by Tara Winkler
And I could understand why. With the orphanage on its knees with poverty, there was nothing to do, but there was everything to do.
But I was here to help, with money donated specifically for the kids at SKO. So I started throwing out ideas of my own. Even then I knew it wasn’t ideal—an unqualified young foreigner coming up with ways to make over a Cambodian orphanage. But action was needed. So action I took!
I noticed that the kids fell upon any food they were given like starving, ravening wolves. The food they were served was literally just a watery rice gruel and a couple of meagre vegetables. I suspected that the skin conditions I was seeing among the kids were at least partly due to poor nutrition.
SKO’s cook was Rath’s sister. I generally found her to be a very quiet, unsmiling person, much like Rath. She cooked on the traditional charcoal stove, like Mina did, with very basic utensils. That couldn’t have been easy when there were twenty-four kids to feed.
The kids needed better-quality meals; that was undeniable. But food was an ongoing cost, which I couldn’t be sure I could continue to provide. I asked Jedtha: ‘Is there somewhere that might donate food?’
He shook his head sadly. ‘We try. Sometime people give us food, but most give food to monastery. We need more funds every month to buy food.’
So, even though I couldn’t commit to providing the funds for this on an ongoing basis, as an interim measure I started giving a daily allowance to the cook to buy more meat, vegetables, eggs and rice for the kids. I also started dropping by the markets every day to buy a big bag of fruit to hand out at my afternoon lessons.
Aside from their nutrition, I was concerned about how poor the orphanage’s health and hygiene standards were.
The kids’ teeth were in a truly terrible state. Reaksmey told me: ‘They never use a toothbrush before.’ So I asked Jedtha if it might be a good idea to take them all to a dentist.
‘Yes!’ he said. ‘That is a great idea.’
On a roll, I asked: ‘What about vaccinations? Are they up to date on all that?’
‘No,’ Jedtha replied. ‘We not have enough funds to do medical program yet. Only some blood test. Sineit’s parent die of HIV so when she got sick Rath take her to get test. That’s how we know she has HIV. Also Rath had all older girls tested for HIV. They are okay.’
‘Only the older girls? Not all the kids?’ I asked.
‘No,’ he said. ‘It would be good to test the other kids, too.’
I was starting to get the impression that the bulk of our funds were going to be spent on health and hygiene issues . . . But I was to find that the health and hygiene issues at the orphanage ran deeper than just a lack of funds.
For instance, there was a dog living at SKO that was the most miserable living creature I’d ever seen. Disease and starvation had turned her into a walking skeleton—just skin wrapped tightly around bone, with only a few hairs left on her cadaverous frame. The poor thing was pathologically timid around people, but she hung around for the sake of the few grains of rice she could occasionally scavenge.
I started buying a bit of cooked chicken for her every few days. I tried to explain to the staff and kids that living with a sick animal could make them sick, too. I don’t know how well my message got through, but they were helpful when I called in the local vet (who usually only ever worked with cows and buffalo). Together, we caught the dog, took her into Rath’s office and I held her muzzle shut so she could be treated. The vet sprayed her mange-infested skin and then injected her with medicine.
She was so terrified that by the time the vet had finished, there was a pool of dog pee mixed with blood and pus from the broken scabs on her back all over the office floor. No one paid any attention to the pool of filth, so I asked Reaksmey what they had in the way of cleaning products so I could wipe it up.
Reaksmey looked at me for a second with his head cocked, then scooped up an old mat from the doorway, mopped up the mess with it, and put it back in the doorway with a proud grin.
I stood there, blinking.
I’m not a germophobe or a neat freak by any means, but after that, everywhere I looked, I saw germs. There was just such a vast gap between my level of concern about basic hygiene and everyone else’s. There was another item for my to-do list: Get kids and staff some education about basic health and hygiene!
It was a great day when my friends Fern, Emma, Elise and Chloe arrived at the bus station in Battambang. We piled all their luggage into two tuktuks and set off for the little pink villa. It was wonderful after all these weeks to be able to communicate thoughts, feelings and ideas without having to trawl through a Khmer–English dictionary—and to drop pop-culture references into a conversation without receiving blank stares in return!
The girls settled into makeshift beds in the pale pink villa without complaint, and really, we were very comfortable. It was like being back at boarding school, with Mina as our adopted house mum, making us delicious meals and making us feel at home, and Chan giving us a ride around town when we needed it.
The girls fell instantly in love with the kids and threw themselves into the English teaching at SKO. This meant I was free to go into town with Jedtha to hunt for the things on the list we’d been creating, which now looked like this:
• Support for HIV treatment
• Cleaning products
• Head lice treatment
• Find and cost dentist
• Find clinic for health check-ups
• First-aid kit
• Bicycles x 24 (surprise morale booster for the kids)
Within a few days, we’d sourced everything on the list except the head lice treatment, which no one had ever heard of in Battambang. One shop vendor pulled out a tall spray can of the household insecticide Raid.
‘You spray this on hair!’ he suggested helpfully. At the look of horror on my face he quickly tried to assure me: ‘It definitely kill all!’ He looked confused when I agreed wholeheartedly, but still declined the offer.
Jedtha found us a local dentist who had previously treated all the kids at their school, which seemed like a fairly good endorsement. The dentist was very reasonably priced too: US$8.75 for root canal therapy!
The kids had never been vaccinated before, so Jedtha and I tracked down a polyclinic that offered vaccinations. Polyclinics are common in France and some French colonies, and provide emergency and other medical services to outpatients. This one was right next to Battambang’s bustling market, Psar Nat. They offered vaccines for hepatitis B for US$10, typhoid for US$10 and tetanus for US$2. The doctor recommended we get a range of blood tests done on all the children first, to check for antibodies. We figured it would be a good way to start a comprehensive medical file on each of the kids.
Organising nice surprises for people is one of my favourite things to do—so the best part of the shopping trip was buying the bikes. We got them second-hand at a great price.
Late in the afternoon, when the kids were all home from school, a big truck reversed through the orphanage gates. It was an unusual sight so they looked up from their chores and homework with great curiosity.
Then the truck driver opened up the back of the truck, revealing twenty-four shiny bicycles. The kids climbed to their feet, open-mouthed. Jedtha called them over and they came running, screeching to a halt in front of him.
I often noticed how happy and relaxed they seemed in Jedtha’s presence. They called him Loak Khrew, the respectful Khmer term for ‘teacher’—a habit I fell into myself because it suited him so well. They listened when he spoke, asked questions with confidence and laughed at his jokes. It was a marked contrast to the meek, reluctant way they related to most other Khmer adults.
Their attention was certainly locked onto him now, even the youngest kid, Makara, a cheeky little scamp with a complete inability to focus on anything for more than a few seconds.
I couldn’t understand what Jedtha was saying, but I definitely knew when he told the kids I had bought them each the
ir own bike. The younger ones squealed and clapped and jumped up and down. Tears sprang into the eyes of the three eldest girls, Sineit, Sinet and Kolab. What a moment. I would never have guessed that a few bicycles could bring so much happiness.
As soon as the truck unloaded the gleaming bikes, the kids took to them, tracking circles in the dirt of the SKO compound. Most of them could ride already, and those who couldn’t threw themselves into the task of learning. I stood and watched them for fifteen minutes or so. It was wonderful to see these kids, who I was coming to really care about, so blissfully happy.
When Chan came to pick me up, I called out goodbye—‘Lee hai!’—and jumped into the tuktuk.
I looked back over my shoulder to wave and saw twenty-four kids on bikes following us up the dirt road. They were pedalling like crazy and calling out: ‘Thank you, Tara!’
I had dissolved into tears by the time we reached the turn-off to the main road. Never in my life had I been on the receiving end of such genuine, wholehearted gratitude. It was a defining moment for me—the moment that I realised what truly special kids I’d met.
After the thrill of the bikes, the next few days, unfortunately for the kids, was all about the dentist.
We booked out the surgery for three solid days, and I sat next to the big, green dentist’s chair, trying to keep each kid calm as they had their teeth cleaned, scaled, filled and, sadly, sometimes extracted. Some of the kids had teeth that were in an appalling state. Some of them needed root canal surgery to save their adult teeth.
We took ‘before’ and ‘after’ photos of the kids—they were all natural hams and loved having their photos taken. They cheered up when they saw the ‘after’ photos, with the stains that covered their teeth cleaned away. Their smiles, set against their lovely brown skin, looked bright, white and beautiful—even with wads of cotton wool stuffed into the corners of their mouths.
Around this time, my friend Lauren Henderson arrived in town to join the other girls in helping us out. I was lucky enough to meet her when I was a volunteer at Oxfam. She was not much older than me, but she was experienced in the NGO sector. It was great to have her support at this time.
Lauren helped me organise hygiene education classes, a head lice eradication program and a basic first-aid box for the orphanage.
The hygiene project was hot, sweaty work but very satisfying. We scrubbed the whole SKO compound clean and gave the kids lessons on washing their hands, brushing their teeth and managing the tropical skin conditions that most of them suffered.
Eradicating the head lice turned out to be an entertaining but ultimately fruitless activity. Since the Raid recommendation, we’d scoured Battambang for treatment to no avail. Desperate, we googled home remedies. The general gist of the advice we found was that suffocating the lice and then picking out the eggs was the way to go.
We tracked down some big tubs of thick, gluggy hair treatment made of clay and some brightly coloured shower caps. The idea was to coat the kids’ heads in the stuff, put them in shower caps, and wash it out the next day. At worst, we figured, they would end up with nice soft, shiny hair.
The kids looked ridiculous with their hair slicked down with grey slime and thought the whole thing was hilarious. But then—just to send them into even greater hysterics—they got to wear fluorescent shower caps.
The shy older girls spent most of the afternoon staring at their shower-capped selves in the mirror and giggling behind one hand. Little Makara, who’s normally a real boy’s boy, decided to go with the whole thing and asked the girls to use some bright pink nail polish I’d given them to paint his nails to match his shower cap. He then demanded to be photographed in a range of effeminate poses, much to everyone’s delight. Laugher roared through the orphanage that afternoon.
The next morning, just in time for school, Lauren and the SKO staff helped me wash the kids’ hair and pick out the remaining eggs. As expected, they all looked fantastic. They tossed their lice-free, shiny tresses around like little supermodels, and we all felt quite smug about our success.
That afternoon, the kids arrived home from school totally reinfested with lice.
Lauren suggested we check with some other local NGOs to see if anyone could help us get the kids’ blood tested. Jedtha tracked down an organisation called Reproductive and Child Health Association of Cambodia (RHAC). They offered to do the blood tests and put all the kids aged fourteen and up through a sex education course—for free!
The kids were a little nervous about the needles but they put on a brave face and were very well behaved. We got a full blood count done, as well as tests for HIV and hepatitis. We knew Sineit was HIV positive but Jedtha had never seen any paperwork. So, to be certain and to have a hard copy record, we tested her as well.
Sineit’s younger sister, Sinet, was quieter than usual that day. I asked Jedtha to ask her if she was okay.
She said she was worried her results would come back HIV positive. I tried to reassure her—and myself—that there was no reason to think that might be the case. But I assumed Sineit had contracted HIV from her mother . . . and Sineit was older than Sinet. So I couldn’t help feeling anxious for her.
I had bitten off all my nails by the time the clinic called to ask us to come and pick up the results.
Lauren, Jedtha and I went through the reports with the NGO’s clinician, one by one.
Sineit was confirmed as HIV positive. But Sinet was negative. I felt my shoulders relax a little.
All the other kids were HIV negative. But seven of the kids had a big red asterisk next to one of the numbers on the tests.
‘Hepatitis B positive,’ the clinician muttered, with a furrowed brow.
I looked at her in shock. I suddenly realised I didn’t even know what exactly hepatitis B was. Was it a death sentence? All I knew was that my doctor told me I needed a shot for it before I travelled.
‘It can be they have from they parents,’ the clinician explained.
‘How serious is this? What does it mean?’ I asked. I could feel my shoulders clench again.
‘Could be okay, but maybe bad,’ she said. We tried to press her for more information, but she didn’t seem to know much about hepatitis B either.
We all exchanged worried looks. What were we supposed to do with this information?
The RHAC clinician recommended we take the hepatitis B-positive children to the Battambang public hospital, after the older kids had finished their sex education workshop at RHAC.
Jedtha gave Lauren and me a lift into town on his moto. We each grabbed a cold coconut and a plain baguette (which in Cambodia is often just a hollow, sweet-tasting crust) and headed for an internet cafe. We wanted to do as much research on hepatitis B as we could before we went to the hospital.
The more I read, the more concerned I grew.
Hepatitis B, said Dr Google, is an infectious inflammatory liver disease, which has caused epidemics in parts of Asia and Africa. It is spread through infected blood or body fluids—so yes, it can be spread through unprotected sex and sharing needles—but also during childbirth and by things like sharing toothbrushes and razors. But not by coughs or sneezes or holding hands or sharing drinking glasses or eating utensils . . .
According to Wikipedia: Chronic hepatitis B may eventually cause cirrhosis and liver cancer—a fatal disease with a very poor response to current treatments. According to the World Health Organization (WHO), an estimated 600,000 people die every year from diseases related to the infection.
I wondered how on earth the kids had contracted it. Was it during childbirth? If so, how come the twins, Simha and Borey, weren’t both positive?
A prickling, paranoid feeling crept up my spine. It was horrible to have to ask myself . . . but was there something awful—appalling—going on at the orphanage?
Lauren and I decided to drop in on the older girls’ sex ed class at RHAC to see how it was going. When the teacher pulled out an erect, hand-carved wooden penis, I had to immaturely cough back a laug
h, but to my surprise, the kids barely reacted. There were a few giggles, though, when each of the kids had to practise putting a condom on it.
Lauren and I couldn’t follow what was being said, but the pictures were fairly self-explanatory. They talked to the girls about safe sex, pregnancy and STDs. I studied Sineit’s face as they talked, at length, about HIV/AIDS. She didn’t react. I wondered what was going on in her head.
Jedtha ferried us all back to the orphanage in three or four trips, with as many of us on the back of his moto as would fit.
I borrowed the Toyota Camry that Chan had bought with the proceeds from the failed cow to take the seven kids with hep B to hospital. Stuffing seven kids into a sedan wasn’t ideal, but it would beat squishing three or four of them at a time on the back of a moto.
The kids didn’t seem too happy about going to the hospital. In fact, Makara ran and hid behind the kitchen shed and had to be coaxed out with lollies. The other kids marched towards the car like prisoners to the gallows.
‘What’s wrong with them?’ I whispered to Jedtha.
‘They see people from they families go there to die,’ he murmured. ‘They think hospital have many ghosts.’
We pulled into the car park of a sprawling French Colonial building set among patches of green grass. And thus began my first experience of a developing world hospital. The grimy, once-yellow and once-white tiles were identical to the tiles at the Tuol Sleng torture prison. Bloodstains climbed the dirty cream walls. Every surface wore a thick patina of reddish dust.
A woman sitting at an old wooden bureau, which served as a reception desk, gestured us to a long wooden bench to wait to be seen. Just beside the reception space, a deathly thin woman lying on a stretcher bed moaned in pain. Her moans became louder and louder. No receptionist, no nurse, no one answered her cries.