Have I mentioned that I have an actual job?

     As you may remember, I had a volunteer position as a clinic manager for the first few months we were here, which ended rather badly. After a few weeks of basking in my free time, then another few weeks of wallowing in inertia, another opportunity came along that started as a volunteer position and has turned into an actual paid job.

     My new role is part-time “Health Advisor” for the Assessment Center of World Hope International here in Siem Reap. World Hope does a number of things in a number of countries, but here in Cambodia their work is focused on providing shelter and assessment for young girls who have been victims of sex trafficking and/or sexual assault. The shelter here can house up to a dozen girls age 5-17, who stay for a short time while their needs are assessed and future longer-term plans can be made. Some of them return to their families, and some go on to long-term shelters where they might get vocational training or other opportunities. They have a similar shelter in Phnom Penh that has been operating for six years, and the Siem Reap center has been open for about a year.

     Referrals come from the police, hospitals, government “social workers” and other NGOs, and the girls come from provinces near and far. This first year of operation has been focused on capacity building and training staff, primarily counselors, social workers, and the housemothers who provide care to the girls 24 hours a day in 12-hour shifts. As is the case all over Cambodia, finding qualified staff is a challenge. There aren’t actually any trained Khmer social workers as we define them in the west, as the first school of social work only opened in 2009. The only other Western employee here works extraordinarily hard to train staff and she has a wealth of experience doing similar work in several countries. She will be leaving here in June, and I know I will miss her immensely.

     My role is to go to the shelter twice a week for a couple of hours each time to provide training and education to the housemothers, maintain appropriate medications and first aid supplies, put some systems into place for monitoring health, be available to assess girls who get sick so they can get appropriate care, and generally provide health consultation. They have a Khmer doctor who fills this role in Phnom Penh, but I am the first to do this here, so we’re still defining my role a bit as it evolves. The amazing thing is that I’m being paid $15/hour, which is a small fortune here. (Consider this comparison: a teacher working in a government school makes $30-40 per month for working half days six days per week.) I’m scheduled for only four hours per week, but there will be times when I work more than that – we will do some staff trainings in the coming weeks, and other needs may arise over time.

    

     The health aspect of this job is very basic stuff. Several girls have had the chicken pox over the last couple of weeks, so educating housemothers about what that is, how to treat the fever and itching, and how to recognize if it’s turning into something more serious has been the focus. Any experienced mother in America could do the same thing with no special training, but Cambodian knowledge about basic health issue is so limited that coaching the staff how to recognize a child who doesn’t feel well and how to take their temperature and treat a fever is where we have to start. The housemothers are all very caring and lovely women, some of whom have children themselves and some who do not. A few of them speak some English, but as usual, the language gap presents challenges. I have a friend translating some of the information we’ve discussed into Khmer so we can build a book of health resources for them to refer to. We also have access to the Khmer edition of a wonderful resource book, “Where There Is No Doctor” and some of the future health trainings can make good use of that as well.

     The girls themselves are delightful. Right now, they range in age from 5 – 14 years old. While they’ve experienced trauma of some sort (or several sorts), most of the time you wouldn’t notice anything unusual about them. They attend school and counseling on-site, and in their free time they do arts and crafts and play games. They are engaging and animated and they like to play with my stethoscope. The little ones are always happy for a lap to sit in and some individual attention, the older ones enjoy a good game of badminton, and they all practice their English with me if they know any. If they don’t speak any English, they just chatter at me in Khmer or imitate my English with great amusement. Sometimes I stay for lunch and enjoy the wonderful food prepared by the cooks. Overall, it’s a pretty fine job!

     I do find that it’s sometimes a challenge to remember that my role is limited to health-related issues. All my years of doing VNA work – which is based on a social work model and involves holistic family assessments – means that I want to know more about the girls and their families than is probably necessary. When I learned that the staff have weekly case meetings to discuss each girl, I was desperately wishing I could attend. As I said, we’re still defining my role, and old habits die hard.

   

     I’ve spent a lot of time lately reading materials that will help me learn more about trafficking issues. Not exactly light reading, but very enlightening. I read a long report recently titled “Forensic Medical and Legal Aspects of Child Sexual Abuse Investigations” which outlines some of the challenges very matter-of-factly: While a forensic medical exam is required for every victim of child sexual abuse, there is no one in the country actually trained to perform such an exam. They have a medical form for such investigations, but some of the anatomy is mislabeled or absent. The police, who are responsible for making referrals for such exams, often don’t do so because of budget restraints – they often do their job without pens, paper, phones and gas for their vehicles, so transporting a victim and paying for a medical exam is impossible.  Never mind that some families’ coping mechanism for the shame of their daughter’s rape is to have their daughter marry the perpetrator. There’s a long way to go here, but there are lots of organizations and people working hard on the issue. I will do my best to do my tiny little part.

     For obvious reasons, I can’t include any photos in this entry. The location of the shelter is a closely-guarded secret and protecting the girls’ identities is most important of all. Trust me – they’re beautiful children.