A Cambodian Expedition Journal – Phnom Penh, 2014

October 2015 | Patient Stories, Stories from the field

By Jadeanne Shaver

SEE Volunteer

Expedition Site: Phnom Penh, Cambodia

November 28 – December 6, 2014

“It opened my eyes, you could say…” Meet Jaedeanne Shaver, an Alcon employee from Fort Woth, Texas, who traveled to Phnom Penh, Cambodia to participate on a SEE expedition. Remember SEE Doc Kevin Winkle, M.D. from Anchorage, Alaska who gave a SEE Webinar last April? Well, he was back at the Children’s Surgical Centre again, restoring the sight of children from all over Cambodia.

For photos, half marathons, laughs, and maybe a few tears, read Jaedeanne’s experience as she aids in life-changing surgeries in Cambodia.

“It opened my eyes, you could say…” Meet Jaedeanne Shaver, an Alcon employee from Fort Woth, Texas, who traveled to Phnom Penh, Cambodia to participate on a SEE expedition. Remember SEE Doc Kevin Winkle, M.D. from Anchorage, Alaska who gave a SEE Webinar last April? Well, he was back at the Children’s Surgical Centre again, restoring the sight of children from all over Cambodia.

For photos, half marathons, laughs, and maybe a few tears, read Jaedeanne’s experience as she aids in life-changing surgeries in Cambodia.

Friday, November 28

American Airlines Flight – Dallas-Fort Worth to San Francisco

I have a few quirks when it comes to traveling….  One of which is I absolutely can NOT pack until the very last minute.  I’ve tried being proactive and packing days, even a full week in advance of a trip and I inevitably forget critical items.  For whatever reason, if I wait until the last minute, I pack like a pro.  So, on Friday morning with my post-Thanksgiving tryptophan hangover, I began to pack my bags for two weeks in Cambodia and Thailand.  And true to form, I packed like a champ.

My daughter and my boyfriend took me to the airport, where they looked on with skepticism as I checked into my flight.  “Yes, I’m flying to Phnom Penh.  Yes, I will be on three different airlines.  Are you absolutely certain my bags are checked all the way through?  Oh, there was a gate change?  And a terminal change?”  No problem.  I’m an expert traveler, and a professional packer, so this will all work out swimmingly, I kept telling myself.  Because in all honesty, I was about to embark on a journey to the other side of the world by myself and I was crossing my fingers that this would all go well and was maybe just a tad bit nervous…..  It starts to sink in that two weeks is a long time to be gone, just in time for the tearful goodbyes.

Flight was delayed, and then delayed again.  No problem for an expert traveler such as myself.  I got a little nap on the otherwise uneventful flight to San Francisco.  We landed and I leisurely strolled off of the plane and encountered a gate agent with a very assertive look on her face.  “Ms. Shaver?  Please proceed as quickly as possible to the international terminal.”  It turns out that due to the delay in the flight, I was now dangerously close to missing my connection to Taipei, Taiwan.

Down the concourse, onto the tram, into the international terminal, to security, back to the EVA Airlines desk, back to security, down the international concourse, and straight on to the plane.  Like a pro.  (Phew!)

Saturday, November 29

EVA Airways Flight – San Francisco to Taipei, Taiwan

This is one of those really big airplanes.  You know, the ones where you walk through each seating class in reverse order.  The fancy seats with the reclining chairs that turn into full-sized beds and big-screen TVs and down comforters and champagne….to the business class with the leather seats and the legroom, and finally back to the economy seats – the plane is 10 seats wide in this section and for some reason smells like farm animals.  We will be “cozy” for the next 13 hours.  I’m sitting next to a Taiwanese gentleman who has an affinity for hand sanitizer.  I’m not kidding, he put hand sanitizer on approximately every 30-seconds.  I began to wonder if he knew something I didn’t …

Thirteen hours is a really long time to sit in a seat.  I read an entire book.  I got a full night’s sleep.  And I watched four “new release movies” with Chinese subtitles.  The entire flight was in the dark.  When we landed in Taipei, I have never been more grateful to see a sunrise in my life or to escape the scent of hand sanitizer.

Each gate in the Taipei airport has a different theme.  Gate 4 was all about Hello Kitty.  Gate 9 had a tropical theme complete with live foliage and a sandy beach.  Gate 6 was a functional library.  One of my college friends lives in Taipei and she said that they will apply a “theme” to anything and everything in the country, whether or not a theme is actually appropriate.  I think it’s adorable.

The good news is that so far, Asia is very American-friendly.  Yes, I realize that my experience up to this point is confined to the international terminal of an airport, but I’m quite pleased that I am able to communicate effectively as well as to pay for my bottle of water with a credit card.  This built up my confidence and helped to reinforce my belief in my travel expertise.

Sunday, November 30

EVA Airways Flight – Taipei to Phnom Penh, Cambodia

This was legitimately the longest 3 ½ hours of my life.  The last place that I wanted to be was in another airplane seat.  I was eager to get to Phnom Penh and begin my exciting mission trip – enhancing sight and enhancing lives!

When we were landing, I took a few photos out of the window.  I thought it was quaint how colorful the roofs were in the city.  As we got closer and closer, I got more and more excited.  Now is when the adventure really starts!

We were herded off the plane and into the customs area.  Cambodian officials were shouting instructions in Khmer at the travelers.  Thankfully I had pre-filled the litany of forms required for customs because it was impossible to locate extra forms, pens, or an individual who spoke conversational English.  Cambodia takes entrance into their fine country very seriously.  After applying for my Visa and paying my $30USD in cash, the angry Cambodian officials ushered me through the declaration line and on to the baggage claim area.  Thankfully, my bags had made the journey as well.  I walked out of the airport and into the sauna that is the climate of Cambodia.

A lovely young man from the Chenda Polyclinic was holding a sign with my name.  I grinned at him and began to introduce myself and tell him about my trip thus far as we walked to the clinic van.  I thought “Wow, Cambodians are really great listeners!” as he grinned back and nodded his head throughout my conversation.  It turns out that he didn’t speak English at all….

We exit the airport parking lot and turn on to one of the main streets in Phnom Penh.  At this point I’m relatively sleep deprived, sweating in the tropical climate, and in complete culture shock.  Moto’s are zipping all around us, everyone has a complete disregard for lane markings, stop lights don’t exist at all, and I’m quite certain that we are going to die before I get to the hotel.  My van driver must have noticed the slight look of panic on my face and in his graciousness, turned on an American radio station in order to make me feel comfortable.  The experience was surreal as we were careening through the crowded streets of the third-world city of Phnom Penh to a soundtrack of Kenny Chesney and One Direction songs.

Miracle of all miracles, we arrive at the hotel without killing any other motorists or getting killed ourselves.  I get checked in to my room, which is an absolute sanctuary in the midst of the chaos of the city.  Despite being exhausted and in desperate need of a shower, I toss my expertly-packed luggage into my room and set off from the hotel towards the Central Market of Phnom Penh.  This market is less than a mile-long walk from my hotel, and for some reason I think it is a great idea to set off on my own.  (Side note:  when in a third-world non-English-speaking country for the first time, take a few hours to acclimate yourself before venturing off unattended.)

Within a few blocks, I’m second-guessing my decision not to utilize some sort of organized transportation.  I’m dodging moto’s, running from barking dogs, laughing at naked children playing in the streets, marveling at the monkey running along the power lines, and gripping my purse a little tighter as I walk past groups of tough-looking men.

When I arrive at Central Market, I am immediately taken back by the smells.  This will be a reoccurring theme throughout the trip – there were so many moments defined by smells.  Central Market smells like a combination of rotting seafood, the most fragrant tropical fruit, burning leaves, and expired perfume.  I shop for souvenirs and get entirely too proud of myself for the manicure I get for $1.  As I am leaving, I gladly hire a tuktuk to drive me the mile back to my hotel and smile graciously at him – my very first tuktuk ride!

Monday, December 1

Children’s Surgical Centre

Today is the first day at the clinic!  I wake up after a great night of sleep with butterflies in my stomach.  Will I be able to get to the clinic without dying in the chaotic traffic?  Will they like me?  Will I be useful?

The clinic’s website has directions written in Khmer, which I take a screen-shot of on my phone.  This will be incredibly useful throughout the week as most of the tuktuk drivers neither speak nor read English.

I arrive at the clinic safely (and only slightly traumatized by the experience) and get a big smile on my face as soon as I see the clinic.

The Children’s Surgical Centre is located off of a main road – you turn off into somewhat of a drive/alley that is lined with huts and street vendors.  There are a few other clinics in the complex, and there is a central park where children are playing, parents are sleeping, and vendors are selling balloons and toys.  The clinic’s waiting room is on the first floor and is open-air.  I walk up the stairs to the third floor administration office where I introduce myself to Harrison and the other staff members.

Harrison shows me where to change into my scrubs and then he gives me the full tour of the clinic.  Side note – scrub pants in Cambodia tend to be made for people who are a standard Cambodian height….. I looked like I was waiting for a flood most of the week!

After the completion of the tour, Harrison introduces me to Dr. Heidi who I end up shadowing for the majority of the day.  Dr. Heidi is from Minnesota and has been over in Cambodia since this summer.  We click right away and I’m so impressed with her knowledge, her confidence speaking Khmer, and her patience with my many questions.

I get to scrub in for a surgery that she is doing for a tumor removal, and in the Operating Room, I meet Dr. Kevin Winkle for the first time.  Even though he has his surgical mask on, you can tell that he has the biggest, most genuine smile.  As I begin to acclimate myself to the environment in the operating room, I notice that most of the surgeons are barefoot.  There are also four other surgeries occurring at the same time in the one room.  Surgeons are walking back and forth between patients – offering advice and chatting with the couple of anesthesiologists.

The staff cafeteria is in a back alley – there are tables set up on a patio with plastic chairs surrounding them.  Cats and kittens purr and rub up against the nurses’ and doctors’ legs.  A window leads into a kitchen where three women cook and set food on the ledge near the window.  The staff grab whatever they want to eat. Most days it was some kind of brothy soup, Pung Mouan Snol (which is an omelet filled with ground pork, green onions, chili peppers, and preserved cabbage), and smoked fish with the head still on. The Pung Mouan Snol ended up being one of my favorite dishes when paired with white rice (which is what literally everything is served with).  Once we were done eating, we each left $2-3 on the window sill and they handed us a Coca Cola.

After lunch, the doctors and nurses gather in the main exam room.  Dr. Heidi uses this time each day to present interesting cases to the staff and to utilize them as teaching opportunities.  She sometimes has to ask her questions repeatedly because of the language barrier, but you can see the doctors’ eyes light up when they make the connection.  And wow….they see some interesting cases at the Centre….

Teams of surgeons visit Children’s Surgical Centre (CSC) throughout the year.  The week that I was there, a team of surgeons from France were also visiting and performing ear, nose and throat surgeries.  Often, CSC will send representatives out to the rural villages in Cambodia looking for specific cases to come in to the clinic depending on the upcoming surgeons.  I’ve heard that telling these families to come into the city is comparable to telling them to go to the moon – they’ve never even seen a city, let alone thought they would ever visit one.  We saw many congenital glaucoma, strabismus, amblyopia, and pediatric cataract cases during our week there.

When the families come to CSC to see the doctors, they sometimes stay at the clinic for over a week at a time.  If they are lucky and there is space available in the wards, sometimes they can get a cot to sleep on.  We saw many families sleeping on benches or even the floor.  It was humbling to see the personal sacrifices they would make for an opportunity for an improvement in their health or eyesight.  I hope I can remember these families the next time I’m waiting in a physician’s waiting room and grumbling about my appointment being 15 minutes late….

Tuesday, December 2

Chenda Polyclinic & Children’s Surgical Centre

My morning begins at the Chenda Polyclinic in Phnom Penh.  Dr. Jim also owns this clinic – many of the same doctors and nurses work at this clinic as well as CSC.  CSC does not charge for any services, while the Chenda Polyclinic is considered a “private” clinic and the patients pay a nominal amount.  The facility is a bit nicer and there is more privacy, which some patients feel is a benefit that they would choose to pay for.  Dr. Kevin is performing a strabismus repair on a child that he operated on the last time he was in Cambodia.  The surgery goes well and we head over to CSC in one of the clinic’s vehicles.

I spend the rest of the morning working with the CSC’s inventory team – logging in the over 150 pairs of reading glasses that my wonderful friends donated to the clinic.  We separate them by power, count them all, and record them in the inventory log.

After lunch, I ask if a monk will take a picture with me.  He agrees, but asks in Khmer that our shoulders do not touch, as it is forbidden for the monks to touch women.  I oblige, and get a chuckle later when I look at the photo and realize that he is standing under a sign which says “Om”.

We see a beautiful little girl with buphthalmos, which is a type of congenital glaucoma characterized by the presence of “doe eyes”.  I think she is stunningly beautiful.  Dr. Kevin tells me that if we don’t operate, she will likely be blind in 6 weeks.  What a blessing that her family has brought her to CSC the week that we are here.

After a full afternoon of surgeries, we venture out into the city.  Dr. Heidi hands me a helmet and tells me to hop on the back of her moto.  I pray that I’m not killed in traffic….  We go to Seeing Hands Massage – which is a massage company that employs only blind massage therapists.  It’s quite a unique experience – much different than a typical American spa treatment. We are asked to change into a uniform, which is essentially a pair of scrubs, and then we go to our assigned massage tables – there are 5 in our large room.  $7 USD gets me the most relaxing traditional Khmer massage – the perfect way to end the day.  I feel as though it is such a worthwhile organization to support and fits right in with the theme of this Medical Mission trip.

Remember how I said that Dr. Heidi was really great at speaking Khmer?  Well, she realized that the entire time when she was speaking to patients telling them to “look” at something during the slit lamp exam (look at the wall, look at my shoulder, look here, etc.), she was omitting the last letter of the word.  This little subtle letter was actually quite important.  She was actually calling them an idiot…..  Hahaha!  I’m sure they were thinking “What is this crazy American doing?  She keeps pointing at the wall yelling Idiot!”

Wednesday, December 3

Children’s Surgical Centre

We begin the morning bright and early at CSC.  I’ve made friends with a few of the kiddos in the pediatric eye ward – every time they see me, they run out of the ward and hang on my leg and giggle while I try to walk around.  It completely fills my heart to see these little ones smile and laugh, but makes me miss my sweet daughter who is on the other side of the world.  I wonder what she would think if I were ever able to bring her to Cambodia on a return trip. I add this to my bucket list.

I spend the morning viewing the post-op follow-up visits, popping into a few surgeries to observe, and working on a training presentation that I have been asked to deliver.  The staff at CSC does their very best with the limited resources they have to keep things sterile and prevent contamination.  An opportunity for improvement had been identified from the last team of surgeons that they could benefit from a greater level of focus on personal hygiene.

I put together a PowerPoint presentation with information from the World Health Organization about proper hand-washing techniques, the importance of the use of hand sanitizer or latex gloves between patient examinations, and how contamination can be spread.  During the presentation, I deliver the material on the slide and then one of the nurses translates everything into Khmer.  It seems to be well received, and they all pass around a bottle of hand sanitizer and laugh.  I can’t help but think of my seatmate on the flight from San Francisco to Taipei – I’m sure he would have loved this class.  Afterward, I have a few people come up to me with questions and requests for more information.  My first training session in Cambodia is a success!

We fill the remainder of the afternoon with more surgeries.  At one point, they are performing 4 cataract surgeries at the same time in one of the operating rooms.  It’s really unique to see the dynamic in the room – and I’m surprised by my new-found level of comfort with barefoot surgeons and nurses in flip flops.  Each patient has a box of Acrysoft lenses resting on their surgical trays, ready to be implanted.

That evening, Dr. Jim and his wife Kanya chartered a boat for our team as well as the French surgical team to go out on the Tonle Sap River.  We have a wonderful catered meal of traditional Khmer food and get to see the city from a new perspective.  It is beautiful and we have a really fantastic time sharing stories, laughing, and getting to know each other and our cultural differences.  We all get a good chuckle when we realize that everyone on the boat is speaking English, but with drastically different accents. We have the following locations represented: England, France, Australia, Thailand, Cambodia, Vietnam, and the United States (and you could really divide that into Texas, Alaska, and Minnesota).

Thursday, December 4

Children’s Surgical Centre

On my way to the clinic this morning via tuktuk, there is a traffic jam.  It turns out the police have shut down the main road to allow a wedding procession to come through.  We pass a long line of wedding guests, mostly dressed in neon pink (must have been their colors) holding baskets of fruit and other gifts.  I find it unusual that they are having their wedding reception at 7:15am on a Thursday morning…. I later learn that when a couple is planning their wedding, they visit a monk who decides their wedding date and time for them, based on their lucky numbers.

Dr. Kevin has a high-profile surgery this morning – one of the Cambodian Admirals has Ptosis and will be having blepharoplasty to tighten the levator muscles.  Cambodians are, for the most part, very stoic people and he is no exception.  He undergoes his surgery with little anesthesia and bows a heartfelt thank-you to Dr. Kevin when he is leaving the operating room.

I’ve noticed a cute little girl periodically running around the clinic for the past couple of days, but it doesn’t look like she’s here for any type of surgery. She likes for the Americans to pick her up and she always tries to steal something out of our pockets. I ask one of the nurses about her. I learn that she lives near the clinic and runs away from her house every afternoon to try to pickpocket from the foreign doctors and visitors. Such a little stinker!  I make a mental note to keep my eye on her.

Today is supposed to be the last day of surgeries.  Dr. Kevin likes to wrap them up on Thursday, so he can have a follow-up visit with the patients on Friday before leaving to come back to America.  Late on Thursday afternoon, a mother brings in her infant who has congenital glaucoma.  Dr. Kevin shakes his head and says “When a mom brings in a baby with this, you change your plans.”  We will be doing surgery first thing on Friday morning.

After I leave the clinic, I take a tuktuk to the Royal Palace in Phnom Penh.  It is such a unique experience to see the beautiful and ornate architecture and learn about the history of the country.  It’s really my first opportunity to be a “tourist,” which I take full advantage of.  I take a zillion pictures and plenty of selfies.  I fit right in.

Friday, December 5

Children’s Surgical Centre

It’s a little surreal sitting in my tuktuk knowing this is my last time to make the commute to CSC.  This clinic has been my home over the past week.  The people have welcomed me with open arms. They have introduced me to their culture, and allowed me to help them in any small way that I could. I played with and hugged the sweetest children, witnessed some incredible surgeries, had my heart completely broken, and had my heart completely filled back up again.

As Dr. Kevin is prepping for the congenital glaucoma case, a mother walks in carrying an infant which is covered by a blanket.  She bows a preliminary thanks to Dr. Kevin and removes the blanket from the baby. This sweet little girl is possibly one of the most dramatic cases of orofacial clefts that I have ever seen.  It is shocking to look on the face of this baby who is trying to smile and interact with her mommy. It’s one of those moments that you just can’t prepare yourself for. My eyes immediately filled with tears as I smiled at the mother. What a strong, dedicated woman.  The baby doesn’t have eyelids either.  You can tell that the eyes are there, but they are covered with a tough callous.

Dr. Kevin explains that there isn’t anything that can be done to salvage the eyesight at this point.  The French team of surgeons will be taking on her orofacial repair next week. But there is nothing we can do. I didn’t realize how many tears I had shed until I looked down at my scrub top and saw the droplets.  As the doctors continued to consult about the baby, I sat behind them and prayed.

Dr. Kevin performs the last surgery for the week on the congenital glaucoma case.  They have set up a microscope with video capability, so they can teach other surgeons. Watching Dr. Kevin’s microsurgery from this perspective is so cool – he has the steadiest hands of anyone I’ve ever seen.  I think he’s found the right job fit.  The family waits eagerly outside the operating room. When they deliver the baby into their arms, they bow a simple and grateful thanks.

I would be remiss to leave this country without trying a bit more local cuisine. Some of my favorite meals were from street vendors, where they told me, “If you like the way it tastes, maybe just don’t ask what you’re eating”. I ate porridge and noodle soup for breakfast each day. I even adventured out of my comfort zone by trying fried crickets (they tasted like peanuts and actually weren’t that bad)!

That afternoon, most of the CSC physicians are presenting papers at a local conference, so we are on our own.  I hop in a tuktuk with one of Dr. Heidi’s friends and we go out to the Killing Fields.  It is a sobering way to end the week here in Phnom Penh.  I have such a newfound appreciation for the Cambodian people. They are some of the most kind and gentle, yet stoic and strong people that I’ve ever seen.  I completely fell in love with their sweet children.

I will be forever thankful for the opportunity that Alcon gave me through SEE International and Children’s Surgical Centre.  This trip has changed me as a person.  It’s funny that I became more familiar with the ophthalmic industry in a third world country on the other side of the world, than I have sitting in the middle of the world leader in eye care. It opened my eyes, you could say…. What the Children’s Surgical Centre is doing for the people of Cambodia is so encouraging and heartwarming. It restores your faith in humanity. Alcon’s generous support of organizations like SEE International enable these life-changing surgeries to take place. It enhances sight and enhances lives.  Good people are doing good work there. In summary, I can’t wait to go back…

Saturday, December 6

Children’s Surgical Centre

I pack my suitcase after breakfast and head to the airport.  I have added on a few days to my trip to go to Angkor Wat in Siem Reap. I will also go to the Thailand island of Koh Samui! My colleagues at CSC found out that I had recently completed a Half Ironman. They asked if I was planning on running the Angkor Wat Half Marathon while I was there. Well, I didn’t even know about the event. But the stars aligned and I was able to run in this absolutely amazing half marathon!

I fill my next few days with good meals, sightseeing, more selfies, and beachside massages for $5.  As wonderful and relaxing as those days are, I am still so eager to get back home to my family. I can’t wait to tell them about my time on the other side of the world.

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