I missed it

So it’s been a week and I think I can now share this. I had to process it over and over until I could get my thoughts sort of straight.

Remember the little guy I was so excited to help? Yeah that was incredible.

<insert Paul Harvey voice> and now the rest of the story: on our way home that day, one of our missionary hostesses Becki said “do you think his eyes got that bad really fast?” All my eye doctor buddies will agree: no way. Then we started talking about going to the hospital to see the new parents and I forgot about it.

As we were finishing up our time in Cambo, Becki said, “it’s weird. I had that kid marked as good vision from last year.” <insert Scooby Doo voice> ruh roh shraggy. I got that sick feeling in the pit of my stomach. I like to think we’re doing a good job. It’s always a balance between how deep to dig into diagnoses because the more time I spend with each patient, the fewer patients get care. I know that. And then the downside to being efficient was shown to me in ultra high definition in this case.

Frankly I missed it. Last year was a blur at the school seeing community members, students and staff. And you know what? I missed that guy. Not that I didn’t see him but apparently I said he was fine. And he’s cried doing homework for the past year. And his teachers have thought he was slow. Ugh.

Latent hyperopia is tricky and one of the reasons eye doctors beat the drum of comprehensive exams vs. screenings is because of situations like this. I would have picked this up in my office. School screening may or may not have caught it. Fortunately no one died and the kid can see now.

We try to uncover what we can help and not simply treat these trips like a journey to the human zoo and finding every crazy incurable problem with each patient. This one however is a glaring example of missing something that should have been caught. Got some thinking to do before the next go ’round.

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A fitting conclusion

This trip has just felt right. We’ve been comfortable with the food, accommodations and work. Granted I was a zombie yesterday and Stacy started on antibiotics last night but overall we’ve felt good physically, spiritually and emotionally. Stacy will probably disagree with the physically as she is sporting dozens of weepy mosquito bites and lymph nodes the size of grapes. Yet she never complains.

Stacy's lunch

Stacy’s lunch

 

Previous trips have often felt like an outer body experience which is great and exciting, but it’s nice to know we’re getting the hang of this. Far from pros and we have tons to learn but it really is a nice transition from just trying to survive.

 

This kind of image just seems normal now

This kind of image just seems normal now

Our day started out by joining the local staff for their morning devotion. I remembered 10 years ago in a Honduran church having the epiphany that God listens to more than English. Sad I realize but just being honest. We may not have understood the songs and prayers in Khmer today but it didn’t matter. We were joining together to worship our unifying Lord and Savior Jesus Christ.

 

Today we saw the employees at the two Agape Employment Centers. AEC 1 employs many girls who have transitioned out of the restoration center we visited yesterday. I thought I recognized one of the girls from last year but turns out she was in the CNN Freedom Project video with Mira Sorvino and that is how I recognized her. The employment centers are a far cry from the sweatshops down the road. In fact, they were the most comfortable working conditions we’ve had all week 🙂

 

Ladies preparing lunch while we look at eyeballs

Ladies preparing lunch while we look at eyeballs

Most of the employees are young and healthy but there were a few young ladies who were quite nearsighted. No problem if you are running a sewing machine all day but it was fun to think maybe seeing the world more clearly beyond 10 feet could open even more doors.

 

I spent this entire week with my good buddy Sarouen. We met last year when Stacy and I visited Svay Pak for a whirlwind 36 hours and he was our interpreter. He’s two weeks older than Stacy and has kids not too different in age than ours. I’ve never worked alongside an interpreter who can stay focused and interested for 8 straight hours. More than his wonderful interpretation skills, I’ve enjoyed his company and getting to chat during our rare spare time.

Dr. Carla, team leader Chad and the great Sarouen

Dr. Carla, team leader Chad and the great Sarouen

 

Conservatively we have seen over 1100 patients on this trip and given glasses to about half. Like I said a few days ago: I try really hard not to focus on numbers because that is a poor barometer when trying to spread the Gospel and simply love on the people. However, I’m the melancholy one who finds lots of reasons not to be here. Looking at those numbers, hearing about the doors opened, and thinking back over the past week and a half I realize there is no other place I should have been.

Good news: we never had to get into our jerky and almonds.  Bad news: when we picked up our suitcase, it was apparent someone else had

Good news: we never had to get into our jerky and almonds stash.
Bad news: when we picked up our suitcase, the local ants had.

Restoration Center

Today we started feeling like we’ve been in country for nearly two weeks. Woke up with mild headaches, differing levels of stomach excitement throughout the day, and overall just a touch weary. However, we still have another day of work and the workers in the two Agape employment centers will get our best care. I write it so I’ll read it and be intentional about it.

A little lost in translation

A little lost in translation

 

We spent the morning at the restoration center. Like I said yesterday, it’s the first stop after being rescued. Literally the first stop. A raid was just conducted last night and eight more girls will be coming there tonight or tomorrow. The restoration center is at capacity but the director says they’ll make it work.

 

At the AIM storefront

At the AIM storefront

Since last year, I forgot how young the girls are. As we were seeing the girls I asked the director if some of them came from high-risk situations. It was my own way of saying “this can’t be real.” “Nope. They’ve had trauma.” Which means rape, forced prostitution and the like. After the Somaly Mam revelations earlier this year, I’ve been careful to sensationalize things. For one, these are not my stories to tell. They are each individual girl’s. For another, sensationalizing one thing means another horrible story/incident becomes somehow less horrible. Suffice to say they are way too young and have been through way too much.

Our one photo from the restoration center. Truly bittersweet that it is designed cute and frilly.

Our one photo from the restoration center. Truly bittersweet that it is designed cute and frilly.

 

Like yesterday I’ll single out one patient. She’s moderately nearsighted and functions sort of OK without glasses. She doesn’t drive a moto and the classrooms are seldom longer than 10 feet so she really doesn’t have to look super far away during her day. However, she’s missing out on the world. Stacy put glasses on her and she gave a big smile. ”Cheebah” or clear in Khmer let me know we did good. Success!

 

The ARC director was helping this young lady leave and paused, then turned toward the girl, then paused, then turned to me, and in a slightly hushed tone asked “does HIV affect the eyes?” Obviously not just a question of curious inquisition. The implication was simply heartbreaking.

 

The afternoon was spent seeing more Agape staff and students. As we were driving home with the gals, one of them mentioned they wished we could have seen Dari, but she just had a C-section and is still in the hospital. I said hey we’re mobile and if she and dad are OK with it we can stop by. So we went to the nicest government run hospital in Phnom Penh.

 

C-section and 5 days in a VIP room will end up costing around $900. Sounds great until you think about the average Cambodian wage. We walked by a non-VIP room that had 5-6 patients in it and is about the size of an average American bedroom. Add in the fact that it is customary for many family members to not just visit but stay and help out and it looked pretty crowded.

 

Family and friends camp out in the hospital courtyard. It was super crowded but I try not to take picture of people. With yes. Of no.

Family and friends camp out in the hospital courtyard. It was super crowded but I try not to take picture of people. With yes. Of no.

Dari and Ratanak were awful cute with baby Manna and I felt really honored to be there. It’s such a special life event especially for new parents and was also the first grandchild so grandma was uber proud too. We’ve heard stories but it was amazing to actually hear Ratanak say, “if we knock on nurse’s door, they no come unless we pay.” If I heard correctly they pay about $5/day to make sure the nurse actually comes when they need help. Otherwise they wait a few hours.

Glad my food group posters generally don't include eel and frog.

Glad my food group posters generally don’t include eel and frog.

 

We didn’t necessarily do it in order but tomorrow will complete the tour of the holistic approach of AIM: prevention, rescue, restoration and reintegration. It sounds like fun to kick down doors, beat up pimps and rescue girls but then what? Well thanks to the power of the Holy Spirit and many of the incredibly devoted people we’ve met it doesn’t end there. Tomorrow we finish our time here by going to AEC 1 and AEC 2. These are employment centers where they make the bracelets we’ve been wearing for the past year as well as screen printing tee shirts.

AIM's storefront down along the riverwalk in the tourist section of Phnom Penh

AIM’s storefront down along the riverwalk in the tourist section of Phnom Penh

Worth it if just for this one

No photos today due to <good> confidentiality policies at the school.

 

With us seeing so many patients on this trip, I had somewhat lost sense of what we were doing. Not in a bad depressing way. It’s just that sitting in that plastic chair for 16 hours while nearly 400 people come by almost turns into work. We’d get smiles when someone would try on their glasses and that kept us going for sure. But today was special to get to see, experience and share a bit more with a little guy whose life will never be the same again.

 

Today we screened over 300 students and staff at Rahab’s School. It was an interesting change of pace from the last 2 days. When we were seeing the community members, 95% of them needed glasses. With the students and staff it was more like 5%.

 

One little fella stands out. My PlusOptix photo screener (thanks for the loaner Cyd!) had trouble measuring him and he was one of the few who wouldn’t look where he was supposed to. Part of the reason we have been able to see so many patients is because they all so well behaved and follow instructions perfectly.

 

Any way back to the little guy. After the screener didn’t work, I pulled out my retinoscope. It’s a handheld light that eye doctors can use to determine a prescription in non-verbal patients or when we just want an objective measurement. That was also goofy so I put in a drop of Paremyd. That’s one of the mean dilating drops we use that makes you sensitive to sunlight for four hours.

 

We told his teacher we’d be back in half an hour and went to a different building. Becki got a call on her phone in essence saying “the little boy who the eye doctor put drops in his eyes is freaking out because he can’t see.” I looked at Becki and said, “I thought that might happen.” Poor little guy was in the main office looking bewildered. I pulled back out the retinoscope and measured +7.50 in both eyes. The drops had slowed down his focusing muscles so he was no longer able to accommodate/compensate for such a huge Rx.

 

We got him some glasses (thanks again to those who donate glasses; especially the less than hideous broken ones) and then went along for a home visit. This is where AIM staff/teachers….well….go to a student’s home. It’s hugely powerful to show the parents that someone cares. Mom pulled out some plastic stools for us and through an interpreter we gathered that this little guy had been crying when mom made him try to do his homework.

 

2 miracles here: 1. Mom cared about his schoolwork 2. The groundwork was laid for eyeglasses. Eyeglasses are very much looked down upon in Khmer culture. Not sure if they are seen as a weakness or if it is left over from the Khmer Rouge era where one of the targets was wearing eyeglasses. So we explained that he should wear his glasses all the time and they won’t make his eyes worse. I went ahead and checked mom and little brother but their eyes were great. We will set aside a few pair for his school file so when these go missing he won’t be in dire straits once again.

 

For anyone living in the States, eye care is available. If you can’t afford it, you can contact a local Lions club, or sit on the corner and panhandle funds to pay for it, or simply call every eye doctor in the phone book until someone takes pity on you. What’s hard to fathom is the idea that it simply is not available to these patients including the little guy we saw today. When I’m reading this post down the road, I’ll keep that in mind as I think of all the reasons I can’t come back.

 

Tomorrow: ARC. Agape Restoration Center. The first stop once you’ve been rescued.

Wednesday morning update

Yesterday I was plumb exhausted and went to write an update and came up with, “Sat in plastic chair for over 8 hours. Saw a lot of patients. Needed VietnameseàKhmeràEnglish translation often. The end.”

 

Today I took a few notes along the way.

 

Start of day: shot myself in face with bidet hose. Stacy: “uh. why are you laughing in there?” It has 10x the water pressure as the shower and it’s really difficult to tell if you are aiming in shower to test or directly at face.

 

Middle aged rude lady shows up and cuts in front of dozens of people in line. Helpers tell her to go to the back of the building to get registered. She’s back near the front in 5 minutes. Probably did this four or five times. When I actually saw her a few hours later, turns out she’s 5 diopters nearsighted (can’t see the big E o the chart). Tell ya what, I’d probably be pretty persistent too if this was my once chance to see.

 

We got to see the district chief as a patient. He’d be sort of akin to a mayor back in the states. He asked the pastor for a report to send to government officials when we are all done saying how many patients were seen and how many glasses and eye drops dispensed. So far he can tell them 383 in the past two days. It’s funny because then they’ll use that info to talk about the great things they are doing. Hey if it means AIM continues to spread the love of Jesus here in Svay Pak, then so be it.

View from rooftop of school

View from rooftop of school

 

I try really hard to leave my western thoughts and desires at home on these trips. To be more process focused than task focused. Not concentrating on numbers or getting a certain amount done. However, I’d have never guessed we could see so many people. And it doesn’t feel the least bit rushed to me, Stacy, the interpreter, the patient or anyone. It is, however, a bit daunting to hear the lead nurse here tell one of the pastors first thing in the morning “you have to stop signing people up at 200 for today.” Yeesh!

Waiting room at mid morning

Waiting room at mid morning

 

It was great this morning to have many of the community members see and hear the students singing songs and praying before the start of school. Just a few short years ago this building was a brothel in the worst part of one of the worst towns in the world for underage prostitution. Praise The Lord!

We'd be in trouble without it

We’d be in trouble without it

 

We’ve settled in to a good routine. Breakfast at 7 (I cook eggs and Stacy has a bagel), Chad (short term team coordinator for AIM) delivers Vietnamese iced coffee at 10, lunch with the staff at 12, Chad brews us coffee at 3 and then dinner at 6 upon return home.

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Stacy’s not resting, she’s fighting cankleitis. I think they’re kinda cute because she’s never been in danger of developing cankles before. Not sure what’s up but her legs swell pretty good during the day. This in addition to the dozen elevated, weeping, mosquito bites all over. And she never complains.

 

So far we have been seeing patients from the surrounding community. I would say 95% of them needed glasses. AIM does medical outreach as part of the ongoing mission to reach the entire community and not just a certain subset of the population (eg: those trafficked and those at high risk of being trafficked). I love the holistic approach. A community and generation are truly being changed. Today we start to work seeing the couple hundred students at the English school.

Not bipolar. Only bipolarish

Things that make me smile:

-Best I can tell my pancreas is still functioning. Blossom makes more than just cupcakes

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-I took a picture of monkeys yesterday because one of them jumped up and slapped the water bottle I was carrying. I’m stronger than a monkey! By the time we got back to the hotel I had forgotten about it. So many random awesome things in a day.

-We continually meet awesome people. Here’s our van driver Kadoe and his dad Sokenoe. Pops is a pastor in Siem Reap. He gave me a huge bear hug when we left and Kimberly said, “Wow. Have y’all met before? He sure seemed to like you guys.” Nope. Just met this morning. Hopefully we are truly being a blessing to those we encounter.

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-Eat your heart out ZICO fans. $1.50 for 2 from roadside stand.

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-I’ve spent the last week with the most beautiful woman in the world. Actually the last 14 years but the last week we’ve been pretty much joined at the hip. I wouldn’t recommend a trip like this to mend a broken marriage but it’s great for boosting an already terrific one. She never complains.

Luckiest guy ever!

Luckiest guy ever!

-My computer remembered the WiFi password at the Grace & Peace Gals’ home.

-We didn’t die

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Things that make me frown:

-Mosquitoes love her almost as much as I do. I won’t show the bite on her upper eyelid. Not everyone loves weird eye stuff like I do. Here’s hoping it wasn’t carrying malaria, dengue or any other fun southeast asia memento.

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-Out of the oven and into the greenhouse. Air conditioning that stops working 2 hours into a 6 hour trip makes me frown. Windows don’t open. They’re only there to let in solar radiation and then trap the ensuing heat. Thermometer outside says 95*

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-Hand sanitizer was in bag that went missing. Since it just got in last night, we didn’t have a chance to go through it before leaving early this morning.

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We’re doing great. Thanks for all the prayers! Tomorrow we start work at the school. You can see a link we just posted on our Facebook page which highlights the groundbreaking ceremony that just took place there. Apparently they rented tents to use during the day for folks waiting in line to see us. Yikes!