We started out with the three of us, the home health nurse, myself and the driver (yes, we had our own driver). The first house was about 50 kilometers out of town. We stopped at the Satellite Hospital on the way to pick up the mother (not sure why, except maybe she took a part time job there). Then we went on to their home out in the country.
The two children we saw first were a 9-year-old boy and his 6-year-old sister. They were at school when we arrived so their mother went to get them, and they arrived within five minutes.
Today they were all looking pretty healthy. But I had looked through their charts on the way out; and the kids had had many illnesses and were frequently admitted to AHC. They were a little bashful of me at first, but we gradually became acquainted as the nurse did routine home checks. And by the end of our 45 minute stay, we rolling around on the floor of their home together, playing goofy games with our fingers, and candy wrappers.
It just goes to show you that kids do not need expensive toys to be entertained! The boy did have one toy, which he showed me…
I think the visit by a van from town was probably enough of an excitement for all the neighborhood women and their children by itself, but to have a foreigner along really brought out their curiosity. The neighbors just walked right in through the front door and sat down to stare and smile at me.
One woman had one of her daughters bring me a bag full of local fruit, which I later learned is called chan. To be polite I bit right into it, and got the sour taste of the outer skin. So then the nurse explained to me you didn’t eat the skin, but even then I couldn’t finish it. Apparently Cambodians like the fruit more for the smell they give to your home than the taste!
Their home was quite larger than I expected, but generally vacant of decoration, as you can see. The two major decorations were the Buddhist altar, and the photos from the rafters that included portraits of their revered King Sihanouk, and the Queen Mother (the kids had a school holiday on Monday because it was her birthday).
Their house is about 10 feet off the ground on stilts, like most houses around this swampy land, and the ladder that goes up to their front door was very steep. All stairs in this country are very steep, just like in all the ancient temples. The Khmer do not seem to mind, but I keep looking for the handrail every time I go up or down!!
The mom is divorced and really struggles to make ends meet. For awhile she was trying to run a little store for the neighbors out of her house, but she was only making about 5000-10,000 reils a day, which is only $1.25-2.50. She could have made more, but just did not have enough money to get sufficient inventory. Her mother lives close by and used to help her, but now the grandmother has grown too feeble to be much help anymore.
At the second house there was a little girl about 5 years old who lived with her mother, grandmother and siblings. The little girl was very shy, and definitely not looking as healthy as the kids at the first house, just not hospital sick. From the charts I noticed that the home health staff often did not find this family at home. Often the mother was away doing opportunistic jobs – usually working in the rice fields - and the girl was either left at home with relatives or neighbors who did not know her medical care, or the little girl went with her mom. Today they were at home.
The home health nurse does a quick exam of the children, and asks a few questions about how things are going. Her main purpose is just to be sure the patients are receiving their anti-viral medications to treat their HIV infection. So they count all their pills, calculate to make sure they have taken enough, then make sure they have enough until next time. The program is funded by an outside NGO (non-governmental organizations) I think based in Germany.
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