Day 10 Reflections and Final Post

The mission trip is over and we have arrived in Siem Reap to start our tour of Angkor Wat and Northern Vietnam.

After spending 9 days in rural Cambodia  arriving in Siem Reap is something of a culture shock!  Except for the Chiropractor, his wife, Gloria and a mirror, we have seen only a handful of non-Asians.  Here there are tourists! 

And, although the town is a bit dusty, the shops, restaurants and massage parlors are all geared to tourists.  The streets are relative empty of cars and motorcycles; there are hawkers begging you to come in for a massage or have a ride in the tuk-tuk.  Really quite distracting after the warmth and friendliness in the rural Khmer.

So, what is the real Cambodia?  I guess it is like our country.  If you get off the interstate highways, you will discover the real America.  Siem Reap is really an anomaly.  It is Cambodia’s only tourist destination so they are going to try to squeeze every Dollar/Euro/Pound out of the visitors.  Can’t really blame them.  If you flew directly here with only a plane change in Phnom Penh you would indeed think that this is Cambodia.  It is not.

After starting our trip at the Killing Fields, then working with the common Khmer, now looking into the ancient history at Ankgor Wat, Cambodia is a microcosm of what we human’s lot has been: subsist, survive, grow, thrive, conquer, war, recover or disappear.  Then it starts all over again. This has been going on for 1000’s of years.

So, did our week of medical/dental care make a difference?  We hope so.  These communities are very poor.  After the typhoon three weeks ago, there were still many houses with water in them.  I do not know how these people live like that.  Since our care was based in either a church or an orphanage supported by New Life Church, the villagers know where help can be had.  This approach to life is quite different then it is in the Buddhist world.  This, indeed, is appealing to all.  They do want to learn more about Christianity. 

We did clear many infections and the Khmer are better off for that, but more impactful I feel is the exposure these people have had to a different way of looking at life.  Not haunted by ancestors and evil spirits, but comforted by a peace that comes with a Savior.

Day 10 The Mechanics of Blogging

Several people in the past have asked about the mechanics of blogging, so I will take a minute to explain what we do.  If this is no interest to you, move on to my final post!

Anyone can open a blog at www.blogspot.com as well as several other sites.  This one is run by Google and it is free.  You name your blog and away you go.

  There are two ways to post.  You can post directly on your blog but that requires a live connection and you would do this if you have no laptop and depend on internet cafes for your blogging.  More convenient is to carry a laptop; write you blog when convenient then upload with a WiFi connection when available.  This works well for me in that I download my pictures from our camera every night to the laptop, then insert them into the blog as I write it.  The software I use is by Microsoft, it is Windows Live Writer.  Also free.

It is easy to use and when you do have a wireless, or wired connection, you can easily upload the blogs you have written.  You will have noticed that I did not/could not upload daily, since several of the hotels we stayed at did not have internet access. 

Finally, I carry a netbook, not a laptop. It is smaller (10 inch screen), has no DVD drive, is only the size of a large book, weighs a couple of pounds AND has 9 hour battery life.  Great for working on the plane or keeping in your backpack.

Gloria has always done a written journal, my journal is basically the blog.  Two different perspectives, and for the few that like to follow what we are doing, a bit entertaining as well.

Day 9 At Sihanoukville Beach

A four hour bus ride to the ocean this morning.

Today was the first time in a week that we saw a Westerner that wasn’t part of our group. He asked me what organization we were with.  I had to respond that we weren’t part of any organization, just a group of around 50 people from Indonesia, Australia, China, Brunei, Singapore, the US, and Cambodia getting together to provide medical care for the orphans and poor people of Cambodia.  He didn’t understand how we could do this, he doesn’t know Dr. Victor Koh!

Because of persecution by the communists in China and the Muslims in Brunei, it is best to not be real specific as to our activities today.  Mainly, 57 people from the community, including 5 of our dental students chose to “get wet”.

 

Afterwards, was, you guessed it, another feast.  And what else but a seafood feast!

These were the biggest prawns I have seen in my life.  Plus the crab; there was good eating for all.

A picture of four of the five students who “got wet” today.

We also learned today that in the wake of the typhoon three weeks ago, people in the Kampong Thom Province were starving because of lack of food.  We “passed the hat around” and raised $1200.  Enough for 48 50 pound sacks of rice to be purchased and delivered to these people.

Day 8 Clinic at Kampong Chhnang

Today we worked in a church, not an orphanage.  The pharmacy, medical, chiropractic and dental were all in the church building; a bit noisy.  Where yesterday there were a lot of fillings requested, today, these people wanted extractions.  (This type of work is still unpredictable).  The dental students were in top form today.  Seating and diagnosing patients and sometimes finishing them before I could check on their decision or performance. 

However, along with the gained clinical ability comes a bit of overconfidence as well.  I stayed busy getting full anesthesia where they failed, finishing extractions they couldn’t, retrieving roots they broke and following up on crowns they snapped off. Did I say I stayed busy?

This is our dental team!  Dr. Fanny is in the pink, the eight dental students are in front of us, the guy next to me is a Cambodian interpreter, he just wanted to be in the picture!

We only worked in the morning, so it was non-stop till 1PM.  Since we don’t like to return to the States with too much baggage, we gave all of the left-over disposables, anesthetic and supplies to the students.  Christmas for them.  We even left our $5 thrift store suitcase to one of the students.  She told us she was going to give it to someone who needed a suitcase!

Final count was 3 full day clinics, and 2 half day clinics, we saw about 270 patients.

This is Keng Wong from Singapore, the coordinator for the trip and Ligar Murni, from Indonesia, (she is the Singapore Airlines flight attendant I mentioned earlier) she screened all of the dental patients.

This evening was our celebration dinner here at the hotel.  They had a nice private room for us, then they started to bring in the food.  Keng, our coordinator wanted to keep it in the budget, so she was “conservative” in her choices.  Hmm. Plate after plate came in of all sort of exotic foods.  A first for us was shark fin soup. Nice flavor, not sure where the shark fin entered into the picture.  Another variation was tofu mixed with shrimp and octopus. All very tasty.  When in Rome…..

This photo is of Victor Koh, (Singapore/US) our leader, and Vek Huong Taing, the local pastor.  He wrote a book about his escape and survival from the Khmer Rouge.  The book is out of print, but he did give us a signed copy!

Day 7 Orphanage at Battambang

Another early start.  Unfortunately, we do have a bug going through our group.  Some people are way down, others a little. Gloria and I stay with the Cipro and aren’t real adventurous with our food selections.  For us, so far, so good.

Another very nice orphanage, but the kids had worse teeth.  We are starting to sense, the closer we get to Phnom Penh, (civilization) the worse the teeth. I am sure it is a diet thing. 

The picture of the little girl below has quite a story behind it.  When we arrived, she latched on to one of the team members and wouldn’t let go of his hand.  She is only three, but dressed in a very cute dress, with “pearls” on, and bracelets.  A real looker.  But, when it was her turn for the dental exam, we discovered that all her upper front teeth were decayed to the gum line and they were infected; so they had to come out. 

She has been our only patient we didn’t treat in a chair. We got a table in the pharmacy, numbed her up, held her down, shut the door and pulled out her infected teeth.  A bit noisy, but she did fine.  I think the pharmacy team members were more traumatized then she was. 

Note:  we did see her romping around in the afternoon, like nothing had happened!

The dental students really kicked it in to high gear today.  At any one time we were treating 6 or 7 patients.  I did more supervising and less treating for the first time. 

We did learn today why many people only want fillings and not extractions.  Apparently there is a legend that many believe that states if you have a tooth removed, you will go blind!  That explains why when I ask the dental student to tell the patient they need a tooth extracted, it would take them a long, long time to discuss it with the patient.  The primary religion is Hindu, but most people believe in evil spirits more than anything.

Six of the students working away!

Got a feeling what a hurricane (typhoon, down here) feels like today.  A rain squall came  through in the morning that was not only so noisy hitting the metal roof, but frightening in its intensity.  It sounded like hail, but it was just large raindrops.  Wind wasn’t bad, but we were told that this part of Central Asia is still drying out from the two typhoons that went through about a month ago.

The students horsing around while I am trying to get some work done.

Day 6 Orphanage in Banteay Meanchey

Couldn’t resist showing you this.  Do you know what it is?  We didn’t, had to ask around until we found out that they are frogs-on-a-stick!  Not sure if they are stuffed with veggies or not!

This New Life orphanage is very nice with about 35 children.  Indeed, most had pretty good teeth; needed to pull less then a dozen, usually only one tooth on any child.

This is the church for the orphanage, we worked in the building next door.

After we checked all the kids we then got busy on the villagers.  They needed the work!  The dental students worked all day with Gloria and me seeing our own patients and supervising/consulting and baling them out of tight spots.  After we closed up almost two hours later then expected, we found out that our medical/dental team had seen about 300 and they turned away 500 more!

We worked from 7AM to 5PM with a short break for lunch.  A very, very long day; sore back.  As I write this, we are in the hotel and I am waiting for my one-hour massage, ($5)!

Here is Dr. Fanny from Indonesia joining us for lunch

Day 5 Getting to Know Everybody

Being on the road for 8 hours did allow us to get to know each other!  Each of our team got to share who they were, what they did both here and in real life; a few details about family, and we always ended with if they were single or not and what their favorite food was?!

Quite a diverse. eclectic group.  Six countries are represented and indeed everyone has a story.  Some were raised Christians, others left the faith of their family to become Christians.  One girl talked about being raised a Taoist in Malaysia.  In fact her father was the local medium for the city.  She was fearful to tell her father of her conversion, but after some time she did and surprised in that he wasn’t outraged.  She actually attributes it to the fact that she is a female and not the first-born.  The only thing he insisted on was that she not be baptized!  Well……she ended up waiting for 5 years till her baptism; her father continues to accept her.

Another member of our team talked about her physician husband’s murder by a patient  ten years ago, and her journey of reconciliation and forgiveness of the murderer.  A very powerful story.

Others include a flight attendant for Singapore Air who greased the wheels for all the extra baggage brought from Singapore.  Another team member writes music reviews for a jazz magazine, interviewing all the current and former jazz greats.  At the conclusion of his interviews he always gives the performer  a book on Christianity and indeed follows up!

Finally, one of our interpreters, now a Christian used to be a Cambodian gangster.  Been shot several times, had some real stories to tell.  Now, finally has peace.

Victor Koh, our leader gave us a history of what Cambodia has been through the last 35 years and his involvement in Campus Crusade for Christ leadership during that time. The local pastor who welcomed us at the airport is also travelling with us and he will be talking about his, his wife and their newborn child’s four year survival from the Khmer Rouge in the jungles of Cambodia.

Finally, we were told that many Asians love Karaoke.  I believe it.  While on our 8 hour ride, they passed the microphone around and sang songs off of 3 different worship song sheets, in at least 3 different languages!  Great to hear some classic and new Christian praise songs in Chinese and Indonesian.

Day 5 On The Road to Northern Cambodia

When writing these blogs, if there is a break in activity, I usually comment about the food! Since almost all in our team are Chinese, the majority rules.  Indeed our hotel has a Chinese restaurant which makes it very convenient for familiar food (for the Chinese).

Actually, I think Cambodia cuisine is very similar.  A typical table setting is a small bowl, not much bigger than a coffee cup, chopsticks, a spoon, like you get at an American Chinese restaurant and a package of napkins/kleenex.  Then they start bringing the food to the table.  A big bowl of rice, a big bowl of soup, and usually two plates of veggies, meats and noodles.

You fill your bowl half way with rice, then you start piling on the rest of the food.  Frequently you use your chopsticks to grab off the main plates.  Gloria and I stick to just the broth in the soup.  It is full of lots of things, but most of them are for the flavor, (if you know what I mean).  The chicken is always “bone-in” so you usually grab the piece with your chopsticks and wrestle the meat off with your teeth, holding the bowl below your chin.  Oh, the napkin/kleenex - that is for all the leftover parts, (remember, no plates).  That’s is why Gloria and I don’t eat the soup “chunky style”, way too many leftover parts!

Having said all of that, the food IS excellent, quite different from Chinese food in the states.  Gloria and I have gotten, out of necessity, quite good with the chopsticks and holding the bowl below our chin, dragging the food and noodles into our mouths!  Indeed, we even got a compliment last night from the Cambodians.

Now for breakfast here at the hotel.  We are given a choice the night before.  Soup, chicken and rice or egg and bread.  I will admit Gloria and I go for the egg and bread, (and a fork!).  We are ridiculed, but we remain strong. Comfort food.  Once we hit the road it may be back to soup and rice for breakfast!

These are the cooks for the “catered” meal at the orphanage.   Catered so that we could be assured of safe cooking techniques.

Now, for full disclosure, I must admit when we travel internationally we always carry a few snacks.  This trip is no exception.  Hello jelly bellies, almonds, cheese crackers and  M & M’s.  We ration these carefully.

Day 4 Dental Clinic in Phnom Penh

We actually started our clinic yesterday afternoon.  We returned from the killing field around 11AM just when the bus was arriving from the airport with the rest of the team.  Lunch together; then we travelled to the New Life Church where we held our medical and dental clinic until 6:30PM.

To our surprise, our dental assistants were dental students from Phnom Penh U. Six of them actually; all spoke some English, some were very helpful, others, not so; hmm, just like US dental students!

Nurses triaged about 130 people in the afternoon; around 30 were sent to us for dental work.  Fanny, the dentist from Indonesia, did bring equipment for fillings, so I focused on extractions and Gloria cleanings. 

Gloria working on a patient while grandma holds her instruments

Since this is an urban setting we had quite the gamut of existing dental work and requests for care.  Many badly broken-down teeth, but frequently the patient only wanted a “scaling”, or cleaning.  As all good dental students, they wanted me to do all the work requested by the patient, but it was my job to only do what was most necessary to control pain and infection.  So, many teeth were removed, a few teeth were filled, and Gloria kept busy “scaling”!

Today we traveled to a rural orphanage for a full day of clinic.  We saw both the orphans and villagers.  Unfortunately many of the orphans had horrible teeth.  Not infrequently if they had only baby teeth, ALL of the teeth in the mouth were decayed to the gumline.  Usually they would have one tooth hurting them, so we pulled that one only.  So sad.

 

         One example of many

Today, we kept the dental students busy.  Frequently, I would loosen the tooth, then let them finish the job.  They also started doing fillings with Dr. Fanny.  I believe they preferred that; less bloody and stressful. 

They did keep me busy when they couldn’t get someone numb, couldn’t get a tooth to budge, or worst of all, broke a tooth off so I had to go after the root tips.  That is a challenge when you can’t lay the patient back, with no water,  or suction, or a drill, and keeping the dogs away.  Just patience, sweat and a prayer.  I did get them all out though!

This is a typical setup.  A dental student holding the patient’s head, another with the instrument  tray and I am doing the heavy lifting

This is our classic set up for instruments.

One of the children after Gloria extracted an abscessed tooth

Tomorrow is an 8 hour bus ride to northern Cambodia, just below the Thai border, then we will have daily clinics at orphanages as we work our way south back to Phnom Penh.

Day 3 The Killing Fields of Choeung Ek

WARNING: GRAPHIC IMAGES FOLLOW

Where were you in 1975?  Gloria and I had just married and we were starting our careers in Southern California.  In Cambodia, Pol Pot was commencing his reign of terror that ultimately tortured and killed 3 million of his own people.

Today, Gloria and I visited the closest killing field to Phnom Penh, Choeng Ek.  Here, tens of thousands of Cambodian’s were killed.  This was but one of 343 killing fields throughout the country.  For four years Pol Pot and his Khmer Rouge went about forcing the country into a stone age subsistence. Attempting to rid the country of all educated people and their families.  The families, so they would not, in the next generation attempt to removed the Khmer Rouge from power. 

The “stupa” contained 18 levels, clothing on the first level, then skulls, finally small bones on the top.

The killing field was overwhelming.  As we walked between the mass graves, the paths still had remnants of clothing, bone and teeth you could easily identify.

 These are some of the 8,000 skulls housed   in the “stupa” to honor the dead

Many of the mass graves have not been investigated.  Each year as the Mekong River floods, more bones are discovered.

One particularly chilling mass grave contained only headless bodies.  As the remains were removed it was discovered that these were soldiers who had refused to torture and murder their countrymen.  They paid with their lives. 

This killing tree is to honor the brutalized infants. What we learned and saw was unspeakably evil.  Beyond our imagination.

Day 2 First Day In Phnom Penh

We had the afternoon and evening to explore the city. We had read about the “Central Market” so we set off to find it.  It is said it looks like a custard pie, so we figured it wouldn’t be too hard to spot.  After a couple of miles walking, sure enough.  Huge with hundreds of vendors inside and out selling everything a local would want to buy.  Very interesting. 

Probably two-thirds of the vehicles on the road are “motos”, motorcycles that carry one to four people at any one time.  There is a national law that requires the driver to have a helmet; about half do. The cars are split between newer small cars and Lexus SUV’s!  Curious mix. Then you have a good number of tuk-tuks; or taxis.

 

Waiting at the stop light, yes, most of the time they do actually wait.

For dinner we headed out to look for a local restaurant using our standard criteria: has to have a few people already eating there, and a picture menu so that we can point to what looks good.  We found one a few blocks from the hotel and pointed at two stir-fry vegetable dishes.  The waitress took the menu to the cook (his kitchen was on the street!) and as they kept flipping the menu back and forth he finally decided to just cook one thing and put it onto two plates!  It was great over rice; a few bits of meat, we think it was beef.  The bill was 15,000 riel.  at 4,000 to a dollar, a good deal!

October 10, Day 1, Flying to Cambodia

As always, these service trips start with long plane flights.  Our 747 left SFO at 1:30AM; the beginning of a 14 hour non-stop flight. Two meals, three movies and 5 hours of sleep later, we land in Hong Kong.  I am writing this blog as we fly from Hong Kong to Phnom Penh; just a two hour flight!  So, from the time we left home until we arrive at our destination – 23 hours.  Typical.

Gloria and I are arriving on Saturday, the other team members will be arriving tomorrow.  The local pastor will meet us at the airport and escort us to the hotel for the day. 

A flurry of activity prior to our departure.  As you may know, Indonesia has been hit by two typhoons (hurricanes to us) an earthquake and tsunami in the last 3 weeks.  The country is reeling.  After we finish our work in Cambodia, another group was formed by Dr. Victor Koh to go to the island of Penang to help with the relief efforts.

An interesting note on paperwork:  The perceived H1N1 flu threat is huge in Asia.  I think they are still reacting to the Bird Flu outbreak they had several years ago.  Much of our time on this two hour flight is spent filling out paperwork.  Required:  VISA Application Form, Arrival Card, Departure Card, Custom and Excise Form, and a Health Declaration Form.  Indeed, many people in the airports and on the planes are wearing surgical masks!

Pre-Trip Planning for Cambodia

Welcome to our blog for our dental trip to Cambodia.  We are expecting about 30 people to join the team.  We hale from the US, Indonesia, Australia, Mainland China, Brunei and Singapore. Our leader is Dr. Victor Koh and the primary staging for this trip is in Singapore. 

Besides dental care provided by Dr. McKelvey, Gloria and Dr. Fang Wijaya from Indonesia; Dr. George Harris, a US Chiropractor, physicians from China and Pharmacy techs from Brunei and Indonesia will be completing the medical/dental team.

In addition, water treatment/purification facilities will be installed in the four locations we are visiting in Cambodia.

Our itinerary takes us to four orphanages in the country, spending a day at each location treating not only the orphans but the local villagers as well.  We will continue to update this blog as we near our departure, and we hope to blog daily when we are in country.