Today I had my first contact with someone in Australia introducing me to the beginnings of what I hope will not be a quagmire of red tape around trying to raise desperately needed funds for our small but functional home of 12 HIV orphans. This evening I visited the children and had my arms draped in homemade bracelets as we conversed in broken Khmer and English, combined with many facial expressions of understanding or confusion, plus hugs and laughs galore. We have planned our final outing together before I leave town and we discussed a little about my upcoming departure and subsequent return. I got home to emails about their enrolments for the new school year, upcoming dental care and various other issues that the Board of Directors are involved with. Some of the children are significantly behind educationally and the board members have different ideas about how to approach this, so emails are flying. It’s proving a really interesting pursuit for me to be involved in.
They are an endearing group of kids living like a big family of siblings. Aged from 15 down to 6 they care for each other, play, fight, tease etc exactly as a bunch of brothers and sisters would. They cycle to school, the older children doubling the younger ones as there are not enough bikes. Not irregularly one or other of them ends up in hospital and so I have taken off my nurse hat and put on my visitor hat quite a number of times over the months. Usually one of the older children accompanies the patient during the day while the adult carer maintains the home situation, then a carer attends to stay overnight and the well child goes home. Caring for each other is a natural and unquestioned aspect to their home life and they take on far more responsibility for each other than children in the western world could imagine. As a random sample, the group includes a 12yo boy who is a natural comedian with a great singing voice; a 13yo boy with the swagger and attitude of a rock star; a 13yo girl with a maternal role in the group; a 13yo girl with an austere persona who sits at the back and says very little, but observes everything and regularly grabs me from behind for a stolen hug; a 12yo girl full of smiles and giggles; an 11yo girl with the sweetness of a little angel; a 6yo boy with the cheek and energy of a little devil. Every one of them has a distinct little personality and getting to know them over the past year has left an indelible mark which I could not have imagined the day I strolled through their front gate almost a year ago to say hello.
During the holidays they have arranged teaching sessions each evening where the more advanced students have paired with a struggling counterpart to try and accelerate their progress before the new school year begins. A charity linked with the orphanage arranged for them to go on a trip to Angkor Wat a few weeks ago, which caused a lot of anticipation and we planned our English lessons in the lead-up to this trip using the topic of Cambodia’s location in the world and Angkor Wat’s location in Cambodia, compared with where the children come from. On return from Siem Reap our lessons centred around how to describe where they went, what they did, when they did it, who they did it with, etc.
Needless to say I’ll miss them while I am away, but the orphanage manager is available by email so I will be able to maintain contact. This is less likely with the other five English students who we adopted from the hospital grounds where they live with parents or grandparents in all manner of impoverishment. This afternoon I was having a usual weekly staff meeting in the Tuberculosis Department’s tropical garden when three of these students wandered through looking for me and wanting my colleague to translate for them in the face of nervous reactions that they had entered a possibly infectious area. The translation was “They would like to ask your permission to travel to their homeland tomorrow and stay there for ten days”. Stifling my umpteenth chuckle of the day I replied that they did not need my permission, but thanked them for letting me know because we will have to say goodbye tomorrow, three months to the day before I arrive back in Cambodia. As our meeting came to an end one of my Ministry of Health colleagues who earns $40 a month and also lives on the hospital grounds, presented me with a beautiful piece of traditional material as my first farewell present. So the farewells are beginning in earnest.
One of the best farewell presents I had this week is a story of chance encounters and improbable coincidence. Some months ago we were visiting one of the orphans in the Paediatric ward where rooms of bare concrete walls, tiled floors and wooden bed bases are overcrowded with sick and dying children receiving next to no real medical attention. One of the babies in a bed nearby was clearly dying, struggling for breath, wafting in and out of consciousness and the size of a 2 month old but according to her subdued grandmother, was 16 months old. It was a horrific sight accompanied by a horrific history of a dead mother, absent father, baby and older siblings cared for by this sad elderly woman sitting hopelessly beside her dying grandchild. When I returned the next day to visit I had determined I would find out what I might do to help this grandmother but the bed was now occupied by a different baby and mother. I assumed that the baby had died and a few days later, asked one of the paediatricians if he knew anything about the 16 month old baby who had died, but he could not place who I was speaking of.
Yesterday I walked through the TB Outpatient area and for the second time in the space of a few weeks, recognised this grandmother. I was heading to a meeting so I didn’t stop but after the meeting I informed my housemate/colleague who was with me months ago that day in Paediatrics, that the grandmother was in the OPD waiting area. She went with her translator to find the woman while I moved on to my next meeting. Once I was free I joined her in OPD and she said I must be mistaken as the grandmother in question was not there. I insisted she was and as I started to scour the benches for her, she appeared around the corner, carrying a tiny but healthy (all things considered) waif in her arms. The three of us recognised each other and exchanged excited greetings. We then received translation that this waif was the baby who we assumed had died! What an extraordinary outcome! Just as the grandmother told us that she fed the baby “milk” made from boiling rice, my colleague pulled me aside to say one of the doctors was looking for me. I found her and heard a story about an 18mo HIV-TB coinfected, malnourished baby living on rice water and was it possible that I might advocate for the very poor grandmother to receive a food basket for the duration of the baby’s TB treatment?
After accepting that I had lost this woman and that she had lost her grandchild to AIDS, I then found out within a matter of moments, that not only had the baby survived, but she was under our care and I had some responsibility for ensuring that she would receive adequate nutrition for at least a small period in her little life! Yesterday they traveled home with some proper food supplies to ensure the little girl will be properly nourished for perhaps the first time ever. The sad, dull eyes of her grandmother were ever so slightly brighter and courtesy of MSF I had a small part to play in this tiny glimmer of renewed hope.
Going home to pay off the mortgage and live a conventional life continues to look less and less like any kind of sensible plan.