March 16, 2010

• Poor and Poorer... (PLINSB, part II)

  In the Khmer countryside, villagers are too sick or too poor to seek medical help, so community health leaders travel out to meet them where they are.  During our visit to Svay Rieng, one of the local doctors brought us with him to visit patients in their homes. 

  The first home we visited was wooden, built on stilts, with a few livestock and chicken running around.  In the front sat a large machine used to harvest rice by separating the rice from the rice stalks.  Upon seeing the machine, the doctor said to us, "Let's go...this is a rich man's house." (Rich? Excuse me?  But this is all they have?!)

  Despite living in a poor province with little income and dry soil, their rice machine provided sustainability.  They were more poor than the average farmer in Cambodia, yet richer than the people we'd meet later...

  ~ ~ ~

  "He's coming soon," a neighbor informed us on our visit to the next patient's home. 

  I shuffled my dirty, beat up Asics along the red colored soil.  (On a side note- It didn't occur to me until now that we should've been more cautious of the thousands of LANDMINES that are buried under Cambodian soil that amputate, maim, and KILL Cambodians on a daily basis.  Not that I would've detected one with my keen eye, but I guess I should've been mindful of it.)  A few homes were scattered around us.  The roofs were constructed from dried palm leaves- not uncommon in the countryside- but not the most durable either.  Nearby neighbors began to come out of their hut homes.  Children wore old, raggedy clothes that barely covered their malnourished, swollen, bellies.  (They had Kwashiorkor... a condition of starvation when your body doesn't have enough protein. I was devastated... I had only seen malnourishment like that in textbooks and on tv.)  Hunger eroded down their thin arms and faces.  They watched us curiously, eyeing our every movement.

  Oh, how helpless I felt!  I never imagined myself being here.  Not only had I come to Svay Rieng, a place so barren, so empty, so hungry, but I had come empty handed! I wish I could've given them more, but I had nothing with me other than the fruits from our car.  (My cousin had prepared me with some fruits for our road trip because she knew there was nothing to eat there.) 

  I handed them a small bunch of baby bananas, lotus seeds, and mangoes.  The children tore open the bananas as if they hadn't eaten in 3 days.  Starving, they threw the peels on the floor and swallowed the fruits faster than the blink of an eye.  I couldn't believe how hungry they were.

  Our patient finally arrived.  He was a lean, thin guy, shirtless, with bare feet.  He looked like he was in his 30's, and I was shocked to discover that he was actually 15.  Poverty, malnourishment, and disease had quickly aged him. 

  "Do you take your meds everyday?" The TB doctor asked him.

  "'Baat' (yes)" he replied.

  "How long is the treatment?" he went through a checklist of questions they ask every patient on each visit.

  "Everyday for at least 2 months."

  "And how is it spread?"

  "Coughing."

  "How can you prevent spreading it to your family?"

  "I have to cover my mouth with a krama (scarf)."

  "And is TB curable?"

  "Yes.  As long as I take my meds everyday."

  "And if you don't?"

  "I will die."

  The doctor nodded in agreement.  He finished the questionnaire, and proceeded with his assessment.  "And do you still have trouble breathing?"

  "Yes, when I run or when I'm working."

  "You must avoid hard labor because it will make it hard to breathe," the doctor cautioned. 

  "But I have to do hard labor (in the fields) because there is no other work here," he explained.

  How can you tell a 15 year old to not work, to not support his family, and to let his family starve? You can't.

  "Ok..Work if you have to...but try to take it easy if you cannot breathe," the doctor warned him. 

  Afterwards, we examined him.  We listened to his chest, and felt more reassured because his lungs sounded clear.

  "Do you want to listen to your own heart?" we asked.

  He nodded. 

  We put the stethoscope into the young man's ears, and then placed the diaphragm of the stethoscope over his left chest.

  "That thumping sound.  That's your heart."

  He let out sheepish grin. 

  I smiled too...it was the first time I had seen him smile.
  
  (Coming soon:  "Poorest"- part III of "Poverty Like I've Never Seen Before")

  • 10:44 am
  • 3 Comments