HIV/AIDS class

On Tuesday morning, the first day of my HIV/AIDS teaching, a pre-test was administered to my class. There were 17 pretty basic questions just to see what they already knew... or didn't know. True or False. "AIDS is a disease for only immoral people," all but one said TRUE. "Mosquitos transmit HIV," half TRUE, half FALSE. "Condoms have small holes that allow HIV to get through," again all but one said TRUE. As I scored the pre-tests, each grade became more alarming than the last. These are 20-30 year olds who have been to secondary school, and most of them are in University. They are all educated, how can their preceptions of HIV/AIDS be so wrong?! I knew immediately we'd have our work cut out for us.

Christina and I spent Monday as a lesson planning day, modifying the curicculum I used in Tanzania this past January to fit Cambodian culture; from what foods to feature in the nutrition portion, to Cambodian statistics on HIV/AIDS prevalence and mortality. We made games, flipcharts, and student manuals, assuming that most of what we were teaching would be just reinforcing what they already knew. I didn't expect University educated Cambodians to have more skewed ideas about HIV/AIDS than uneducated Tanzanian villagers.

Throughout the week, we covered basic biology, disease progression, infected and uninfected body fluids, transmission, prevention, nutrition, health and hydration, life skills like communication and decision making, and empowerment. Because of the pre-test results, we were sure to reiterate whenever and wherever possible, that ANYONE can get HIV, not just immoral people like they seemed to think, and that you can't tell by looking at someone if they are infected, another question they failed miserably on. Teaching and discussing HIV/AIDS is a tricky subject because you want to convey that people with HIV/AIDS are just like everyone else, that they shouldn't be treated any differently and that they deserve to be respected in society, but at the same time you don't want to make it seem like its something to be taken lightly. In college I wrote a paper about HIV/AIDS in America, before I started traveling to learn for myself and teach others on the subject. In my paper, I discussed how America has dismissed HIV/AIDS as a serious problem. My generation learned about it once in school, but not really knowing anything about it, we don't see it as a threat to our society. We're not afraid of it and careful like we should be. As research for my paper I sent away for a magazine for HIV positve gay men. The magazine was full of ads for different HIV medications, most featured big strong men rock climbing or weightlifing, and one that I especially recall was a man breaking the ribbon at a marathon finish line. What do ads like these tell the audience? It implies that HIV is no big deal, take the medicine being advertised and you'll be fine, able to run marathons and climb mountians. Yes, people in the US with HIV are generally healthy due to proper nutrition and an availablity of medication, but the message being sent out is that HIV is a simple issue that can be easily taken care of with a small pill. The ads show that people with HIV are just like everyone else, but they lack the message that it is a serious disease. It's not an easy thing to discuss and teach, you want to make people accepting of something while trying to scare them from it at the same time. We're trying to make the sudents understand that it's a terrible, lethal infection that they should be extremely cautious not to contract, but also try to get them not to treat those infected any differently. Easier said than done.

This week we taught two classes, one in the morning and one in the afternoon, both of similar ages and background knowledge. The translators we used had a difficult time, and that aspect was much different from Tanzania where we had fluent English and Swahili counterparts, but we made it work. Each class asked great questions and we made sure not to progress until we were certain they understood. The post-test scores came in yesterday and reflected a big improvement in knowledge. Like in Tanzania, we talked about how they can share what they have learned with others to spread awareness and reduce stigma. Knowledge + Attitude + Skills = Behavior change, not just in themselves but in others.

While I wrote this, I got to talk to my sisters Amy and Alyssa :) Love you girls and I miss you XOXO

HAPPY BIRTHDAY TO MY WONDERFUL MOTHER, DIANE, AND MY FAAAABULOUS BROTHER, DAN <3 <3 <3 Love you two and I hope you have wonderful birthdays!!

I'm leaving tomorrow to go back to Wat Opot for 2 weeks!! There is limited internet in the office, so I will try to post pictures and write about the children while I'm away. In case I can't post before my return, I want to plug in that my birthday is September 12 and if you REALLY REALLY want to do something for my birthday, please go to Wat Opots website posted on the right-hand side of my blog and make a donation to their paypal. Every cent goes directly to the kids and running the community, and the private donations they rely on have slowed down significantly. Thank you :)

From Kat to TeachAH

When I went to write an email this afternoon, I noticed the date. August 23?! Is that right?! There's absolutely no way I have been here for 5 weeks. It feels like I've been here for 5 days, but at the same time I'm already having trouble remembering what life was like before Cambodia.

For the past two weeks since making my tearful departure from Wat Opot, I have been working alongside the newest GSC Cambodia volunteers in a low-income primary school in Phnom Penh. Christina, a 28 year old trauma nurse from Detroit, joined me my first weekend back in the city. I had previously mentioned this school in a past blog post. It caters to the very poor, mostly children of factory workers. Cambodia's government is very corrupt, as is the education system. Public schools are supposed to be free, but if you don't pay your teacher they won't acknowledge you in class, make you sit in the very back, and refuse help requests. So the "public" school system that should be available to everyone, is only available to those who can pay. This school we have been working at charges a flat monthly rate of about $1 US so that students can be guaranteed fair education and treatment.

Me with some of the students before dismissal.

At this school, I had two roles. My first role was that of "TeachAH" of English and mathematics. Instead of calling their teachers Mr. or Mrs. LastName like in the States, all of the children here just call their teachers, teacher. With their pronunciations, or lack thereof, they said it so cute and it never got old to me one bit! As an English teacher, I covered pronunciation, spelling, grammar, and vocabulary per their curriculum. Math was simple addition and subtraction (LUCKILY for me... and them!!). My other role, together with Christina, was nurse. For a few hours each day, we conducted basic check-ups on each student one by one covering all basic systems, vitals, and health history. Healthcare is expensive in Cambodia, and many of the students had never seen a healthcare provider ever in their lives. The kids for the most part were very healthy. The bottom of each child's sheet (which will be kept on file in the school) featured a section for Follow-up Considerations. For most we noted dental hygiene education, one child had a faint heart murmur which we reported to the Director to ensure follow-up with the family, and a few children had noted visual impairments. One little girl stated, via translator, that she kept having daily headaches that always started half-way through the school day. We asked if she could read the board during class, she said yes. We then asked her to read a poster that was only about 10 ft away, and she couldn't do it. It wasn't until someone had asked her to read something right then as a test did she even realize she couldn't see well. The only thing is, I wondered whether or not her family was in a position to be able to get her glasses or even a more official eye exam. Since most of the children had decaying teeth, we implemented a dental hygiene program. Each morning and afternoon we taught a different class about teeth brushing, why its important, how many times per day, which parts to focus on, how much toothpaste to use, etc. It helped that I taught dental education to kindergarten classes as part of my community health clinical just before graduation this past spring. I think it was effective, and we have asked the teachers to ensure follow-up with the students on dental health.

The little tiny boy is the brother of the kid behind him. He is too young to attend school, but refuses to be without his older brother. He follows him to all of his classes and just sits next to him patiently. They love each other so much, and it made me miss my Amy!!

Last weekend, the third GSC volunteer arrived in Phnom Penh. Molly is a 23 year old recent graduate from Santa Clara with a degree in public health. During her orientation week, she spent some time with us at the school. Her orientation also featured a day trip to Wat Opot and I got to go! I was in heaven and loved every second being back with the kids. My shadow Srey Nith, who I mentioned in my last blog, has started getting a bad fungal infection on her head. She had had one before that was healing, but now is back. It broke my heart to see her head with oozing open sores, but she was the same little happy goof ball. Love her :) I can't wait to go back there this weekend!!!

I have lots to share about my last two weekend adventures. One weekend was spent in Bangkok, Thailand and the other in Sihanoukville, Cambodia on the Gulf of Thailand. The former was a cheap, spontaneous trip, the latter was included in our GSC program fees. Both weekends were so much fun and I'll be sharing about them in my next post.

I hope that everyone who's going back to school in the next few weeks has a great start! Thanks for checking in, and have a wonderful day :)

Wat Opot

I apologize for going so long without posting to my blog! I have been back from Wat Opot for over a week now and have had the hardest time writing. During my writers block, one of my closest friends in the world, Whitney (who also has a birthday today, HAPPY BIRTHDAY!!) said, "just start with the first squishball and go from there." Taking your advice, Whit, lets see what happens...

After settling in to my new room and getting the initial tour of Wat Opot, I sat down for lunch with Wayne, the Wat Opot director, in an outdoor covered dining table next to a fish pond. No more than 10 minutes into lunch I saw the first child, a little tiny bald boy with a big bandage on his head wearing a matching red plaid PJ set walking around by himself. I could only see him from behind. Wayne explained to me that he was about 3 years old and HIV positive. His mother had died and his grandmother carried him around for the first two years of his life afraid that if she let him go, he would die of AIDS too. I cant remember exactly what happened, but his grandmother ended up bringing him to Wat Opot. He had never walked or done anything for himself. It was a tough adjustment to be thrown in with 59 new kids running and playing and he didn't take it well. He cried and screamed all day long and refused to leave his bamboo mat/bed. When Virak turned around, I expected to see a sad, lonely little boy. Instead I was greeted with a devilish smile letting us know he was up to no good. For the rest of lunch, Virak hid behind the chairs giggling, stood on the edge of the fishpond until told by Wayne to backup, running away in a laughing fit, "hiding" behind small bushes and trees, and doing silly dances. His feet are turned out, but he is recovering well from his early sheltering and apparently is now fitting in great. Hearing his story and seeing him now, I couldn't believe it. How does a small child recover from something like that so quickly? I knew that this place would be special.

My first day was unreal. Before leaving, Kristen and Cora -- another two of my closest girlfriends-- helped me pick out lots of fun things to do with the kids. My only regret of this trip is that I didn't bring MORE bubbles, balloons, glow sticks, stickers, colored sidewalk chalk, silly bands, crayons, pens, and playing cards. I was so foolish to think that 3000 stickers would be enough!

All afternoon we played with the goodies I brought as I tried to learn names and faces. I already struggle at home remembering Abby, Sarah, and Maddie, throw in names like Srey Nith, Nak, Socheat, Ty Meng, Sey Oun, Vis Na, Conthea, Srey Pao, and Neapeah and you've got yourself a struggle. My name on the other hand, they picked up easily although they called me Kat rather than Kate. I loved it and thought it was so cute to have herds of kids yelling "KAT KAT KAT!" wherever I went. It didn't take long for me to get attached.

Dinners at Wat Opot are so much fun. I eat with Wayne and Mark, a long-term American volunteer, as children slowly gather around waiting for us to finish so they climb in our laps and play. Medications are passed out at 6:30, but before then, we walk over to the on-site crematorium to pray. On my tour when I arrived, Wayne showed me the crematorium which was still warm from the 4 month old baby who had died of AIDS the day before. Wat Opot was started 13 years ago by Wayne, a former US Marine medic who was wounded in Vietnam, and a man he met in Cambodia, Vandine. Together, an American Christian and a Cambodian Buddhist started Partners in Compassion. Their focus was care and awareness of HIV/AIDS, and they opened Wat Opot (named after the Buddhist temple it is located next to) first as a hospice center. Over the last 13 years the hospice has allowed over 500 people to die of AIDS comfortably and with dignity. The crematorium was built early on when there were too many bodies to keep up with. Today, Wayne and Vandine run separate PC projects. Vandine handles the home care and community health center, while Wayne oversees the orphanage. Wat Opot has grown slowly to become the family it is today. Most of the children there have been left behind after their parents, siblings, and friends have died on the grounds.

Pictured to the right is the side of the crematorium building, and in the background, where the ashes are kept. Looking in the the window in the side room, you will find a wall lined with pictures and urns of just some of those who have died. In the room there is also a gong, candles, and incense that is lit each night while a special Buddhist chant and Christian song are sung. The nightly participants vary as the prayer sessions are open to anyone. There are usually 5 or 6 children that attend, sometimes even the little ones. It is just awe-inspiring to see these little children who have been running around all day like regular kids turn into mature adults in seconds. Some of these kids have experienced more emotional trauma in their short lives than some of us will experience in a lifetime. Once the prayers are over, the children once again return to being kids. Without knowing some of these kids stories, you would never suspect they have experienced what they have. Little Srey Nak, for example (pictured left), came to Wat Opot with her mother who was dying of AIDS. She sat at her mothers bedside for 2 months watching her slowly die. Once her mother had passed, she was cremated on site and Srey Nak became part of the Wat Opot family. From what I've heard it took her a long time to smile. She would scream and cry if anyone came near her, and it was near impossible to make her comfortable. Today, she is a happy little girl in a giant loving family. She was one of the kids I became most attached to. Look at those precious curls :)

Srey Nak is HIV positive and on antiretroviral medications. The children who are seropositive follow strict medication schedules, taking them at 6:30 am and 6:30 pm sharp each day. These drugs are serious. Other medications if missed may cause a headache or fatigue, but when you skip out on ARVs, you risk resistance and in countries like Cambodia where second-line drugs are the last option, you can't afford to mess around. This is why our group had such a hard time in Tanzania seeing HIV positive people in poverty who may have gotten medications from the government but would take them irregularly because they couldn't afford food to take them with, causing them to feel sicker. I saw many vicious cycles in Tanzania like that, people were too sick to work, so they had no money, so they couldn't buy food, so they wouldn't take their medications, this caused the HIV infections to worsen, causing them to be too sick to work and on and on. These people had drugs so they thought they were OK taking them occasionally. Imagine telling someone who can't buy food that by not taking her medications, they were in some ways just killing themselves faster. The kids at Wat Opot know there is no messing around when it comes to taking pills. Even the little tiny ones swallow big pills no problem because there's only one thing, besides stealing, that Wayne absolutely does not tolerate, and that is refusing to take medication.

Over 2 wonderful weeks at Wat Opot, I tried my best to stay busy. That included cleaning and covering open cuts and wounds, especially those of the HIV positive kids, wiping runny noses, scrubbing fungal opportunistic infections off one little girls head, then holding her as she cried in pain afterward, caring for the mumps outbreak that started right before I arrived, giving out hugs and kisses, playing games, throwing kids into the air and spinning them around, coloring, and just being there to hold them, especially the little ones. I got particularly attached to one little angel, Srey Nith (right). On my second day, I ran over to a little girl after she fell off a swing on her face and was screaming and crying in pain. I picked her up, brushed off her face, and let her cry as she laid her head on my shoulder and held on tight around my neck. That was it. After that, she was my shadow. Srey Nith is 3 years old. 6 months ago, her mother died of AIDS leaving her behind with 2 older sisters. That same day that she lost her mother, her uncle had all of the girls tested for HIV. Srey Nith was the only result to come back positive. Her uncle immediately had her sent to Wat Opot. Maybe he was scared of HIV, maybe he wanted the rest of the girls to be sheltered from perhaps losing their little sister one day too. Whatever his reasoning behind it, Srey Nith was suddenly alone without her mother and her sisters, never knowing her father. I think her father had died, but I'm not sure. Srey Nith is fitting in well to her new family. She is the sweetest little girl with a smile that just melts my heart. Her head is shaved because of a fungal infection that is healing beautifully. Luckily her head didn't require scrubbing I don't think I could have handled it!! One night I was thinking before bed, that if I was a little older, had some money, and a place to live, I would adopt her in a heartbeat. Nevermind that the US apparently doesn't allow HIV positive kids to be adopted in, I would have done it. Then I thought more. Why would I take her out of Wat Opot? This place isn't an orphanage. It's a family. Children don't come here as a waiting room for adoptions. In fact, Wayne has only adopted out two children and didn't want to see either of them go. Sure these kids sometimes drive each other crazy, but isn't that part of any family? They love each other, and they care for each other. There's only one child that I (I hate to even type it)... didn't like?! Can I admit that?? He was just such a bully most of the time to the others and I would get so mad and frustrated. However, one night little Virak was sitting outside of the medical building crying and waiting for someone to come get a painful splinter out of his foot. I was walking over to him but still pretty far away, when I saw this bully walk over to Virak. I picked up my pace afraid of what would follow, but stopped in awe when the bully sat down next to crying Virak, put his arm around him and hugged him. He sat there with Virak until I got there so that he wouldn't be alone. These kids all have a common bond: they know what it's like to lose everything and everyone that they have in the world. The Wat Opotians have amazing lives. They are happy, as healthy as possbile despite their diseases, get three full and nutritious meals a day, have a bed to sleep in, a school to attend, and a big family to love and comfort them. If someone tried to take my sister from me, I wouldn't have it. Same rules apply here.

As I said my goodbyes and drove away from Wat Opot, I was so sad to leave but so happy. I have never experienced anything like this place in my life and am so fortunate to have had the opportunity to meet and love these incredible people. I am happy to report that I am going back to Wat Opot for my final 2 weeks in Cambodia!! I will restock my treats, hugs, and kisses and wake up each day until my return with a smile :)

Thank you so much for your help in getting me to these beautiful children.