Dr. Eash - Days 4 - 8

Day 4 – 4th March 2019

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Siem Reap 6.50am local time. Currently waiting for the cook to provide me some poached eggs on toast for three dollars. It is light out and cool. The few late mosquitos dot around trying to collect crimson juice from early human wakers. I have had a warm welcome from Jon and his wife Meiko. They have introduced me to some of their friends. I have located a gym and a supermarket here, so I am sorted! There are many expats here and the ones I have met have done great community building work - from charity work to biofuel production. Great stuff.
Jon showed me around the TLC office yesterday and introduced me to some of the staff. He merrily typed away at his desk as his office reached a sweltering  36 degrees Celsius by 10am.

He then showed me around Siem Reap and to drove us Naga Earth's headquarters. Naga Earth convert cooking oil into diesel and handwash. They collect the cooking oil from local restaurants and everything is beautifully recycled.

During the road trip we spoke about Jon's life and how he started working in Cambodia after a chance meeting Dr Haing S. Ngor, the Academy Award Winner and author of Survival in the Killing Fields. 

Day 5 – 5th March 2019

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Way of life is very different here.

I woke up at 4.30am today barely able to sleep. Most likely due to excitement and my earlier four hour nap. My tuk-tuk drove me through the streets of Siem Reap during dawn to the TLC office. From there after a three hour journey and a pit-stop for breakfast we arrived at the river clinic. I was accompanied by 2 local doctors, a midwife and cook. Dr Rida studied in Russia and could speak English so we conversed about the local population demographics.

After three hours and many involuntary sleepy head bobs, we had made it. The lake clinic was located behind a house on stilts. We took boxes across to Dr Phirom and Samrong, the village chief’s son. They carried the boxes into the clinic traversing the wooden plank that lay between a longboat and the clinic itself. Soon all boxes were loaded onto the clinic. We had an amazing lunch with kale, rice and fried chicken, prepared by Sathya our cook. After lunch, we napped for half an hour. The we woke up 10minutes before 2pm to set the room up as a clinic and for the eventual crowd of locals. 2pm came and many people and children waited outside. I teamed up with Dr Rida to see patients, I typed and she translated. Most were babies with colds but we also so a woman in her 70s with a dog bite to the hand. Dr Rida cleaned the wound and we felt it was necessary the patient had some antibiotics.

After we had seen all the patients, Dr Rida and the midwife- Sreyneth went looking for mussels. Dr Phirom went fishing. As the sun set I read, showered and we all dined together. Rice, kale and fish head stew this time. After dinner we placed our mosquito nets up and read/rested for an early start the next day.

Day 6 – 6th March 2019

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Lying down by the river bank, I gazed upwards to be met by the most stars I had ever witnessed in 26 years. Just to add to the magic, in the background, Dr Phirom played Cambodian ballads on YouTube. I began pondering. I realised how powerful yet primitive our minds actually were. And how a physically immaterialised thing such a thought held so much power. A mass genocide occurred in the nation that I laid my head on. It was started by a single thought. Whilst I laid there my eyes viewed the stars and I contemplated the many scientific discoveries we as humans had unearthed of the heavens above. These were also started by thoughts.

The clinic was interesting today. Majority of our cases were type 2 diabetics, those suffering with gastritis or both. An interesting case of a pulsatile neck lump took me by surprise. Clinically looked arterial and confirmed on USS. Examination of her abdomen also revealed a possible triple A. Her blood was stable. We advised her to visit Phnom Penh for a CT angiogram.

A women later arrived complaining of coffee ground vomiting and rectal bleeding a week ago. She revealed that she enjoyed Cambodian wine. We put two and two together. She was most likely suffering with an upper gastro-intestinal bleed - possibly varices or a gastric ulcer. A patient on the National Health Service in the UK would have received pabrinex, an oesophago-gastroduodenoscopy, bloods, transfusion, proton pump infusion and a visit from the alcohol liaison team as well as the gastrointestinal specialist. We didn’t have these luxuries. OGDs are expensive and many of the villagers cannot afford this procedure. I gave her 30mg of omeprazole and asked her to come in tomorrow for a blood test, I also supplemented her with iron tablets. If she bled again we advised an OGD.

Day 8 – 8th March 2019

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Today's topic: Being comfortable being alone.

Weekends are relaxing. A time to get back to more of an urban way of life. I’m staying in a hostel in Siem Reap and possibly planning on staying there for the entirety of my stay.  I am free to explore and experience this wonderful city and I love it. But I am on my own. I have always been more introverted than extroverted, better at listening than speaking and find joy working alone on projects. But during weekends I somewhat crave human contact. Do not get me wrong though, I am not lonely, I have made friends at the bar and the hostel staff and I have a little chat. I think I will try to wring out all the benefits of being alone during the weekends. I plan on meditating a lot more, travelling and reading more than I usually do. And I am sure I will make friends along the way.