Project LOKUN

Project LOKUN - A Medical Humanitarian Project

Children in Cambodia Children in Cambodia

Time flies. It has been more than two months since I returned from Cambodia. And frankly, life is back to normal. But let us not be disappointed as yet with this article. I had just finished the Clinical Skills Foundation Course, which is the special term between M2 and M3, which though thoroughly important and irreplaceable, meant that the holiday between year two and year three is effectively only three weeks long. In such a setting, spending ten days in Cambodia, from the 3rd to the 13th of June, does require commitment and dedication. It is after all, a form of community service, and not a real holiday. Although having said that, community service is a misleading phrase, because it gives the impression of a unidirectional service and sacrifice. In the end, I believe we the students gained infinitely more than the people to whom we provided free medical services. The trip I joined was the third such trip to Pursat, Cambodia. Project Lokun (hokkien for doctor) is a student-led initiative to provide free and sustainable medical services to the people living in the more rural aspects of Cambodia; it aims to reconnect people living outside of the city, with the national health system. Other than providing free medical services, the other aims of Project Lokun are to try to rectify the problem of malnutrition, water sanitation and other health issues such as disease transmission prevention through education, both of the school going children, and adults.

We are currently working with CROAP; an NGO in Cambodia, which currently promotes sustainable agriculture in Pursat Province and are looking to provide social services for the community it serves. We also have Dr. John Lee, Dr. Goh Wei-Leong, and Dr. Gladys Wong providing us with invaluable advice and necessary liaisons.

Project Lokun also aims to collect proper epidemiological data of the community in order to better facilitate the planning and execution of effective interventions. Our daily activities consisted of running clinics in three different locations everyday for four days, and conducting education in two different schools everyday for another four days. Additionally, when we were not having clinics or school education, we did education door-to-door in the vicinity of our living quarters (a new addition in the third trip) and spoke to families about disease transmission and prevention, management of common diseases (such as how to make oral rehydration solutions to lower morbidity due to diarrhea) and also general education on some specific diseases such as tuberculosis. Sometimes the distance from one door to the other meant a ten-minute walk in the sun!

Going door-to-door to talk to families opened my eyes to the type of living conditions the people had. It was a lot more communal, and in the day, when the men of the house were out in the fields, the women brought their children along with them, and they visited their neighbors to interact. In general, most of their houses were neat, but the general state of dustiness with flies and poultry flying about their food, would not go down well in the stomachs of most Singaporeans. Children are especially sensitive to such unsanitary conditions; therefore it was unsurprising how it was so coincidental that a baby was running a fever while we were visiting. Clearly, some education was needed, but there was also a limit due to scarcity of water as a resource, and lack of plumbing, and lack of electricity, the very things we take for granted living in Singapore.

I was in-charge of one aspect of the education team, and one of the biggest challenges was the preparation of the teaching aids such as posters and thinking of ways to make the delivery of our simple messages (washing of hands after going to the toilet and before meals!) effective. The other big challenge was communication through the language barrier via our dear translators. Imagine trying to do some direct communication to the students via basic hand gestures and acting. It was a new, interesting and rather exciting experience! Finally for clinics, as mentioned, there were three teams running simultaneously. Two teams went out to villages relatively nearby our living quarters, and the third went to a more rural site, requiring a half hour motorbike trip in via dirt roads rendered impassable to vans because of heavy storms. We went to both villages on the land as well as floating villages, i.e. on boats. The sight of more than 50 people queuing up early in the morning awaiting our arrival is an easy yardstick to how difficult it is for them to reach medical treatment. There were also quite a few patients with advanced diseases that require long-term follow-up with their own health system, which we attempt to facilitate with our referral letters. This referral system is still in the beginning stages of being established, but this together with a physician we hire to conduct clinics every week, are our best bets to achieve our ultimate aim of a sustainable health care system for these Cambodians living in the outskirts of the city.

Life in Cambodia was a different experience. We were deprived from most luxuries granted by electricity (at least limited by the Sun and our solar cells) such as the television and the Internet, but yet, never craving for it. We rejoiced whenever the fans were working, offering us some respite from the heat, although I think we were very blessed because we came during the rainy season so the temperature was mostly bearable. Of course it also meant getting caught in the huge tropical storm once in a while, and having to deal with the insects that came into the house because of the rain! In general, there were much more bugs everywhere, the bathroom, the bedroom and everywhere else. But these bugs sure did bring out the heroes in some guys and gals, and many a comical episode!

It is not difficult to look on the bright side of things in Cambodia. During the blackouts we experienced at night, it quickly became apparent that it was a blessing in disguise, because the stars in the sky were revealed in their full splendor! Things also quieted down and the sound of frogs croaking complemented the wonderful sight. Looking at the acres of paddy plantations and the occasional bull was a very therapeutic experience too.

Miracles abounded in Cambodia, especially since we could not have expectations having come to a foreign country. One miracle was the Sunday mass. It was not going to be easy attempting to attend Sunday mass in a primarily Buddhist country. However, CROAP was a catholic mission based NGO, and there was a priest living somewhere around us, although we never saw him. As such, we could not make arrangements to attend mass with him beforehand. But that Sunday, just when I had already given up hope of attending Sunday mass, the van transporting the priest and other parishioners passed by us, and we managed to flag it down and go celebrate mass the Cambodian way.

It was a yet another very novel experience. We sat on straw mats on the floor, almost throughout the mass (even the priest sat on a chair through most of it, the way rituals are conducted in Buddhist temples apparently), burnt joss sticks as incense, heard totally different songs—Cambodian styled tunes, and witness the celebration of the Eucharist in Khmer. It was a wonder also, to see that the majority of churchgoers were youth, and they were in charge of all the mass proceedings, such as leading the congregation and the proclamation of the Word. I felt truly loved and blessed by God, to be granted this opportunity for Catholic mass, in the Cambodian Buddhist majority. And truly, being able to attend the Sunday mass was by no effort of ours, but by God’s grace, without which nothing can be done.

While preparing for the trip, having to sacrifice time and effort amidst other commitments, I did wonder why on earth I signed up. I had not yet been invigorated by the passion others felt for these people we have not even met. In Cambodia, there was no more such thought, not least because it would have been utterly counter-productive, but also because of the overwhelming impetus to meet the very immediate needs of the people. Back home in Singapore, even now, I wonder again, why on earth I signed up.

I wonder now, not because I regret going for Project Lokun, but simply because on deeper reflection, I had no clear reason for going, other than to experience doing some humanitarian work in Cambodia. My reason was, “why not?” not a very good and inspiring reason, I must say. However, I figure the finger of God was on me that day, when I heard the call for volunteers, and again on that day several months later, when I gave the confirmation. Only He could possibly make me volunteer to exit my 'comfort zone'! And it is a good way to see how God’s grace can be truly sufficient when in totally foreign surroundings.

We were totally dependent on our translators for survival, and there was no ‘quality assurance’. But in his great mercy (really!) he provided us with Cambodian translators who were trained as teachers. They sure brought the level of our lessons to a whole new level, as they took our material and brought it to life. Also, he gave us air-conditioned minivans, without which, we would not have survived either! :P

On a more serious note, there was one incident that happened while my group went door to door giving our education spiel. The man of the house returned home, in the afternoon, and our enthusiasm at his arrival was quickly dampened when we realized he was high on alcohol. I was not expecting such a situation to occur, not in the ‘countryside’ at least. It is easy to come away with the impression that all Cambodians are hardworking people with no vices other than not covering their cooked food and allowing poultry to fly around. I had forgotten that Cambodians were human just like me, faced with the same choices as me. The choice everyday to discern and do God’s will. To be a hardworking farmer, or to sink into a drunken stupor. To be a hardworking and truly enthusiastic medical student eager to learn, or a student contented with just getting by. Choosing to do God’s will often seems to be choosing to suffer but it eventually brings happiness, but oftentimes choosing what will bring immediate gratification leads to eventual unhappiness to self and to concerned loved ones.

Having said all this, the Cambodian people are very hospitable. Once, during clinics, one family gave us fresh coconuts to drink. That act in itself was such a great generosity. However, the coconuts were not yet chopped open, so someone volunteered to help us chop it. After that was done, as spoilt Singaporeans, we asked for straws, but there was none. So actually, we happily settled on just drinking the delightful juice straight from the coconut’s mouth. Not ten minutes later, a Cambodian came back with a new packet of straws that he had bought for us! I was totally blown away. Being hospitable to strangers is an important Christian virtue (as often exhorted in the bible, both the old and new testament), and it is clear that it does not take a Christian to be hospitable. They are an inspiration to me to always extend hospitality to strangers, even if I feel I have little to offer, because God can magnify any effort in sincerity, just like the five loaves and two fish.

I miss Cambodia. I miss waking up in the morning and preparing for a day of purpose. It is not that my days now, in the past or in the future, do not have purpose. It is just that days in Cambodia had very clearly defined purpose, but was at the same time, stress free. For an example: clinics-- we go there with our team of doctors, our medicines and equipment, and just set up shop. People came and went, and we just handled them as they came. Run out of medicine? Too bad. Nothing we could do about it either. Run out of plastic bags (like it did during mobile clinics) then just a mad scurry to transfer stuff so we save a few more bags. Most patients were genuine, while some had dubious reasons for coming. But we just took them as they came. This kind of easygoing attitude made life simple, and saved us much frustration.

Every day was a brand new day, and a chance to do maximal good (and minimal harm). We lived one day at a time, not worrying unnecessarily, leaving everyday in the hands of the Lord, knowing that he would provide us with the needed resources to help the people, and that we are merely instruments. I think this is the way Man was made to live, like it says in the book of the Ecclesiastes. Plunging into the day with our best effort and trusting God to make the most of our humble efforts. That is why life in Cambodia was fulfilling and purposeful, and simple at the same time. And that was why I had such a great time there!

Back in Singapore, life goes back to normal. Life does not change because I went to Cambodia. Responsibilities are once again taken up, and the easygoing life ends. It is easier to lean on God when in a foreign country; the challenge is to do the same in our ‘daily toil’. But with one more concrete experience of God’s grace in my life, maybe life ‘back to normal’ will be just a tad less normal, and more godly.

Joyce Tang
Year 3 medical student
Project Lokun 3 (June 2008)

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