September 11, 2011

Women in Waiting

I am starting a list of women in waiting for Nokor Tep. Their stories are simply told and their own diagnoses – what has me so upset is the number of women who are so very desperate that they want pictures taken of where they hurt. This is Cambodia where women are naturally shy and inhibited – it is the nature of their pain that results in foregoing dignity for a chance to be heard. These are some of their stories:

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Chan Saran is 63 years old and gave birth to 4 children. Her husband is still living. Four and half years ago, she suffered from a prolapsed uterus. She went to a doctor who told her to get an operation but she had no money and so never went. For the past 4.5 years, Chan Saran has walked in pain – when the pain is too great – she takes local herbal medicines to help. Her desperation is great. She is waiting.

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Poun Roeung is 39 years old and has given birth to six children. Poun’s breast began hurting 5 years ago – once, a long time ago she went to seek medical help. It cost a lot of money and the medicine she got didn’t work. She and her family are very poor. She can no longer work very hard – when she works hard her breast and her arm hurt very much. This makes her husband very angry. When he comes home from the fields he expects his rice ready – when it isn’t he beats her severely. He refuses to allow her to go and look for help. She is desperate and waiting.

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Hak Own is 16 years old. For the past three years, Hak has had a breast lump that has grown in size and causes her much pain. She has never gone to a doctor because her father is blind and cannot work and her mother is too busy because she needs to earn enough for all her seven children. Hak is afraid she is dying – she often faints now – the breast is heavy and she can’t sleep from the pain and the fear. Hak is so afraid – so very afraid. She is waiting.

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Chat Toll is a 42 year old woman who suffers from a vaginal discharge tinged with blood. She went a doctor who told her she had lumps in her uterus and she needed an operation but she had no money for such things and so didn’t go. She is a widow and has a fear for death which she believes is near. She used a Cambodian saying to explain her great fear –“I will die but with my eyes open”. This expresses her fear for her children who will be orphaned with no one to care for them and her soul will not rest as she must watch her children from the other side.

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Cheong Sophea is 39 years of age. She has had a breast lump that has hurt for years. More significantly is the constant discharges that she has – they are smelly and her belly hurts. A doctor told her she had cysts in her uterus which should be removed. He gave her medicine but the medicine didn’t work and she is getting worse. She believes that she is dying and that there will be no one to take care of her children. She is sad and waiting.

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Ad Neoun is 30 years old with 4 children. Her belly has pained for the past four years but she has never gone to a doctor because it’s too far and costs too much. Ad Neoun has been abandoned by her husband who is angry with her for being sick and no longer willing to have sex with him. She is very tired and in pain. She is waiting.

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Khuen Somally is 26 years old with 3 children. She has painful breast lumps that keep growing. She has never gone to a doctor because there is no money and it’s too far. Somally believes that she is dying – she cries that she is too young to die – she is afraid and waiting.

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Ouk Na is 42 years old and has given birth to four children. Ok Na has a breast lump which in her mind means that she is dying. Ok Na’s two sisters both died of breast lumps – she believes that no one can help her.  She says it’s no use going to a hospital – it will cost too much and she will have to sell everything and she will die anyway. She is waiting.

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Sous Chea is 52 years old and gave birth to 6 children – 1 of whom remains at home to take care of her. She has a breast lump and a doctor says she needs an operation but that costs too much money and it probably won’t help – besides she is too old and doesn’t want to burden her children. She has lost hope and is waiting.

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Hien Phun is 40 years old and has 7 children. Hien has suffered for many years with a white discharge that is now turned red. Her belly and her back hurt all the time. She doesn’t have the money to go to a doctor. She says she ignores her pain because she has the children to raise. She is afraid that she is dying – but she can’t die yet – because there will be no one to take care of her children. Her husband abandoned her several years ago. She is waiting.

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Ouk Chin is 55 years old and gave birth to 7 children. Her sister Ouk Na is 45 years old with 2 children. Both women have suffered for years from vaginal discharges that are smelly and hurtful. Both women were abandoned by their husbands because of the constant problems. Ouk Chin’’s pain is quite severe both in her belly and her back but her sister’s pain is starting to move from her belly to her back as well. They are alone and afraid – there is no one to help them. They are waiting.

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Thoy Pich is 43 years old with 5 children. She believes that she has both uterine and breast cancer but she doesn’t know for sure because she is too poor to go to a doctor. She has only bought medicines “to interrupt the pain” as she says. She says she is responsible for feeding her children. She cries as she tells us she can’t work anymore because the pain is too much – yet I struggle to work because my children only have me to take care of them. Thoy Pich is desperate and waiting.

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“I am Nheb Tan. I have 5 sons. I am a farmer. My husband died 8 years ago. I have illness like this: itching burning pain cervixitis, bacteria vagina candidacies, cervical metritis, and yeast vagina. When I have money I go to the hospital. I take medicine and I feel better. My body is always itching. I am sad. Sometimes I don’t want to go on living because there is no money to take care of myself. My sons because I am sick cannot continue to study. They must to find money for the medicine and for the family. The end I hope has the hospital can help poor people like me. ” Nheb Than is waiting.

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May 11, 2011

May 2011

It is an exciting time for us as plans for the hospital continue to be refined. In that process some questions from a number of people about various aspects are helping us to make better decisions and to clarify the processes needed as we move forward. One of those questions is what does excellence in health care mean? Well for us it means a number of things:

First it means that everyone who comes to the hospital will be treated with respect and dignity. That is not often the case when the poor are involved. It does mean providing systems that allow for this to happen – it also means that social and cultural norms are part of practicing of excellence without losing excellence in medical treatments and vice versa.

Second it means providing excellence in the treatments that are available. It does not mean that we will have every medicine available to treat all ailments but what it does mean is that what treatments and medicines we have will be given and done with excellence.

Thirdly it means that we get the best personnel possible and train them in excellence.

So we have been busy putting some things in place. We are in process of searching out and appointing a medical Director. This will enable us to develop a clear movement forward in the deciding things such as equipment, personnel, etc.

A second very exciting aspect is the formation of a Scientific Committee, which will be headed up by Dr. Ing Kantha Phavi. We are interviewing a number of people for this committee, people with backgrounds in the various medical fields as well as research fields.

With the appointment of a Medical Director plus the Scientific Committee we will be able  to develop a plan of action for what is needed in all aspects – with a priority being put on training – we would like to develop a permanent training schedule – one that will enable us to train Cambodian as well as International medical personnel on various aspects of treatments, medications, etc.

We are also busy with the architectural, mechanical and engineering plans for the building of the hospital. At each stage, there are discussions on what our vision is and how to enhance that vision – for example – flow of patients each day – how to make sure it is efficient, respectful and workable.

We are busy ensuring that Nokor Tep is protected under Cambodian systems and we have the beginning of a very strong board – there are 4 of us now – and that is good.

I feel that the way forward is good. Each day I am confronted with the health needs of the women we work with. I can help but think – only by God’s grace that this is not my situation.  But for me – being thankful that I have access to health care may not excuse me from thinking of my neighbors. I am thankful for the privilege of being able to do something about it.

Janne

April 20, 2011

Last week was Khmer New Years and Miriam and I went off to Bangkok for a few days’ holidays with some friends. We took our respective girls to a theme park and as they were riding the rides we talked about Nokor Tep Women’s Hospital and our vision. My friend said without thinking, “I don’t know why you are doing this? Ignorance is bliss and what people don’t know, won’t hurt them”.  As I was watching our two girls do an upside down turn on the roller coaster, I thought to myself, in this instance, ignorance is bliss. I really don’t want to see my girl hanging upside down on a ride I don’t trust.

As I was thinking about her comments, I became a bit more pensive. Ignorance is bliss – what an odd statement – rather an arrogant one on our behalf, for I do believe we tend to make judgments from a position of choices and wealth. I thought about our many families that we work with, where illness and ignorance are not bliss. In fact, the opposite is true.

For Sokha, life is extremely hard. She has 10 children, the oldest, a girl at 16. Several years ago, Sokha became ill – at first she lived with the discomfort – she would faint without warning –she was breathless. She began to go to local elders for help and they encouraged her to take herbal teas – which she did - but things got worse. In desperation her and her husband sold a hectare of land and with the money, they began the rounds of doctors in nearby towns – each cost money – each guessed at the illness – there were no tests done- each gave her medicine and nothing changed. They sold the last hectare of land and with this money she went to Phnom Penh. The money dwindled fast as clinics couldn’t help her. In desperation she finally found a hospital that carried out some tests. She suffered from high blood pressure and heart palpitations. Their medicine worked. Then her husband became ill. Every day he passes urine in his blood but there is no land left to sell, no money left to eat with, no way to find help. In desperation they made their 2 oldest daughters go to Phnom Penh and find work in a factory. One is fourteen, the other sixteen. With their income, there is food on the table.

But the girls were frightened to be on their own, so they hooked up with a man who offered them a room to sleep in if they would but sleep with him. He offered safety in a sea of confusion, hundreds of workers, long days and short nights – surrounded by men who took advantage of the young girls, girls who are frightened and away from home,  girls who have no knowledge of what life is all about. Inevitably, the youngest is now pregnant – she continues to work – the family must eat. As we talked and Sokha finished her tale, she looked at me. I didn’t know, she said, I didn’t know where to find help with my illness, I was afraid to die, we sold all that we had, now my husband is sick. I didn’t know about the factories, I didn’t know what goes on there. I just didn’t know.

For Sokha and so many like her, ignorance does not bring bliss – it brings poverty and guilt, it brings hurt and pain.  And the illness, the illness remains.  I am saddened.

Nokor Tep is part of our answer to Sokha’s pain and to thousands of others like her. I thank my God that I have access to medical care – that I am not so ignorant of what ails me. I ask my God that we change the dictum of ignorance is bliss to ignorance is not acceptable. Thank you for standing with us as we travel this path together – with all the Sokha’s in Cambodia.

April 2, 2011

April 2, 2011

It’s been a while since I posted on the blog. Lots of reasons – mainly putting things into place – like getting the detailed architectural plans to be drawn – including engineering, electrical etc – the things you learn while you make a vision real.

Last week we had fundraisers in from Australia – Pauline, Glenn and Deb were her to make a short video about the needs of Nokor Tep – in that process Pauline asked for s short summary of our vision and what the current needs are – so I wrote that up for her.  Now I share it with all of you.

What is exciting is the number of people from different parts of the world who are actively working to make this vision reality – it means so very much.

We are working on a web site as well – basing this in Cambodia is proving to be a challenge but I am hoping to announce that soon as well.  Thanks for listening – I promise to write more often.

A Succinct Picture of our Vision

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Our vision of Nokor Tep Foundation is comprehensive. Currently, less than 7% of the rural population has access to medical care. It is also very clear that 90% of the women in Cambodia suffer from long term infections of various kinds.

The centerpiece of this vision is Nokor Tep Women’s Hospital. The hospital is the venue by which to treat women in desperate need of medical care.  The hospital is the core of the outreach to these women.

An Education and Preventive Unit will be an integral part of the hospital. In this unit – materials will be developed to educate women, staff will be trained to be able to screen women in their communities and mobile units will be formed to go out into the communities for screening, education and minor treatments. Severe medical cases will be brought to the hospital for treatment.

The hospital will also have a research unit where research will be carried out in the various illnesses affecting women.

The hospital will be the core unit where training in all aspects will take place. In short, the Nokor Tep Women’s Hospital is the heart of our vision.

First Step:

Our first step is the actual building of the facility itself. The design and initial architecture has been completed and detailed plans are being made, permits are being applied for and land has been found.

Our vision is to begin building the facility – the hospital itself by beginning of January 2012. The cost is estimated to be five and half million ($5,500,000.00) US dollars for the building itself. None of our vision can be made concrete without this happening so fund raising has begun.

$5,500,000.00 – How can this be done?

Nokor Tep Women’s Hospital is the opportunity for many to be able to stand with the women of Cambodia. Our vision is to develop a wall of partners, people who gave so that the women here can live.

To make this happen, we are looking to make it possible for all who would like to be a part of this vision. In very simple terms, we need:

55,000 people to donate $100.00 each

Or

11,000 people to donate $500.00 each

Or

5,500 people to donate $1000.00 each

Or

550 people to donate $10,000.00 each

Or

275 people to donate $25,000.00 each

Or

110 people to donate $50,000.00 each

Or

55 people to donate $100,000.00 each

Our vision is big but the need is great. All of us together can affect the lives of so very many. Once we know phase one is well under way, phase two of outfitting the facilities will begin in earnest.

Recruiting for positions and staffing of the hospital has already started but we are unable to complete any of the appointments until we are sure that the facility will be a reality.

February 18, 2011

February 18,2011

Yi Vannary is my Administrative assistant and has been with me from the start of Tabitha Cambodia. When I first met Nary she was deeply traumatized by the events of her life. In order to help Nary regain some sense of normalcy back then, I had her tell me about her life. Today we reminisced about parts of her life’s journey for Nary was telling me how she is sharing the vision of Nokor Tep Women’s Hospital with her friends.

After the fall of the Khmer Rouge, Nary, like so many Cambodia women, was all alone – she was the sole surviving member of her family. At that time, there were rumors of single women being raped and brutalized. She was very frightened and desperately looked for a family to join. This is how she met her husband and her mother-in-law. They married out of necessity and fear. Nary related how her experience with sex and childbirth happened.

I was 14 when the Khmer Rouge took over Cambodia and I lived under this regime for 3 years, 4 months and 27 days. When freedom came, I was 18 years old and there were so many stories of single women being raped and killed by the soldiers - so I married the first man who would have me. No one told me about sex or what it meant to be married, My mother didn’t tell me and my mother-in-law didn’t tell me. That first night my husband and I slept together – he put his leg over me – I thought what is he doing? So I pushed him away. He did it again and again I pushed him away. Then he put his arm over me and I thought, what a restless sleeper – and so heavy – so I pushed him away again. But he continued until it happened – it was so painful and so disgusting – I didn’t know what he was doing.

I became pregnant and when it was time for the baby to be born, my husband and his mother brought me to a clinic and left me. The doctor came and said – take off your underwear – I was only 19 and no one told me what to expect. I thought he was very rude and I was so scared that he wanted to rape me so I got up and ran away. I didn’t know where to go and it was raining so hard. My pain was very bad. Finally I sat down under a street light and the baby came out. It was raining and dark, I was so afraid, I didn’t know what to do and so I cried and cried until morning came. That first baby was so alien to me – I didn’t understand what had happened, I didn’t know what to do.  A woman came by and helped me back home.

I had three children with my husband – while I was giving birth to the third child, he disappeared.  My mother in law never told me what happened to him – I was sent away from her house and for years lived in squatters areas – so very poor – no one to help me – but each night I came home from work – I kissed my children. A few years ago my husband returned – he had gone to France where he married two other women – now he wanted me back – but I didn’t want him. It’s been so hard. I never want another man – no more husbands for me.

I would like to say that Nary’s experience is unusual but sadly, it isn’t. In Cambodian culture, a woman’s role is to do as she is told without questions and without recourse. To talk about intimate relationships is fiercely frowned upon. As a result, many women suffer from all kinds of injuries from sex gone badly and births unattended.  Severe vaginal infections, prolapsed uteruses, fistulas, and so much more –are the norm here – not the rare occasions.  Nokor Tep is so needed, Nary said, no woman should suffer as I did. It’s not right!

Janne

February 12 2011

February 12 2011 

Today I met a woman – a nurse and a lay person – whose life’s work is to bring comfort to the poorest that are ill. As we were talking, she said to me, we don’t help any woman over 50 years of age if they have cancer. I almost choked. I replied, I am 62 years of age and have just finished my major treatment for breast cancer – if I hadn’t gone to Singapore, you would have written me off! Paula’s response was immediate. I can only help so many women, she said. Cancer treatment is expensive and difficult to find. I have to use my own money. The women coming here are women whom are very poor and do not have the resources to pay for treatment. By the time they come here, they have sold all that they own. They are young women with young children. Even if the treatment just gives them a few more years, the children have their mother for that time.

We talked some more. Most of the women that come, she said, are fourth stage cancer. Their pain is horrific and they are desperate for help. You know Janne, they all want to live – it doesn’t matter whether they are rich or poor –they all desperately want to live and so they sell everything – sometimes even their own children at a chance to find medicine, a cure and most often release – release from the pain.

She introduced me to a young woman of 26 – she was very ill – she was living her last weeks – away from home and all those she loved – but it was better this way she said. I have no money – we have sold everything. It is better this way.

I was saddened – she still had great beauty. What would it be like to die away from her children, her family – how sad it must be. Then we talked to an 18 year old, ill with breast cancer. She had chemo yesterday and was feeling nauseous. How many, I asked, are so young? Paula’s response was sad – too many she said – Cambodia has a young population after all those years of conflict. The treatment is not always the best and it costs so very much. Even paying $2.00 for a mat to lay on in the hospital is beyond their ability to pay.

We talked about Nokor Tep’s Women’s Hospital. Paula was so enthusiastic – we need it so badly. There are so many women who need the help. I will provide a safe haven for any woman you have that needs treatment and time. Just bring the hospital.

I shared with her our vision for education and prevention – helping women to understand their bodies better, of helping them to detect early signs of not only cancer but other diseases’ – Paula’s response was – just imagine if we could bring all women’s cancers down to first stage treatable and hopeful. Can you imagine, she said, of the children who would have their moms and the husbands who would have their wives – how good that would be. 

I shared with Paula of those who said, but how expensive this would be. Paula’s response touched me – you tell then she said – love is never expensive – if freely given. You get so much back – a smile, a touch, a hug and sometimes you give life itself. What price should we put on that?   

I met a woman today – a woman of compassion and love – a woman like minded in so many ways – a woman’s whose passion is mine. Nokor Tep Woman’s Hospital has become our vision. Hopefully it will become yours as well.

Janne