My week in Siem Reap

Monday, June 14th
On Monday, we woke up early and headed to the regional RACHA office in Siem Reap to meet with Theary. We loaded in a truck and headed toward the boats that would take us to the floating villages. Background: The Tonle Sap floating village is a popular tourist spot but is, in actuality, a real village. Due to the excessive rainfall during monsoon season, some villages have resorted to staying on the river instead of waiting for their homes to be swept away. There are floating schools, restaurants, and health centers to accommodate the nomadic villagers. A main problem in this village, ironically, is the access to clean, safe water. Recently, RACHA and USAID created a floating water sanitation station to help the community. Today, Teary was presenting the newly built sanitation station to the USAID Director of Southeast Asia and the Program Manager of USAID in Cambodia with Kata taking pictures and Julia and I accompanying them. It was really amazing that we were given the opportunity to see all this happening! We had met the USAID team at the dock and rode on a boat together to reach the village. While Teary was conversing with the Director, I decided to chat with the Program Manager. She has a degree in economic development. She has been a Peace Corps officer and has been working for USAID for about eight years (three in Bangladesh, five in Cambodia). Her job description includes monitoring all of USAID’s projects in fields such as health and education. I was telling her about my interest in both economics and public health and the possibility of combining these two fields. For example, RACHA is beginning to implement micro financing opportunities for communities to sustain their health projects. Although there are few projects, besides RACHA, that implement micro financing as apart of their public health programs, she said that it could be something being used in the future. Well by that time we arrived at the water station. The station was built with $80,000 and it provides clean water to over 6000 people and counting. At the station, Theary gave a short presentation to the USIAD director about the structure and development of the station. The community also sells the water and as a long term goal hopes to earn a profit to sustain themselves. After the presentation and short tour we visited the floating health center (which was on shore at this time) where we saw a woman who had just given birth to a baby. Everyone present was excited about the improvements RACHA and USAID were making to the health of the floating village community. After an exchange of cards, we left the USAID team and headed back to Siem Reap. For dinner Theary, Julia, the Siem Reap RACHA leadership, and I had dinner at this traditional Khmer restaurant. We were served pot luck style with famous Khmer dishes such as Lok Lak and Amok. The meal was very tasty. During that time, Theary introduced us to the director and assistant director of RACHA in Siem Reap and told them to find activities for us for the next two days. From there, we bid Theary and Kata farewell (they were returning to Phnom Penh) and after a look around the night market decided to go asleep.

Tuesday, June 15th
Tuesday morning didn’t start so well. I had fainted at the health center we were touring. When I don’t eat a good breakfast, my blood sugar/ blood pressure becomes very low and if I don’t treat it I will faint. Well luckily our guide, Kong Visal, was not only the assistant director of RACHA in Siem Reap but a doctor as well so he was able to treat me. Talk about an interesting first impression…What we were suppose to do that day (instead of returning early so I could eat and sleep) was visit a community health clinic and observe a community based education on water sanitation. We spent most of the morning at the health center (while I rested and tried to finish the coke they gave me to drink for energy) but after I was feeling a little better we were able to make it to the end of the community education. Background: RACHA’s community based education (CBD) programs uses volunteers from the community to educate their village on certain health issues. These volunteers are put through a training session by a RACHA staff member and given incentives to remain an active educator (money, free medical services, free food, etc). Not only do these CBD educate the communities on important prevention methods but they also use this time to promote the usage of the health centers for delivering babies, treating infectious diseases and other health issues that should be treated by a medical professional rather than a traditional healer. This CBD on water sanitation stressed the importance of washing dishes, washing hands, and using alum tablets to clean dirty water. After a three hour lunch period (where I proceeded to pass out then eat) we return back out to the community to see and CBD on avian influenza. This workshop stressed the importance of carefully handling and killing chickens, especially sickly chickens. After visiting another health clinic we returned home. The health centers are of pretty low quality, especially given the fact that women give birth in these environments. The HC are opened (look at the pictures) so flies and animals are able to walk to and fro. The facilities are mostly run by nurses or midwives with one or two doctors serving as chief. The services for these services are very cheap with the highest paying procedure (child birthing) costing only 10,000 riel (less than $3). For people who are unable to afford these services, there is an equity fund that anyone can borrow when they need to. Later that night Julia and I decided to head back to the night market and bought a couple of souvenirs for our friends and family. We then headed to see an Aspara show (traditional Cambodian ballet) and chow down on some delicious pizzas (we couldn’t help ourselves!). Then we fell asleep.

Wednesday, June 16th
Wednesday was a very good day. After eating a big breakfest (I was ordered to) we head one hour outside of Siem Reap to some remote villages to see the World Food Programme distribution in action. We came early so the food had not yet arrived. Before the community could receive the food, they were required to sit through an education presentation where community volunteers and RACHA staff instruct the villagers about proper nutrition, the amount of food that should be given to who (expecting mothers, children, and mothers of children), proper sanitation, vaccination and the services provided by their local health centers. In order for these families to receive the food, they must verify that they have had the appropriate vaccinations and prenatal care given by the health centers. This is used to encourage child birthing at health centers rather than by traditional birth attendants. After about an hour of waiting the food finally arrived. In total, there were about 11 villages present trying to get food. After unloading all the food from the truck, the food was distributed to each village representative who then distributed the food to each individual villager. Overall the system was very efficient with no person getting more or less than what they should. Our only concern with the system was the fact the rice was set to expire this July, yet the food is expected to last for 5 or more months. We reported this to Dr. Visal who plans on directing this information to the World Food Programme representative. We then traveled to another village to see their CBD on TB. When you think you may have TB you have to go to a health clinic as soon as possible to get tested. If you test positive then you will be given medication and sent back home. While taking the treatment at home, you are expected to cover your mouth with your hands. We asked the village how many of them have had TB recently and over half of the village raised their hand. They had all finished treatment but some were still getting sick. We tried to stress to Dr. Visal the need for them to be isolated while they are sick because of their risk of infecting others but he told us two reasons for not doing this. One, it was some sort of cultural factors that the individual needed to be around their family when they were sick and secondly most of the health clinics didn’t have to capacity to house these sick patients. We also asked if there were any deaths in the village from TB and there was one. He had failed to get treated in time. A villager had a question about her cousin who had been treated for TB numerous times but was still getting sick. We tried to explain to her that her cousin probably has a drug resistant strain of TB and that he need to go to a health clinic as soon as possible (Dr. Visal had sent someone from the health clinic to follow up with the woman’s cousin). Later that night after a delicious dinner, we headed to the night market (again!!) to buy some more gifts and get fish foot massages (tiny fish eat away the dead skin from your feet). We had dinner at this Cambodian and Vietnamese buffet place (which was really good) with Dr. Kong and his wife. They were so funny. The wife didn’t speak English so Dr. Kong had to translate for her but whenever we wanted to compliment her on how pretty she was he refused to translate! He said he was jealous because people kept on saying that she was so much prettier than he was! He was also telling us about their age differenced (13 years) and whether that would be appropriate in America. We then explained to him that not only was it okay for a man to marry a younger woman but now older women are marrying younger men (cougars!). He was so shocked by this that refused to translate for his wife (ha!). We then headed to sleep for out big day of sightseeing tomorrow.

Thursday, June 17th
Before we returned back to Phnom Penh we decided to visit the symbol of Cambodia, Angkor Wat. We woke up early and took a 20 minute ride on a tuk tuk to the area of Angkor. Background: Angkor is home to hundreds of Hindi and Buddhist temples the most famous and spectacular being Angkor Wat. Angkor is a UNESCO World Heritage Site and is consider one of the eight man- made wonders of the world. Words cannot describe the beauty that is Angkor Wat. When I visited Spain I was able to see all of Barcelona from La Sagrada Familia cathedral. It was the most beautiful site I had ever seen, until now. I tried to take as many pictures as I could but you have to see it to believe it. Aside from the Angkor Wat we saw other amazing sites such as Ta Prohm, Banteay Kdei, and Angkor Thom. Overall, our trip to Siem Reap was very rewarding; by Thursday night we finished the trip with DIElicious cheeseburgers and packed to return to Phnom Penh the following morning….