Cupcakes and Prosthetics

The bone on Dara’s amputated leg continues to grow, and will continue to grow into his early 20s.  It pushes through the stump, eventually causing pain and becoming infected.  Recently he has been in a  lot of pain from a recurring infection.  The repercussions of this include a lot of missed school, loss of appetite with accompanying weight loss and inability to wear his prosthesis due to the pain.

Bone growing through the below-knee amputation of a 6yo.
Bone growing through the below-knee amputation of a 6yo.

I can often have conversations with Mum and Dad via broken Khmer and various miming / sign language.  Sometimes I wonder if we think we understand each other whilst actually talking about entirely separate matters and we have a lot of laughs together.  The other day, talking to Mum, we didn’t understand each other so I pulled my phrase book out of my bag, found the word I needed, and pointed to it’s Khmer script.  She looked briefly, before explaining to me that she cannot read.  I called Win for a translation instead and he informed me that her 14yo daughter had gone to Phnom Penh “to work in a house as a servant”, for a salary of 300,000 riel (US$75) per month.  Later in the day I texted Win to thank him and said “I’m so sad for that daughter”.  His reply: “I think it is normal here for the poor.  Just try to help when possible”.  This morning we drove past one of Kampong Cham’s mansions and Mum pointed to it, explaining that at the age of 14 she worked in this house as a servant.

For a few weeks now, conversations with Mum and Dad have been about an operation on his leg.  Our language barrier makes it really hard to get a detailed picture of what is going on but yesterday I knew the appointment was today and that Mum was going to carry him on her hip, the c.2km to the appointment.  So Chom met me at Shackville last night to discuss the situation.  Chom agreed to transport them to the appointment and after some discussion Mum and Dad both expressed some anxiety about the cost of the operation.  If they travel to Phnom Penh they are away from work, losing $4 per day and have to pay for their transport costs, but the operation is free.  If the operation can be performed here, they have to pay the hospital costs which could be as much as $50, which they don’t have.  While I stress about which Spanish language school I can afford to attend in Spain, these people can’t afford basic health care!  Chom suggested that I attend today’s appointment with them, to get a better idea of what is being planned, so that I know exactly what help is needed.  So at 7am today he picked me up en route to Shackville, where Dara and Mum boarded the tuk tuk and off we chugged to the Handicap International Rehabilitation Centre.

Handicap International is an excellent NGO who are, according to their website, “an independent aid organisation who work in situations of poverty and exclusion, conflict and disaster.  We work alongside disabled and vulnerable people on 327 projects in over 60 countries worldwide”.  Two French doctors were working in 1982 at Khao I Dang (“KID”) Refugee Camp across the Thailand border where many thousands of Cambodians escaped to during Khmer Rouge rule and subsequently during the Vietnamese occupation and war.  Friends and colleagues have described their experiences of attempting to travel to, or spending time at, this camp.  One in particular tells of crossing landmine-ridden fields to reach the border, before being shot at by Thai border guards and having to run back into Cambodia, past the stench of dead bodies and hearing landmines explode around them.

These doctors began fitting thousands of injured Cambodian refugees, mostly landmine amputees, with prostheses.  The doctors trained local people, set up rehabilitation care for refugees in this and other camps, and Handicap International was born.  When refugees were repatriated home to Cambodia in 1993 Handicap International went with them to ensure their access to necessary services continued.  The organisation grew into a broad-ranging disability service across a number of provinces in Cambodia, and extending to other countries with similar humanitarian needs.

Today 1 in 5 of Handicap International’s clients in Kampong Cham are landmine victims (there are still thought to be up to 10 million unexploded landmines on over 700 square kilometres of Cambodian soil today).  Many other amputees, including Dara, are victims of road traffic accidents.  The organisation are still involved in mine clearance, as well as road safety programs, disability-related mother and child health, supporting local rehabilitation centres, integration of disabled children into schools and various other disability-specific projects.  Their work as a founding member of the International Campaign to Ban Landmines which led to the Mine Ban Treaty, saw them awarded with the Nobel Peace Prize in 1997.  As with so many humanitarian aid agencies, they rely on private donors to sustain their activities.  Their  most recent annual report can be found here:

On arrival Dara was given a triage number before moving to the waiting area near the physiotherapy and prosthetic production area, up a long ramp.  At the triage area a young woman appeared and sought me out with “Good morning Madame!”.  Sometimes people just want to say hi, so I replied in kind.  She then asked me “Do you remember me?”.  I studied her face and realised it was the groom’s sister from the wedding outside Skun two weekends ago!  She was en route to work and recognised me so stopped to say hello.  A number of mothers and babies with no apparent physical disability were there, and also a number of other amputees with prosthetic legs and other disabilities.  A man in a white coat came out to talk with Dara, asking me if I was an Occupational Therapist.  I explained with Chom’s assistance that I was a family friend.  The man then attempted, unsuccessfully, to put Dara’s prosthesis on, before disappearing and returning with a set of crutches and lessons in how to use these began.  Dara was very excited, repeatedly calling to us to look at the frog hopping!


Waiting for arrangements between doctors here and Phnom Penh may take all day so we decided to leave Mum and Dara there and Chom will pick them up later.  We went via a local restaurant to buy breakfast for Dara and a recharge card for Mum’s phone so that she can call Chom for pick-up.  Upon our return a vendor selling fruit and sweets from a round tray on the back carrier of her bicycle was parked on the path nearby.  Dara was eyeing off some coconut and sticky rice “cakes” in banana leaf cups.  For 25c I bought him two of these, one of which he devoured in the blink of an eye.  Chom passed the phone charge card to Mum, then received it back from her and punched the numbers into her phone “because she doesn’t know how to read the numbers”.  As we left Dara had a very big smile on his face, devouring cake and talking about the cars in the playroom a few metres away.  Entering the ramp on our way out, a complete stranger stopped me and placed a plastic bag steaming with six cobs of hot corn into my hand.  Chom translated that “In his village there are a lot of corn and he want you to eat it”.  Six cobs of corn!  Luckily it’s easy to find hungry beneficiaries around these parts, so they didn’t go to waste.

Coconot sticky rice cupcake in a banana leaf cup
Coconot sticky rice cupcake in a banana leaf cup

2 thoughts on “Cupcakes and Prosthetics

  1. You can’t complain that there is no variety in your days. I am impressed at the number of NGO’s operating in Cambodia. In spite of them, there is such a huge need.


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