It is much more difficult in Phnom Penh, to find the impetus to write. My accommodation is a fifth floor apartment overlooking rooftops for as far as the eye can see. This removes me from community life somewhat although I’m slowly starting to recognise the neighbours beyond our apartment block. We recently relocated our office to be near the clinic, in another part of town. Now we drive to and from work in tuk tuks. This puts us on the bustling city streets for half an hour each morning and evening, with many fascinating sights and sounds. In work hours I find myself walking the short distance between office and clinic a number of times each day, again putting me on the always-intriguing streets. Still, a significant amount of my spare time is spent suspended in the sky, disconnected from the community I live in. This is not a complaint – I love the apartment and am enjoying my expatriate colleagues / housemates. We arrive home before 6pm, I go for a swim, share a drink and meal, then hit the sack in time for another work day. Our location and routine diminish the inclination to write. Perhaps once I get a weekend routine going this might change.
According to The World Bank four million people were lifted out of poverty between 2005 and 2015 due to positive developments in the Cambodian agriculture sector. Most of these people remain poor and vulnerable with a loss of US70c per day being enough to drag poor families back into poverty. Defining and measuring these categories is a complicated discipline which I am not equipped to explain here. My observations on poverty are that it is not always, or solely, about individual income. Rather, there are many factors at play. Someone with a home and secure and livable income who lives in a place where access to education or health care is limited, is still affected by poverty. Nowhere is this more obvious, than in many of Australia’s remote indigenous communities where public facilities such as education and health care are often insufficient and people experience social and economic challenges which affect their well being and contribute to the indigenous health crisis.
An extremely common Cambodian story is that of families separated due to work commitments. Twice a year the nation celebrates important national holidays which routinely see economic activity grind to a halt much like Christmas or Easter in western nations. My tuk tuk friend in Siem Reap, who I call Rav here, had not seen his mother for three years despite living a mere 320km away. His sons are now 5yo and 6yo, significantly different to the tiny boys their grandmother last saw. Rav is probably “poor”, rather than impoverished. He pays $40 a month for a small rented room (literally a room with a bathroom and a kitchen bench with running water on one wall). Driving tourists to the temples makes this rent and the family’s other short term expenses do-able if he is careful, except in low season when the lack of customers turn an already competitive market into a very tight squeeze. His income doesn’t stretch to taking time off or to the cost of tickets to travel away. When I saw him in Siem Reap in February Rav was very low, feeling trapped by his economic circumstances and worried about his mother’s ill health. I have regular donations from a number of friends and family and so I told him that I had some donor money I could contribute to get the family to Phnom Penh to visit his family. At first he was reluctant but as Khmer New Year drew near, he agreed to my offer and brought his wife and sons to Phnom Penh for a three day visit.
The family met me for lunch oneday. Rav said that his mother could no longer walk and they did not know what to do for her. He did not know if her feet were swollen, but both feet were causing a problem. My suspicion was liver or heart failure, which lead to fluid retention and immobility; or uncontrolled diabetes, which can lead to loss of feeling in the feet due to a build up of sugar in the bloodstream. I suggested that she should go to hospital but they were reluctant due to hospital fees. 70% of Cambodia’s health care costs are paid for out of pocket by patients, with many thousands of already-poor people going into debt or selling assets to cover the cost of medical needs. A large portion of the country’s population are considered vulnerable to these “health shocks”. Paula’s family, who sold their house during her illness and whose father now lives permanently in Malaysia in order to earn enough money to continue paying off their health care debts, are an example of this cycle of poverty connected to medical care.
With their hesitance about hospital I suggested to Rav that I visit his mother. That night at dusk, after a half hour tuk tuk drive to the edge of town, I arrived at her tiny rented room. Rav’s two sisters with their partners and children, his mother, and he with his brood were all apparently occupying this tiny space. Perhaps another reason that Rav doesn’t make regular visits to the family? Lying on a bamboo mat on the floor, his mother sat up while I found a space to sit beside her. With Rav’s translation she proceeded to give a very clear description of sciatic pain radiating from her right buttock into her groin and down the back of her right leg, with some lesser pain in the left leg. Astoundingly I had just been discussing sciatica with a family member who had been given a low dose of Amitryptilline which alleviated their pain almost immediately. With the assistance of a physician friend I was able to recommend the medication. Darkness enveloped us and Rav suggested that I needed to go, as though he was concerned about my safety in his overcrowded little laneway. The assumption of people like Rav, is that they have nothing to offer when in fact, their small acts of caring and of sharing their lives have a big impact. It is amazing to me, to be so warmly welcomed into the homes and lives of people living so differently from me.
With many thank yous and goodbyes, the tuk tuk wended down the dirt lane and out onto the main boulevards towards home. Phnom Penh’s outer suburbs at night are an experience unlike the Phnom Penh expat night life where well lit pavements are lively and fun but removed from the grime, congestion and poverty which most expats, despite living in this city, are far removed from. Elsewhere in the same city, public squares are unlit and dirt-floored, chickens saunter through crowds as their cousins rotate on spits, open fires grill all sorts of meat, you inhale a fluctuating mix of barbecue smoke and exhaust fumes, markets heave with people, motos and the beat of popular music and traffic regularly grinds to a halt.
Traveling through these bustling, dimly lit neighbourhoods I pondered, as always, on the difference between my privileged and egocentric experience of the world, which comes with it’s own set of complicated disadvantages, and the world as it is experienced by most humans. The more I see my birth entitlements, the more I see that others are no less deserving than me and that my so-called successes were really more a matter-of-course related to my privilege, than indications of real success.