Mon., Aug. 3, 2009 - Day 10 - Fri., Aug. 7, 2009 – Day 14

Some pics on the way to meetings. I saw this fighting deer sculpture thing in the National Museum too.


Lunch that the housekeeper made for me. Quite yummy. I gave her $20 to buy food and make whatever she wants.




This week was my second week of work.

Monday - I am no longer in the corner of Nemo’s office. I have my own desk, chair, and desktop computer and I’m sharing the office with a nice woman – we’ll call her Aussie. I’m still working on the monthly report and waiting to obtain data from different people. I met with a guy in charge of one of the surveillance systems and it turns out he’s interested in MPH in IT in the US. I am still in search of gyms here. I visit the gorgeous Cambodiana hotel gym w/ swimming pool and tennis courts and they are offering a 1-month membership for $56. I’m only here for 2.5 more weeks. Himawari gym is $75 per month and I didn’t even take a look at the gym – too rich for my expenses. I walked slowly home and accidentally hit upon a mini shopping mall for the native Cambodians. It reminded me of the huge Shanghai underground mall that had individual stalls selling clothing, shoes, jewelry, although the Shanghai one was much better. The one here is much smaller and they don’t offer a lot of varieties. I stopped at a first one and saw a skirt that might be good for work. They only sold small sizes, but their small sizes here are like girl sizes. They literally sell clothes that say 12 or 14 from The Children’s Place to adults. So I look at the pile and the woman takes one look at me and says no big size. I was slightly offended for a second but then remembered that I am in a country where most women are very small and for the first time in my life, I’m towering over them and I’m almost the same height as all the men here. So I will admit to my non-Asian hips and accept the fact that I can never fit into a small bottom (pants, shorts, skirts) in Asian countries. I continue walking home to the sound of “moto” and “tuk tuk”?

Tuesday – Dory and I go to the Pasteur Institute of Cambodia to go over data. Pasteur has its headquarters in France but has sites all over the world. The one here is responsible for a lot of virology and bacteriology data, such as sub-typing the influenza viruses into H1N1, H5N1, H3N2, etc. Their data is confusing and I meet with several individuals, but the person in charge of the data has left and another person in charge is on vacation. So we are left with one person who is compiling data using an equation/program that someone left behind without much idea as to how the data is generated. Dory and I finally leave with a potential of obtaining data the following week. That night, I went back to the VIP sports club in hopes of getting a cheaper gym pass. It is raining and I ask Mr. Lam (same last name as mine!) for a ride, he is the housekeeper’s husband and works as a moto driver. I don’t remember the ride to the gym being so long but in the rain it seemed like forever. Mr. Lam leaves and I try to bargain my gym membership. I gave him 8000 Riels, about 4 times more than what I should’ve paid but I got so confused with the big bills and it was raining. A woman listens to my story (I’m a student interning for free, with only 2.5 weeks left, and I plan on paying extra for tennis lessons) and asks a man (prob the boss) if there can be a discount. I also say that the Russian girl I met also signed up at the gym recently b/c of my recommendation. So they drop the price for a full membership from $40 to $30, Monday – Sunday, free access to gym, pool, and tennis courts. Except tennis lessons are $5 and I need to pay $5 for lights after 6 PM. So I’m happy about the price, even though it took 2 visits and a lot of pleading. I work out for 20 minutes and am about to have a heart attack on the treadmills b/c the machines are so old, many buttons don’t work, and the entire machine shakes when I run. So I leave the gym and bargain with a moto driver for a ride home. $3. No, 1500 Riels. $2. No, 1500 Riels. Lady, 1000 Riel takes you back to the gym from here. 2000 Riels. 10,000 Riels. I leave him and continue walking. Here is the great irony of this country. When you don’t need a ride, every man on earth asks you and holds up the index finger to get your attention. When you do need a ride, they are not paying attention to your waves. I flag down a tuk-tuk driver and begin the process all over. To Independence Monument – how much? $3. No, 1500 Riels. 10,000 Riels. No, 1500 Riels. OK. So I hop on and am excited to go home. When he lets me off, I give him a 1000 and 500 Riels bill and he looks confused. 10,000 he says. I am surprised. What? I said 1500 Riels and you said ok! He says Noooo. 10,000 Riels. I say that I took a tuk-tuk all the way across town for $1 so this is halfway. He says no, 10,000. I say that I told him I didn’t bring that much money to the gym and told him that if he met me at the gym the following day, I would give him an additional 500 Riels. He laughs nervously and I suggested that he repeat the customers’ prices just to be sure in the future. The motor for the tuk-tuk is loud and he’s wearing a helmet so perhaps he didn’t hear me or maybe this is a gimmick to get more money out of me. I’ve heard these misunderstandings happen a lot. I get in and Buddha suggests that Mr. Lam takes me to avoid these situations. I happily agree.

Wed. – I go to lunch with Aussie and she takes me to the Living Room, a cute place for lunch that offers free wifi and outdoor patio seating arrangements. I order this plate of meatballs with tomato sauce, hummus, bread, and salad, for just $6. It was so delicious. Aussie works with emergency pandemic influenza preparedness, which just sounds awesome. GW is actually revising their plan, which is good b/c it needs improvement. Aussie tells me how she used to be a midwife and worked for MSF (Doctors without Borders) in Rwanda and other conflict-ridden areas for months on end. She interrupted these experiences with 2 Master’s degrees in Ireland. There is 1 story that stood out to me. She was in Rwanda during the genocide and working in refugee camps. The many organizations there carved out a makeshift map of the camp and divided their personnel and services in the camp. There were many deaths and after months of no clean water, there was finally a point when engineers devised a system to bring water into the camp. Another day, she asked the director how many deaths occurred overnight (I guess they kept mortality statistics every morning) and he said zero. She kept asking the question, getting annoyed. And he kept saying no deaths. She was so amazed that the death toll finally became zero and I could tell that it was still an emotional experience over a decade later when she told me the story. I cannot fathom what it would be like to work in those conditions. And she didn’t even stop there. She went on another mission working in dire conditions and then decided that she wanted to switch. So now she works as a short-term contractor for the WHO to work on emergency preparedness. She also asked me a lot about my family and America, especially about med school and loans. Everyone outside of the US is always astonished when they hear how expensive school is in the US. In the UK & Canada, much of the tuition is subsidized and/or very low. Why the US can’t do the same, I don’t know, but luckily, schools like Harvard are offering to cover students who can’t afford their tuition.

Thurs – I visit NAMRU2, the United States Naval Medical Research Unit number 1, detachment Phnom Penh (based in Jakarta, Indonesia). It is in the facilities of the National Institute for Public Health. Turns out I’m using their data but I didn’t know that when Dr. Navy originally told me about NAMRU2. Dory and I go and I meet the Director, a Lieutenant, and a woman (secretary?). They ask me about my schooling and everyone says a MD/MPH is a great thing to do and they wish they did it at the same time. We finally get around to the data and they are all very helpful in enumerating the number source and even gave me an article providing background of their system. I go on a tour with the woman and Lt. of their labs. All the patient data is kept locked b/c of HIPAA regulations. Interesting – HIPAA extends all the way to Cambodia. I also find out that people can’t be hired as permanent staff at NAMRU2 without Congress approval/funding. So they have a lot of Cambodians working not as permanent staff. Quite interesting although I haven’t had microbiology yet so some terminology is lost on me. We take a picture b/c they capture everyone who visits the lab.

Left to right: Secretary woman, lab person, me, Dory, Lt., another lab person.

Fri. – I sit in on a United Nations meeting called to order by Nemo. It’s so funny b/c they were preparing for a huge influenza pandemic and ordered tens of thousands of gloves, antibacterial solutions, face masks, etc. So now with all the extra stuff, they may donate it to the Cambodian Ministry of Health. I met people from UNDP (UN Development Program) and UNICEF (UN Children’s Fund). I tell the UNICEF coordinator that I have been raising money for them via the Trick-or-Treat program since high school and I get some more business cards.

I am nervous. Today is the Technical Working Group meeting at the Ministry of Health with people from the US NAMRU, US CDC, and other organizations interested in pandemic influenza. Nemo gives a quick background and I ensure my scientific poster presentation mode. Everyone is given a copy and I go through the report. The guy sitting across from me offers data from Angkor Children’s Hospital (which Marlin suggests I do an away elective 4^th year there). Afterwards, I meet with Dr. P of US CDC and he tells me he did peds residency in Hawaii and did the Epidemiology Intelligence Service with the CDC and lets me know that they offer a 6-8 week elective for 4^th year med students too. He offers to put me in touch with people and I am meeting him next week to talk more about this. I have no idea what I want to do in the future, so all advice helps.

I get home and go out to dinner with my housemate, Belle. We eat pho by the riverfront for $2.50 while children and adults come up and beg us to buy their books/DVD’s and ask for money. It is so sad. I order Angkor beer, which tastes pretty dilute but was actually pretty enjoyable. She ordered Anchor beer. It was so good!!! Well worth the $2.50. We went shopping at the night market by the riverfront and it was so crowded with lots of Cambodians. I bought a dress for $2.50 and a mini cupcake (but really a sponge cake) for 1500 Riels (less than 25 cents), and a sugar cane drink for 1000 Riels. We go home with Buddha’s friend who is a tuk-tuk driver and pay him well ($6) for a few hours of service. And then I pack for my flight to Siem Reap to see the temples!!