Healthcare in Cambodia

Happy New Year!  As 2017 finished and 2018 started, I've been reflecting on my current state of transition into new things – potentially everything is changing in the next few months (study to work, moving house? moving province? moving church?...). I have been seeking God in this waiting and been encouraged by deepening relationships and opportunities that I sense God is directing me into.  It's all still cloudy, but I thank God that He already has the purposes for us and is working them out (Proverbs 19: 21)

Before I talk a little about healthcare provision here in Cambodia, let me tell you a bit about my Christmas and end of term.  My presentation and exam at school went well – thank you for all your prayers.  It turned into quite a different final week:  Anny's grandmother was seriously unwell and then died and Anny's mum needed to return to see family in Vietnam.  But no-one had ever been responsible to care for Anny's personal needs, except her Mum.  Fortunately we have a great God who had prepared and built up the relationships between Anny, myself and my housemate Marijke, and so we were able to help support her whilst her mum was away, visiting her each morning and evening to get her to and from bed to wheelchair, to shower and dress.  I am so thankful that Anny could ask us and we could do it – a nurse and an OT as close friends – perfect provision!  It is a significant thing to be asked into a Cambodian home in such a way – God blessed all of us through this. 

And that leads into Cambodian healthcare provision. The government training for nurses occurs mostly in training colleges with practice in hospitals and clinics, but the training is patchy.  Part of my vision long term, is to improve the mentorship of newly qualified and student nurses- a long term goal!  As I mentioned in my last email, there is a fundamental problems with service provision in Cambodia – communication problems, lack of professionalism, lack of knowledge, lack of resources.  As I mentioned in my last news – people's experience of medical care can be very poor and there are many barriers to accessing care, including health beliefs.  Unfortunately I was not able to attend the nursing conference as I'd hoped but two former colleagues of mine did attend and they were encouraged that the nursing sector is improving in professionalism.  How this affects delivery of care in health facilities which lack basic resources (clean regular water supply, for example), is another matter

In the last couple of days I was privileged to have the opportunity to join with another mission agency going into two different villages to bring good news of Jesus and this time with some medical care, so they invited me to join. We did simple health check, gave lots of advice about health, gave a few medicines and identified a few folk needing further medical care, helping them to get to an appropriate hospital, but then also offering to pray with them, that they would experience the healing of Jesus.  I was so pleased to have this opportunity to use professional skills and integrate my hope and trust in God as Healer.  Wonderful!  One lady shared her joyous testimony – she told us that she spent 6 years in bed, unable to walk.  Then she prayed and asked Jesus to help her and she got up and started walking again – Amen!

I spent Christmas with friends in Vietnam – so good to encourage each other and enjoy time with their two small children.  Christmas meal was spent with neighbours of my friends, many different nationalities came together and were full of thanksgiving, and with some Christmas songs – I loved it!

No news yet on the Cambodian musical instrument – unfortunately the school I approached is not currently offering lessons, so that idea is on hold for the present. But I am practicing singing praise songs in Khmer with the guitar!

A difficult thing that happened last week, was that my bag was stolen as I was cycling home.  Thankfully I wasn't hurt, and have practically been able to sort things out, but I am feeling more vulnerable out and about.  Petty crime like this is occurring more and more in Phnom Penh.

I restart language school next Monday – my final full time level.  I'm looking forward to this, but also feel a little pressure about what will come afterwards, since I still don't know.  I am pushing doors, but also praying and learning to wait – to trust that if I don't hear or see the way forward clearly, I may just need to wait a bit until I do.   I have meeting planned with a contact in the ministry of health January 10th, so I pray for favour and God's directing through this. 

For those who support me in prayer:

Thanksgiving: for the opportunity to build deeper friendship with Anny and support her during her grandmother's death; for time with friends over Christmas, time to relax and rest; for an encouraging finish in my last language exam; for the joy of opportunity to visit people in more rural areas during a health outreach, giving some simple health support and praying God would bless them.

         
And prayer requests: for God's kingdom to come in this kingdom;  for me to finish full time language study well; for discernment about work ministry hopefully starting late February;  to find a Khmer church and build Christian language skills.

Coming up... team work – how this can be both rich and challenging when the team is multicultural.

Specific diary dates: 

- January 8th Start back at language school (last full time level)
- January 10th Meeting with a contact in the Ministry of Health
- February 5th Refocusing group discussion.

Here's my latest update about E2S conference, tasting different foods, traveling more in Cambodia, and considering how I might connect musically with Khmer people, as I move towards finishing full time language study. Oh and I'll share about my latest school project.

Some of you know that I am vegetarian (actually pescatarian) but I am fairly relaxed about this. Simply put, it's harder to eat no meat here: when I am invited to someone's home, in a country where vegetarianism is anathema and guests are honoured with choice meat, it's tough to decline. In addition to this, there are less vegetarian options in restaurants. But I am also adventurous and curious to try new things. Recently I tried grilled frog and poached giant-snails. They were both served with tasty accompaniments and really were not difficult to swallow... but I can't go so for as to say I enjoyed the texture of meat. The snails were a bit chewy/gristly. However, of Khmer foods, I do enjoy noodle breakfast (khteiu and noom banchok), pancakes with beansprouts (bunchauw) and various different slaws (khmer soups). And of course one of Cambodia's signature dishes- fish amok (coconut curry base with kaffir lime leaves).

 

Since my last news, the political tensions have increased, with the only significant opposition party leader indicted for conspiracy against the government, followed by the whole party being closed down by judicial ruling- 100 politicians banned from politics for 5 years. Since the ruling, several members of the independent election committee have resigned (elections planned for July 2018). Newspaper headlines have stated this is the end of any semblance of democracy in this kingdom. Several international organisations have been raided and threatened with closure.

In this context it is easy to become intimidated, wary, even frightened. But as a follower of Jesus, I know that His kingdom is greater and His authority is higher. I am confident that he is working his purposes out and He will bring justice. However, I do need to be more cautious about security and you might notice that I refer to things in more veiled terms than previously, as I seek to be more discrete. This will definitely apply in unsecured facebook messages, although whatsapp is encrypted and thus considered more secure. Please respect that this news should be shared sensitively.

The E2S conference last month was great to meet other partners like myself working across Asia- representing 9 different nations, and hearing the international vision and community of Interserve. It was encouraging to hear experiences of long term partners and their faith to serve God wherever He calls, with skills and talents that he uniquely gives us. One insight that I feel may be  from God, was about how I could use my musical gifts to connect with Cambodians. I am wondering about whether I could learn a Cambodian traditional instrument and want to see how I might pursue this.

Continuing to learn to handle a dirt bike is also a joy and challenge. I am considering whether I might be able to join a motorbike prayer trip in January, if I can get enough practice in on dirt roads before that. I pray for a mix of self-confidence and vigilance against dangers as I ride the roads.

Anny's baptism was a wonderful celebration as she gave testimony to God's faithfulness and trust in him- wonderful to witness this. We continue to meet twice weekly to improve my Khmer conversation, but we also had a lovely fun outing of high tea together lately. She is lots of fun!

At language school I am mid-project which I will present in a couple of weeks time as part of my assessment. I am looking at the communication in government hospitals between staff and patients. As I have interviewed Cambodians about this, it has been a sobering reminder of how challenging it is to work for justice here in the health sector. All my interviewees have informed me that under the table payments are necessary for patients to receive care and that hospital staff are often rude and careless with patients, especially those who are poor, which is the vast majority of the patients they treat. 

Wishing you a wonderful time celebrating Christmas -

may Jesus be at the heart of it.

Political musings and a pause from language school (7 Oct 2017)

After promising it for a while, in this update I'll reflect on the political situation in Cambodia. I'm also in the midst of a pause from my usual routine which has created space and opportunity for me to do some different things. 

I am currently having a pause from my regular language school, due to insufficient students for my level. Therefore until mid November I have opportunity for a few different things. I was so grateful to have a week out of city life, trekking in the north of Vietnam with a few team friends. It was very beautiful and caused my heart to be full of thanksgiving and praise. We had fun walking slippery paths through bamboo forests and rice paddies, with plenty of 'Buffalo chocolate' underfoot- our guide's euphemism!

Following my trip to Vietnam, I was back in Siem Reap, then borrowed a motorbike to visit old friends further north. It was lovely to meet a friend's new spouse and 2 new babies. Being back on the motorbike was also such a pleasure and Cambodia is looking its best just now as the vibrant green rice fields are about to be harvested. Lightening and storms make the biking that bit more exciting!!

Last week I started a course called Refocusing Leaders- run for mission partners from different organisations all working here in Cambodia. We spent time reflecting on our past, noticing God's fingerprints and directing of our lives, then inviting Him to speak with us as we prayed and reflected. I will have several weekends for this course over the next 8 months and I expect it to be a rich journey deeper into understanding my identity in Christ and God's purpose and vision for my life.

Now back home again in Phnom Penh I am meeting daily for language coaching 1:1 with Anny, enjoying our growing friendship and discussing a lot about faith as she is getting baptised at the end of the month- a time to celebrate! I am starting to learn more Biblical/Christian Khmer with her, with a view to getting equipped to use TEE tools (Theological Education by Extension). This is a community based way of teaching about Jesus and living Christian faith. 

At the end of the month I'll attend an Interserve regional workshop (called Equipped to Serve or E2S), which is a part of induction to joining Interserve. I hope this will also be encouraging to meet other partners from across Asia and share our experiences about walking in faith cross-culturally.

Politically, there have been some significant changes and tensions over the past 4 months. Local elections held early summer indicated strong opposition to the leading party who has been in power for over 3 decades. Unfortunately the leader is clinging on to control: arresting the opposition party leader, just yesterday taking out a court case to close down the party, also closing down free press. The feeling of oppression is tangible. Relations with the US are more tense. Cambodia's economy is growing fast, with heavy Chinese investment and ties with Vietnam. There feels an increased ominous threat to democracy as we look to national elections next July. Development and faith based organisations that criticize the government are threatened with closure.  A couple of months ago one agency issued a report stating the problems with child sexual exploitation and they had to do a lot of diplomacy to remain working here. The government may restrict international work and visas in a bid for greater control. We pray, watch and wait.

Photos:  Top - Amazing rice terracing in north Vietnam where I was trekking with some team mates. 

Left - Amidst the corn fields.  Right - Visiting my friend Van Douer in northern Cambodia- lovely to join for lunch with his family, meeting his wife and son! 

Next time... a bit more about Khmer foods and some different things I've tasted!

For those who support me in prayer:

Thanksgiving: for great team fellowship day together and praise nights held monthly; for a wonderful time of holiday and joy trekking in north Vietnam; for deepening friendships and renewing of friendships; for the Refocusing course and all God's blessings through that.
           
And prayer requests: for team members to access visas and comply with changes in the laws (I'm covered until April); please pray God would grow Cambodian leaders for the Cambodian church; for me to absorb new Biblical Khmer and grasp well the language I've been learning over the past 5 months and after this to discern where and how God wants me to serve Him.

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