I have to admit that I've been pretty fortunate in these last three weeks. Literature reviews, clinical observation, minor editing and drafting of reports and such desk work leaves plenty of time for shenanigans such as facebook, random shopping trips and playing many rounds of cards with the clinic's IT guy's. Amidst all of that, I was stressing a bit over how I was running out of time and how national ethics approval hadn't been granted and I hadn't collected a single ounce of data for my own project. But lo and behold as the weeks wind down and I now only have about 2 weeks left, I'm suddenly moving at breakneck speed. Apparently, public health in Cambodia moves from 0 to 100 in a heartbeat. This, I have noted for future endeavors. Just as I was getting comfortable with my routine and beginning to come to terms with the fact that my project would not come to fruition, I get a call yesterday from my boss. I'm in the midst of getting dressed to attend a family dinner banquet and this is roughly the exchange that follows:
"Hi Susan? This is Dr V. Approval has been granted. Are you at the clinic right now?"
"No. I was there this morning but I'm not even in the city anymore. My family is having an event."
"Well, my boss is free this afternoon and wants to meet you at 3:30."
"Ummmm... what time is it now?"
"3."
"Errr....ummm... okay doctor, I'll .....meet you there....." ***click***PANIC***
When I begged my cousin to drive me and told him where it was, he informed me that it was roughly an 45 minute drive from where we were. JOY. So I hustled into the car, promising my cousin we'd be back in time for the banquet and that I'd owe him big time, and gathered my thoughts for my impromptu presentation with my boss's boss. Just to clarify, translating a proposal into Khmer is not easy for me, but I had 45 mins to pull it together. Regardless, I was terrified. Let me provide you with a bit of context. When my boss walks into the clinic, the staff bends over backwards to accommodate him. When he walked into the dinner party the clinic had a few weeks ago, everyone stood up at once and formally greeted him like some dignitary walked into the room. And now, I was going to meet HIS boss. Eep. Needless to say, I was ready to pass out.
It went by in a blur with my cousin sitting and smiling politely next to me, providing emotional support and ready to revive me should I actually lose consciousness. Somehow, I managed to get the guy really excited about it and he quickly decided that we were not going to do 3-4 sites in the capital but rather 9-10 sites and we'd include 2 additional provinces all in a week and a half. He promptly told my boss that he needed to select the sites by tomorrow so that he can write up a formal letter head to send to the sites before the Cambodian new year and that data collection would start immediately after the holiday. Gahhh. First I had no data and now I don't have enough time to collect it all. Don't get me wrong. I'm in no way complaining but now it's crunch time and I have a team of one. Me. Plus one of the IT guys who I duped into helping me by offering to do his literature review for him. He still thinks that we're only doing 3 local sites though. I should probably fill him in...
And so the craziness ensues... *fastens seat belt*
Monday, April 11, 2011
Thursday, March 31, 2011
...I gained some perspective.
What would you do if you hadn’t been paid for the last 3 months at your job? What about 5 months? I imagine that there would be extensive similarities between everyone’s responses, likely wavering somewhere between outrage and taking to the streets in a one-man riot. Not here. Since the very first day I arrived, I’ve seen the staff work diligently to care for the patients that fill the waiting area throughout the hours of the day. Granted, I was a little thrown by the fact that lunch lasts roughly two hours here but quickly learned that this was just a cultural norm that varied little from one workplace to another. In any case, the moment I learned that these amazing people continue to come to work day-in and day-out without having been paid for months makes me feel immensely selfish for complaining about my own project’s slow progress.
It’s ironic that just a few days ago I was fighting tears and feeling pretty near defeated in the prospects of getting anything more than my 120 hrs of “experience,” essentially tossing my project and paper out of a metaphorical window. But tonight I spent the evening with thirty special people that have helped to shed a new perspective on all of this. Yes, I came out here thinking I was going to “do public health stuff.” Tonight I realized more than ever that this is a soul-searching trip. One that hopefully ends with me coming to grips with the lessons the universe throws in my face and ultimately figuring out where in this giant mess I really belong.
Wednesday, March 23, 2011
...it was my third day of clinic.
Today marked day three of clinic time here in Phnom Penh. This isn't exactly what I had intended to be doing at this very moment but is exciting nonetheless.
Rewind to last saturday when I had my first meeting with my site preceptor, the head of the research branch of NCHADS (National Center for HIV/AIDS, Dermatology and STDs) and the director of the NIPH (National Institute of Public Health). I walked into the room with my cousin dressed in some slacks, a ribbed tank and a short sleeved work-style jacket thrown on top. Mind you, it's approaching April in Cambodia so it's a nice sticky 90 degrees outside. So naturally, I was dressed in my business-casual attire but was sweating like a pig as I greeted him and sat down. By the end of the meeting I was told that approval by the National Ethics Committee would take almost another 3 weeks before they actually reconvened to review my study protocol and that fieldwork and data collection will have to be put off until almost after the New Year. Joy. Tossed from one ethics committee battle to another. Lucky for me he offered to fill my hours with a pseudo-TA position at a few seminars on thesis writing, research and proposal drafting for their MPH students. Also there's an HIV clinic attached to the school where I'd be able to get in some good observation and clinical time with the head doc. Not what I had hoped since I'm scheduled to present my project and a 30-some page paper the first week of may and I hadn't had a single lick of relevant data, but in any case I can't complain when handed valuable clinic time.
Patients at the clinic are amazingly diverse in socio-economic status, age, and gender, demonstrating the state of HIV in the country. So far, I've come across every case that I've always read about prior to this. Pregnant women, migrant workers, women who contracted them from their husbands, women with young babies who are awaiting their child's test results, the typical cases we hear of in our MPH classes. HIV patients aren't exactly new to me since there were plenty that I met at my old job in DC but observing things patients in a cultural context that's so very near and dear to me is a very different experience. It's hard to describe. Stigma runs so deep here that it's hard not to cringe when the physician's etiquette changes depending on the type of patient or the case he/she meets. It's especially hard when there is a patient who is obviously sick and has a CD4 count of just 100 but doesn't quite understand that its not okay to forget to take his medication or to forget about his follow up appointments, or simply doesn't have the means of transportation to make it to his appointments.
I'm working with the records and database folks this afternoon so it will be a nice break from clinic. Pictures will follow next week when I remember to bring my camera cord from Veal Sbov. I know a blog gets boring with just words. :)
Rewind to last saturday when I had my first meeting with my site preceptor, the head of the research branch of NCHADS (National Center for HIV/AIDS, Dermatology and STDs) and the director of the NIPH (National Institute of Public Health). I walked into the room with my cousin dressed in some slacks, a ribbed tank and a short sleeved work-style jacket thrown on top. Mind you, it's approaching April in Cambodia so it's a nice sticky 90 degrees outside. So naturally, I was dressed in my business-casual attire but was sweating like a pig as I greeted him and sat down. By the end of the meeting I was told that approval by the National Ethics Committee would take almost another 3 weeks before they actually reconvened to review my study protocol and that fieldwork and data collection will have to be put off until almost after the New Year. Joy. Tossed from one ethics committee battle to another. Lucky for me he offered to fill my hours with a pseudo-TA position at a few seminars on thesis writing, research and proposal drafting for their MPH students. Also there's an HIV clinic attached to the school where I'd be able to get in some good observation and clinical time with the head doc. Not what I had hoped since I'm scheduled to present my project and a 30-some page paper the first week of may and I hadn't had a single lick of relevant data, but in any case I can't complain when handed valuable clinic time.
Patients at the clinic are amazingly diverse in socio-economic status, age, and gender, demonstrating the state of HIV in the country. So far, I've come across every case that I've always read about prior to this. Pregnant women, migrant workers, women who contracted them from their husbands, women with young babies who are awaiting their child's test results, the typical cases we hear of in our MPH classes. HIV patients aren't exactly new to me since there were plenty that I met at my old job in DC but observing things patients in a cultural context that's so very near and dear to me is a very different experience. It's hard to describe. Stigma runs so deep here that it's hard not to cringe when the physician's etiquette changes depending on the type of patient or the case he/she meets. It's especially hard when there is a patient who is obviously sick and has a CD4 count of just 100 but doesn't quite understand that its not okay to forget to take his medication or to forget about his follow up appointments, or simply doesn't have the means of transportation to make it to his appointments.
I'm working with the records and database folks this afternoon so it will be a nice break from clinic. Pictures will follow next week when I remember to bring my camera cord from Veal Sbov. I know a blog gets boring with just words. :)
...I remembered why I came.
(Much delayed post due to lack of internet. Original composition 03/15/11)
I had woken up that morning with a raging sinus infection and thought to myself how wonderful the 17-hour plane ride was going to be with that added bonus. The remainder of the day flew by and with each passing hour I began to realize that I was getting ever closer to getting on an airplane and flying to fulfill some self-imagined delusion of grandeur where I would bring with me the countless hours of reading, research and lecture to help “fix” the problem of HIV in Cambodia.
My family had gotten together for dinner that evening and amidst all the packing, unpacking, repacking, kisses and well-wishes, I was beginning to ask myself if I was really cut out for this. Now don’t get me wrong. I knew I was going to have it made. It was only going to be six short weeks, I would be staying with my grandma who lives in my parents’ four bedroom house with western toilets and running water in a country that I had visited five times prior. Compared to most, I was going to be living it up. It wasn’t the trip itself that was rattling my nerves, but rather the reason I was going. I know Cambodia, the country and the culture, very well, despite being raised in America. There is such a complex social hierarchy that exists there it’s impossible to explain. This, I knew, would stand like a giant pink elephant in the corner of the room and will ultimately make data collection a very difficult animal to tame. I have lost countless hours of sleep obsessing over how I was going to conduct myself, how I would speak to or approach certain people. Yes, I’ll be the American, but I’ll look just like them (except plus an additional 4-5 kg), making the situation a little more complicated.
Fast forward almost two full days, (Or was it one? The time difference has thrown me WAY off.) and I’m sitting here on my laptop drinking this extraordinary cup of coffee pressed out of beans that were grown in rural northeastern Rathanakiri and my nervousness has dropped to near undetectable levels. Why? Because after all those hours of traveling, obsessing, and planning, when I looked out the window of the descending plane and saw the fields, and the giant winding river, I felt a familiar tug. When I looked out the passenger window of my uncle’s pickup and saw the stream of mopeds and caught the eyes of the little boys playing tag in front of their parents shop (the youngest wearing a t-shirt and flip flops but no pants), I remembered how much I loved this place. I came here because even though I’m “akang,” part of me calls this place my country and those faces are the faces of my people.
Subscribe to:
Posts (Atom)