Paula was discharged from hospital late last week. She remains in the US to be near the care she needs and because the surgeons don’t want to send her home to a place without running water until her wound, which may need further surgical intervention, is healed. But she is healing and becoming stronger by the day. She has normal physiology again and is absorbing nutrients for the first time in five years, which in turn means she is walking around and starting to “be” normal again. I receive regular emails from one of the Cham people who sees her daily and will edit/paste this morning’s communication between us as the only way to articulate Paula’s experience. When I returned to Cambodia a few weeks ago Chom asked me “what day did Paula arrive in America?”. October 4th. “That is her birthday then because it is the first day of her new life”. I sponsor Paula’s brothers to English school and have promised Paula that I will sponsor her once she gets home ($4pp per month). Chom is the intermediary for this and some other people I’m trying to maintain support for. He has been sending messages about our little sponsorship program to keep me updated on everyone.
Yesterday I returned to my permanent position here in Alice Springs. Things have changed yet everything has stayed the same. Feeling as though I’d just taken a long weekend, I was happy to be back. As happy as I can be if I cannot be in Cambodia, that is! I had a small house re-warming on Saturday night and with a projector shining onto the wall of the shed, showed a few of my Cambodian photographs. I sent a message to Paula, who is easy to keep contact with while she remains in the USA with English speaking friends who have internet and email. I told her that I’d shared her story with my friends who were all amazed. The reply below radiates Paula’s elation.
Paula and her mom are doing well. They are very excited that I brought them to stay at my friends house, specifically Paula. I told them about your party, and they were more excited. She asked. ” what did Helen’s friends think about my story and the people in Cambodia”?
She said, When she goes back home, I will learn to speak English. She wants to express her feelings to you. She has a lot of things to say.
She wants to thank all the Drs who saved her life, Cate, Karen and specially you. She hope someday in the future, when she go back home, she wants to go help people with you. For the past month she learned a lot from you, the nurses in the US who help took care of her, and all the people who came to visit her.
All these people that she met change her life. She will work hard to find money and someday she wants to go Australia to visit you.
She asked me, next Friday can I bring her again, and show her around the city. I said if you well enough, and I have time I will. She still cannot believe it that she and her mother are in the US.
She said, “I feel like this is a dream to me”. “if it is a dream I don’t want to wake up”.
I’m very emotional about her.
Yesterday, on our way back to the hotel, I stopped by at Safeway store to get a few things for them. She asked me “please. …., I want to go in too”. I cannot believe it. You should see her face, how excited she was. It seems like a big deal for her. I forgot about a girl who was came from a small village in Cambodia. Since she is in US, she has not seen the outside. This is the first time in her life she actually in the American store. I have tears came out of my eyes. You should write a book about her story. I am serious! You are going to make a lot of money. If you do, you can help a lot of people.
I should let you go now, have a great day at work.
Talk to you soon.
My reply, which vaguely expresses the elation that I feel for having been a part of this story:
It is very early here and I have to get ready for work.
But I read your email and it is so amazing to hear all of this about Paula.
I don’t know what to say. I will be thinking about it all day, probably all week!
Thanks so much for looking after them SO well and for keeping in touch with me. I cannot tell you how much I appreciate it.
Please tell Paula that my friends were really fascinated to hear the story about how her life has been saved and also to hear about Cambodia, how beautiful it is but how much suffering the people endure. It is difficult from a country like Australia (and USA, as you know), for people who have never seen these things, to imagine it. Just like Paula could never have imagined a shop like Safeway until she saw it.
Give Paula and her Mum a huge big hug from me. I will be thinking about everything you told me and am so happy now.
I had been in Cambodia about a week when one of the MSF expats announced excitedly that on a bicycle ride that day, she’d cycled through an Islamic village with a mosque and many people dressed in Islamic attire. Islamic people in Cambodia seemed a curious thing to our uninformed minds. Since then I’ve learned a little about Cambodia’s Islamic population, the Cham, particularly since becoming involved with Paula’s family and fellow villagers during the preparations to get her to America.
Paula remains hospitalised after surgery five days ago. Apparently she spent a night in ICU at the weekend but has since returned to the surgical ward. At this stage we still don’t know when she can be discharged from hospital. Upon discharge she will need to stay nearby for at least a month or so, to receive appropriate follow up before returning home to Cambodia. The wound is expected to heal only gradually, hindered at least in part by her poor nutritional status. A plastic surgeon has been added to the medical team caring for her. Surgery last Wednesday was a six hour affair involving two highly experienced gastro-intestinal surgeons and their team. The following night at dinner Sean (not his real name), the surgeon, talked about the operation. Paula’s digestive tract was, in his words, “a monumental wreck” and she would have died within the next few months without corrective treatment. They were nevertheless, able to patch the various anatomy together again and he believes she will make a slow but full recovery, returning to a normal life within the next few months.
Last week was highly emotional for all of us. There were tears as Paula was wheeled away from her mother to the operating theatre early Wednesday morning. It was a long and anxious day for those of us waiting in the wings. Sean knew this and we received the occasional phone call from the theatre, to let us know that all was going okay but taking longer than hoped. There were more tears on Thursday when Samantha and I met with an American paediatrician organised by Sean, to discuss her critically ill son. At two years old, he has an undiagnosed neurologial condition. Based on photographs and the story of his clinical picture, the paediatrician was able to deduce that he has some sort of progressive genetic condition which is slowly causing deterioration in muscle tone. That there is no cure and the condition is terminal was tragic but not unexpected news. To have an informed clinician speak at length with knowledge and empathy was an entirely different experience compared with the lack of care or attention he receives in Cambodia. This stems from an under-resourced system in which staff are so often powerless to help. Prior to last Thursday noone had spent more than a few moments at a time filling in scripts for this boy with a mysterious condition, during episodes of acute illness. One Cambodian clinician told his mother, when he presented with probable pneumonia, that there was no point treating him “because he is disabled”. So the time spent with a first world paediatrician, offering her advice free of charge, was a bittersweet pill for Samantha.
On Friday Samantha and I made the return trip home to Cambodia. There were many tears and tight, persistent hugs as we left the hospital, especially with Paula’s mother. She is nearing the end of a very long journey, having spent years caring scrupulously for her no-longer-dying daughter, while maintaining a semblance of family life for her other offspring and Paula’s son. She has also continued to run a small local market stall while her husband and oldest son are overseas earning what is for rich-world-citizens, very small amounts of money to send home. All because of the debts incurred by Paula’s medical needs. Paula and her mother remain in the capable hands of a first world medical team and a strong, supportive Cham community who I spent only a brief but very impressive time with.
What we now know as South-East Asia is made up of a vast and diverse number of ethnic groups. According to UNESCO there are at least 25 ethno-linguistic minorities in Cambodia alone. The dominant Khmer population makes up about 95% of the country’s more than 15 million people. The biggest minority outside Khmer is Mandarin Chinese, consisting of around 440,000 people. Next in line are the Cham, at over 200,000 people.
The history of Cham people is long, involved and complicated, so I cannot do it justice here except to provide a brief history as I understand it. They probably travelled to what is now the central coast of Vietnam sometime before 600BC, from Malaya or Borneo. Developing from smaller tribal groups and growing out of a preceding Kingdom known as Lin Yi, the Kingdom of Champa, as seen in the historic map above, existed from around the 7th century AD until it was completely annexed by Vietnam in 1832, finally rendering the Cham a stateless people. At this time many, following their last King, fled to Cambodia. Here they settled in communities across the Mekong Delta but most predominantly in the province of Kampong Cham, which literally means “Cham Landing” or “Cham Harbour”. Today most of Cambodia’s Cham population live in the provinces of Kampong Cham and Tboung Khmum.
Originally Hindu and Buddhist, the Champa Kingdom began to be influenced by Islamic merchants from the Persian Gulf as early as the 9th century AD. Today most of Vietnam’s Cham people remain Hindu whilst most of Cambodia’s Cham are Islamic. They speak and write their own language, living in their own distinct villages where mosques and goat herds replace pagodas and pigs. Cham villages are interspersed between neighbouring Buddhist villages and Cambodian Cham speak Khmer as their second language. As with so many minority and landless populations across the globe, Cham of both Vietnam and Cambodia have a history of persecution. Half of Cambodia’s Cham were annihilated between 1975 and 1979, targeted specifically by the Khmer Rouge. Many more escaped during or after this brutal period. This exodus from Cambodia saw Cham people scatter far and wide and there are a number of Cham communities across the western world including USA and Australian cities.
After spending so much time with Paula and her mother, as well as other members of the family more intermittently, I have had some interesting experiences. During one of their recent hotel stays in Kampong Cham town, I knocked on the door of their room, opening it to the sight of Paula on the bed against the far wall and an eerie sense of another presence in the room. Kneeling on the white floor tiles, wrapped in white prayer attire from head to toe with only her face visible, her mother was deep in somyang (prayer). Her face appeared at first sight, to be suspended in mid air and I literally jumped out of my skin. At other times, preparing for prayer, she washed her feet in front of me, or had to explain to me why she was fasting (a cultural practice upheld during times of anxiety, such as on the day of Paula’s surgery).
Since the day we met I have known that Paula and her family are Cambodian Cham. Only recently did I realise how strong the cultural implications of this fact were. When we embarked on our “mercy mission” to the USA, I had no clue that I was travelling towards a much more significant Cham encounter in the USA, than I had experienced to date in Cambodia. This lack of experience on my part is entirely due to my “stranger in a foreign land” existence. I am surrounded by Khmer and Cham culture in Cambodia but I see it through western eyes, which very often means I don’t see it at all, short of noticing a beautiful mosque, colourful Islamic clothes, or understanding the occasional superficial observation unique to Cambodia such as the way people greet each other. During our travel preparations Sean’s wife, I’ll call her Cate, located a local Khmer person in USA, who in turn located a Cham Imam. They both picked us up at the airport on arrival and transported us straight to hospital. During this journey we discovered that the Imam grew up in the village directly opposite the shore from Paula’s village. Last week I showed him a photograph of myself standing with an elderly Cham man in this particular village, who he recognised as his neighbour! His parents remain in this village and he visits home with his young family every few years.
I lost count of the number of Cham visitors who appeared in Paula’s hospital room during the two weeks we were with her. We bought almost no food during our time in the US because bowls, containers, pots and pans filled with various home cooked meals, rice, fruits and snacks appeared on a daily basis such that we filled both the hospital and the hotel fridges. My plan to purchase warm clothes for Paula and her mother was cancelled when bags of second hand clothes appeared from multiple sources. My plan to purchase a sim card so I could have telephone access was cancelled when a telephone was loaned to me. As the person acknowledged by Paula’s family as making her mercy mission happen, I was overcome by the fuss that was made of me by everyone coming to meet us. Such that some claimed they had travelled to meet me rather than Paula. An undeserved amount of praise was heaped on me. Statements such as “even though I never met her, she is Cham and so she is my sister and you have saved my sister’s life”, “I have lived in US for 35 years and never once seen a Cham able to come to America for treatment, it is truly amazing”, “every night when I close my eyes all I can see is your face”, “you must be the famous doctor who brought our Cham sister to America”. Every day tears were shed, amazement was expressed, gratitude was articulated in words and gestures. It was flattering, humbling, bewildering, confusing and overwhelming, all in one hit!
At no time during our preparations within Cambodia and journey to America had I remotely anticipated that I would even meet Cambodian Cham people, let alone from villages I know and visit. Some of the conversations were hilarious, along the lines of me looking at a Cham person who in turn was looking back at an Australian who asked:
“Where do you come from?”
“Yes, but where in Cambodia?”
“A province north of Phnom Penh called Kampong Cham”
“I know Kampong Cham, where are you from there?”
“It’s in <specific district>”
“Oh, you’re not from <village name>, are you?”
“Oh! How do you know my village?!”
Beyond my initial sense of neighbourly welcome, we were in effect adopted into a large, strong, collaborative extended family. I greeted the first invitations to spend time with people in their homes, keenly. But my western brain expected these invitations to dry up after one or two meals. Instead, the invitations escalated to the point that it became impossible to see everyone who wanted to meet us! People continued to send home cooked meals, phone calls from strangers seemed relentless, asking when we were free to eat at their home or at a restaurant, insisting on paying for everything and transporting us etc. Samantha, a Khmer nurse, was not only accepting, but very welcoming of the constant array of attention and invitations. Her only regret was that the local Khmer community were not extending the same open arms to her as Paula’s Cham commuunity. She wondered aloud, if she was the patient and not an escort, would the Khmer community have rallied in a similar way for her?
At the same time I began to wonder constantly, when I would possibly get some time and space to feed my western need for solitude and independence! It was only when I began to recognise the slow sense of suffocation that enveloped me, that I was able to reflect and realise I was in the midst of a very affable, yet intense, culture clash! My attempts to step away from the attention were met with more determined invitations, which in turn increased my own determination for some solitude. I didn’t understand why I was being so hotly pursued, and my increasing dissociation from such warm and friendly people, who I liked a lot, was causing an equal amount of confusion. About a week ago I declined an invitation for lunch and received a telephone call from the would-be hostess trying to persuade me to change my mind. Tired and confused, I announced that I was starting to get stressed by the constant intrusions into my time and could they please let me have some time off. I was astounded when she replied with a very kind and gentle tone, “we thought we could share a meal with you. Are you too busy to come today?”. It struck me that as much as I needed some space, this community needed to extend their generosity and friendship to me. I was only in town for a short time, which for me made my time and space more precious, while for them it made their need to see me more urgent! It was perhaps one of the most awakening moments of my life, to be able to visualise my own cultural norms as compared with those from another world view.
Back in Cambodia for a week before winging my way home to Australia, my first mission was to visit Chom’s wife and children at her mother’s village about a three hour motorbike ride from here. He hadn’t seen his now-six-week-old son for five weeks and was waiting for me to accompany him. The journey took us through Paula’s village, where we stopped of course, and many Cham villages I now know a little more about. Chom’s wife is from a village with a pagoda which divides two distinct village populations physically, with Cham homes upstream of the pagoda and Khmer downstream. We took a drive through the Cham side of this village the other night. Looking at the villagers in their Islamic attire, who stared back at me, I ruminated on how I could be in prosperous America one week, socialising with people from this very place and days later find myself driving through their impoverished home town exchanging glances and smiles with their family members. This trip was an adventure in itself and I’ll blog about it later.
Existence would be intolerable if we were never to dream ~ Anatole France
These words could have been written specifically for Paula. After developing severe, chronic abdominal pain during pregnancy in 2011, her interim years have been a living hell. We met on one of her most wretched days, approximately 16 months ago. She had already undergone five surgeries and her gaping wounds, oozing faecal liquid onto her abdominal wall, have caused constant pain, immobility and severe malnutrition. The family spent thousands of dollars seeking medical care for her mysterious abdominal symptoms. They sold their home and later, their grandfather mortgaged his home so that it is currently owned by the bank. With over $5,000 owed, her father moved to Malaysia and her brother to Thailand. Both send their wages home to cover the repayments. The family (Mum, seven children and Paula’s son plus various other extended family) live in the home of Paula’s aunt while she too, is in Malaysia where she can earn more than is possible in Cambodia. When she returns, the family will be rendered homeless and do not know where they will live. The debt will take them three years more to repay before they can begin to think about re-establishing a new home.
Not long after Cambodian surgeons informed Paula that there was no hope, and that she should go home to die, she was diagnosed with pulmonary tuberculosis. She began standard TB treatment, which in a “dying” patient is more a public health protective measure, than a life saving intervention. A few months later culture results from her sputum specimens confirmed that her TB was resistant to one of the standard drugs, and she came to us in order to begin a drug resistant (DRTB) treatment regime.
A beautiful young woman with a dedicated and loving family, her story seems to have evolved into a very rare instance of DRTB actually saving a person’s life. Without the TB diagnosis she would have remained at home waiting to die. Instead, she came to the attention of people with “outside connections”. A rare and unlikely opportunity for an impoverished rural villager from Cambodia. She has featured in two separate reports on TB in Cambodia by Spain’s largest newspaper, El Pais and also in a fundraising brochure for a European branch of Medecins sans Frontieres. She’ll never know the existence of such paradises as the hillside home of Patricia Wells in Provence, near the medi-eval village of Vaison la Romaine, with it’s clifftop castle and ancient cobblestone laneways. Yet it was in Patricia’s beautiful garden of lavender, herbs, vineyards and summer blossoms, where Paula’s fate changed dramatically, one sunny day in June this year.
Since that astonishing day when I heard the words “my husband could probably fix her”, followed sometime later in the same conversation with “if her husband treats her for free, I will cover the additional costs”, I have had many doubtful moments. Awaiting confirmation of charity care from the treating hospital in America; sending Paula, her mother and our Khmer translator (my ex-colleague, “Samantha”) into the US Embassy in Phnom Penh to obtain visas; seeking medical clearance from the airline and many other stages in the process of getting her here. Amazingly, almost a week ago we did get her here. She is hospitalised and investigations all show that her condition is operable and she should return home in good health, to a normal life, reasonably soon!
The astonishing coincidence of happening to have lunch with the very people who could make this happen for Paula, and happening to mention her miserable existence to them without knowing of their connections and abilities in this regard, appears to have set a pattern for Paula’s continuing good fortune. The long haul flight from Cambodia to America was challenging to say the least. She travelled the almost four hour journey to Phnom Penh airport in a minivan with at least 30 family and neighbours. I have no idea how they crowded in together, with Paula lying on a stretcher bed in the same vehicle! By the time we (Samantha and I) arrived at the airport, in our own minivan with Samantha’s hordes, the Paula hordes were already there, crowded around her stretcher bed which they’d positioned outside the main doors. It was amazing to be a part of the excitement and I have never been the subject of so many photographs as I was that night before check-in.
We made it across the Pacific Ocean with her, a 25 hour journey in total including 14 hours of flying time broken by an 11 hour stopover. The excitement of going on an aeroplane was slowly overshadowed by her progressive exhaustion. By the time we boarded our second, much longer flight, she appeared more like a little old lady than the 25 year old beauty that she is. Pushing her tired little bones through Customs and Immigration made for an expedited entry into the USA, with officials showing nothing but compassion and respect. There is a large and tight-knit Cham community here and an Imam met us at the airport with his wife. As they drove us into the city to the hospital we discovered via conversations in Cham and Khmer, that he comes from a village on the opposite shore of the Mekong from Paula. In fact, I believe he comes from the village where Chom and I rolled in the tuk tuk!
This week the world has shrunk even further as a steady stream of Cham visitors have appeared daily, some of whom even come from Paula’s actual village! Their stories seem to be a mix of escaping as refugees during and after the Khmer Rouge era, or more recently, being sponsored by wives or husbands already living here. Their immediate connection with Paula, especially for those who know them as neighbours and extended family members, but even as strangers meeting for the first time, is surprisingly strong, based on a mutual language, religion and culture originating from a distinct area of the Mekong Delta. It has been amazing as an outside observer, and also a little overpowering as someone from a very individualistic culture, to find myself embraced by this community spirit. Karen, paying for the out-of-hospital expenses, has so far had a very tiny food bill because home cooked meals are arriving daily from the community. The hotel we had booked for Paula and her mother post-discharge until she is deemed fit to fly home will probably be cancelled. A choice of family homes are earnestly offered for them to move into for as long as they need.
On Thursday I was asked to spend the night at a family home with Paula’s mother and Samantha, who is also having a very awesome first-overseas experience. We were picked up and transported about an hour from the city to a large family home where extended family and neighbours were either waiting, or joined us later. A large meal was simmering on the stove, conversations flowed in Cham, Khmer and English, beds were organised, a neverending supply of food was served, children played at our feet and talk of Cambodia, America, food, religion, health care, poverty and wealth kept us awake until after midnight.
Yesterday morning we were taken on a tour of the area after breakfast. We were due to attend the mosque and talk to the community about their Cham sister/daughter’s plight but information arrived that Barack Obama was coming to town for dinner and traffic delays were expected. Paula’s mother stayed behind while Samantha and I were driven back to the city in time to avoid the traffic and ensure Paula was not left alone for another night. As we approached the city a phone call arrived to say that the community had raised over $1,000 towards the family’s debt! This morning a follow up phone call has placed this at $2,000! Equally surprising is the information that Paula’s mother, 2 years my senior, has told the community that “my mother will decide what to do with the money”. Naiively accepting this comment, as I vaguely wondered who she meant as her mother died during the Khmer Rouge, I was then informed “you are the mother, so it is your decision”. Brain whirling in horror, I maintained some telephone composure and discussed how the money can best be utilised – by paying it towards the family’s debt, and how to best ensure this happens.
In the early days Paula regularly asked “do you think there is any hope for me?”. My colleagues and I reassured her while in private discussing whether these reassurances were the right approach given her utterly hopeless condition in a country where a prolonged and miserable journey towards death is accepted so often as normal. To have dreamed that an outcome such as this was remotely possible, would have been ridiculous. Yet, the utterly ridiculous appears to be taking shape! If only she were not just one of many thousands with equally harrowing existences.
My right eyeball became acutely aware that it was aligned with, and traveling at a speed of knots towards, a steel rod hanging perilously from the back of a truck on Cambodia’s National Highway 7. As my face came within arm’s length of the pole pointing menacingly at it, our taxi veered left into a narrow space between the truck to our right and the median strip to our left. If only I could speak Khmer, I’d have compared the danger of our road trip with the safety of flying in an aeroplane, to Paula’s mother. She has made and continues to make, untold sacrifices for this one of her eight children who has been rubbing shoulders with the afterlife for 4+ years now. One of the biggest perceived risks she is now prepared to take, is embarking on an international flight. Aeroplane travel is not something she ever imagined she would experience and she would prefer if it were possible to drive from Cambodia to America!
Yesterday morning my final visa preparation chore was a dash to Handicap International who have been such a great and helpful organisation, to plea for the loan of a wheelchair. An elderly stroke victim and a number of amputees were mobilising on the physio bars as babies were held by waiting parents to be seen in the busy rehabilitation area. Relieved to be recognised by the right people, a finger pointed to the nearest appropriate looking chair, then a dismissive wave when I tried to offer identification or guarantee with a call to “bring it back tomorrow!”. Once again Paula refused to eat pre-travel. On arrival at the hotel, she insisted on walking the 10 metres from car to hotel reception, causing another faint. She spent the afternoon resting and eating but again this morning, due to the early Embassy appointment, she refused breakfast.
The US Embassy in Phnom Penh is an attractive cream-and-black modern building garrisoned by high steel sharp-tipped picket-style fencing. Massive satellite dishes furnish the roof and lawn inside the fence where Stars and Stripes fly in obscurity behind the high security structures. Uniformed guards monitor the perimeter path on foot and by moto. The block-sized fortress sits in the shadow of Wat Phnom, an ancient Buddhist temple atop a small hill north of the city centre. The city’s only two skyscrapers tower over it from the other side. The grand century-old Raffles Hotel le Royal is located a short stroll across a lush strip of parkland. This small area of the city could fool you into thinking you’re in a wealthy country. Until you see the hand-pulled scavenging trolleys piled with recyclables making their measly living, or the cyclos pushed by men with faces so wizened that they could be 100 years old. Only a privileged few in this place, get to enjoy their dotage. At both ends of the spectrum, age does not preclude you from having to earn your daily rice. In the countryside the peers of these labourers are in rice fields or husking mountains of corn.
In a rush of confusion upon registering at the security window, I was, as suspected, denied entry and suddenly found myself waving reassuringly as my three anxious companions disappeared through the heavy iron door. I crossed the road to say hello to Samantha’s family who had accompanied her en-masse to her very exciting visa interview. Her young son, almost two years old, was limp in his grandmother’s arms as she sat on the pavement. His cerebral palsy has led to severe malnutrition caused by frequent vomiting. His hands are clenched permanently and his little arms and legs are wasted away. Despite her own heartache, Samantha is excited at the prospect of a trip to America and told me last night with tears in her eyes that “first I will worry about Paula, then I will focus on my son”.
It was three hours before we laid eyes on each other again. My tuk tuk friend drove me to a pharmacy where I located some Vaseline for Paula to use on the acid-scorched skin around her abdominal wounds. We then drove to an Islamic restaurant to get some Halal food so that she would have something to eat as soon as she exited the Embassy. As I noticed the massive mosque complex in this neighbourhood for the first time, two Buddhist monks in bright orange robes under yellow umbrellas strolled underneath the crescent-moon-and-star-topped minarets towering towards the clouds. After posting a picture of this symbolic scene on Facebook I learned that the temple, funded by a Dubai-based businessman, opened earlier this year and is the biggest mosque in Cambodia. Stopping at the gate so I could photograph it, an Islamic man approached my driver to tell me I was welcome to go inside. With nothing to cover my head, I declined the invitation until another time.
I later read that Al-Serkal Mosque was inaugurated by Prime Minister Hun Sen, during which he spoke of Cambodia’s religious tolerance. From my observations living in a Cham populated area, I would have to agree with him. Which by no means makes me a supporter of his other political views. Paula lives directly opposite her village mosque, a large and beautiful temple. It is common when visiting her, to see men and women arriving for or leaving from prayer, dressed in full Islamic regalia, including women in niqab with only their eyes visible. This doesn’t stop them from offering waves as they shout “hello” in English, or from slowing or stopping to watch the unusual visitors with curiosity.
Returning to the Embassy with takeaway containers of rice and beef, we parked over the road to wait. We sat diagonally across from each other in the tuk tuk, our legs resting on the seat opposite as a footstool. The topics of wealth and poverty monopolise conversations in this country of extreme contrasts. Even more so this morning in this prime location where the power of a wealthy minority imposes visibly over the toiling and disempowered majority.
At almost three hours to the minute since they disappeared out of sight, Tuk Tuk suggested I might want to climb Wat Phnom? Just as he spoke the words, Samantha, Paula and her mother exited the main building and made their way towards the roadside security exit. Tuk Tuk drove around the block to park up beside them while I crossed the road to greet them. Upon sighting me Samantha broke into a wide grin and threw her thumbs into the air. Visas approved! The excitement of the moment was overshadowed by Paula’s visible exhaustion. Mum helped her into the tuk tuk while I showed Tuk Tuk how to fold the wheelchair which he hoisted onto the floorboards between the seats. Samantha and I climbed in behind the wheelchair and we high tailed it to the hotel to get Paula horizontal asap.
Inside the Embassy everything had gone smoothly until Paula had to stand up to be fingerprinted. She immediately fainted and a doctor was called. He wanted to postpone her interview until another day but meeting with serious resolve from three determined women, he agreed to allow her to persevere. There was no doubt of the authenticity of the visa request and everything was approved promptly. This afternoon she has been resting in bed and eating French Fries, which she has ordered as a takeaway breakfast for the morning taxi ride home! We are all in a permanent state of exhausted elation. All that is needed now, is to get a blood transfusion sorted out for Paula pre-flight, and put our travel arrangements in place, which is being done from New York. My October departure from Cambodia has been known for years. What wasn’t known until today, was that I’d be returning home to Australia via a mercy dash to the US West Coast.
Various other updates to follow, but I needed to post this amazing news.
The world is full of magic things, patiently waiting for our senses to grow sharper ~ WB Yeats
The day I met Paula and her family 16 months ago, they were resigned to a diagnosis of terminal cancer. Tears were common at that time and I remember not believing our initial reassurances to her, that there was still hope she could be cured despite what she had been told. You might wonder why doctors and nurses would give a patient false hope. Without any first world resources of even the most basic capacity, her diagnosis was made purely on the basis of medical guesswork. She had since been diagnosed with a second illness (Tuberculosis), which potentially explained her “terminal cancer” of the lining around the intestine, called the mesentery. I have seen mesenteric TB before, in a young man in Australia, who was also diagnosed initially and incorrectly as having terminal, intestinal cancer. In Australia’s robust health system, diagnostic tests eventually gave an accurate diagnosis without any unnecessary interventions and he was treated successfully with anti-TB drugs. Not before he too, had grieved his imminent death for a few weeks until the conclusive test results brought good news. There has been no confirmed good news for Paula, just an evolution of realisation that she appears, despite her chronic state of ill health, not to have terminal cancer. It was memory of the Australian man’s experience which urged me, despite not knowing, to give her as much hope as I could muster from my ambiguous thoughts.
There are tears now too, but today’s tears come from a different place altogether and now they flow as far away as America, where a dozen or more people who have never met Paula are already involved in getting her into the hands of those with the skill to cure her. Until today I’d managed to remain stoic in the face of all Paula-related tears, be it last year’s mourning or this year’s rejoicing. Today however, Paula’s grandfather ambushed me with some dignified and humbling words. A group of her siblings and other extended family were with me in a semi-circle facing Paula on her camp bed. Another translator friend (not Chom, whose long-overdue son finally entered the world late last night) was sitting with us. Tall, quiet and elegant, her grandfather entered the room of their elevated wooden home and sat beside me on a mat on the bamboo slat floor. He lives over the road from Paula, beside the big colourful community mosque, and obviously saw us arrive. After sitting for a few moments he spoke to me serenely as he allowed an occasional tear to swell before blinking it away. He waited for translation at the end of each sentence before continuing on and his words included the following. We have nothing to give you to say thank you. But we give you our hearts. You are not from our country and we do not have the same religion but you help us anyway. We don’t know why you do this for us and we never met anyone like this before. My reply to this was that I have a lucky life and I want to share it with others who don’t have my luck. Nodding recognition of this, he continued. Everyday I go to the mosque five times and five times everyday I talk about you and I ask Allah to give you a long life, good health and good luck. You should have everything you wish for because you are taking my grandaughter to America. The only dry eyes in the room belonged to raucous children. So I finally capitulated to the infectious Paula tears!
After time with The Eye Sisters on Monday, I made a mad overnight dash to Phnom Penh on Tuesday to farewell friends holidaying from Australia. Wednesday was a return mad dash home, on a bus that broke down about halfway up the highway. Hanging around on the roadside, passengers chatted and formed friendships. A young guy who I’d noticed in his seat diagonally across from mine, hoisted himself off the bus with a walking crutch. His left foot hangs loosely at around knee level on a shortened, deformed leg. He works for a company, traveling the country to repair machinery. Keen to speak English with me, we had a friendly chat and swapped numbers so that “when I have spare time I can call you”. Looking for shade, I then joined a mother with her three small daughters under a tree and we had a conversation of sorts, in Khmer. In desperate need of the toilet, I then walked to a nearby restaurant where a lot of fellow passengers were hanging out. Asking in Khmer for the toilet, the server instructed her small daughter to escort me. She led me across a large dust bowl behind the restaurant and into the yard of an elevated wooden house. Near the stairs leading up to the front door, a crowd of men appeared to be playing cards together. They turned in unison to look at me, we chum-reap-suored each other and I was led behind them to the toilet. A typical brick outhouse with squat platform and makeshift bathtub filled with mud-brown river water for “flushing” things away with a plastic pot floating in the water. On my way out, the owner stopped playing cards and escorted me back to his restaurant, speaking in English to ask where I was from, where I was going, apologise for the mud-brown flushwater, etc.
About two hours later I finally arrived home and Paula was already here, lying on her hotel bed, with Mum, 5yo son and 15yo brother. Too embarrassed to be seen in public and too incapacitated to walk far unassisted, she did not leave her room for 48 hours. But she was thrilled to be here. The family had already eaten lunch and announced that the western hotel food was delicious, much to my surprise! Mum did ask if there was any dried fish, which there is not, so the next morning I headed early to Central Market and got the Islamic restaurant to make up five takeaway breakfasts of rice and dried fish which I shared with the family in their room. But they were keen to revert to the hotel food thereafter, much to my amusement, including a hamburger order! We managed to apply online to the US Embassy – a massive rigmarole which took up about ten hours of my time including time with a translator going through a myriad questions relating to intent of travel, then paying the fees and organising all relevant documents, making the appointment, then requesting an expedited appointment for medical emergency, all via required and exacting processes. We took 5yo son for a couple of tuk tuk rides, to organise the fee payments at the bank and get his grandmother’s visa photograph taken, which helped keep a bored child semi-happy, assisted by the acquisition of a new truck at Central Market.
Forty eight hours later it was time to drop them at the morning minivan for the journey home. Paula never eats prior to travel, in order to avoid digestion problems during the journey. This causes her blood sugar to plummet and she becomes very faint. We went by tuk tuk via the photograph shop to have her visa photograph taken. On an empty stomach and weighing 30kg, her mother half-carried her into the shop, a distance of around 15 metres. She sat down, suddenly looked very pale and then glided gracefully to the floor with Mum’s very calm assistance, unconscious. About 20 seconds later she woke in Mum’s arms beaming a smile, eliciting guffaws from everyone looking down anxiously at her! She soon sat up for her photograph and we dropped them at the minivan under assurances she would be fine. My heart sank later in the day when a new website page instructed me that the passport sized visa photograph had to show the ears of the person – both women had their hijabs in place and ears out of sight. This week we have to go through the process again, although this time I’ll arrange it at a time when she has been able to eat.
Two of Paula’s brothers are reportedly very clever and through my time with the family I’ve learned that English school costs $4 per month which the family cannot afford. This week I agreed to sponsor the two to attend private English classes and today’s trip to the community was in order to put this in place for them. Chom was insistent I pay the fees directly so that I can see the school and know the fees have not been redirected. We arrived at their home this morning and the boys changed out of their Islamic long dresses and headgear, into shorts and shirts. We then drove the 8km to the nearest town and found the private English school. Five months of fees for two set me back US$40. What a worthwhile expense, especially for 16yo who keenly speaks to me in single words to show me his enthusiasm to learn my language. Each afternoon 11yo brother will go on the carrier of his older brother’s bike and they will travel the 8km to school for an hour, then make the return trip home. It might require a second bicycle but I will wait til Chom is free to advise me on this. Such small amounts of western money can make such big differences in the lives of people in the poor world. My experience here over the past two years has taught me that sharing the magic magnifies the magic, for myself as much as anyone else. All of us from the wealthy world can enrich our own lives by sharing some of our magic with those less fortunate than ourselves.