Friday, October 25, 2013

Cooking Attempt #1

I tried this whole “cooking” thing that everyone keeps talking about.

Well…I didn't quite make it that far.

Shall I begin by setting the stage?

    It was a stifling hot afternoon; the kind of hot that makes a body exclaim the obvious (“Man, it’s hot!”), and then, exhausted from attempted exaggeration, seek the nearest shade – sure to be at least ten degrees cooler.  I was looking especially village-chic in my usual rural wear consisting of long pants, a dri-fit shirt, and a sweatshirt over that as I wandered, sweating bullets, down the road to purchase the orange vegetable I had been craving for a few days: pumpkin.  I was feeling pretty good about myself, changing up my lunch routine by tossing the whole “peanut butter sandwich” deal I had been eating for the last year-instead I had begun going to road stands and buying vegetables to cut up and eat, and that day I had even gotten eggs to boil.  I walked down the road to the next village over, purchased my goodies, and meandered back to my house to set up the cutting board and get a knife. 

    You know how your mom always tells you to put the vegetable on the cutting board and cut down, while she holds it in her hand and expertly chops vegetables in the air in the time it takes you to manage a cut in half? That’s me and my host mom.  That day I tried to be her.  I held the pumpkin in my left hand and cut down with my right.  In this situation, I think it’s fair to say that I don’t know my own strength (and what strength it must be!) because I cut straight through the pumpkin to my index finger.  I pulled the knife out of my finger and bright red blood gushed from the slice.  Jumping up, I jammed my finger into my mouth, trying to reason that any iron lost would go straight back into my body while I ran up the stairs to my bedroom where my med kit was stashed and pulled out gauze and band-aids because I couldn't find any medical tape.  With mad medical skills, I managed to wrap the finger and then assuming that the blood would stop soon, went back downstairs to finish cutting the pumpkin.  I was still hungry and still craving pumpkin and it seemed like a rational idea.  The cutting took 2 more minutes during which time 6-year-old Man Kheang came over to me and asked what happened to my finger.  “Kut miriam die?” I said to him, which sounded to me like ‘cut finger.’  He corrected me, “moot kambut” (cut with a knife) and thus my Khmer lessons continue.  Soon I was back upstairs putting pumpkin into the toaster oven and eggs into the water heater holding my bleeding finger up and wondering why pressure and gauze wasn't doing the trick of halting the bleeding.  So I did what anyone does when they have a medical emergency and their mom isn't on hand: I called my friend, Amy, in Kampot – the next province over.  

“Hello?” she answered the phone.

“Amy, I cut my finger.”

    “Amaaandaaaaaaa,” she said to me (in the voice she always uses when I call her from the city after chugging chocolate milk and making myself sick. “You know what milk does to you” she scolds, exasperated while I groan in agreement and over the following few hours, curled in the fetal position on the bathroom floor, swear that I will never again eat myself sick with dairy after weeks of lactose-free food in the village; a promise that I know, even as I make it, I will inevitably break at the next available opportunity.  Milk is just so good).  Luckily though, she was sitting next to Hayley and handed the phone off to her, “Amanda cut her finger” I heard her say with a resigned air.  Hayley (the ultimate nice girl) sounded appropriately concerned, “Whaaat?!” and then I heard her clearly through the phone, “You cut your finger? What happened?” 

    I explained the pumpkin debacle and followed it with a description of my still-bleeding finger.  “I am not really sure what to do,” I said, and she answered promptly, “you should call Medical Duty.” 

(In PCCambodia we have two medical officers and the ‘medical duty’ is a phone number of a phone manned 24/7 by one of the two doctors on staff.  They o answer no matter what-kind of like an ER on the phone.) 

    Hayley was right.  I had started pacing in the upstairs outside of my room at this point and it had been twenty minutes since I cut my finger, blood still pouring out, me burning through gauze (not literally).  I dialed Med Duty and waited for an answer trying to frame a question out of my cut finger.  The phone was answered.  “Hello AHmenDah” I heard on the other end – the Duty Officer was Navy, the Khmer half of the medical staff.  “Hello Navy (pronounced Nah-VEE),” I answered in the most cheerful voice I could muster, “I have a problem.”  “Yes, what is it?” she said to me, patiently.  “Well, I cut my finger...not on purpose.” And proceeded through the story yet again, explaining how the bleeding had not ceased for 20 minutes.  “Ok,” Navy said, “You are in Kampong Som? I will call the clinic and we will see if we can get you an appointment. I will call you back.”  I thanked her and hung up, still pacing, though now in a circle, while I waited. 

    She called back right away.  “Amanda,” she asked me, “are you in the city or are you in a village?” I told her I was in my village and reminded her which one it was.  She knew it. “Oh,” she responded, “so you are not so close to the city then.” I’m not.  “Maybe you will come to Phnom Penh instead,” Navy said to me and I thought to myself, well, we just jumped from a little over an hour to my provincial town to 6 hours to Phnom Penh, but in light of the 10% of my digits still pouring blood, I was okay with heading straight to the capital.  She told me she would call my health center director and see if he would take a look at it to determine if I needed to come in and get stitches.  I went downstairs to wait for him as he made his way via car to my house and I remember thinking as he got out of the passenger seat, “Who is driving?”

    He unwrapped the gauze and observed the bloody mess while telling me to hold it up and attempting to wrap it up again (I was out of band-aids) the whole while I was sitting next to the now warm pumpkin.  Then he asked me if I had been crying, because Navy had told him I was crying.  “Bong yoam?” Man Kheang said to me, (Bong crying?).  I don’t remember crying…but if Navy said I did, maybe it was all in my voice.  I looked at him and smiled.  My health center director left me with instructions to keep my finger up and pressure applied and I sat with Man. 

Bong,” he said to me in a 6 year old serious voice, “When Mea cut his finger, he didn’t cry.” (Mea is his 10 year old cousin)

“Oh, Mea klang.” I told him, (Mea is strong). 

He nodded in agreement.  “But when I fell and my nose was bleeding, I cried.  It’s okay to cry.” And he looked at me again with a serious face – possibly the most precious moment I have ever encountered. 


    I headed upstairs to my room and got a phone call from Navy.  She told me that my health center director (whom I lovingly refer to as my ‘HCD’) thought I would be fine, but there was a lot of blood and he couldn't quite see how deep the cut was.  “Come to Phnom Penh and we will just to make sure it is OK.” I told my host mom, she called my HCD who was heading there (so I wouldn't have to take the bus) and then ran upstairs to throw some clothes in a bag while I re-wrapped my finger. 

    Out of band-aids, my eyes tore wildly around the room for an adhesive agent, finally coming to rest on the ultimate of bonding materials: Angry Birds-themed Duct tape Supermom had sent in a care package.  One handed, I tore off a piece and did my best to wrap it around the gauze, unable to help the smile materializing on my face. 

    Minutes later I was in the passenger side of the HCDs car, on my way to Phnom Penh.  He sat next to me and chuckled – I’m sure he thought I was a complete idiot to be going to the hospital with moot kambut but in my defense, at this point I was just following the doctor’s orders.  About half an hour into the drive, rain pouring down steadily, he pulled off the road and motioned to a muddy path in front of us.  “Sam-sup nea-tee” he said to me, (thirty minutes).  I nodded.  Am I not always up for the adventure I never see coming?  We mucked through the mud to a house off the beaten path where his son received a blessing from a man who must have been holy (I didn't ask any questions), and then trekked back to the car. 
    About a week earlier my HCD had mentioned that he was teaching his son how to drive.  This didn't really connect to anything that was going on until he pulled over again about half an hour after that, and his son climbed into the driver’s seat.  I double checked my seat belt. 
    I hadn't met his son beforehand, and though HCD told me that his son was 20-years-old (or roundabouts), he looked to me more like 14-years-old, 15 if I was being really generous and accounted for some serious failure-to-thrive in childhood.  So when he got behind the wheel of the car and started driving at half the speed his father was driving, passed by semi’s and tuktuks alike, I wondered if I would have a finger left at the end of this journey…or if I would even make it to Phnom Penh. All of the sudden the blessing made sense, (“Maybe I should have gotten one” I thought to myself) and I realized I was holding tight to the door – to do what, I don’t know.  Maybe tuck and roll if I foresaw something dramatic happening in advance. 
    HCD sat in the backseat, giving instructions in Khmer to his son who generally responded in a like manner.  Soon enough they started bantering and listening in, I wasn't sure whether I wanted the conversation to continue in favor of entertainment, or cease in favor of attention on the road. 

“Slower, gentle. Do not try to pass now, I will tell you.”

“The truck just passed me. What does that sign mean?”

“Don’t worry about it.”


    Eventually we made it into Phnom Penh and headed toward the HCDs house where I met his daughter and her husband who ran a pharmacy nearby.  “We will wait for a bit, and then go to eat rice. After that I will take you to the hospital,” HCD told me in Khmer.  I nodded. He said we would make it by 6pm (about 15 minutes afterwards).  Twenty minutes later I climbed into the car and he told me to call my doctor.  “We will go eat rice and then I will take you to the hospital. Maybe 8pm.” He said.  I called.  She disagreed.  He took me to the hospital. 


    They asked me immediately how they could help and then for my passport, which I promptly handed over, filling out hospital forms with English translations.  Then I was taken back to the doctor who eyed my Angry Birds-Duct-tape wrapped finger.  “I ran out of band-aids” I said, by way of explanation.  He just smiled at me…I don’t think he hangs out with kids much. 

    Taking off the tape and gauze was a little challenging since by the time the blood finally stopped gushing out of my finger, there was so much of it that it glued the gauze to my wound which promptly reopened upon gauze removal.  They got to work cleaning so that they could examine my finger and once they did, proclaimed me not in need of stitches.  Then the jokes started.  “Are you left handed?” they asked me (what should be a simple question).  “Well,” I answered, “I usually write with my right hand,” which is the truth.  “O good, then you don’t need this finger, we just take it right off.” (chuckle-at-a-joke-well-completed-while-overtired-and-American-little-me-smiles-weakly,-protesting-while-bringing-out-my-best-“no, no!”-laugh-and-joke-along).  It was examined, cleaned thoroughly, and Navy arrived just as the last piece of tape bandaged it up.  She assured me that we would take a look soon, and possibly go to see the hand surgeon. 


    Two days later I was sitting back in the doctor’s room in the Peace Corps office, watching blood flow from my reopened wound.  “I think we will call the hand surgeon” Navy told me as the blood continued to flow, and made an appointment for the following day.  She tried to be reassuring about it, “Just to make sure there is no lasting damage.” But she kept saying, "hand surgeon," "hand surgeon."


So to the hand surgeon we went.
He was very pleasant. “You are a Peace Corps Volunteer, what are you doing in your village?” he asked me as I sat down, and I thought that he must see a lot of us, the way he was talking it seemed like he knew a lot about our organization.  Then Navy walked in and sat down.

 “Do you see a lot of Volunteers?” I asked him.  “No,” he said to me, “not many.”

“Oh, you know a lot about Peace Corps.”

“Yes,” he responded, “I am Navy’s husband.”  And Navy looked at me, nodding and smiling. 

Whammy.

Navy, you could have just said, ‘my husband’ instead of ‘the hand surgeon’ every time you mentioned him.

He took a look and explained to me that Navy brought me to see him because of the location of the cut.  Had I moved my finger a bit when I had cut it, or the knife, and cut a little bit lower on my finger, I would have been in danger of severing the nerve ends for good and lose the sensation in my fingertip (which at the moment, was gone).  "Maybe you will not get 100% of feeling back in your fingertip" he said to me as he held my finger gently between his own, "but maybe you get 98 or 99%".  Good to know.  I settled my expectations at 98%-99% sensation returning in the following few weeks and thanked him for his expertise on my poor digit.  


So I was sent back to site and here I wait for maybe 98% or 99% of sensation to return to the tip of my finger.

And I am still just dying for anything pumpkin flavored.


Happy Halloween!
xo-Amanda

Sunday, October 13, 2013

The ANC Project

      One of our goals as PCVs in Cambodia is to increase maternal and child health awareness in the villages.  In order to do this, three other PCVs and myself just finished leading a pilot of the ANC Project at a health center.  Amber, Margaret and I traveled to Brittni's health center to teach a couple of her Village Health Volunteers the essentials about pre-and postnatal health.  We covered simple things like maternal nutrition and the importance of iodine and iron in her diet, to more complex items such as traditional beliefs we are working against.  The idea is that the Village Health Volunteers, who have more contact with pregnant mothers in the village (who may not come into the health center to see us), will be able to do a little education of their own, and will be better able to counsel a pregnant woman on whether or not she needs to come in to see midwives at the health center.  
     First we composed a manual of sorts, with lessons and activities to assist in the workshops.  All of the lessons and activities are accompanied by necessary props (paper-wise) as well as Khmer translations and Khmer-English transliterations.  We planned for the manual to be able to be used by any PCV if they want aid teaching about ANC care at their health centers.  After completing this pilot session, we are now making small changes to improve the manual and the workshops, and will be having another (hopefully smoother, more improved) workshop at my own health center early next year.  



The Village Health Volunteers participated in activities after each lesson.

 Amber and I go through the importance of iodine in a pregnant woman's diet for both the mother and the baby.


This was during a review session, I went through steps pregnant women should take, such as going to the health center for checkups, learning about good nutrition and changing their diet for the benefit of the baby, saving money for the birth, and having a plan to get to the health center.

The Village Health Volunteers (back) with Brittni's tutor (back right) and PCVs (front from left to right) Amber, Margaret, Brittni, me





Here's to more ANC Projects, more education, and better health.

xo-Amanda