Monday May 23, 2011
Rebuilding
After an awesome and extremely busy weekend in Siem Reap where we saw the temples of Angkor Wat, shopped the day and the night markets, had a sort of art crawl- Cambodia style (6 people to one tuk tuk going hut to hut visiting the artists themselves and buying paintings), and saw traditional Cambodian dancing at a buffet dinner theatre, it was time to head back to Phnom Pehn. Today was good to help digest all we had seen and also gave me some time to reflect on things thus far. Seeing the temples of Angkor Wat at sunrise was an amazing experience. People from all over the world gathered in this one place and stopped and quieted themselves for just long enough to take in the beauty of the day beginning over this ancient architectural, cultural, and spiritual wonder.
While on the bumpy bus ride back to Phnom Penh, I took the time to do some reading, listen to music, to the outers, and think about things. As we talked and laughed with our guides for the weekend, Ratinah and Niron—two native Cambodians who are brother and sister, I also read a chapter or two from the book Bones That Float. After reading one particular passage I was especially taken back. In this passage, I learned more details of America’s role in Cambodia’s darkest hour: the horrific events and genocide of millions of Cambodians by the Khmer Rouge. In supporting the coup of King Sihanouk, instatement of the Lon Nol government which lead to war with the North Vietnamese, and bombing Cambodia with more than 500,000 tons of explosives (more than all that fell on Japan in WWII), the U.S. helped to strengthen the Khmer Rouge. The bombings alone killed between several hundred thousand and one million innocent Cambodia civilians and motivated the Khmer Rouge to overthrow the Lon Nol government and viciously murder millions more Cambodians who were deemed “traitors.” Even more disheartening is that most Americans don’t even know a thing about it.
However, as I read I overheard Niron talking and laughing with us as if we had all been friends for years after just knowing each other for three days. This stark contrast to the relations of America and Cambodia in the 1970’s and then now as we all sat together made things very clear to me as far as one purpose of this trip. In being here and working in the hospital, seeing the sights, and meeting and living alongside the Cambodia people we’ve met and become friends with, we’re also being a part of something much bigger: rebuilding the diplomacy and views of each other together. The people we have met here all throughout Cambodia have been among the most accepting, kind, and positive people I have ever met. Even after all that has occurred in the past, they still remain so gracious and welcoming to all of us. It’s really encouraging to see such beauty within people.
– Michael Seamon

Our trip started out early saturday morning to Siem Reap. We loaded the bus and got ready for a five hour bus ride. Little did we know how bumpy this ride would be. The roads in this country are driveavble, but not as great as we are used to back in the states. Also, the Cambodian people do not drive like we do. They are in a hurry to get there as one might describe it.
We stopped at a market on the way to use the restroom, buy water, etc. As we pull into the parking lot to park the bus. We are surrounded with small children and some women. As we get off the bus they instantly start asking us to buy things from them. This is a very over whelming feeling, or at least it was for me, because so many of them are arround and your not so sure what to do. When I finally made it off the bus I was greated by a young girl. I am not sure how old she is because in Cambodia you cannot really tell their age, due to the malnutrition in children here. She was very sweet and asked me all kinds of questions. She wanted to know where I was from and what I was doing here. She also wanted me to buy some pineapple :).
I wondered around the market taking in my surroundings. The markets here are an extremely different expereince. One thing that makes them different is the fact that they sale crickets and spiders. Some of my fellow students decided to try the spiders there, I did not. I had no desire to eat a tarantula. One of the other nursing students that tried one decided they taste like beef jerky.
After we finally got over all of the spiders and crickets I was approached by a older lady holding a baby. She was begging for money or food for her child. It hurt to see the small child bundled it her arms knowing that she has no clue when the child’s next meal will be. I ended up giving her a little money in hopes she would have enough to feed her child.
As we got back on the bus I thought to myself that children should not have to live like this. Most of the people begging or selling something were children. A lot of them were telling us that if we bought something they could go to school. I wonder if they even go to school and where our money is actually going. Its a very hard to thing to watch children beg for money and know that no matter how much you give them it may not make a difference. It makes me realize how truly blessed I am to have what I have in my life. I hope one day maybe the children in Cambodia will not have to sale fruit and beg for money on the side of the road.
– Rachel Painter

Saturday evening we had the privilege of getting to watch the sun set from atop Phnom Bakheng, one of the temples of Ancient Angkor. As we hurriedly made the trek up the hill as the sun was going down, I lost count of the number of languages I heard the other visitors speaking. When we reached the temple, I started to realize how big the crowd really was. Hundreds upon hundreds of people had come to see the best view in all of Angkor as the day drew to a close. We all circled the temple’s summit, trying to find the best place to watch. I was beginning to become overwhelmed trying to dodge pictures-in-progress and step aside so guards could remind hot, sweaty men to please show respect by putting their shirts back on. It quickly became apparent that we wouldn’t be able to get a picture without at least 5 or 6 other world travellers in every shot.

In an attempt to escape the chaos, I found a little out-of-the-way spot farther back from the prime sunset watching site. Taking myself out of the commotion, the chaos transformed to a moment of peace. When I took the time to sit back and listen, the sounds of a hundred languages began to blur into the same hum of human awe and excitement. I overheard a Khmer tour guide speaking with an Indian couple in English. I saw three Japanese girls show an American how to light incense. Watching the horizon dotted with cranes doing restoration work, I felt like I was seeing the past and the present at the same time. I took my shoes off and felt the cool of the stone against my feet, placed there centuries ago, walked over by visitors and worshippers of different religions and nationalities and over many different periods of time. As I watched one of the most beautiful sunsets of my life, I realized that in this crowd of strangers, I’d never felt more part of the world. It’s times like this that I feel God at work, bringing people together over time, distance, and language. He always manages to bring people back together, sometimes in spite of ourselves, and no matter how hard we try to keep ourselves apart.

Our experience with Cambodia and its people exemplifies this in a way I’ve never felt before. Everywhere we have been, we experience the same warmness and truly genuine hospitality of the Khmer people. Smiles and sampeahs (a Cambodian greeting and sign of respect) greet us with every new person we meet. The second time we see them we’re already old friends and get hugs instead. To think of everything these people have been through, from the horrors of the Khmer Rouge regime to the grim poverty and heartache that followed, that warmness means so, so much more. For a country who has seen so much pain, we have seen so much love and joy. There is a reason why there are so many ex-patriates (someone who lives outside of their home country – not to be confused with ex-patriots – someone who is no longer patriotic) in Cambodia. The relationships, love and commitment by those people of so many different nations are inspired by the hearts and welcoming nature of the Khmer people. I give God full credit for putting us all in this wonderful place at such an important time. I think I speak for us all when I say we felt so lucky to be a part – even if only for three weeks – of such a amazing nation.
– Emily Morse, Nursing Faculty

May 20th, Friday
Today, was our 2nd day at the hospital. We rode the tuk-tuks there. These are super fun to ride in although it can be dangerous considering the way Cambodians drive. (Although there are traffic signs/laws in place, you will often see people going against traffic and driving super close to each other.) Anyways, in the Sihanouk hospital, I was in the main pharmacy with two other pharmacy students, Rachel and Dan. We learned about the pharmacy work flow process. It was quite interesting to learn that there was an actual messenger that would drop off printed labels to the pharmacy from the Community Medical Center (CMC), which is another hospital across the street. He would then pick it up to deliver it back to the pharmacists at CMC to dispense. In addition, we learned that everyone in the pharmacy is a pharmacist so there are no pharmacy technicians. They are in school for 5 years. There are only 2 pharmacy schools; one is taught in English, and the other in French. In the pharmacy, there is also a separate section of the pharmacy that had medications for only HIV/AIDS patients since that is prevalent in Cambodia.
After lunch, the pharmacy worked on a little project. Dr. Franks listed some common medications, for which the pharmacy students created a list of counseling points and important information that pharmacists should know. When we were done with that, we returned back to the hotel and had some time to ourselves before dinner. I used that time to catch up on emails letting my family and friends know what I’ve been up to here in Phnom Penh.
For dinner, about half of the group went to a place called Java. It was a trendy and relaxing place. They had mostly American food. I ordered a hot pastrami panini, which was pretty freaking good. I also had a strawberry milkshake that was made w/ 3 scoops of ice cream! Also the best milkshake ever! After dinner, I also had my first massage ever. It was weird at first and I didn’t really know what I was doing. But it ended up being pretty good. I definitely enjoyed it, especially considering it was only $5 for a half hour! Can’t beat that price in USA. hehe.
Well, I have definitely enjoyed my time here so far and am looking forward to our next adventure in Cambodia!
– Pamela Wong
PharmD Candidate, 2013

Greetings friends! Or as we would say in Khmer, “sues ‘day!” We woke up today feeling refreshed as we are finally adjusting to the twelve-hour time difference. The morning began with an early trip to the hospital by tuk-tuk in order to arrive in time for rounds. We split off into groups so that we could get an in-depth look at the dispensing processes used by Sihanouk; Dan M. and Dan S. went to the warehouse, Norman, Belinda, and Dr. Franks stayed in the central pharmacy, and Pamela and myself went to the CMC. While in the CMC, I ran in to Sineth, one of the women we met at church last night. She immediately recognized me and greeted me with a hug and a smile. We began speaking about the differences between Cambodia and the United States which turned into a conversation about God and how he works in different ways. I told her how moving it was to attend the Phnom Penh Church of Christ. The second we walked in the church we could feel God moving within the people. In the United States, it often seems like we think we need to attend a big, fancy church with a state-of-the-art sound system in order to be a good Christian. However, I personally do not believe that God can be contained within any sort of walls and therefore church can be anywhere- be it a church like the ones seen in America, a modest building in the heart of a city, or even a field. The members of this church seem to understand this concept much better than me; I have never felt such a sense of belonging during my first visit to a church, especially one in a foreign country! After my visit with Sineth, I joined the pharmacy and nursing students and faculty for yet another delicious lunch at the hospital.
Once we finished lunch, the pharmacy students learned some exciting news- we were invited to sit in on a P&T (Pharmacy and Therapeutics) meeting conducted by several surgeons and pharmacists. In this meeting, my eyes were opened to many issues that I have never thought about before. For example, I had assumed that any and all donations made to the hospital in the form of medication would be beneficial to the hospital. However, I had never considered the fact that the hospital is then financially responsible for the incineration of any medication that reaches its expiration date before being dispensed to a patient or sent to another pharmacy. Because of this, it can actually hurt the hospital to receive a donation of medications that will expire soon. This is not to say that Sihanouk shouldn’t receive donated medication; rather, it is extremely important to be in contact with the hospital regarding the supply and demand of medications before donating them.
At the end of the P&T meeting, we learned that we were in for yet another treat. We had finished early enough to take our first visit to the Russian Market! The market consists of clothes, jewelry, and other souvenirs from this great country, but in order to purchase these items it is best to learn a new skill- bargaining. I had a wonderful time finding presents for friends and family while trying to negotiate with the vendors. Susan also took us by a boutique called Beautiful Shoes where we designed custom-fitted leather shoes in any design and color that we wanted. It is a great feeling to know you’re helping the local economy by buying from vendors from the area… at least this is what I tell myself in order to make my shopping sprees seem somewhat philanthropic. 🙂
As I conclude today’s entry, I wanted to say a BIG thank you to all of our friends and family at home who are providing us with continuous support. Your thoughts and prayers have been incredibly encouraging to everyone on the trip- keep it up! Also, feel free to comment on any of the blogs in order to give us your perspective. Thanks and we love you all.
– Rachel Bettis (Pharm.D. Candidate, Class of 2013)

I have already experienced so many miraculous and extraordinarily beautiful things since I have arrived in Cambodia. From the lovely children on the streets of Phnom Penh selling me Cambodian bracelets and roses to the ancient and legendary temples visited in Angkor Wat, I truly feel beside myself. There is such a sense of humility and hospitality when you walk down the streets and enter different areas. My favorite part about today was watching the sunrise along the edges of the famous Angkor Wat temples. Although waking up at 4:30 am is a huge stretch for me, I truly experienced a sense of serenity I couldn’t have found anywhere else on Earth. I was surrounded by many different languages of astoundingly gorgeous people from cultures all around the world. It was nice to sit and enjoy the peace of nature. There is such joy in establishing the common ground of respect amongst people you have never met before.
– Abby Turnham

We awoke at 6:00 this morning, our feelings a mixture of jet-lag and adrenaline-fueled excitement. After a traditional Khmer breakfast of noodle soup, we all piled into the van and headed to Sihanouk Hospital Center of Hope (SHCH). We braved the infamous Cambodian traffic and arrived at our destination—a completely charity based hospital—a shining beacon of humanity and God’s love, right in the heart of Phnom Penh. Our tour of the hospital grounds was beset every step of the way by smiles and hugs from the Khmer people, excited to see their friend and former colleague, Susan Taplin, return to Cambodia yet again. We were shown the surgical and medical wards, the HIV clinic, and the pharmacy department. Our next stop was the pharmacy’s base of operations, a warehouse across the street from the hospital. It was filled to the brim with donated medications from around the world. At the CMC & Jeremiah’s Hope, another branch of the hospital system, we met Cambodian physicians who were trained by various teams of doctors that had come to serve over the years. In particular, we were introduced to Dr. Tisopheap, a renowned Cambodian cardiovascular surgeon. We spoke with him at length about various projects and opportunities pharmacy could participate in. This was very exciting and we sincerely hope this serendipitous meeting will bloom into an amazing relationship.
After a phenomenal lunch, prepared for hospital volunteers by the Khmer community, the pharmacy students were whisked away in tuk-tuk’s (open-aired taxis connected to a motorbike) to the government hospital, Kossamak. Emanie, a 14 year veteran nurse of SHCH, toured us through. This hospital is designated primarily for patients capable of paying for their medical care. There was a striking comparison between the two facilities, but it was obvious that both institutions were doing good works for the Khmer people. A particularly touching experience on our tour of Kossamak was when we entered the room of a young boy with polio. Both his feet were clubbed and he had been deprived of his ability to function in a way most people take for granted every day – walking. When we arrived he was recovering from a recent operation on his right foot and awaiting a second operation for his left. The best part of this story is that the Cambodian government was providing his surgeries completely free to the family as a part of the new program designed to combat crippling diseases such as polio.
The next stop on our action packed first day was none other than a Cambodian church! We attended Wednesday night service, with the majority of it presented by a Khmer pastor with an English translator. It was a beautiful service and the crowd was completely enthralled. The highlight of our service came when Ms. Taplin was invited to introduce our group and say a few words in front of the congregation. When she walked up to the podium and began speaking Khmer, the native language of Cambodia, the crowd exploded with cheers. Afterwards, we broke up into groups of men and women. The men had a moving session on leadership through following Christ’s examples.
Last on our list was a late night meal with a group of 10 nursing and pharmacy students visiting one of the local restaurants, Flavors. We ate on the patio and were joined by Dr. Corneelia from SHCH, a close friend of Ms. Taplin’s. Our meal was anything but normal once the child we dubbed “Ouwn” (Khmer translation: little brother) arrived on the scene. He proceeded to speak to us in flawless English using catchy phrases and chicanery to unload his wares. I say chicanery because I was personally challenged to a high-stakes rock-paper-scissors showdown. He was selling beautiful scarves for $1 but had other plans in mind for me. The terms of the competition were the best three out of five rounds would win. If I won I would receive a scarf for free, but if he won then I would have to buy the same scarf for $5. It was a humiliating defeat for me with Ouwn solidly winning three rounds in a row, even throwing the winning “scissors” in a deft behind-the-back move.
To comprehend that this is only the first day we have spent in this breathtakingly beautiful country is beyond my ken. Stay tuned for more epic adventures!
– Norman Mang (PharmD Candidate, class of 2013)

Thursday May 19, 2011 (click images to view larger size)
Wow. Everyone that has been on this amazing trip promised it would be life changing and they were right. There is a magic here that extends from the people to the architecture. This morning we went to the government hospital. It was shocking how poor the conditions were. There are several people to a room, no bedsheets, under the beds cooking pots served as bedpans, and no air conditioning in any patient areas. The nurses work 24 hour shifts and if a patient wants better care, in some cases, they have to bribe the nurse for it. The patients at this government hospital are taken care of by their families. When a patient goes to the hospital, it is the family members who do the bathing, turning, and feeding – not the nursing staff. I observed a nurse administer two injections for pain on separate patients, during which she did not wear gloves or sanitize the injection site with alcohol. There was a room dedicated to polio patients…it never occurred to me that polio was still a disease that is prevalent in other cultures.
Never get on a moto…never get on a moto…never get on a moto. 99% of the patients we saw had been in a moto accident. We aren’t talking about a bruise or a scraped hand…these patients have compound fractures and severe head trauma. One of the more interesting patients found himself in a fight with the wrong guy and was attacked by a Samari sword!! Part of his left hand had been chopped off and there was a large laceration to the back of his head. They might not have guns here but they have swords.
After finishing rounds we returned to Hope hospital. It was a breath of fresh air. The nurses are rock stars. I followed two ED nurses for several hours. One nurse is responsible for 4 patients in a room the size of an American closet. They are fast and accurate. One of their main concerns is keeping cost down for the patient and they will do anything in their power to help facilitate cost reduction. A patient came to us with heart failure and the nurses told me it can cost up to $5 dollars a month to treat it. When I told them it can easily cost thousands of dollars back in the States, they just looked at me in disbelief. We had a slow moment and the nurses seized this opportunity to quizzed me on drugs. They wanted to know what the drug did and the class it was in! Thank you Dr. Buckner and Dr. Adam because I got them all right!
I am really enjoying my experience here. It will not only make me a better person, but a better nurse. I promise to post pictures soon!
– Blair McKown

Huummm… how to begin?! Most of us are still trying to recover from the airplane ride – somewhere in transit we lost a day, I guess we will make up for it on the way home. My brain, personally, is trying to recover, so bare with me and allow for some grace with my entry here. 😉
Up at 5 am this morning. It is amazing how busy the streets are with the Cambodian people at 5 in the morning! It seems to be a normal part of the culture to get up and exercise. There were people walking, jogging, practicing martial arts, and my favorite – jazzercising! It is refreshing to see a culture in which exercise is a daily norm and people seem to enjoy it thoroughly. I wish we saw more of that in the States.
The day of arrival is like some strange fog out of a dream that you can’t quite remember. Ms. Taplin walked us down half of her running path and it almost killed me. I am embarrassed to say that I could not keep up if I tried. It was beautiful and exotic all at the same time. The smell of spice was thick in the humidity and the stream of people rushing around on every side of me felt quite overwhelming at times. I have no words really that can describe how surreal it all seemed. No sleep + power walk with Taplin = sleep deprivation and hallucination!
Now to the important and gruesome stuff: disclaimer – this is a nursing blog ;)…
The second day we were off to the hospital for a “tour”, well that turned into a full day’s work in the clinics and Post-op – and thank God for that because I got to do some awesome wound care!!
There is nothing that can prepare a person to deal with human suffering. I don’t think we ever become immune to it and if we do then it is time to reevaluate ourselves. I have been witness to great extents and examples of human suffering but the experience at the hospital the second day forced me to look at suffering in a whole new way.
The skin on one of our patients foot had completely separated from the layers of muscle. It was something to see. You could see every part of the muscle and then there was just a hallow hole between it and the entire dermal layer. Diana had the rare privilege of changing this dressing and packing that hole to increase the tissue granulation and promote healing (they use sugar in the wounds – like antibiotics, btw). This procedure had to be agonizing and unimaginable, yet the patient never cried out in pain, she made small sounds, but never anything substantial. She suffered in silence, her eyes cried out enough for her whole body, abut her voice never betrayed her. She pleaded for relief and the dressing change Diana did provided her with some of that. It is hard to inflict pain in order to heal a patient. When Abby saw her yesterday, her wound had looked considerably better. This woman suffered in a way that we can not even pretend to understand and yet she was so thankful and appreciative of what we were doing for her. The gratitude was all over her face every time she folded her hands and bowed her head for us. It is amazing the difference in coping styles amongst our cultures.
I know tomorrow will bring something totally new and I look forward to it.
—
“Those who dream by night in the dusty recesses of their minds wake in the day to find that all was vanity; but the dreamers of the day are dangerous men, for they may act their dream with open eyes, and make it possible.” – T.E. Lawrence
** sorry I posted this so late… been crazy busy – Candice Rose 🙂

It is Friday night here! We are leaving for the temples in the morning and I couldn’t be more excited for our weekend trip! I named this entry BEAUtiful because all I see here is beauty. The people, the country, the river, the sky, the smiles….EVERYTHING. I enjoy watching and taking in all of the beauty around me. Whenever I get the chance I just watch. Today I was especially taken by these beautiful people. We did check-offs at the hospital today for the nurses. We sat and listened to them tell us various nursing procedures in English. This is not an easy task especially with words such as catheter and manometer! The nurses look forward to this every year and are very anxious and excited. I am so grateful that I got to participate.
I fell in love more and more with each interaction with the Cambodians. They are beautiful inside and outside. I told Mrs. Taplin that I had not seen a single Cambodian who did not have a captivating, precious smile. She said that this was the land of smiles and it sure is! The people are accepting, genuine, welcoming, warm, loving, smart, and beautiful! Not only did I appreciate the time we had to serve the Cambodian nurses today with check-offs but I am so thankful for our time in the clinical setting. While waiting on patients we get to sit and talk. The nurses know some English and are always eager to learn more. They are so smart and I have learned so much from them. Drawing blood from someone who does not speak English was painful for me. I kept asking the nurse to make sure she was ok! You make instant friends with the people and when I see them a second time we hug and they say, “hi Suzan”, as I try to discretely look at their name tag to attempt pronouncing their name. So Dina and Navy say hi to the 2010 team! Lastly I will add that they are a very expressive people. As we ride to the hospital in the mornings on the tuk tuks I see such a wide range of expressions. I end by simply saying that I am in love with these people! I LOVE CAMBODIA!
– Suzanne Hutson