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

Getting to Cambodia is not quick or easy; it costs a small fortune and takes more than a day of flight, airports, taxis, and Tuk-Tuks to arrive to any hotel. However, we had a great time doing it! On our first day, a group of around 30 students, professors, family, and even the dean of pharmacy took over the front of the Nashville International Airport. Traveling was a breeze! A thirty-something or so hour breeze… I don’t know if it was because of our group size, our smiles, or my safari hat… but our group slid, like butter on a hot pan, through every airport security checkpoint. It took less time to get through security as a large group then it ever has for me as an individual. On the plane ride from California to Hong Kong, we ate, watched movies, ate, slept, played games, and ate (at least I did). I have to mention that a majority of the pharmacy students played a game of “trivia” on the airplane and that I was able to beat Dan Stirling in Trivia. Normally, this never happens… so I have decided to blog about it so that he does not forget anytime soon. : )
O.k., enough bragging… I wanted to mention how great of a group we have going on this trip. I am not saying this just because I came. Seriously, every single student and faculty member, regardless of whether they are in pharmacy or nursing, are some of the most friendly people I have ever had the opportunity to spend time with in my life. I feel very blessed to be a part of such a group and I am already anticipated doing great things, and learning many life lessons with and from them. At this point, I have to admit that I am writing the blog for day #1 on day #3. That being said… I will give you a heads up and let you know that this assumption has already, in only 2 days, proven to be very correct. I will not spoil it for now… so you will have to read their blog days if you want to hear about that amazing work we are doing, and will be doing long after this trip is over with. (click image to see larger size)
In closing, I will briefly mention a couple of traveling tips that you should consider before planning a trip of your own to Cambodia. 1.) Don’t bring anything except a laptop and a power cord. You can buy everything here for a fraction of the cost, including luggage, cloths, hair gel, etc. 2.) Don’t even THINK about renting a car… get a Tuk-tuk. There are no noticeable traffic laws or traffic police here… and if you try to drive, you will crash. 3.) Bring a group of friends and strangers with you, the experience is lost without being able to talk about every second of your trip. 4.) Quit your job and just stay here forever! You will here more about this soon, but this country and experience is so amazing that you could spend a lifetime living, learning, and giving, and two weeks is just not enough.
– Dan Myslakowski (PharmD Candidate, class of 2013)

Pardon the technical interruption. The ability to comment on future posts has been enabled following changes in the system to block several relentless spammers.

Diana Perricone Senior Nursing Student Cambodia day 1:
We landed in Phnom Penh at about 10:30 AM on Tuesday, May 17th. It was very weird to realize that we left on Sunday, and just completely skipped Monday altogether.   I could tell by looking out of the window of the plane while we were landing that this is certainly not like any place i have ever been.  From the plane you could tell that about 90% of the roads here are dirt roads.  We got to the hotel by two vans which was only about 10 minutes away.  Driving through Phnom Penh was very surreal (and terrifying cinsidering traffic laws appear to be completely non-existent). I have never seen so many abandon buildings in one area in my life. Then, I realized that they aren’t abandoned at all…they are fully occupied homes, businesses, dr.s offices, etc! So many of these buildings look like something that would be deemed unsafe, and condemned in the US. Some of the names are pretty funny. For example.. I’d probably avoid the “Sour Dentist.”. 
Although so obviously empovershed, Phnom Penh is beautiful.  There are many stunning buildings that look like steriotypical asian palaces and temples (and for all I know at this point they are!).  We got to our hotel, and began to divide into groups of roommates.  There was one girls room that would occupy 3, which Abby, Suzanne and I wanted, but the pharmacy girls insisted on having it, so Suzanne is rooming with Rachel P and Abby and I stayed together.  We waked upstairs to our third floor room (which is actually the 4th floor) and it proved to be a little bit of a hike.  Its not that I’m out of shape, but we were already so hot, that any amount of exercise was killing us, and also, the stairs are uneven, which just really throws most of us off.  We spend some time unpacking and showering (which we all desperately needed after traveling for 36 hours) and headed downstairs for a quick tour of our area.  It was at this time that I realized that my wallet was missing! I went back upstairs to look for it, and it was not there. We have searched the van from the airport as well as contacted the airline, but imhave a strong feeling it’s never coming back.  That being said, I am now completely broke in Cambodia. A little scary, but I am oddly at ease with the situation, and I just know that my parents and teachers and I will work something out. In the meantime, the gracious people on our trip lended me some money to use so i won’t be missing out on anything!  
We had our first meal at a beautiful restaraunt around the corner from our hotel.  I had pineapple fried rice (delicious) and tasted some of my friends more adventurous choices and everything was SO good.  The kids in Camboida are ADORABLE.  I’m going to be fighting to not return to the US with 8 of them.  Since we obviously look like tourists here (I mean, were white for one, and for two several of us are blonde, which may as well be a sign stapled to our head that says “TOURIST”) the kids get excited and say (sometimes yell across the street) “HELLO!” My mother and father would melt. It is so humid here, that although it’s only in the mid 80s (considered a chilly day) I can honestly say that I dont think I have ever sweat so much in my life.  
When we got back to the hotel, most (if not all) of us went to the grocery store.  I was surprised to see that they have many of the same brands as we have in America such as McCormick spices.  We bought mostly bottled water for the trip (trying to avoid parasites!). Then some of the girls went to have massages ($9 for a 1hr massage!!) and the rest of the evening was spent relaxing with each other before all going to bed.  It is now 5:20AM in Cambodia (just cant sleep anymore) and were looking forward to getting to go to the hospital today.  

Hi everyone…..we are here and are getting exposed to the closeness of the equator and how that relates to the feeling of sun on our skin. Which translates to IT’s HOT. Depending on how hot it gets and how long we continue to go without sleep, we may have disturbed thought processes related to fluid volume deficit and sleep deprivation.(okay, so these are nurses writing this brief entry)
In all seriousness we are here and doing well. Our goal is to stay awake until around 8PM, then rise early for a run and then off to the hospital. You will get more details later. Thanks for all your prayers.