A chilling history

This morning I visited the Choeung Ek Killing Fields and the Tuol Sleng/S-21 museum. If you have no idea what I'm talking about, here's a little history. In 1975 the Khmer Rouge, an extreme communist group took control of Cambodia. They pretty much wanted to send their control back to the middle ages, kicking everyone out of the city to make them work on farms, and destroying any sign of intellectualism/moderism including schools, hospitals, courts, technology. People starved as the Khmer Rouge did not feed the workers enough, and they killed anyone who was suspected of disobeying their rule, or anyone from the previous upperclass. This includes everyone from doctors to lawyers to peasants, along with their families, including children. In their 4 year genocide 3 million people were killed, and the UN backed trial for the war crimes are only getting under way now.

Tuol Sleng was a high school, but during the Khmer Rouge's rule, it became one of the biggest and most famous jails. People sent here had their mug shot taken, were interrogated and tortured (by electrocution, beatings, drowning, and many other gruesome ways) until they admitted to whatever crimes they were accused of. Children, women, men, elderly, young, no one was spared and everyone who was sent here was later killed, minus the few people who were alive when the building was discovered by the invading Vietnamese. Now it is a museum and the old classrooms are clearly cells. The beds have been left in some, with their shackles and photos on the wall of the gruesomely beaten and dead inmates that were found there. Also in the museum are thousands of the photos taken of the prisoners. There are rows and rows of them and the expressions are all different. Some people looked frightened, others angry and defiant. A few were grimly smiling.

After interrogations at S-21, people were brought to the CHoeng Ek killing fields to be killed - again by brutal methods. Sometimes they were shot, but often they were beaten with everything from garden hoes to bamboo stalks, all while blindfolded with their hands tied. Some were buried alive and then covered with chemicals to kill them. They were then buried in mass graves - the largest with 450 bodies. 20 000 in total were killed and buried here in total. There was a tree on the grounds called the killing tree where children were beaten against to kill them. One grave was found to have only headless bodies, another naked women and children. Of the over 100 graves, 86 have since been exhumed and now their skulls and clothing sit in a huge memorial on the site in a glass case. It was chilling to see the thousands of skulls lined up. As you walked around the grounds you could see all of the sunken areas where graves were and beneath your feet bits of clothing and bone were everywhere sticking up through the ground. It actually made me sick to look at and ting about.

It was a very creepy and disturbing view into what humans can be capable of doing to each other. As it was so recent, it is even more chilling to know that many of the people I see on the street lived through this themselves. When I was in Kampot, in southern Cambodia I did a tour on Bokor Hill which is an old abandoned French casino and resort type place from the 50s (also taken over and used by the Khmer Rouge for nastiness in the 70s). Our guide told us his personal history which including being forced to work on the Khmer Rouge farms, watching his sister and parents be killed, then escaping to hide in the forest for 2 years before joining the Vietnamese to fight the Khmer Rouge. It definitely put a face to all of the history I've been reading and learning about. It is definitely still fresh in the minds of the Cambodians who lived through it, I'm sure.

Temples!

So I did not give Laos credit in my posts. It is really an absolutely stunning country that has, for the most part, a laid back feel. The landscape consists of hills and rivers covered in lush forests and fields. Vang Vieng had these huge cliffs - a lot like Krabi actually. It was completely overrun by young teenage travelers there for tubing and drinking which distracted from the beauty. We spent one night at the bucket bar (literally drinks are local whisky and coke mixed in a small bucket and you get one free between 8 and 9pm) staying up until 4am watching the world cup final, plus we kayaked by the tubing bars (which had slides and ropes that looked far too dangerous for me) and we had enough of that scene. One guy I was traveling with had a nasty motorcycle accident so couldn't even go in the river for fear of infecting his scraped up knees. The water isn't the cleanest I've seen. But the caving, kayaking, and lounging were all fantastic here and I got some great pictures.

Luang Prabang was a lovely town, full of monks and temples, plus nice restaurants, great French architecture, and fantastic shopping. We dragged ourselves out of bed at sunrise one morning to watch the monks file out of their respective temples and collect alms from local Buddhists up and down the streets. It was very neat to see, although I felt like I was disrespectful just for watching this daily ritual as a tourist. The night market was great, and now that I am in Cambodia, I realize how relaxed it was there. Of course you must haggle, but it was pretty low-key and not too pushy in Laos. In Cambodia people chase you down to get you to come to their stall, incessantly ask/tell you to buy their stuff and don't make eye contact if you don't want to appear as if you are making any sort of commitment. I spent a lot of time (and money!) shopping in Luang Prabang, but an hour at the night market in Siem Reap and I feel like I have had my fill. Luang Prabang is the kind of place where the days just slip away - we often passed the afternoon at a place called Utopia drinking fruit shakes, laying on lounge chairs reading, or even napping.

The traditional food here in Cambodia is definitely more appetizing and varied than Laos. I have had a delicious Khmer style curry for supper the last two nights. Today was my first day at the Angkor temples. I decided to bike as it is the cheapest way to get around, and also, I could use some exercise. I definitely guzzled a lot of water, and sweat buckets, but probably covered about 30km or more. I hit up most of the temples in the main area, saving the 2 major ones for tomorrow. The temples really are majestic, surrounded by tall trees and jungle. If you could find some peace and quiet away from the children and ladies selling books, bracelets, food, and drinks, it was just amazing. One temple I saw was the one from the Tomb Raider movie. The people selling things are as insistent as the market stall owners and its hard not to get frustrated and numbed by the children chasing you down to buy trinkets.

Apart from the people trying to sell me things, I have found Cambodians to be incredibly friendly - children all waved and shouted hello to me as I biked by and when I looked lost (its a huge area), a man came and pointed me in the right direction. The waiter at the restaurant I was at today was also very friendly - its not hard to get a smile from people in this country which is commendable given the violent history of Cambodia.

Beautiful!

This will be a short blog as a lot of people are waiting to use the computer. This country is probably the most beautiful place on earth. In our last town, Vang Vieng, we were surrounded by huge limestone karst mountains covered in forest, then on the drive to Luang Prabang we went on a REALLY winding road through the mountains and the views of the valleys were just stunning.

In Vang Vieng we skipped the tubing and instead went on an amazing kayak trip down the Nam Song river, stopping at a couple caves along the way. One we had to swim underwater to get inside. It was very cool. The tubing scene was kind of gross and full of drunk 18 year olds - not really our scene.

I am in Luang Prabang now, a very French looking river town with great shops and an awesome night market. I forsee myself spending a lot of money here...even by Canadian standards. I am so in love with this country!

Loving Laos!

So I've been in Laos for about 2 days now and I am already loving it for so many reasons! First of all, as it was once under the control of the French there are bakeries everywhere selling delicious baguettes and pastries. I've kind of said screw it to my budget and waistline for good reason. Secondly, I've finally found the backpackers! I've already met more people than I did in all of Thailand, and many are traveling solo too. It's great to have some company. The captial I think has around 300 000 people, but its got a fairly relaxed feel to it. Things have been pretty easy so far, granted the tourist district is pretty set up for, well, tourists. The only thing I am not liking about this country is the heat - as hot as it was in Bangladesh with no ocean to jump in for relief.

I went to the Lao National History Museum yesterday - lots of old pottery, but it also goes through the struggles for indepence as this country was under control of the French for a long period, but the US were also in here as well in 70's I believe. My Lao history knowledge kind of sucks. ANyways, the captions for the displays were so strongly anti-American, it was very entertaining. For example, "The guns the Americans brought to Laos to kill innocent Laos people." or "The surrender of the Imperalist Americans and their puppets."

Today we went to Buddha park. We took a public bus which was packed with a door that slammed open and shut as it pleased. It was interesting as we really had no idea where we were supposed to get off and got a little worried when it started heading towards immigration into Thailand at the Friendship Bridge. But we got there ok and it was really neat. It's just a small park filled with huge Buddha statues. There were tonds of them and they were all different. There was also a big pot type thing that you could climb to the top of. I got a lot of neat pictures.

So tomorrow I am heading to Vang Vieng which is kind of the party town of Laos. I will be going tubing down a river stopping at bars along the way which should be a lot of fun. After that its jup to Luang Prabang which has some great markets so I can catch up on my souvenir shopping.

The Island Life

Well I just got into Krabi after about a 3km hike with all of my baggage from where the stupid tour bus dropped me off. I've actually been doing an awful lot of walking lately as I'm trying to save the moolah. Also why I am eating bread and peanut butter all day. My parents must be so happy reading this. So Koh Phangan really looks like the google images that come up. It takes a 3 hour bus ride and another 3 hours on a ferry to get there. Most people headed towards Haad Rin (the site of the full moon party, and the party spot on the island) but I headed the other way up to Bottle Beach - a secluded beach on the north side of the island, accessible only by a longtail boat or a very shaky motorbike ride. I have no idea how to drive a motorbike so I opted for the boat. It was secluded and gorgeous, and I was able to meet up with a couple I had met in Krabi. I spent several days here just lounging on the beach...and I will probably have skin cancer popping up from my ears to my toes as a result. My malaria medication has a pharmacist label on it saying to avoid excessive or prolonged sun exposure while using the medication. Well that's kind of difficult when you have gone to Thailand to lay on the beach for a week. I have never been so sunburnt in my life - sunscreen had no effect and I literally roasted. By the end I had to hide on my balcony until the sun went behind the clouds.

I was on Bottle Beach for Canada Day and there were no fireworks of course, lol, but there was another group of Canadians there. The resort staff gave us these huge white chinese lanterns to decorate and then we lit candles in them and sent them flying beside a fire on the beach. It was pretty cool and seem an appropriate way to celebrate.

Most people in Thailand are Buddhists and as a result pretty much every little business/house/restaurant has their own little shrine set up with rice and other offerings out. I don't know much at all about the religion (I've been a bad cultural tourist, not learning any Thai either), but the shrines are very ornate, usually gold and colorful with flowers decorating them.

After Bottle Beach I headed to Mae Haad, which is renowned for its scuba diving and snorkelling. I lacked the time and money to do a scuba course so opted to snorkel. The water wasn't perfectly clear, and I was just going off shore so it didn't look as colorful as National Geographic makes it out to be but it was still pretty cool. However, I kind of suck at it as the masks completely seal off your nose and I kind of got freaked out and felt like I was suffocating just breathing through the snorkel. Everything under water looked so much bigger and there were lots of differnet kinds of fish swimming through the coral. I also saw lots of sea cucumbers and a sea urchin, which sent me back to shore to put on my sandals. My last day I was in Thong Sala where I spent just a bit too much money on food and souvenirs so I am trying to last on about $5 for the next day and a half before I fly out, as the cheapest rooms were full at my guesthouse in Krabi. All in all, 4 novels, several peeling sunburns and many hours in a hammock later, I am ready to head out from Thailand and into Laos. Wish me luck!

Thailand!

So I have been in Thailand for about 3 days now, but it feels like much longer. I have been staying in Krabi at a good little guesthouse. After Bangladesh, it feels so civilized here. People actually follow basic traffic laws, there are street lights, and turning signals are used as the manufacturer intended. I am loving the cheap food here and I've been having a pastry and a mini pineapple for breakfast - for about 50 cents total. On the weekends here there is a night market with tons of food stalls selling various meats, rices, fruit, drinks, you name it. Most things are on a stick or you get a little take out bag. There is also tons of jewelery and clothing. It has been a good place for me to practice haggling and, frankly, I suck. Thank goodness I have several more weeks and markets to practice.

Krabi town is on a river, not the ocean, but the entire province as these huge ridiculous limestone cliffs everywhere. They're gorgeous. Yesterday I took a sorngthaew (spelling is something like that) which is pretty much a truck with 2 benches across the back that do local routes of transportation regularly. I went to a beach in a nearby town. According to the guidebooks its not a beach worth stopping at, but I thought it was lovely. The town felt really touristy - full of resorts, and even a Best Western Hotel. But it was nice to finally get in the water - which was ridiculously warm and felt wonderful.

Today I went rock climbing in a nearby place called Railay which is pretty much famous, worldwide for climbing. I started out the morning with a couple girls from Singapore and our guide. It was high tide so went went into the island a bit to a small rock wall. We did 3 climbs there and my poor technique resulted in a banged up knee, but it was a ton of fun and you get a real rush when you are able to make it to the top. After lunch we headed to a different rock wall that was on the beach. It was much bigger (about 30m was the highest climb I did) and at the top you had a beautiful view of the area. I could not believe how much the water went out a low tide here - a good 400m it looked like, although I suck at estimating. There were lots of people climbing on this wall, and after 3 more climbs I was done, with shaking arms, and bruised knees. So I head through some limestone caves to the other side of the peninsula and a gorgeous beach. This area is resort central, but it is low season so the beach wasn't too busy. I spent a couple hours alternating between baking to a deeper shade of red (after what seems like a million applications of sunscreen too!) and cooling off in the water.

Tomorrow I head across the Malay peninsula to Koh Phangnan, an island that apparently has some great beaches. It is where the full moon party is held each month, but that's too crazy of a scene for me so I timed it to arrive a few days after the party.

And that's how they rope you in...

After being in Rangpur, a decent sized city, for the last 9 days, I had almost forgotten how beautifully green this country is, and the drive to Kurigram was great for reminding me! The drive up was more or less in the countryside (still people everywhere of course) and the sides of the road were full of fields of rice and jute. Along the road were huge trees that were hanging over the road too, making a canopy of sorts. It was a nice drive and I would have takend some pictures if we weren't hurtling by at the breakneck (by Bangladesh standards) speed of 70km/hr. The rains which are becoming more frequent, and lasting longer with the approaching monsoon season, made traffic a little lighter on the highways so travel was a bit faster. Although it still takes over an hour to drive about 55km.

I was only in Kurigram for 2 days, and one of those days was the best of my trip so far, from a medical learning standpoint. Instead of standing in the corner of the OR watching a surgery (which was interesting, but got tiring) I went on rounds with the doctors, and the ones I were with that day were fantastic for explaining things to me and understood that I had done cardio and resp so let me examine those patients, look at chest xrays, and talk about treatments. It's not much compared to the early exposures people are having in Canada I am sure, but its the most medical interaction I've had since I've been here. I also walked out into the village to see a nutrition centre with both and inpatient and outpatient ward. The outpatient ward does workshops and screens for severe malnutrition in children under 5. If their weight is less than 3 standard deviations from the WHO average for their height, they are admitted and put on scheduled feeding protocols. The recovery they make is so rapid - within a week they are often discharged. The centre was staffed by what seemed like a great group of boisterous nurses. They were also giving out H1N1 vaccinations as they are apparently hitting their outbreak now.

The guesthouse in Kurigram is small - only 3 rooms I believe. The person running it, Joseph, was working in Rangpur when I was here last and he was very excited to see me. The perfect word to describe him is simply kind. He is soft-spoken and pulled out his camera to show me pictures of his daughter, son, and wife who he is very proud of, plus some pictures of the other U of M students who went through. I also got to meet his son when he came up for a visit. I had such delicious suppers there as he said that rice and dahl get so boring. It was a wonderful note to be leaving Bangladesh on. People like Joseph are what makes you keep going back to places like Bangladesh, even though I can say that, on more than one occasion I looked around and thought, "what the hell am I doing back here?" But because of people like Joseph, I may just be back again.

I'm not creative and can't think of one

So I realized I haven't really done a good job of describing my surroundings very well. And my description of the hospitals I'm in really hasn't been giving the places justice. The government hospital I was at in Lalimonirhat (and I will be going to another one in Kurigram over the next couple days) is the main hospital for the district. This is a bustling, big, busy hospital, that also happens to be pretty disgusting. Every surface is dirty with god knows what and there are red spit marks everywhere - everyone spits constantly in this country. It is red from paan - and nut/leaf/spice type thing that is like chewing tobacco here. Everyone uses it and it turns the mouth red. There are people everywhere (which is not unlike the entire country) and the facilities leave a lot to be desired. The beds that are there have lumpy old mattresses and rusted metal frames that look like they are from army barracks from WWI. The operating theatre was a bit of a relief from the smell and grime, but even there, equipment was very outdated and everything from gauze to gloves is boiled up and reused. They can't afford to throw things away. This and the patient's blood being wiped off the floor with a rag and a bucket of water before the next patient came in. However, there were attempts at sanitation, and the whole thing was not just a free for all of scalpels, it just clearly was nowhere near Canadian standards. The private hospital, like I mentioned in a previous post, was a lot cleaner and better organized, and did have more up to date equipment, but there is still the same beds with people everywhere. I saw several patients with surgical drains leading to a glove that had been taped to the end of the tube.

The streets of Rangpur are a congestion of rickshaws, autorickshaws, bikers, pedestrians, motorcycles, and some vehicles. There are actually sidewalks on some streets here, but they are shared with small businesses and vendors, goats, dogs, cows, and the occasional motorcycle that is too good for the road. Everything is loud - from the colors to the endless horns and bells from every vehicle as people squeeze by each other. Some cars and motorcyles have been outfitted with the most obnoxious horns playing songs or just high-pitched whistling. Yet streets are somewhat organized in Rangpur - with boulevards and roundabouts, but that doesn't mean people obey the traffic courtesies (I don't know if I would call them laws here). However, it is fun to go down to the supermarket (more or less a 3 story mall) that is filled with tailors, fabric shops, shoe shops, and cell phone stores. Women here love fashion and shoes as much as in Canada, so long as they can afford them.

Tomorrow I am off to Kurigram for a few days at the government hospital, then back to Dhaka, Kuala Lumpur, and off to Thailand. It has been very different being back in Bangladesh for a second time, alone, but it was definitely an experience that has pleased me, frustrated me, and tested my patience. I am looking forward to the next part of my journey that I am more in control of and to hit the beaches in Thailand!

Football Frenzy

So Bangladeshi people are really into the World Cup. In the evening when games are on, every little TV, in every shop will be tuned in. At the hospital I am at now they have lounge type areas (a couple plastic chairs on the landing of the stairs) with TVs and in the evening people crowd around them. The favourite team by far is Argentina, followed by Brazil. Flags for these 2 countries are everywhere and you can see tailors making them in the street. It is enough to make me watch the games, even if I don't care too much for the sport.

People in Bangladesh are often very vocal, strong, persistant people. In the hospital, the doctors are often yelling at people - obviously I have no idea what they're saying, but emotions run strong, be they good or bad. People in the street will yell at me, "Hello, how are you?" and if I don't answer, will keep yelling "Hey sister" at me. You may think it is rude not to answer, but it is pretty much a constant barrage as I am alone and I have my limits. The staring is also much worse now that I am by myself. I even have some people who will point, whisper, and laugh, and then stick their camera in my face to take a picture. I know I am new and exciting to them, but this gets almost exhausting after a point and I feel bad when I feel myself getting frustrated and bitter about it. When I was here with a group, there were other people to divert some of the attention to. However, not all people are like this, and there are many people who are helpful - I was directed around to several cell phone shops yesterday and managed to finally find a charging cord for my Ipod, something I had forgotten at home.

Surprisingly, in such a poor country, there are not many beggars on the street. Perhaps this is because everyone is poor, and so few tourists, etc. go through to help condition people. However, yesterday at the supermarket I had a little girl come to me holding out her hand asking for money. For various reasons that I have heard from various sources and people, giving money out, especially to children does very little and may cause more harm than good. So I said no and kept walking. She chased me and grabbed hold of my leg and wrapped herself around me. I had to pull her off me and she kept chasing me and doing the same thing until I managed to lose her. If you have never traveled anywhere like this, I may seem calloused, but if I gave in to this one child, no doubt I would have another 10 at my feet and as kind of a person I like to think I am, this was not something I was giving in to. It was a disturbing and troubling experience for a number of reasons and is definitely the first and only time I have encountered this in Bangladesh.

Night Surgeries

So the schedule that doctors work here is definitely very different than back home in Canada. There are few patients and work to be done before 11am and most scheduled surgeries at this hospital take place from 9pm into the wee hours of the morning. It is very weird. I have been able to watch a couple surgeries and the facilities at the private hospital I am at now are definitely much better than at the government run hospital I was at last time. Some patients have paid for private rooms with a bathroom and sometimes with a TV. Even the common wards are nicer - though not Canadian standards of course. There are probably 20 patients in a room with half walls between every couple beds, but fans and plug ins. I guess this is what money can buy in Bangladesh. In Lalimonirhat wehn I explained our public healthcare a doctor seemed amazed and kept posing different situations to me, "so if I came in the middle of the night and needed an emergency appendectomy....it would still be free, doctors would come?"

As for surgeries, I have seen a hysterectomy, circumcision, and hernia repair here - all things I know nothing about. I also finally saw the use of general anesthetic - I had begun to think it was just spinal blocks for all! In the middle of the intubation, the power went out and while the hospital has generators, there is always a moment before they kick in that we are left in the dark. I have been spending most of my time with the Obs/gyn doctors and hopefully I can remember some of the things I am learning come block 4. One of the doctors I am with takes my recognition of the names of structures she mentions to mean that I know all about anatomy - which in the case of the abdomen and reproductive structures, is definitely not the case. I got a taste of what upcoming clinical placements will be like - me standing by and watching the surgery and her saying, "in order from outside to inside, list all of the tissues I cut through and then what types of stitches we are using to close everything back up!" and various other questions, putting me on the spot and making me feel like an idiot as I don't know the answers.

The different ways to become a doctor

So I definitely end up explaining many times over what medical school is like in Canada and what the process is. Their schooling in general is different here with many students entering university type courses after grade 10. Grade 11 and 12 end up being more specialized towards science or business, etc. Then after grade 12, medical school is 5 years followed by 1 year of internship. It was quite difficult trying to explain, through a language barrier, that I had already done a degree and explain the varying lengths that our "internship" could be. And they also ask what subjects I am doing my first year, lol, and I struggle to explain the systems approach in simple English as their first year is just straight up anatomy and physiology.

One of my fears coming to Bangladesh was that people would think I knew more than I did, and ask me to do clinical procedures I was not comfortable with. Up until now I have faced the opposite and have only observed from the corner of the room. I wonder if this is because 1st year med students in Bangladesh would have so little clinical knowledge. It has been a bit frustrating as today I was told that I was looking at and EKG machine. While it was archaic, I still knew exactly what it was and they seemed surprised and entertained when I counted the HR from the strip.

Today, I also decided to treat myself with some retail therapy in Rangpur, purchasing 2 new salwar kameez(es?) and a new saree, as well as navigating through shops to buy fabric and instruct a tailor as to what I wanted for my saree blouse and petticoat. It was a long, hot walk around town, but I felt like I had accomplished something and it was nice to come back and put on clean, new clothes after wearing old ones for the past 8 days.

you are only one?

Hey everyone, if you are wondering why there have been no posts yet it is because this is the first I have reached internet since I have been gone as I spent the last week in Lalimonirhat.

Often when I am introduced to people, they have seen the previous group of 5 U of M girls go through and ask, suprised, if I am alone. A lot of things have been different this time being alone - good and bad. It gives me a lot more time to reflect by myself...and read and play solitaire also. And because this is my second time around, there is no longer a shock and awe feeling for all of the things I see around me. I switch from being completely at ease with what I see, and probably not reacting enough, to being to see past the fact that yes, there are crazy things around me, but I expect that. Instead I think I ask why things are happening instead of just noticing they are happening. Like I wonder why people are going places, and whether people on the side of the road are homeless and begging, or are field workers on a break.

There is a huge bridge being built (currently all traffic crosses on the rail bridge) literally brick by brick by hand. I imagine the pyramids being built the same way.

Anyways, I had a lot of downtime in Lalimonirhat, but when I did get a chance to observe surgeries I saw several C-sections. Many women do not seek out obstetrics care until there are complications. As well, I saw a really sad case of a woman who had been slashed by her lover who attempted to murder her. She had extremely deep cuts all over her head and torso and because she had eaten in the morning, they used only local anesthetic to stitch her back together, so she was screaming in pain. It was awful. Her head was so swollen, with blood everywhere, and her finger had been cut off. It was all because her lover had lost his job, but she was working. And her mother refused to let the lover marry the woman if he did not have a job. It was an awful glimpse into the social problems faced by women in this country daily, and the medical limits in this country as clearly in Canada she would be getting a CT, MRI and much better pain control at the very least.

On the road again...

Hello everyone,
I'm glad you've found your way to my blog and I appreciate you reading it, even if this is the only post you read. In 3 days I am heading to SE Asia. My first stop is Bangladesh for 3 weeks in clinics and hospitals doing and seeing crazy things. After that I am off to the islands of southern Thailand and then flying to Laos, working my way south to Cambodia. I cannot guarantee that my blogs will be very frequent as that is reliant on my ability to find functioning internet everywhere I will be, but I promise to do my best. I am super excited for this trip, so wish me luck and stay tuned for updates!
Teryl