Saturday, August 27, 2011

365 days; 4,637 questions

     Back in December, soon after I left my first job at the clinic, I posted a blog entry that included the following quote:
"...I beg you... to have patience with everything unresolved in your heart and to try to love the questions themselves as if they were locked rooms or books written in a very foreign language. Don't search for the answers, which could not be given to you now, because you would not be able to live them. And the point is to live everything. Live the questions now. Perhaps then, someday far in the future, you will gradually, without even noticing it, live your way into the answer."
                                                                                          Rainer Maria Rilke, 1903
                                                                                          in Letters to a Young Poet

     Today marks one year since we arrived in Siem Reap. I am living the questions, as hard as I can, and there are more questions than ever.

     I had every intention of writing an entertaining retrospective of the last twelve months, but this just isn't one of those days; all feeble attempts to write have been quickly deleted. Steve and I thought that perhaps we should treat ourselves to a nice dinner out to celebrate, and then we were invited to a party to celebrate two birthdays and a farewell, so instead we'll go hang out with an interesting bunch of young expats and we'll toast to birthdays and farewells and anniversaries.

     And I'll keep trying to live the questions, which come fast and furious. There are plenty of new questions since this time last year, and some of the same old ones continue to provide fodder for endless mulling and theorizing. Now I understand why Cambodia advertises itself as the "Kingdom of Wonder" - it leaves me wondering about so many things every day.

      So, lacking profound things to say about our first year in Cambodia, I will instead leave you with a peek at my notebook collection. Some of you who know me well may remember that I love notebooks: the symbol of a fresh start, of learning something new and promising myself I will only write neatly this time, a repository for lists and random thoughts and notes from dinner parties. One of the good things about Siem Reap is that there are a number of shops that sell notebooks, and I've amassed a nice little collection, each chosen for their interesting cover art or captions.

"Whispers of love
Love is good for your heart
My love for you will never end"
"HEART TO HEART ENVELOPE SET
Love and friendship"
"Enjoy your writing with MengFeiEr products"
"WOOO is super ecological building material"
"WORK SHOP"

"I lost you.
This is in the world,  each persons have the person who wants
look for, once missed will not come back."
"very good"
"so love"
"pain past is pleasure"
"of all...papo terie r"
"notebook"
"best"
"story"
"beanfield"
"No. 1
STRONG
Good quality worthy of trust
Be the best oneself"

"FLOWER
Happy time
together we spend
exciting every day"
"That's incredible!"
"Sim Sim!"
"happy"

"What's up in your Fashion?
Precious things are very few
That must be why there's just one for you"
"Lattice emotion
Because earlier results in the past (the first due to consequences)
is one of the characteristics of the causal link, but the causes and consequences
must be contact with the inevitable, that the relationship between
...pace...home...step up...nest...cell...shack...
...cage....bleach...coop...fossa...
the two is the relationship between
cause and be caused"

"I promise that I'll be able to recover all my memories of you
she said all of a sudden as we were walking along...
We've se enten so together. Ever nery In rla I would fee your traces. Newborn babies.
the pntt on the plate that you can see under a paper-thin slice of sashimi:
fireworks of one summer. The moon hidden by clouds over the scene at nig...
When I'm sitting down inadvertently stei on toes nnd have to apol
when someone I've dropped..."
"Eternal Forever Hot Thailand Summer Chili"
"Silent is a silent movie
only images of early film, film itself is silent, only the background music. 
Dramatis personae through the movements, facial expressions
so the that audience understand the plot, a bit like a pantomime. When necessary,
would be to insert some subtitles to help viewers
understand what people say."
(The even smaller writing in the upper right makes even less sense.)
This one is valued for the caption printed on every page:
"Take up your pen and open your note book right now. Note down what you thought,
what you felt. Return to the writing age. After many years,
when you open the notebooks, you will find something
different about yourself. You will feel that everything is on its way to somewhere."
   
     As a matter of fact, I do feel like everything is on its way to somewhere...


Wednesday, August 17, 2011

Nothing is ever as simple as it seems


The idea: Provide vitamins to poorly nourished children in a developing country. (Who can argue with that?)

The plan: Ask people in the US to donate vitamins, have someone bring them to Cambodia, and deposit them in the office of a small NGO focused on children with disabilities so they can be distributed.

The result: 5,470 doses of vitamins ready to be distributed! Fantastic!

Vitamins - they're good for you
(unless you overdose)

The challenges:
  • The  vitamin collection includes various types and brands of vitamins. Some have iron and some do not. Some are about to expire or already have, and some are good until 2014 or beyond.
  • We cannot give the vitamins in their original containers because they have mostly arrived in large bottles of 150-300 vitamins per bottle, and there aren’t enough bottles to distribute one to each family. Even if we had enough bottles, people here are unfamiliar with child-proof caps and tend to either not be able to open them easily even after instruction, or so frustrated that once they wrestle it open they prefer to just leave the cover off so they don’t have to struggle with it again and again. This would mean the vitamins would likely go bad due to moisture, or would be eaten all at once by the children because they look and taste like candy.
  • We can repackage the vitamins in small ziploc medicine bags that even come with pre-printed no-literacy-required cues about how often to take them, but these are not child-proof, and keeping medicine out of reach of children is either impossible or not a priority. (Impossible, you ask? How can that be? Well, where can they put it if they live in a palm-leaf hut with no furniture? It’s not like they have a medicine cabinet, or even a drawer or cupboard. Even if they hang it on a nail high up on the wall, children here are have very little supervision and are excellent climbers. And it’s a foreign concept to keep children away from medicine – when we gave out meds at the clinic, the parents would often hand the little bags to their toddlers to carry home.)
  • Iron-containing vitamins can be toxic – even potentially fatal – if you take too many. But how many do you have to take? A good bit of internet research reveals a good bit of info, and the most conservative estimates say that 10-20 mg/kg of iron is nontoxic. This means that for a 10 kg. (22 lb.) child, 100 mg of iron is probably the upper limit of safe. So giving out any more than 100 mg of iron at one time means taking the risk that as soon as we’ve left the family’s house, some kid is going to eat the whole bag of vitamins and get sick.
  • As I mentioned above, the assortment of vitamins on hand vary in their iron content. Some are iron-free, some have 5 mg iron (a low dose, which means we could give up to 20 vitamins in one bag without potentially poisoning anyone), some have 9 mg, and some have 18 mg (which means anything more than 5-6 vitamins could be potentially toxic to a 10 kg child.)
  • So now the vitamin bottles are all labeled in big fat Sharpie with their expiration date, their iron content, and most importantly, how many we can safely give out at one time. 5-6 vitamins isn’t much, especially since we see some families only once or twice a month, and there may be several children in one family who will share what we bring, but what else can we do? I’ve discussed this forever with the local project manager about how important it is to provide education to the families about giving all medicine properly, and we will give the vitamins out to parents in medicine bags rather than as loose “candy” in the bottom of a goodie bag that is handed to children, but he is not at all confident that parents will pay attention and heed our warnings. So we cannot give more than could cause damage, which means that in many cases we will be giving far less than anyone really needs.


     This is a classic example of the challenges we face here every day. Something that seems simple rarely is. You have to contend with more than just sourcing the thing you need, you have to figure out how to distribute it sanely.

      Anyone have any brilliant suggestions? All ideas are welcome. 

Sunday, August 14, 2011

Doing what I can, as soon as I figure out what that is.


     It’s been an incredibly busy week, in some of the best possible ways. I’m not even sure quite where to begin, but let’s start with my new job.

     I am now employed part time by Safe Haven, which is a partner of Community First Initiatives. For those who don’t want to take the time to check out those links, here is a brief explanation: Safe Haven is a small organization started by an American woman whose connection to Cambodia started years ago when she came to make a documentary film about children living in the garbage dump. (Sorry, one more link: Small Voices.) The mission is to one day build a school for children with disabilities, who otherwise have no opportunity for education in Cambodia. Until the school can be built, Safe Haven has an Outreach program that serves up to 50 children in a handful of villages outside of Siem Reap. These children all have one or more disabilities, including things like CP, seizure disorders, Down syndrome, orthopedic problems, or mystery conditions which haven’t yet been diagnosed. Along with the Khmer Project Manager and physiotherapist, my job is to visit these children at home and facilitate their medical care. This means trying to figure out where (if anywhere) they’ve been getting their medical care, what kind of medications they’re taking or should be taking, and will also include accompanying some of them to Phnom Penh in the coming months when they are scheduled for orthopedic surgery, and then following up at home to make sure their recovery goes smoothly. In other words, I’m a visiting nurse again, and I’m very happy about that.


This beautiful girl is the primary caretaker for her younger brother,
and she does an amazing job.

     Despite whatever neat little explanation I can try to offer about what the job entails, I’m still really trying to figure it out, and as expected, there will be challenges. I have been very lucky in these first two weeks on the job to be able to accompany a visiting team of speech language pathologists from Columbia University who have come to evaluate a number of the children. I always learn something useful when working with professionals from other disciplines, and this has been no exception. It’s been great to tag along on their visits to begin to get the lay of the land and start thinking about how I will gather the information I need from families and what I can then do with that information. As has always been the case in my experience here, getting a history from parents about their child’s health issues is confusing and difficult. So often, what they report doesn’t make any sense based on my Western medical knowledge, and asking the same question in slightly different ways or several different times often gets completely different answers. Again, I cannot tell whether it is a language/translation issue (though the Project Manager seems to be a very good translator) or a lack of understanding on the part of the parents about the facts of the situation. Possibly, it is just because if I ask the same questions more than once, they assume they didn’t yet give me the “right” answer, so they try something different the next time I ask– I have no idea. But this is consistent with all my experiences here, and with those of other professionals, so at least I know it’s not just me.

This is what happens when the Safe Haven crew makes a home visit:
lots of people gather around to see what's up.

     Here’s an example of the type of challenges that come up. I went with the speech team to visit a five-year-old girl.  If she has any particular diagnosis, no one knows what it is. This may be because there just isn’t one, or because the family doesn’t know what it is. She’s been seen at one of the two children’s hospitals in town – unfortunately, at the one that doesn’t allow Westerners inside and never shares any information with anyone, including the other children’s hospital. (The man who runs this place is a master at fund-raising and publicity, but no one knows why he won’t allow any sharing of information, which fuels all sorts of rumors about what really goes on behind those closed doors. Experimental treatments? Pharmaceutical testing? Who knows.) In any case, this lovely little girl presents with gross developmental delays, little recognizable speech, and “severe headaches.” 

     In trying to get information from her grandmother, who appears to be her primary caretaker, I asked lots of questions about her history, which is always a slow process when done through a translator. This is the picture I got: She was born very small and stayed in the hospital for two weeks because of a “problem with her navel being cut” and being weak. She has been back to the hospital twice since birth for “strong fevers.”  Her problem now is that “she gets headaches”  a few times a month, but when trying to pin down how they know an essentially nonverbal child has headaches, all I could get was that “first she gets a fever, then she wants to have a seizure, then she has a headache.” When she has an episode, they give her paracetomol (Tylenol) and then “she is fine after 3-4 minutes.” Doesn’t add up. First of all, both “fevers” and “seizures” seem to have a different definition here than we have at home. People often report a fever when they have none, and no one even has a thermometer, so a fever seems to be more of a global “I don’t feel so well” sort of thing. How they can tell that she “wants to have a seizure” is a mystery, and no one can seem to explain whether she has ever actually had a seizure. (Another nonverbal child’s parents reported that they knew when his skin condition was painful because his “lips get very red .” And after that, of course, “he gets a fever.”) The only intervention I’ve been able to make for this kid was to teach them about the correct dose of paracetomol – they were giving this little 12 kg girl a large adult dose of a brand that includes a hefty dose of caffeine. A week after teaching them how to give the dose properly (correct dose at correct intervals), they told me that she was much better and her latest headache didn’t last nearly as long. Who the hell knows? Sometimes I think that the best I can possibly hope for in some of these situations is to at least prevent people from giving toxic doses of medications, which I suppose is worth something.


     Another child we saw had an episode of (possibly?) TB meningitis at the age of eight months or so, and has been severely delayed in his development since then. He has been taking a liquid antihistamine twice a day for years, which his mother explained is for his “fevers.” She clarified that which type of medicine she gives him depends on what the local health clinic has in stock at the time, so brand and amount are not consistent. She also had empty bottles of amoxicillin (the cure-all for everything in Cambodia) which she gives him for a few days every time his cough gets bad (which explains the rampant amoxicillin resistance here. His lungs sounded lousy and his overall muscle tone is very floppy, but near the end of the visit, when I asked the mother what she was most worried about related to his health, it turned out to be an itchy skin rash and his severe and chronic constipation. Luckily, I had some good skin cream to offer at the time of that initial visit, which will likely help the rash. I also have some knowledge about treating constipation in children and some expert  professionals back home to consult with via email, so with the limited options available here, I hope we’ll be able to tackle the constipation as well over the next few weeks. His respiratory issue is probably the thing I worry about most immediately, but I’m guessing his lungs have sounded lousy for years, and if there’s one thing I know, it’s that identifying what the family is concerned about and trying to address that issue is what works best to begin to build trust and rapport. I shall let you know if that strategy is as useful here as it is at home.

     As I said earlier, working with the speech language team has been great. The professor and supervisors are crackerjack at their jobs, and they have seven graduate students with them who are all eager to learn and put their knowledge to some use. I have tried to soak up what they can teach me while they’re here, and I have certainly been soaking up the camaraderie and opportunity to share experiences and ideas. I will miss them all terribly when they’re gone, but I expect to keep in touch and am thrilled to have their expertise only an email away.

     The children I have seen so far live about 20-30 minutes away from Siem Reap by motorbike, which provides me with a fantastic opportunity to get out of the traffic and into the countryside. It's particularly beautiful this time of year - green and lush, sometimes wet and muddy, and the fields are dotted with farmers transplanting rice and herding their cows to the next grazing spot. One community served by Safe Haven, Sen Sok, lies about 90 minutes outside of town in an area which can only be reached by big 250 cc motorbikes, and we’ve made two attempts to get to those villages which have so far resulted in a score of Cambodia: 2, Safe Haven: 0.

Rice ready for transplanting

     Our first attempt to get to Sen Sok was a week ago. The speech team hired big motorbikes and drivers and we set off in a convoy of three. Within 20 minutes or so, one of the bikes had problems, which turned out to be seized rear brakes, aborting the whole mission. An hour and a half after first setting out, we were back in town where we started, so we installed ourselves in a local restaurant and ordered drinks. It made for a wonderful day of hanging out with wonderful people, but we weren’t exactly doing what we had set out to do, so Plan B was made to try again the following week.

This is a monster-sized bike around here.
     Last Friday, we set out again, this time in a convoy of five. After about 45 minutes of riding on the main road, just where we were turning off to hit the dirt, one of the bikes got a flat tire. In general, a flat tire in Cambodia is no big deal because there are mechanics and air pumps everywhere you look, but tubes and tires for the big bikes are not so easily available. Eventually someone was dispatched to go back toward Siem Reap and get what was needed, and after an hour of sitting in the shade and chatting while we waited, all was well again and we set off. We roared along, all of us female passengers hanging on and trying to avoid getting our asses pinched by the seat bouncing against the frame of the bike as we flew over potholes. These bikes are not really designed for two people, especially when one of them is a “sturdy” foreigner, otherwise known as a fat barang. Luckily, the scenery provided lots of distraction, and as the rice fields and palm trees and buffalo and naked children whizzed past, I could only grin at the thought that at that moment, this was my commute to work.

     Another 30 minutes or so into the ride, the same bike had a flat again. Now we were nowhere near any source for parts, and there was clearly an underlying problem that wasn’t going to be fixed by yet another innertube, so it was time to find a shady spot again and sort out the options. While the drivers and local staff conferred with village men about our predicament, the rest of us found a roadside shop with the ubiquitous orange cooler and had a beer. Another 45 minutes or so passed – we had started out at 8:30 in the morning and it was now somewhere around noon, and we hadn’t yet seen even one of the four children we hoped to visit.

Yup, flat again.
     It became clear that the only option for the broken bike was to have it trucked back to Siem Reap. Most of the homes in the villages where we were going were still too far off or inaccessible for the rest of us to continue the journey given how much of the day had already disappeared, and now everyone was worrying about whether the remaining bikes were going to hold up under the weight of the passengers. The best we could do was to go and see one child who lived not too far away from where we sat, and then all return to town with the broken bike and pick-up truck that was on the way to collect it. So off we went, to see the child who we were all the most anxious to see, a five-year-old with severe CP who was badly malnourished because of his feeding difficulties.

     Like some kind of crazy barang circus parade, we all arrived at this child’s home. Three big bikes and four big white people took up most of the space in front of the little stilted palm-leaf house, and the Khmer project manager went to greet the family. Even from afar, I could see by his reaction that something was wrong, and I immediately assumed that after all our efforts to get there, the family probably wasn’t even home. Unfortunately, the news was much worse than that. The child had died a week earlier.

     This situation brought many things to my awareness. For one, I’m not completely sure about the culturally appropriate response to this kind of news. I don’t even do well at home knowing what to say to someone who has lost a loved one, and I don’t understand Cambodian beliefs and practices around death nearly well enough. I had to wonder if the death of this severely disabled child was in part a relief for this family. For a family of subsistence farmers, a child who not only can’t contribute to the good of the family but also requires a lot of time and energy to care for is an enormous burden. The situation also made clear the fact that Safe Haven hasn’t yet had to decide how best to respond to a family under these circumstances or what to tell them about future involvement with the organization. In true Cambodian fashion, the mother was smiling and greeting everyone, and someone went to get mats and spread them out in the shade so we could all sit down and talk.

     It is impossible to know why this child died. The family described what happened by saying “he had a seizure for 24 hours and then he died.” Did he truly have a seizure? Did he die of complications from his malnutrition? Did he have other underlying medical problems? Did he get a run-of-the-mill illness that his fragile body couldn’t overcome? We have no idea. We don’t much about this child at all – he was only just discovered by Safe Haven staff a short time ago, and as usual, his history was mysterious.

Kids in the village checking out the foreigners.
     Children – and adults – die here all the time. They die of things that we never have to think about at home, despite our messed up healthcare system – things like TB and diarrhea and pneumonia. People die of things that we have every expectation can be cured or managed: diabetes, hypertension, appendicitis, bleeding ulcers, cancer. They often die without a diagnosis or any medical attention at all. And even when they can get to a hospital, that doesn’t mean that diagnosis or treatment will be available. I spent a morning at the government Provincial Hospital last week, where I was invited to witness a surgery (actually, I was invited to ASSIST in a surgery!) and the scrub sink outside the operating room had no running water. We had to scoop standing water out of an open plastic bucket to wet and rinse our hands. That’s the state of medical care in Cambodia, in a nutshell. (That hospital experience deserves a blog post all its own, but I’m not sure I have the fortitude to write about it.)

     So that’s how I spent some of my time so far trying to get a grip on what my new job will be. I think it will be wonderful and awful and beautiful and painful. I will be dealing with everything from constipation to death. I will spend hours trying but not getting to where I need to be. I will collect black and blue marks on my ass from riding on motorbikes over red dirt roads. I will try to forge relationships with my Khmer co-workers and the families I will visit. I will pass out paracetomol and condolences. I think I will sometimes wonder who the hell I think I am that I expect to be able to do something genuinely helpful, and I hope that sometimes I will have moments of clarity about the fact that I have something, however small, to offer. I will take it all in, and try to figure it out, and hope that I can give back even a tiny percentage of what I gain from this experience. Wish me luck.

I wonder where this road will take me?


Monday, August 01, 2011

Cambodia: the adventure continues

     I am motivated to write by the realization that if someone looks at my blog for the first time, the entry that greets them is the one that's full of my whining and complaining. Not a very good first impression.

     It's also no longer an accurate reflection of how I'm feeling, fortunately. As we all know, those moods come and go, and thankfully, that one has gone. Life is back to feeling like a more balanced mix of charming amusements and mild frustrations, interesting opportunities and predictable routines, with an occasional bit of novelty thrown in now and then.

     I took my motorbike in for service and an oil change last week. There's a Suzuki dealer just around the corner from our house, so I stopped in to see what would happen if I tried to explain the funny noise and odd hesitation I was noticing. I was shown to a plastic chair and my bike was put up on a lift a few feet in front of me while two men in spiffy uniforms went to work dismantling practically the whole thing. Bit by bit, they showed me pieces they removed that needed replacing. Some I could recognize: the chain, the sprocket, the brakes, the wheel bearings. Some I couldn't recognize at all. Each part was presented to me with a sad and apologetic look and the receptionist translated for the mechanic. "Sorry, Madame. This one, need new also." I would ask how much, and would be told, "Sorry, this one three dollars." (Or two dollars, or - OMG - nine dollars!) Much like when I would take my car in for service to an unfamiliar mechanic back home, I would wonder whether this particular part truly needed replacing, but would put myself at their mercy for lack of a better option. In the end, it took 25 minutes to replace everything with new parts right out of the boxes, and cost $36. And I must say that the bike both goes and stops much better than before. (Sovann was quick to tell me that I paid too much and should have gone to one of the roadside mechanics who set up shop under a tarp, but in the end I felt like I got my money's worth, both in terms of service and confidence in the experience.)


After all that repair work, I took the bike for a wash.
For about 60 cents it got all cleaned up while I was given a chair and the opportunity to
read Khmer newspapers or watch Tom & Jerry cartoons on TV.

One of the more popular models: the Suzuki Smash.
Why not just call it the Suzuki "Accident?"

     We splurged and bought an oven a few weeks ago. It's more like an over-sized toaster oven, but it does have temperature control and is big enough to hold a loaf of bread, so that's mostly what I've been making. It's amazing how much pleasure can be had from a loaf of warm oatmeal bread or a pan of brownies. Before we got the oven, the only food I ever made here is hummus and burritos, but now I find myself occasionally interested in cooking. Perhaps I'll expand my repertoire even further.



     I'm planning to go to a combination yoga and cooking class in a couple of weeks. I've been saying I should try yoga for years and never have - now seems as good a time as any. I'm a little late on the yoga bandwagon, but it's time to give it a whirl.

     Work at the World Hope Assessment Center feels more and more comfortable as time goes on. As with any job, the first few weeks or months are fraught with moments of confusion and the accompanying lack of self-confidence that comes with either not being sure of the best way to handle something, or being quite sure that I have no idea how to handle something. But I learn, and I do some research, and I ask questions. Sometimes I try something and find that my basic instincts were spot on, and sometimes I find that I've misread a situation entirely. The language barrier is a part of my daily existence, and even with people who speak relatively good English, we have moments of mis-communication. But I feel more and more comfortable in my role, which is always a good feeling.

     Another part-time job opportunity has presented itself, which I will explore further this week. This one involves working with a relatively new organization that serves children with disabilities and would include coordinating their medical care as well as doing home visits. In some ways, it's the perfect fit for my skills, except for the part about not having a lot of experience with children with disabilities, but I can learn. More news about this when I know more.

Random photo for your amusement:
a condom ad at the local corner store, funded in part by USAID.
I really need to ask someone to translate the words for me.

      Steve continues to play tennis like a maniac as often as he can. In a good week, he can play 3-4 times, sometimes early in the morning before the heat becomes too oppressive, but he's been known to play in the worst heat of the day when the opportunity presents itself. He's enjoying his new morning job, where he's finding that his skills are appreciated and his ideas are valued. Such a refreshing change. And in the category of trying new things, Steve was one of six speakers for the inaugural Nerd Nite Siem Reap. This is an event in which people have the opportunity to speak to an audience about something they're passionate about, and they can show 20 slides for 20 seconds each in order to do it. Can you guess his topic? Food, of course.

Steve and his fellow Nerd Nite presenters.
      Jaz is about to finish a full-time online semester at CCV and is already enrolled in her classes for the fall. She's teaching a few private students and plans to start a morning teaching job at another international school in a few weeks, after she and Sovann come back from a real vacation in Thailand in mid-August. She hasn't left Cambodia in over a year, and has really only left Siem Reap to go visit Sovann's family, so she's long overdue. And Sovann, who has struggled the past few months with no tuktuk work at all, has just passed the entrance exam to a very good culinary school here in Siem Reap and will begin his full-time studies in September. I look forward to sampling all of his homework - he's already a good cook, but I hope we'll be able to taste all the things he's learning over the next 10 months.



      Speaking of vacation, Steve and I are talking about taking a long weekend to get out of town. All the long-time expats offer the same advice: get out of town on a regular basis! We haven't listened to that advice well enough, and several of them who read the last blog entry pointed out that my mood might be greatly improved by a brief change of scenery. So maybe we'll head to Bangkok or the Thai beaches in the next few weeks for a mini-vacation. It doesn't have to be too expensive, though it still feels decadent when you think about the fact that most Cambodians work harder than we do and never have such a thing as a vacation. Add that to the list of things to feel ambivalent and/or guilty about...

      While folks back home in Vermont were having a heat wave, we had a bit of a cool spell. The rains, which had ceased for a couple of weeks, returned and brought much cooler weather for a few days. While that brings its own challenges (driving in the mud can be as challenging as driving in ice and snow, and a hard rain while you're driving a motorbike can feel more like hail as it pelts down on you), it was nice to have a break from being sweaty every minute of the day. Of course, after a few days the rain stopped again and the heat returned full-force. It usually cools down a bit after the sun sets, but the other evening it was still more than 90 degrees at 8pm, which I find a bit too much.

     There are social events and dinner parties and new restaurants around town, and thanks to a very active Siem Reap Expats Facebook page, we hear about new things all the time. A great new falafel place just opened: $3 for falafel, fries and a beer. We're looking forward to trying the new Texas BBQ restaurant someday soon. There are art openings and more live music than ever before - life in Siem Reap isn't all about sweating and trying to keep the ants out of the cereal box. All these youngsters in town know how to party, and if we pace ourselves carefully, we can keep up now and then.





     So there's our latest news. More details will be coming soon about the new job, and I have some other ideas percolating that I've been meaning to write about for a long time, so stay tuned.

Sunday, July 17, 2011

Sometime I have terrible, horrible, no-good very bad days (Warning: This post is rated R for language)

     Usually I wait for the right mood to strike me to write a blog entry. If I'm not in a "writing mood," it just feels like a huge chore and nothing productive comes of it. And if I'm not in an upbeat mood, then I feel like I write things that sound too morose and I certainly wouldn't want anyone to think I'm not happyhappyhappy all the time!

     But I'm not happyhappyhappy all the time. Sometimes I'm irritable. Sometimes I'm cranky. Sometimes I'm downright bitchy and want to tell everyone around me to fuck off almost every time they open their mouths. Sometimes I'm sad, or a bit lonely for my friends or my family back home, and sometimes I even cry over stupid little shit.

     For those who are looking for a light-hearted glimpse into the exciting life of an ex-pat living in a foreign country, fuck off. (Just kidding.) Well, partly just kidding. I'm in one of those moods right now. And it's in some kind of rapidly-cycling roller coaster with the tears. We could blame it on hormones - though I'll spare you all the details of my peri-menopausal symptoms - but whatever we want to blame it on, here it is. And since I got a fair amount of feedback that even more serious topics are welcome here, off we go.

Nine Things That Piss Me Off This Week:

1. You know that little trick I mentioned about putting an ice cube in your ashtray to keep the ashes from blowing all over? Well, it's a giant pain in the ass because I forget that it's there and I put my cigarette down and the end gets all wet and soggy and there's nothing more disgusting than wet cigarette butts and ashes. Not to mention that I've wasted a cigarette. Luckily, they're only 30 cents a pack. Too bad I'm a smoker; maybe this is the universe's way of telling me to quit. Certainly Steve's way of telling me to quit isn't working. He says, "I hate that you smoke!" which makes me want to say, "Fuck off!" And then I light another one.

2. And while we're on the subject of things I just mentioned in a blog entry, that whole "don't get offended when people call you fat" thing is wearing pretty thin, so to speak. Last evening, I ran into a Khmer friend who I hadn't seen in a couple of months. He's a nice guy, and pretty savvy because he works with foreigners a lot. He greeted me with a big smile, and said, "Hi! Wow - fat! You're so fat now." Then he looked over at Steve and pointed out to him, "She's so fat!" I was not amused. Guess what I wanted to say back to him? You guessed it: "Fuck off!" Instead, I hit him. On the arm. In that friendly Khmer way people do here. But maybe a little harder than that. And I can't let it go, because all day today my mind keeps wandering back to that moment and I've been writing scripts in my head about what I'd like to say the next time I see him. "Hi! Wow - so thin! You look like an HIV man!" Because that is what people here worry about when they're very thin - that other people will think they have HIV.

3. Have I mentioned it's fucking hot? I knew that it would be, of course, and usually it doesn't bother me so much, but the last couple of weeks have been brutal. Hotter than usual, as others here agree, but even less tolerable for me than it seems to be for everyone else. I sweat under my eyes and above my lip, and I can't even enjoy being in the hammock unless there's a really stiff breeze - which usually just feels like a really hot blast furnace.

4. Corruption. There's a ton of it. Not that we don't have our own forms of institutionalized and government-sanctioned corruption in the US, but at least in the US the kids don't have to pay the teachers to make sure they pass their tests. And violence - again, not that we don't have plenty of it at home, but my job here reminds me every day about the victimization of young girls in particular, and how some families' response to their daughter's rape is to accept payment from the rapist's family in order to drop the charges, or to arrange for their daughter to marry the rapist now that she's "damaged goods" and no one else will want her. (There's a lot more to say about that, and I have a half-written post in the works on that topic.)

5. Our landlord is pissing me off. We rent the upper half of a lovely house, and the landlord and his family live downstairs. One of the advantages of this arrangement would seem to be that if we have a problem, the landlord is easily available to attend to it. But apparently he's far too busy, and if he ever gets around to arranging a repair of some kind, we're supposed to pay for it anyway, so it's easier to just tackle it ourselves from the start. And also, the fact that they take great care of the plants in their yard would suggest that they take pride in their home, but why is the yard still strewn with garbage sometimes? I swear, there was a broken computer keyboard lying next to the driveway for months, not to mention the cellophane noodle wrappers and other detritus that just blows around the yard. WTF? 

6. My fucking computer. The one that keeps breaking and not getting fixed properly. The one I bought here when we were robbed and all our electronics were stolen, so I had to pay more than I would have had to pay at home for what appears to be a piece of shit. It says it’s an Acer, which we’ve always had good luck with in the past, but either I got a lemon or Acer sends all their shit computers to Cambodia. This is compounded by the fact that the repair shop is so difficult to work with (see previous post on that topic) and the new symptom it develops every week. My keyboard is “fixed” now, though the squeaking sound it makes whenever I press any keys in the middle suggests that it won’t last. Also, it likes to randomly shut down with no warning. And this week, its modem seems to be failing because after an hour or so, it loses its connection to the internet and then claims there are no wifi connections to be found – despite the fact that everyone else in the house is still connected. The solution is to restart, which wouldn’t be so difficult if that didn’t take 8-10 minutes, probably because of all the extra software that the repair shop likes to install every time they “fix” the damn thing. (They probably installed some keystroke logger and are reading this right now and getting ready to report me for criticizing the government.) (Nah, on second thought, anyone who thinks you can fix a keyboard by changing the font probably isn’t clever enough to do that.)

7. Smells. Especially when the landlord is cooking fish just off our balcony and the neighbors are burning garbage (at least they get rid of it somehow) and the hotel down the street is spraying clouds of DDT or something to control mosquitoes.

8. Ants. This is apparently Ant Season. The ants we have are tiny little things – really really tiny – but what they lack in size they make up for in number, and they have some magical way of getting into “airtight” containers. They’re just as likely to be found in the bathroom or the bedroom as in the kitchen, so they’re not always looking for what we would think of as food, but they march in miniature battalions all over the walls. And sometimes you’re sitting somewhere, innocently minding your own business and swearing at your laptop (or your landlord, or your friends), and you feel a minor tickle on your ankle or your hand or your neck, and then you realize there are ants crawling on you. At least these ants don’t bite, and you can’t really taste them if they get into your food. But there are also biting ants, and an occasional bite from one of those will hurt for days and take weeks to heal. Fuck off, ants.

9. Myself. Mostly I am just pissed off at myself, for feeling like this. For being annoyed and pissed off at the things I can usually laugh at or ignore. For having lost touch with the sense of fun and amusement at the quirks and charms of this place that I love. For smoking cigarettes and getting fat. For writing in incomplete sentences. For being such a pain in the ass to live with that Steve has to steer clear of me whenever possible, which then gives me another reason to be pissed at him. I wouldn’t want to live me right now.

     So I’ll either post this before I lose my nerve and then suffer the angst of having exposed my negative self, or I won’t post it and then I’ll suffer the shame of being unwilling to share my darkest moments.

     On another (but related) note, this is one of those times when I think about who might read this drivel. This blog started years ago as a place to write about our travels, and then evolved into a place to write about our new life in Cambodia. The original audience was people back home who were interested in what we were up to. Now there are readers who I don’t know at all (because I allow access to anyone who stumbles upon it) but also includes people who I know here. I worry less about exposing myself to friends and family at home – and I don’t care so much about strangers – but knowing that people who I see here on a regular basis may read it makes me feel far more vulnerable. We all attempt to present ourselves in one way or another, and this post admits that I’m not always who I would like to be. So for any local friends reading this: no looks of pity please! It will provoke either a “fuck off” or tears, and we don’t want that.

Now please excuse me for a moment while I restart my fucking computer and use the time that takes to consider whether or not to post this...

     (And damn, I forgot to mention about how much the tourists bug me, with their culturally inappropriate dress, their belief that they can save the world by volunteering for a day hugging some orphans, and their obnoxious habit of walking in the middle of the street as though it's a pedestrian zone.)

Saturday, July 16, 2011

Eleven random things I've learned that are useful in my daily life in Cambodia (with unrelated photos just to make this post more colorful)

1. When driving, it's legal to turn right on red (and left on red, and straight on red) but it's illegal to drive with your headlights on during the day.


2. Calling someone "talkative" translates into an insult.



3. An ice cube in your ashtray will keep the ashes from blowing all over the table.


4. Even though an establishment - including a health clinic - has posters on the wall extolling the virtues of hand-washing, it doesn't mean there will be a sink in the bathroom. (And if there is a sink, there will never be any soap or hot water or towels.)





5. When leaving your helmet sitting on your parked motorbike, make sure it isn't upside down or it will fill with rain, take days to dry, and smell like wet helmet for two weeks.


6. Just because there's a clock in the bank lobby, don't assume you will know the correct time. (Recently I visited a bank with a row of clocks that claimed it was 3:27 in Cambodia, 3:45 in New York, and 12:09 in Paris.)


Gotta do something to kill time while waiting for customers...


7. Don't be offended by anything. Examples:
  • Being asked how much you pay for anything (and then being told you paid too much.) 
  • Being told your tires need air because you are very fat. 
  • Almost being run off the road by another driver. (Just exchange big smiles and move on.)
  • Having your arm stroked and squeezed by random strangers while being told how white you are. (I like to blow their minds sometimes and remove my watch, showing them my untanned strap mark so they can see how white I really am.)
  • Having a vendor quote a price that you know is twice what the locals pay. 
  • Being asked to borrow money.

     

    8. There are many kinds of policemen. In some circles, they are known as the "shit police" (the traffic police), the "fucking shit police" (any kind of police who fine you and pocket the money or charge you to investigate a crime), and the "tidy police" (who keep the peace, so to speak.) There are also the temple police, the commune police, and the tourist police, as well as others, I'm sure.

    This would be the "police who take their kids to work."

    9. If you want to know exactly how hot it is so you can whine to your friends back home complete with objective data, bring your own thermometer as there are none to be seen here. Nor are there any weather reports, unless you go online.

    10. Don't fret about buying meat in the market that is hanging around in 95-degree heat. (It's only been dead a couple of hours, so there hasn't been enough time for deadly bacteria to grow.)

    11. Really, never assume anything.
    • Never assume that the neighbors won't set up a wedding tent in the middle of your street requiring you to drive the long way around or straight through their party. 
    • Never assume that someone will call before coming to visit, that they will knock when they arrive, or that they will be able to interpret your unspoken signals that it's time to go home.
    • Never assume that germ theory is a universally accepted concept. For example, if you get conjunctivitis, you may be told that it's probably because you looked at two dogs having sex.
    • Especially never assume that there's no logic behind the way things are done here - just because the logic is not obvious to you doesn't mean there isn't a kind of logic involved that you don't understand yet.
    Wedding tent in the middle of our lane.



    Thursday, July 14, 2011

    Ten reasons I haven't posted lately

    1. It's been too damn hot. We've been having a bit of unseasonably hot and humid weather in the middle of what is supposed to be rainy season, and the temperature and humidity knocks me out. 


    2. I've been busy. I'm working more, and while it's far from full-time, it is sporadic and unpredictable enough to leave me feeling like I'm working more than I actually am.. 


    3. I'm cranky. See #1 above.


    4. I'm too in love with my iPad, which works perfectly well for 90% of my computing needs, but isn't so great for writing long text. I could use my laptop, with its still wonky keyboard, but I'm usually too lazy to go to turn it on and wait through the five-minute start up process.


    5. So I guess being too lazy has to go on this list too.


    6. I'm feeling kind of lousy these last couple of weeks, with a collection of vague yet extremely annoying symptoms. Every day I give myself a provisional diagnosis of something different - virus, thyroid imbalance, MS, chronic fatigue syndrome, brain tumor, menopause, spinal misalignment, benign paroxysmal positional vertigo, middle age, Lyme Disease, mitral valve prolapse - you name it, and I've probably considered it. It makes me cranky (see #3 above) and tired.


    7. Sometimes I get all bent out of shape when I post something on the blog and get no responses about it. It seems I crave more interaction than a blog format provides, which leads to...


    8. I spend way too much time on Facebook, where I can find that interaction I'm craving, and stalk people from back home, and keep a connection alive just by taking 2 seconds to click "Like." (If I ever feel like writing again, I could tell you how the evolution of the way I use Facebook over the past year reflects something about where I am at both physically and psychologically, but that would probably only be interesting to me.) 


    9. I feel like the novelty/honeymoon phase of life in Cambodia is over. My perspective and outlook are shifting, and I find I'm more likely to want to post about more serious topics, which I don't think most of you will enjoy reading. (And then you won't respond and I'll get all bent out of shape.... see #7 above.)


    10. 


    OK, maybe I can only think of nine reasons. (So maybe Reason #10 should be lack of creativity.)


    Just to keep this post from boring you completely to death, I will include a photo. This is is the brand new sign for my favorite business in town - well, the business whose name I love more than any other. Their sign and awning used to say "Steel Door Achievment" (missing a second "e") and  now it says "Steel Door Achivement." 


    I wonder what they did with the old awning. I would totally take it and use it on our balcony...