musculoskeletal concerns.  We worked as a team to identify the proper professional needed for each case.  The PT/OT team also spent the afternoon preparing educational materials for the upcoming day tomorrow.

Today, the nursing team primarily focused on mothers and children, with cultural perspective seeming to be the theme of the day. Because there was such a high number of mothers and children seen there were several things that we realized that we never noticed before. One was the relative age of mothers. Today we had a mother who was 19 with two children. This provided a dose of perspective as several members on the team are around this age and could not even imagine being in her shoes. It was also shocking to realize how access to care differs from America. Back home, if we have a concern with a child we can just drive to a clinic; however, here in Guatemala mothers showed up from all around carrying babies on their backs knowing that we were the only resources they had access to. It was eye-opening and humbling to see how far these women came just for us to get the opportunity to care for them.

Written by: Kristin & Dylan from nursing and Lexi & Maggie from PT/OT