alicespringstomind

About half a million of Cambodia’s 15 million population are employed in the garment factory industry.  These workers make around $80 per month.  Export from this industry earns the Cambodian economy around $5 billion per year.  In recent times garment workers have been lobbying for a pay rise to $160 per month.  Today at least five Cambodians lost their lives over the issue.

Demonstrations have been occurring around the country for some weeks now.  Here in Kampong Cham military police have been heavily present outside a government building very near our office and while I haven’t seen any demonstrators, I have heard their chanting from a distance.

The Prime Minister of Cambodia, Hun Sen, is from Kampong Cham and the town despite it’s visible poverty also has a small amount of extreme and conspicuous wealth.  Hun Sen was a commander in the Khmer Rouge but he fled to Vietnam in 1977 during some internal regime strife.  In Vietnam a rebel army was formed in which he became one of the leaders.  This army was sponsored by the Vietnamese government who liberated Cambodia in 1979 and installed the new government, of which Hun Sen was initially Deputy Prime Minister.  Since this time he has maintained leadership in the country under a number of different titles, but for almost 30 years as Prime Minister.  This has been a hotly challenged position with accusations of ballot corruption as recently as last year following the July election.  Demonstrations are a frequent event across Cambodia, but particularly in the capital of Phnom Penh.

It was with apprehension that I read in yesterday’s newspaper that the government warned of “consequences” if garment workers continued their demonstrations.  Yesterday’s apprehension was followed today by great sadness at the news that military police opened fire on striking garment workers in Phnom Penh, with at least five dead and an unknown number wounded.

While this was happening in the city I was having a very peaceful and interesting day visiting patients in the countryside of Kampong Cham.  Patients with Drug Resistant TB are required to take their medication by DOTS (the acronym for Direct Observed Treatment, Short Course).  When a patient is diagnosed with DRTB, our DRTB nurses travel to their home and identify someone willing and able to take on the role of directly observing every dose of medication.  Usually this also involves administering at least one medication by intramuscular injection.  On a regular basis the team travels out to perform “surprise visits” on both the patient and their Home Based Care Nurse (HBC Nurse), to ensure that everything is happening as it should with no complications or problems.  The medications cause many side effects and require a reasonably strict regime, which if not followed well can result in poor outcomes for the patient as well as placing their household and close contacts at risk.

We arrived at the office early and piled into the car.  A driver, a social worker, a nurse and myself.  We left the city and headed south on the main road, as always past many sights including ox-drawn carriages piled high with hay, trucks almost doubled in height by their produce, with sometimes dozens of workers seated atop the produce at dizzying heights.  Long wooden carriages being towed by motorbikes or bare tractor engines carry groups of women to the garment factories for a day’s labour.  Tuk tuks and mini vans overloaded with people or produce, motorbikes carting whole vegetable stalls with produce held between the knees of the driver, piled up against the drivers’ back and stretched across the back of the bike in cane baskets.  None of these things are of interest or concern to the locals I travel with but all continue to make me wide-eyed and agog.

Recently the most common sight in front yards has been rice drying on canvas tarpaulins in many front  yards, but this morning rice had been replaced with the white chopped roots of cassava much like the photograph below, stolen via Google.

A moderate distance out of town we pulled into a small concrete roadside home.  Reminiscent of a quaint old colonial cottage, with widely spaced metal bars behind wooden shutters in the window space; an adjoining thatched lean-to, dirt floors throughout and the tin roof reinforced with dried palm leaves.  Next door a family were sitting on the grass in a circle, I guess eating something together.  Chickens pottered about, puppies played, and a fence of bamboo was suspended across a space of about two metres with grass sheaves crossed over the fence, drying for an unknown but no doubt productive purpose.  The closest image I can find of this scene is these sheaves of wheat.

With hammocks slung between anything vertical that is strong enough and bamboo-based day beds always situated in outdoor undercover spaces, the family appeared and perched in various locations to join us as we spoke with the young patient about her medication regime, side effects, concerns about not yet being allowed back to her job at the factory, etc.  Without a translator I rely on snippets of information from my colleagues, who very kindly always include me in the conversation whenever possible.  A lively and jolly conversation transpired while a young man approached a large ceramic tub, collected water from it with a handled plastic pot, transferred a trickle of water into a smaller tub and washed himself before disappearing into the house, reappearing in a smart shirt and trousers, and driving off on his motorbike.

From this house we visited four more locations including a home I had visited previously, where I was welcomed with greetings of familiarity and many smiles.  It was here that I was motioned to sit on a plastic chair which was brought downstairs from the house, to the breezey dirt floor space underneath the house.  Children appeared from all angles and stared at me, laughing whenever I made eye contact with them and otherwise smiling gently as they observed my every move.  As I watched the pet chickens pottering around I suddenly found myself in the path of a retreating chook as she hurried to escape from an attacking rooster and landed noisily almost in my lap, creating a brief din of shock and hilarity as my colleague shouted “sorry!” at me and brushed some wayward feathers off my t-shirt!

At another elevated bamboo home I was invited upstairs and inside.  At the top of the stairs I hesitated as I looked down and through the gaps in the bamboo to the ground about 3 metres below and wondered if this precarious looking floor was going to hold my weight.  My two colleagues and the two residents were already inside sitting down and all encouraged me in with assurances.  We sat on a floor mat near a mosquito net covering another mat used for a bed, in a setting very similar to this image stolen from the internet.

Everywhere I have been, people have very little materially but much to give in the form of welcoming smiles, reassuring gestures and inclusiveness towards the obvious foreigner who doesn’t even know how to walk on the floor of your home.

After our last home visit we drove back to the town of Skun which is best known in the travel books as the place where tarantula spiders are deep fried and served as a snack.  I’ve been through Skun a number of times now but had not seen the spiders.  Today we stopped at the side of the street market in Skun to drop someone off.  Immediately the car was surrounded by vendors offering us various dishes being held up to the windows.  As I looked up at some chunks of pineapple and tried to absorb the scene before me, a big plate of fried tarantulas appeared at my window with a pair of hopeful eyes trying to tempt me!  Needless to say she received a categorical shake of the head in response before we drove off to escape the hopeful masses.

We pulled into a local outdoor restaurant for a Khmer lunch and I got to know my colleagues a little more.  Khmer food is delicious but nothing goes to waste, so eggs are eaten complete with shell, chunks of meat are interspersed with chunks of offal, the rice is bottomless, and chunks of tropical fruit come on large wooden sticks for dessert.  Many of my colleagues are not from Kampong Cham and spend days or weeks at a time away from their family in order to support them with the small but reliable wage that MSF can offer.  Stories are commonplace, of fathers who live away from home except for one or two weekends per month, mothers who work seasonally in the rice fields (hard physical labour) near their children, but after harvest season travel to the city, leaving the children in the care of elderly grandparents for prolonged periods so that $80 per month can be earned in the garment factories.

Back at the hospital I attended an education session with my translator.  Everyone in the room except me was Khmer.  The presenter asked was he to present in Khmer or English?  The room remained silent.  I suggested it should be in Khmer as I was the only non-Khmer person there.  He replied in Khmer, that he would present in Khmer but that it was important for everyone to practise their English and learn to understand and speak it well because “when you use English you will understand the world much better and have many more opportunities”.

That is no doubt a true statement.  But Cambodia and Khmer speakers are opening my eyes to the real world, too.