Sunday, 28 August 2011

Cambodia the Country of Wonders

The waterfall at Kbal Spean
Hello again dear blogging buddies " Cambodia the country of wonders" is a common slogan used here to promote the up and coming tourist industry it has come alive for me on many occasions over the past year as recorded in previous blogs but my latest travels to Cambodia's spiritual and cultural  heart really did reveal "wonders" on the grandest of scales
Siem Reap is described in the guide books as 'a charming town with its many colonial style buildings tree lined streets and winding river' it is now growing and thriving on the increasing numbers of tourists on their way to see the Temples of Angkor.
When the French explorers rediscovered Angkor Watt it was not much more than a village
The wonderful Banteay Srei temple

The main Temples of Angkor are about 6 kms from the town centre. Chris and I stayed at our favourite hotel Terrace Des Elephants the friendliest and quirkiest hotel I have ever stayed in it was my third stay there and now I would not consider staying any where else including the legendary Raffles and many other 5* hotels springing up in Siem Reap
On our first day we got up at 4 am (yes I know I am mad) for a 5 am departure by tuck tuck to see the sun rise over Angkor Wat this was an act of faith in itself as its the rainy season so no guarantees that we would see the sun at all and it was looking doubtful as we passed through the dark tree lined streets through a light drizzle. We were joined by several other hundreds of mad people but the complex is so vast that we felt as if we were there alone and dame fortune did smile upon us as day break approached the clouds cleared and we did indeed see the sun rise over Angkor Wat .
The history of Angkor Wat starts around the 9th century Khmer religious beliefs, art and architecture all stemmed from India who introduced both Hinduism and Buddhism to the country which had a profound effect on the culture.The indigenous Khmer's though did not entirely abandon their beliefs in their heroes/guardian spirits good spirits and evil spirits who roam the land bringing sickness and death.
'Spirit houses' are in evidence outside most homes and buildings to this day complete with offerings.
We had a great guide who took us all over the temple complex including Angkor Thom entering along the impressive causeway through the south gate -Bayon where I saw the carving of a woman giving birth which is the emblem of CMC -then on to the Terrace of the Leper King  -Elephant Terrace - Bayon - Ta Prohm where the trees and temple ruins have become as one then back to Angkor Wat
The following day was even better we travelled about 30kms in our tuck tuck through small villages past vivid green paddy fields and other crops its so interesting traveling in Cambodia especially by tuck tuck as you get the chance to see how people live their homes how they cook and spend their time as just every thing goes on outside.
As we neared the Kulen mountains the heavens opened up and the rain just poured but undeterred we donned our rain capes and set off on a 1050 m climb/walk over rocks and tree roots crossing precarious bridges and other obstacles to reach our destination of Kbal Spean.
Our goal being the 9 th century river bed carvings along a tributary of the Stung Kbal Spean which eventually finds its way into the Tonle sap river. These ancient carvings are just above a very attractive waterfall which for those brave enough to try it was accessible me and my pal took the view that we were wet enough as it was so declined the offer of our guide to sample the healing waters
We were however bowled over by the sight of these ancient stone carvings which included many lingus arranged in rows images of gods and animals as clear as the day they were carved.
The most impressive for me though was the 4 faced god of Brahma on a lotus North of the natural bridge.
A stunning place well worth the climb.
After a very good lunch our guide took us to my all time favourite temple Banteay Srei ( means woman's fortress ) It was so intricate made from sandstone and being beautifully restored I just loved this place it had much more of a spiritual feel to it than some of the larger temples 
Two young monks entering Angkor Wat temple

Angkor Wat one of the 4 basins of the cruciform cloister
Almost at the top of Kbal spean

Not the sun rise and a pity about the scaffolding but this is me in front of Angkor Wat temple

Reclining Vishnu in the stream just N of natural bridge ( note sun just come out )

Monday, 22 August 2011

Making History and other tales from Cambodia

Some of the Phnom Penh Provincial Council midwives being sworn in at the Council's official opening of its 22nd provincial office
Well dear blogger there is much to do here in Cambodia and not enough time to do it as reported in my last missive  my work at the Council is going well I have just completed an outline proposal for them in order to secure more resources to accelerate their progress towards achieving the regulation of Midwives in Cambodia. This is hugely important as the evidence shows that in countries where there are robust systems in place for regulating the profession then maternal and newborn mortality and morbidity rates improve.
There is not a week goes by now that there is not a horror story in the newspapers here of women dyeing for the want of skilled/ birth attendance and increasingly the public are going to the press with their concerns (note not the authorities!) about the behaviour or competence of midwives which on the one hand is terrible but on the other it is good  for pushing forward the case for registration and regulation.
Last week I had the pleasure of attending the launch of the Provincial Council for Phnom Penh so far the Council has opened 22 offices one in every province where all midwives will be expected to register it was held in PP's Municipal referral hospital I was told about it 10 minutes before it was due to start but as it was only around the corner from the office I got there on time.
Cambodians certainly know how to put on an occasion the hospital director was there ( a very stylish lady) and her deputy plus 45 invited guests from the district ie hospitals and health centres.
The event kicked off with the national anthem and then introductions I was asked to stand and got a round of applause!! my only regret was that as I didn't know in advance I didn't look particularly smart and would have liked to have taken the opportunity to wear my new sampot ( Cambodian Skirt) after introductions Ing Rada read out the Royal Decree which set up the Council and outlined its role and function after which the nominated midwives for the provincial Council were sworn in. Below are pictures of the event.
In the centre is Ms Ing Rada President of CMC on her right the hospital Director a Dr and on her left the deputy Director also a Dr.

  The Council has two further provincial offices to open and one regional office but has not the budget in this financial year so further delays CMC's progress in achieving full registration of all midwives even further so it seems more important than ever that our proposal to international donors is successful we are planning to meet with them in the near future.
These fantastic midwives had no idea that they were making history by pioneering regulation of midwives for Cambodia it was great to be a part of it
All efforts now are going into preparing the Councils executive team in presenting their case at the donor meeting  I want the international donors to see how committed these midwives are and that given more resources they will make a big difference although this will not be easy as money is tight.
Wish us luck!!!!
I have been busy on other work fronts too the informal health and related professionals network meetings are going well and gaining new members all the time we are now at 31 and I can see people making connections and we friendships are blossoming which is so important here we have had some very interesting  presentations and discussions so I hope that it will continue when I leave.
Also just written an article for Health Messenger which is a health magazine aimed at nurses and midwives at health centre level so a wide readership. It is unique in Cambodia and is produced in English and Khmer.
My article was about the attributes of a good midwife which of course included the clinical skills and competencies required but  also I tried to emphasise the personal/behavioural qualities including care, compassion and advocacy vital  components in my view and much in need of here.
I used as a case study one of the student midwives I have met at the valuing life clinic here in PP Theary is a second year student at University and is just the sort of role model for the future midwife Cambodia needs she is kind listens to the women understands their problems and talks to them as equals she gives me hope in the future
Talking of the clinic there was great excitement last Saturday as I took more of the equipment sent over from my old pals at the SHA and clinical skills network and pride of place was the haemacue (haemoglobin measurement machine) purchased using donations raised by my wonderful Vocal Expressions Ladies Choir of Holmfirth it was fantastic we tested every woman attending the ANC as it is so long since we have been able to rest their Hb every one had some degree of anaemia which is endemic in poor communities but can be a killer for pregnant women after delivery as even moderate bleeding with a depleted Hb can be disastrous.
One young woman had an Hb of 8.7g (normal 12-14g ) at 32 weeks she really needs urgent treatment so as you can see already the haemacue has been worth its weight in gold
Testing for anaemia

The wonderful haemacue
Lea Howie!!!
PS ALL photographs published by kind permission of the subjects