Working in the Hospital

First Impressions of the Hospital I work at in Stung Treng.

These views and impressions are my own and do not necessarily represent the views or opinions of VSO or of any of the management or staff of the Hospital.

My Hospital working day begins at 8am with a Management meeting where Ward Managers report on the activity over the last 24 hours and other likely and unlikely issues are discussed, for example:

-The Hospital has run out of strong painkillers and will not get any until the end of the week.

-A sick child needed a transfer to Phnom Penh but even though a Charity was found to pay for the transfer, the parents, who were poor village farmers, said they had no money to temporarily stay in Phnom Penh or to return afterwards, they therefore took the child back to the village untreated.

-The men: Doctors and Administrators, of the Hospital should not begin playing Boules in the Hospital grounds until the afternoon- in the morning they should work.

-Someone stole the pillows from the doctor’s overnight room so now he doesn’t have one!

By 8.30 I go to the Maternity ward, there are 10 beds on the main ward, two early labour beds and a room for births. One day there were as many as 22 patients lying on benches, on the floor or on mats with their babies etc.

The Maternity area is situated in a relatively new building built by Overseas aid.The Maternity ward is light and bright with white tiles everywhere but has no sinks in it at all. The birth room had 2 sinks both tied off with tape as the drains were blocked, all the toilets were also blocked- this lasted for 3 weeks and was blamed on relatives putting food waste and fish bones down the toilets.

Each woman/patient has relatives who stay with her (they sleep on the floor) as basic care and meals are not provided by the hospital to the patient.

Relatives bring food from home or buy it from the market nearby or give some money to a woman who has a basic kitchen under the Maternity Waiting House (a place where pregnant women who live a long way from the town can stay to await labour)

Photo of the Kitchen area under the Maternity Waiting House. There is no other kitchen in the hospital.

If the cleaner has just been the main areas look clean but on busy days especially if it is raining then the floors are very dirty even though people take their shoes off outside before entering.

The Patients are a very mixed group all bunched together- women who have miscarried, women with new born babies, women whose baby was stillborn, readmitted women who have hemorrhaged,women with eclampsia(fitting) also some older gynae. patients with cysts or bleeding etc.

The Labour ward bed looks very basic and is not very ergomomic.

Wood delivery bed with vinyl cloth. Every woman who gives birth in the hospital uses this bed. Also see basic wood trolley.

New birth beds came with the new building but they are more like large flat trolleys- no back rest and the Lithotomy poles are too wide apart .The new bed is rarely used for women and is used as a shelf to store things on.

The delivery instrument trolley is a basic  wood thing with dirty rusty wheels. Bits of vinyl tablecloth are put on the bed and trolley –these are wiped between patients.

So far staff have been mainly welcoming and friendly and there are some lovely 3^rd year student midwives who are intelligent and caring. There are no teaching aids in the hospital so after  a teaching session with me about cervical dilation,  one student made an excellent teaching aid using cardboard and paper  I was delighted by this and am hopeful that changes for the future of maternity care is in their hands.

Lovely student midwife with her home made teaching aid.

I will write more about the Midwives and the care they provide next time.

Cambodian'' Kicker'' Game

We have noticed in Cambodia, especially when we were in Kampong Cham ,the local people play a skillful game in the evening when it is cooler and before it goes dark.

What is used to play the game , a Shuttlecock

I mentioned I’d seen the game to our language teacher Dara and he kindly bought for me, from the market ,what they kick around which I can only describe as a Shuttlecock.

It seems a very social game with laughing and chatting as they kick the shuttlecock between them with the aim to keep it up in the air and to set your opposite number up with something they can return and therefore keep the flow.

I think to be really skillful you need to have been playing since your school days?

Some people seem to get quite flash and kick with the side of their heels.

Hope you get the idea from the short video.

Dressing up

One weekend we joined with the other Volunteers in Stung Treng to go along to a Photo Studio and have make up applied and dress up in Kamai clothes and adopt some of the classic poses they use for photographs.

Whats in the Box?

We met at the Studio and some of us went straight to the makeup chairs others went to select what they wanted to wear. You could also just sit down and watch the others having their makeup applied and being transformed and take pics of your own.

 The makeup was applied to the men also and was applied quite thickly. Many hairpieces were used especially on the women to create totally different colours and styles compared to when entering the shop.

Nice shoes Chris- did you keep them?

The size differences to the Cambodians soon became apparent when we tried on the clothes quite often they were too small so the choices were to change to something bigger or if you liked the item to squeeze into it and possibly have it gaping open at the back.

Note feet nowhere near the floor!

When we were all made up and dressed we went into the photo studio to be put into various poses with props for the pictures taken.

Head stretched?

We had then to wait for 2 weeks for the pictures to be sent to and returned from being photo-shopped in Phnom Penh ,there looks to be a bit of stretching etc applied as well as adding the background scenery.

The Women Volunteers of Stung treng!

A  selection of photos were printed out in the shop and the whole experience was paid for by buying at least 3 printed pics each ,we also got a CD with 40 odd pics on. Yet another Stung Treng experience!!

Male Volunteers Stung Treng

Washing Day

There’s no doubt about it clothes washing is certainly different for us in Stung Treng, the method we us here is the normal way for Cambodians and Volunteers we know.

We don’t have access to a washing machine or mains hot water. We have a large circular aluminium bowl that we take outside with our dirty clothes to the washing area for the house we stay at. This has water pipes that contain cold water that comes from where, we do not know, it could be the rain that is collected off the house roof and which is stored in big concrete tanks at the back of the house.

Angela just starting the wash( note Dog in picture it chews everything!!)

Anyway the water is not heated and is luke warm from the ambient temperature.

Bowl on the ground under the tap, you squat down and put in the powder and fill with water. You then squeeze, pull, pound, rub with a brush, let soak, the clothes and hope they are coming clean. Then pour all that water onto the concrete (including your hopefully bare feet) and the water runs into a drain of sorts. Fill the bowl up to rinse then pour out and fill again with fabric conditioner.



Chris doing his bit sitting on very small stool



Let soak for 5 mins then pour out again and hand ring the clothes.

The washing is best done early morning when it is cooler, there are fewer flies about and the large ants don’t run as fast.

Chris scrubbing clothes with a brush on a board.

We then take the wet washing and put it on a wheeled frame to dry in the sun.

Good drying days are guaranteed you just need to watch for the Monsoon rains later in the afternoon.

Then next day your clothes are ready to wear again we don’t iron as it’s not really possible with no board and a tiny travel iron and it doesn’t seem necessary-have our standards dropped or does the Cambodian sun contain anti creasing rays?.The last excuse is that we are poor VSO Volunteers with more important things on our minds!!

Bend that stiff back Chris!!

The landlady has a local women who comes a couple of times a week to wash their clothes in much the same way we do but they would think far more efficiently. The funny thing is they have an electric washing machine outside which looks quite new but we have never seen it used.

For me, Chris, it is a fairly painful experience washing clothes. You have to get so close to the ground and the stool you sit on has legs 6inches./152mm/15cm long. The only way I can stand from this lowly position is to grasp the full bowl and jerk myself up. If the bowl is empty i.e. not heavy, I have to crawl onto my knees to stand- it’s all because I am not supple. Also I need to be wearing my shorts as I get wet with the water slopping about. Also the ants are waiting for me to assume this position and they race onto my legs to enjoy the experience of being lifted up high hanging on with their teeth.

Angela washing, Chris up a Mango tree taking picture

VSO Volunteer tips for clothes washing: do some every day so they don’t pile up, don’t ring out clothes too much the soaking ones dry in the sun it is so hot.

VSO 20 Years in Cambodia

On Saturday 28^th May we went to Phnom Penh for a boat party to celebrate VSO 20 Years in Cambodia.

For us the day started early as we had to travel from Stung Treng in the North East of Cambodia down to the Capital Phnom Penh. For this journey there are 2 options – the Bus leaving say 7.30 ish and taking 10 hours or a shorter sharper shock to the system i.e. Minivan. We joined with the other Stung Treng Volunteers and went on the Minivan. When you book a seat the driver takes your phone number to call you on the day of travel and tell you he is outside your house. We were called at 3.30am and picked up about 4.00am.

We arrived in Phnom Penh about 11.30am excited at the prospect of a party later in the day but equally excited about………….SHOPPING!!!!!........being able to buy essentials we couldn’t get in Stung Treng e.g., face cream, Gin, chocolate, pasta and savory crackers.Maybe these can be bought in ST but they aren’t really visible in the shops.

4.30pm we set off to a loyally Posh Hotel ,Raffles, as they have a Happy Hour for Cocktails so instead of $8 each drink we paid $4.

Then 5.30pm down to the water front to see the boat and board the good ship.

It was great to see other Volunteers from our starting group again, those who had gone off to other Provinces, and we were soon chatting about Cambodian experiences so far.

We drank the good old staple (for us anyway) Klang beer.

We set off to cruise the river but as it went dark about 6.30 I soon lost sense of where we were in relation to the starting point.

When I looked over the side we seemed to have a similar boat tied to the each side of us so we were in effect 3 boats fastened together I can only think this was for stability to stop us turning over.

We had a fantastic time and caught a Tuk Tuk back to the hotel. This took far longer than it should as I mistakenly gave the driver the address for the Computer shop I’d visited earlier in the afternoon and told him to watch out for the hotel. There had been a traffic accident on the road and we drove around in ever decreasing circles passing through the middle of the carnage each time.

It was nice to go to Phnom Penh for a change of scenery and the long periods travelling is part of the Cambodian adventure.

Broken Laptop

Sorry not to have posted for a while the Laptop is broken at the moment I think it got too hot. We will get it fixed ASAP but computer repair  shops are basic or non existent in Stung Treng.
We have lots of news , we've been to another Province for a few nights stay and stayed in an unusual setting in a wooden bungalow amongst trees. Angela has also been busy at work so we look forward to updating on these topics we must remember to relate the tale of the live cat fish in a cardboard box at the hospital management meeting.
So fingers crossed on fixing the laptop.Normal service ASAP.

Home-Stay Visit

A few weeks ago as part of our In-Country Training, VSO gave us an opportunity to experience how it is to stay in a rural village as guests of a Khmer family.

So Saturday 9^th April we left at 8.30am to travel to the village which was approx. 1 hour away from Kampong Cham where we were based for language training.

The Country of Cambodia is divided and administered as   :

Provinces (Kaet)

Districts (Srok)

Communes (khum)

Villages (Phoom)

So for the Homestay we were in:

Kaet – Kampung Cham

Srok – Kong Mas

Khum – Soka Koy

Phoom – Pong ro

On arrival we were formally greeted by the Commune elders and given a briefing on the current economic and social situation in the area by the Commune Chief.

We were then invited to individually introduce ourselves to the Commune elders using our newly acquired Khmer language skills.

So 20 Cambodian males gazed at me in expectation:

‘Sua-sdey, Knyom chmuch Chris mok pii Pro teih Ongklay Knyom tweu-Kaa chea moi Ong kaa VSO now Stung Treng chea moi pror pon Angela.’ Well I tried…

We were then taken to the Phoom where we were to stay and introduced to our host families

(I.e. the 7 members of our group having 2 couples were split into 5 houses all close to each other)

The Village house where we stayed

Where we slept we have yet to put up the Mozzie net 

Our host was a Kamai lady approx. our age and during the course of the afternoon various members of her family and relations wandered through the house. It took most of the afternoon to talk about our family in the UK swopping family photos and then to try and put together some sort of family tree for where we were staying.

The youngest daughter, aged approx. 11, was called What Iye and could speak some English as she studied it at school, she was a great help showing us around and clearing up confusion due to our limited Kamai.

What Iye and baby Brother

Midday we were told to have a shower which entailed going under the house to the outside toilet room and pouring cold water over yourself with a bowl. It was impossible not to gasp with shock at the first cold splash hitting your hot head. Then we were told to take a midday nap which was our first introduction to where we would be sleeping during the night. A thin short rush mat had been spread out on the floor of the living area and placed in one corner.

I can’t say it was comfortable but that is what was provided so we got on with having a nap.

Chris trying out the sleeping arrangements

In the afternoon we went a short walk within the village area and saw the river and a curious building; it was cement rendered on the outside walls with plastic pipes set into the walls all around.

The Curious Cement building

We could not get an explanation of the buildings function due to language difficulties but think it is something to do with collecting bird spit. This drab windowless concrete façade is a living birds nest factory and is meant to mimic caves where the swiflets would normally live and has inside a carefully spaced matrix of wooden rafters replacing the ledges and crannies of the cave ceiling. They are used in Chinese birds nest soup.

In the village and especially around our house there were lots of dogs of all ages and sizes. We were told many of these are in effect a ‘cash crop’ as they are reared and sold to Vietnam where I understand dogs of a certain breed are eaten as meat. Anyway the dogs all lived, played and fought together and had a definite pack/lead dog mentality.

Some of the many village dogs

We were able to have a try at raising water from the well with one of our neighbours, fun to us but probably tedious to them.

The Water well

We were given a lovely evening meal of at least 3 separate dishes .fish, meat and vegetables and we both had plenty to eat and were given a couple of cans of beer each.

A general impression of the day was there were many females around with children from new born to early teens but not many men as they were probably working in the fields. As the evening drew in the cows were brought in from the fields and tethered to the ground outside our toilet block presumably because they were too valuable to remain in the fields on their own overnight.

The cows brought in for the night next to the toilet block

As it got dark the women came into the living area sitting on the floor preparing the children for bed.

We had a visit from a fellow volunteer Paul and his male host who we think is the brother of our host. They both were bare chested and I (Chris) was pestered by the Kamai man to take off my shirt, after 10 mins of ‘No’ I gave in and took my shirt off.

Get your shirt off Chris!!!

Then we all sat cross legged on the wood floor and he proceeded to demonstrate how flexible the Kamai man is and we how stiff the western male is (by putting his leg/foot behind his back) and laughing at our attempts to cross our legs for any length of time. Paul quietly told me his host had been drinking at a wedding all afternoon and that was why he was so frisky. He picked a bottle of Jonny Walker whisky off the sideboard and insisted we each had a half beaker full to be downed in one we were too polite to refuse and anyway wouldn’t it help sleeping on the floor?

Johnny Walker - Down in One!!! 

We rigged our new mosquito net up over our rush mat and prepared to sleep next to 3 ladies and 4 young children one a new born baby- nobody used the big double mattress bed in the far corner of the room we never did find out why.

Eventually with every one showered and changed for sleep we were shown by our host how to unlock the main door during the night if we wanted to go to the toilet which you will remember is down the steep steps, under the house and into the small toilet building.

Lights out every one lying down and going to sleep- that’s when the fun started.

Before I describe the following I hope you have seen the film ‘Out of Africa’ with Robert Redford(Denys) and Meryl Streep(Karen Blixen), in particular the scene where the car has broken down and they are surrounded by 100’s of Water Buffalo on the African Plain. Karen Blixen, in an effort to get rid of the beasts, shouts ‘Shoo.. Shooo…’ anyway back to the Cambodian homestay in the dead of night…..

11.45 pm Angela woke and said she needed the loo so to minimise disturbance I said I would go as well. We unlocked the door and took two steps down-one dog growled in the dark, by the bottom of the steps we were surrounded by barking growling dogs but couldn’t see them it was pitch dark and no lights just our dim torch.

We stumbled under the house in the direction of the toilet block followed by 15 + barking, growling dogs we were almost at the toilet when for some unknown reason Angela decided to break our silence and said ‘Shoo… Shooo.. go away’- the dogs went WILD, WILD,WILD; the tethered cows by the Toilet jumped up and tried to pull their steaks out of the ground Mooing…it was total Mayhem!!!. We jumped in the toilet block and slammed the door shut. Before we left the house we were worried about seeing rats but they were the least of our worries now!!!

We went back out and walked quickly back with snapping at our heels and ALL of the dogs in the village joining in now. When we got back onto ‘the thin rush mattress’ we couldn’t stop laughing as the noise was deafening.

A long night then passed and we got up at 6am to a breakfast of spicy noodles. We gave our lovely hosts some gifts of food and toys we had brought with us and got back on the mini bus to swop tales with our fellow volunteers who had been staying nearby.

It wasn’t easy but it was a unique experience and I for one will never forget the night of the howling dogs.