Back in Phnom Penh

Arm WrestleMay 31
We are back in Phnom Penh and starting home visits outside the city while the rest of the group is working in the hospital. Today was my first day back in the hospital since arriving from Ratanakiri. My clinical experience today was spent in the OR where I was able to witness a surgery on a patient who had been cut by a large knife or sword on both hands. It is only the second surgery I have seen, but I would like to try and compare and contrast the two. First of all the one I saw in the U.S. was an open heart surgery while the one I witness here in Cambodia was a reconstruction of the patients hands and wrists, so the surgeries had many procedural differences already. The surgery here had already started when I arrived in the OR. The surgeon started work on the left hand where he needed to fix two broken fingers through the use of screws and repairing tendons in the wrist. The same was done for the patient’s right hand as well. From what I saw everything the surgeon did for the patient here would have been done for a patient in the U.S. But like I said I have not witnessed this type of surgery yet in the United States. As for the staff in the room it was very much the same as in the U.S minus the perfusionist who is used in an open heart surgery and was not needed for this procedure. There was a first assistant who was helping the surgeon directly with the surgery whether it was cutting sutures or helping with moving the patient’s body into the correct position. There was also the anesthesiologist who monitored the patient’s vitals and another nurse assisting with supplies and lighting. Compared to the surgery I witnessed in the U.S I would say there is not much difference except for maybe the equipment here is slightly older. I left the OR feeling fascinated about how much they can repair the body after such extensive damage.
Children GroupLater in the day pharmacy and nursing students went to visit a local orphanage. The purpose of the visit was to assess the children to make sure there were no underlying health issues that were going unnoticed, but also to interact with the children through games and playing. This was our second visit to this particular orphanage and both times I left feeling uplifted by the joy of the children. They have a lot of energy and were happy to see us again. In the home they live in there are around a dozen or more orphans and never once did any of us see them quarrel or argue it was incredible to see all of them get along so well with one another. The people who run the orphanage are loving to each one of them and the children are well off. Each of them goes to school during the day, they all have beds to sleep in, and they all eat dinner together. It is safe to say that these children are better off then many others we have seen during this trip. I am thankful for the people who give these children homes and the organizations that make it possible for these children to thrive in a country where so much of the youth live in extreme poverty. It is truly a blessing to be able to witness such a place.
Cody

Perspective of an Overwhelmed Soul

Small SpaceSo many wonderful experiences occurred today. We all went to church at the Phnom Penh Church of Christ from 9:30 until 12:00. The speaker covered the subject of second chances and used Jonah as a Biblical example of how God seeks people out regardless of what trials and tribulations are happening in our lives. Three different people shared their experiences of second chances and every one of them were very moving. After church, we got to see a man be baptized.
Once we left the church, we then rode the bus to participate in a rice drive for different families who are in need of food for themselves and baby formula for their children. From the second I stepped off the bus and
looked into the eyes of the beautiful people, I was instantly moved. Regardless of what these families lack they expressed a happiness that I have never witnessed before. Boys around the age of 7 were holding their infant-aged siblings as if they were their fathers. Every child took care of one another. Many of the breathtaking mothers are currently pregnant. I met one woman who was holding a baby and is expecting her 9th child within the next few months. Another woman has four children and has not received contact from her husband since the last time she saw him four months ago when he left for work as a fisherman. She and her family live in a two room house that is the size of many living rooms in a middle class American home. This woman
held such dignity and optimism when I was around her, and it really amazed me that she could have such a beautiful outlook on life when it seemed like she was in a binding situation. It was truly moving.

Loaded Cycle   Supplies



ChildrenThe whole group and others involved with this project are so very thankful for the donations put forth for this community. Today I have realized how privileged I am and how selfish I act sometimes. Things that many people, like myself, take for granted such as: a glass of clean water, a plate of warm food, a bed to sleep on, walls to protect us from the storm, and the ability to wash and clean our bodies are blessings to these people. Once again, I am living this day from the perspective of an overwhelmed soul, and I am so thankful to have been graced by the presence of such extraordinary people today.
Arin Turnham (Nursing)

Day 11

May 25th, Friday
Today I woke up at 5 in the morning to be on the bus by 6am. We had another bumpy bus ride heading back towards the city. We stopped at Women’s Development Center in Stung Treng. There was a kindergarten nearby that we visited there, where the kids there are the first of their generation to get an education. Most of the people in that village don’t speak Khmer; instead they speak Lao. At the Women’s Development Center, we saw how they produced raw silk into beautiful silk clothing. I thought it was cool to see the color of the cocoons be yellow because I’ve only seen them white. Then we saw how they dyed it and how they made cloth out of the silk threads. Afterwards, we ate lunch there and then arrived at our new hotel, the Golden River Hotel.
In the afternoon, we went to see a nursing school. It was a big one but it was kind of empty because the students had exams and so class did not start until the following week. I thought it was cool that they can provide housing for up to 100 students for free (because some of the students come from far away). But they have about 400 students.
Later, as we were looking for a place to eat dinner, we made a pit stop to take pictures of the setting sun over the Mekong River. It was quite a beautiful sight. It was a definitely a great way to end the night.
Pamela Wong
PharmD Candidate 2013

Saturday

BoatOn Saturday the group woke up early and made a short but interesting drive from Stung Treng to Kratie. There we witnessed a true rarity, freshwater dolphin. In Cambodia these playful and enigmatic creatures number less than 100. A boat ride on the Mekong let us observe them upfront and in person. We then headed back to Phnom Penh, our Cambodian home away from home.
By the time we reached our destination we were physically, mentally, and emotionally exhausted from the previous days, but, as we have recently become accustomed too, had little time to rest. In this case we were all very glad for this as we were treated to an amazing home cooked meal from Ohmpea, Susan Taplin’s driver and dear friend. Not only were we provided with various dishes including chicken, fish, noodles, but we heard great stories and singing from Ohmpea himself. It was refreshing to see the bond Susan and Ohmpea had with each other, a true friendship that neither time nor distance could hinder; a friendship that should be an example to all of us.

boat_rd_sm.jpgDaniel Stirling (PharmD. Candidate 2013)

You have entered the Twilight Zone Beyond this world strange things are known

We shall call this entry: the bus drive through the Twilight Zone!
Made it to Ratanakiri, finally. Ms. Taplin told us it was only going to be a 9 hour drive, well twelve hours later we climbed off of the bus, bones aching and sore butts! 
We should go back to the beginning of the day first… We climb on the bus at the crack of dawn to venture on this grand trip across the rugged roads of Cambodia.  When everyone had finally piled on the bus we set off.  Taplin had been informed that the roads were in decent enough to travel, so there should have been no problem, right?!  Wrong…
We found ourselves at the mercy of the bus driver for the entire trip.  The seats in the back of the bus are bigger, so – having not sat back there before, I decided it would probably be best to sit back there since it was going to be such a long drive… BIG MISTAKE!  The back of the bus was like riding on that amusement park ride that you first think is awesome but soon realize if you stay back there much longer you might puke! There were times when my butt came at least 6 inches (if not more) off of the seat!  Guess that is what I get for trying to take over the “good” seats!
Back to the bus driver… People in Cambodia drive like they are all in the Indi- 500, so when our bus driver was driving abnormally slow and other buses were passing us, some of the impatiences (myself included considering my insides felt like jello) on the bus started asking what was up.  Pip (the awesomely adorable Cambodian we took with us as our ad lib tour guide/haggle genius and thank God we took her, she was so necessary) in turn started asking the bus driver why he was going so slow.  Every time someone said something to him he would slow down until finally we were crawling along at about 30-40 mph.  So then the pressure was really laid on him and he finally snapped! It was like something out of the twilight zone – he would speed up, slow down, speed up… when he finally snapped, he revved the bus so hard I thought I was going to fly into Michael’s lap! Here we are, flying over this dirt road with so many pot holes it looked like Swiss cheese, getting our brains sloshes around and going grey from fear!  The bridges were the most terrifying part, wooden, old, could break at any moment… Yep, friends and family, 12 hours, 9 of which were sure madness and we all survived!  But the best part of the drive has yet to be discussed… Let’s just say that finding ways to use the bathroom on a road through the jungle in the middle of no where can be quite the bonding experience and I will never complain about a gas station bathroom in the States again after seeing what the Kehmer people live with daily!  I have so much respect for their ability to balance.
Blair and I got settled into our room at the Cambodia resort, which literally looked like a secluded jungle paridise, and fell out on the beds from exhaustion.  Well, unbeknownst to us, we were not alone.  There was a tenant lying in wait for Blair in the bathroom.  Oswald, a   3 1/2 inch roach that was as wide as a small rodent, crawled out to tell her that she was in an occupied room and Blair started screaming!  Oswald had not expected such a unwelcoming reaction and clung to the basket that held the soap in an effort to make himself invisible.  Blair was freaking out, I went into the bathroom, worked myself up, – “you’re hardcore, Candice, you can do this.  No roach is going to defeat you, ect.” – grabbed the basket, and carried it into the hallway.  Well, Oswald didn’t appreciate it, he took off running full speed ahead at Blair and I, that is when the pandamonia set in.  I was screaming, Blair was screaming, had Oswald’s mouth been bigger he would have been screaming! We were all running around like maniacs and in all of the chaos I slammed the door in Blairs face trying to save myself!  I don’t believe in karma, but if I did, I would say I fell victim to it!  Oswald took off under the door, right back into our room, charging like a freight train directly towards my feet!  Oswald escaped that night, but he got his come-up-it’s, that’s another story.
Building relationships, experiencing events that will change you forever, finding pieces of yourself you had no idea existed, and falling in love with a foreign land and people – that is what Cambodia is about!
I miss my boys, the food, and language!
Sorry this post is so late, it was meant for Wed May 25.
“Two roads diverged in a wood and I – I took the one less traveled by.” – Robert Frost
Candice Rose – Graduate Nurse, Class of 2011

Day #10: Surviving the “Dry Season” (PharmD Perspectives)

Rachel - WaterfallThis is my very first blogging experience so please bear with me! I am excited to be able to blog about today, somewhat because it’s my birthday, but mainly because of what an AMAZING day we had. We are in the distant Ratanakiri province and after having to endure the 12 hour bus ride on a bumpy dirt road to get here, our day today has made it worth every mile. We had a very adventurous day!
We began our day by eating breakfast poolside. I would describe our hotel as a resort in the middle of a tropical garden. The buildings were carved out wood and the grounds were filled with deep green leaves and bright pink and orange flowers.
Our first adventure was swimming in a waterfall. We were so excited to be able to go swimming because the climate in Cambodia is extremely hot and humid. I am originally from Florida and I thought it was hot and humid there, little did I know, it can actually be worse! The waterfall was surreal like something from a movie set. The water felt great! Since we were the only one’s there it felt like our own secret playground. We swam around and climbed on the rocks. Some students claimed they could feel fish gently nibbling on their legs and feet. Luckily, this did not happen to me!
Our next stop was another waterfall which had a store that rented traditional Cambodian dress for both men and women. Many of the students rented clothing to take pictures around the waterfall. The store also offered elephant rides! I really wanted to ride the elephant, but the animal lover in me would not allow it. When I found out we could buy some of their sugar cane to feed the two elephants I decided to that instead. The elephants had a big appetite! They were so cute and despite being so big they seemed to be very gentle. After I fed one it let me pet its’ trunk.
After eating peanut butter sandwiches on the bus we set off for our last adventure…more swimming! This time we swam in a moderate sized lake. The lake was created by a volcano and we were told it was over 160 feet deep. The water was nice but there were spots of hot water located right next to spots of cold water. After we were tired of treading water, we decided to head back to the hotel to eat dinner.

Rachel - Elephant   Cold Drink



When we arrived back at the hotel, Blair, Candice and I called dibs on the first available massage appointments. The massages in Cambodia are so affordable! We had a little bit of time before dinner so I decided to get a foot massage poolside while drinking my favorite banana and mango smoothie. All in all it was a great and adventurous day!
Rachel Franks

Bumpy Road Adventure

Sun and WaterWednesday, May 25
Today we checked out bright and early at 6am for a nine-hour trip to Ratanakiri. We stopped along the way for a chance to stretch our legs and eat some authentic Cambodian food. Much to one of the nursing student’s surprise, there aren’t many roadside rest stops so when you have to use the bathroom, the side of the road is your best bet! The dirt roads proved to be incredibly bumpy and the trip ended up taking twelve hours, but it was twelve hours of singing, laughing, and fellowship. Throughout the bus ride, it was apparent how connected the nursing and pharmacy students had become over the past two weeks. It was dark when we arrived at our destination, and as our road-weary group piled out of the bus we realized that the primitive bungalows we had been expecting to stay at were actually more comparable to a resort seen in a movie. After a delicious feast prepared by the hotel staff, several of us donned our swimsuits and hopped in the pool for an evening swim. Now we are all headed to bed for an adventurous day of waterfalls and hiking tomorrow.

swing_sm.jpgRachel Bettis (Pharm.D. Candidate, Class of 2013)

Day #7: S-21 (PharmD Perspectives)

“Same same, but different” is a common saying for English speaking people in Cambodia. That is, the English word “same” sounds very similar to the Cambodia word for “different”. Many t-shirts have thus been produced for Americans, such as myself, to help remind ourselves how hard it can be to communicate ideas to other people. Today, after a 7 hour bus ride back into the city, our group went to a place known a “S-21”. It used to be a high school, but during the last regime was converted into a torture prison and death camp. Over 25,000 prisoners were recorded to have entered this prison. Less than 30 years later, only 12 survivors are known. It is very hard for me to convey the emotions and history behind this prison. No person could accurately convey the emotions that you feel when walking through this place of death. I have posted pictures taken by both Candice Rose and myself to convey with images what I cannot in words. I have also added some more inspiring pictures from other days (besides this one) as well to lighten the mood.
Dan Myslakowski (PharmD Candidate, class of 2013)

Falling in Love with Cambodia

Angkor Wat SunriseThis morning started off with something we’d been looking forward to the minute we researched this trip: visiting Angkor Wat. After the beautiful sunset we had witnessed the evening before, we knew seeing the sun rise over Angkor Wat was an absolute must. Niron suggested we leave for Angkor Wat around 4:45 a.m. in order to arrive before the sunrise. After our long trip and the many hours spent stimulating the Khmer economy at the Siem Reap Night Market, this task was a bit harder than expected. We ended up arriving just in time to see the sun cresting over the temple. This magnificence can only be experienced and never accurately described by text or photo.
Afterward, we explored the temples of Angkor. I was astounded by the beauty and majesty of Angkor Wat. I can hardly believe that nearly 3,000 years ago, the Khmer people moved thousands of enormous stone blocks—which weigh several tons each and originate from the mountains—to create the largest religious structure in the world. As we moved through Angkor Wat, intricate carvings lined nearly every inch of the structure. My favorites were the beautifully detailed aspara dancers, representing an ancient form of dance that is characteristic to Cambodia.
Mini Independence_MonumentThe structures themselves weren’t the only notable sights of Angkor, elephants transported travelers between temples. On the road, there was a band of monkeys that haggled visitors for food. Musicians, whose families were harmed by the land mines planted by the Khmer Rouge, played beautiful traditional Khmer music on instruments you will never see in America. Several people were so inspired by the music that they bought drums and flutes to entertain us. At the entrance of each temple, masses of children approached us—some without shoes—pleading us to buy their souvenirs. At least three children would follow each of us, pulling out their different wares and shouting out the prices. It was heartbreaking being unable to buy something from every child, especially knowing that they spend the majority of their days helping to make a living for their families. It reinforced the need for the work that we, and the beautiful people at Hope Hospital, are doing.
A couple of us had the opportunity to visit the Cambodian Cultural Center after visiting the temples. We took Niron’s personal moto, with the warnings against them ringing heavily in my ears. My blood pressure hit new peaks during those ten long minutes. It was definitely an experience I’m glad to have had, but would prefer to avoid in the future. When finally arrived, we found out that Niron had never been inside despite his multiple visits to Siem Reap. We offered to buy his ticket since we had developed such a close bond with him throughout this excursion. The Cultural Center was awesome! It’s how I would imagine an amusement park, Cambodian style. It had miniature displays of important scenes in ancient Cambodian history, such as the construction of Angkor Wat. There was another exhibition that depicted key peoples and time periods throughout Cambodian history, in chronological order. Another phenomenal attraction was a Cambodian-Chinese comedy and acrobatics show. At one point in the show, there were ten performers balanced on one. My favorite attraction was the miniature models of some of Cambodia’s most revered buildings. Needless to say, I mock ‘Godzilla’d’ a couple in humorous photographs.
Acrobatics ShowAfterward, we headed out for Koulen Restaurant – oh my goodness. I would have to say that this was my absolute favorite place to eat thus far. The restaurant is an enormous Cambodian buffet, featuring a wide variety of foods, including freshly made noodle soup and fried bananas. It was wonderful to taste the flavors I’ve been familiar with my entire life, and then some. What came next pulled the night together—an Aspara dance performance. Each dance told a story of love, conflict, or the simple joys of everyday living all using graceful and deliberate movements. I have seen these dances on television, but that night revealed those videos never did the actual performance justice. I could see everyone at our table was enthralled, despite being up for over fourteen hours.
I love being so completely immersed in my culture, learning many things I’d never known. I’ve come to fall even more in love with Cambodia. They are a beautiful people, each Cambodian I’ve met has been kind and generous with a warm heart.
Bel

Don’t go chasin’ waterfalls!!

Cambodia Day.. I don’t even know anymore:
Our adventure into Ratakaniri was interesting to say the least.. We had to travel for nearly 12 hours by bus through the Cambodian jungle to get to our destination.  We took a full bus over bridges made of nothing more than large, uneven sticks over bodies of water of which are probably infested with who-knows-what.  It was a bit nerve-racking, but completely worth it in the end.  
Our hotel here has full electricity and air conditioning. They have a pool and a spa, and a remarkably good restaurant.  I feel like since we arrived, we have been on vacation! 
During our day here in Ratakaniri, we first went to the waterfalls. The first one was great; we had to cross a wooden, swinging bridge (the kind you see in the movies that breaks at one end) to get to the location of the waterfall, it was really beautiful and exciting. We got to swim in the waterfall, and the water felt oh-so-good!! Abby got some great pictures of all of us swimming since she didn’t bring any clothes to swim in.  Next we went to another waterfall, but this one was equipped with elephant rides through the jungle (on unmarked terrain, without a pathway) and some really cool native tribal outfits we got to play dress-up in. We got some pretty cool pictures.  Next, we went shopping briefly before heading to swim in a lake in a crater (which is either the crater of a volcano, or a crater made by a meteor.. It’s up for debate). Its really fun to be in a place that is so un-touched by westernized society. The locals there would come up and try to speak english to us.. And you could tell that it was very basic conversation skills that they have learned. The essential “hello, my name is… Whats your name? How are you?” etc. Pretty fascinating.  
Not excited to have to leave Ratakaniri tomorrow to begin the adventure back to Phnom Penh, but I’m excited to see what the trip back will have I store for us!
Diana Perricone