Wednesday, April 2, 2008

A FINAL REFLECTION BY BRIAN

Brian Ake
Cambodia Reflection
April 1st 2008


On Monday, March 10th I left Boston, which began my 32-hour journey to the other side of the world. I arrived in Cambodia on Wednesday, and right from the start, I realized that this was going to be a special mission. I met up with the student sponsor, one of the other students, a PIT, and a nurse in Los Angeles and right away we all connected on a personal and professional level. One thing that will always amaze me is how 67 total strangers from all different backgrounds were able to come together in those two weeks and perform an amazing amount of surgeries, in an extremely poor part of the world. Teamwork proved to be one of the themes throughout the mission.

When I first set foot in Cambodia it was a surreal experience. It was as if during the bus ride from the airport to the hotel was one long dream. The hoards of mopeds, not at all worried about what side of the road they were whizzing by on, and the shacks that shouldn’t be considered houses, littered the sides of the road.

I was at first taken aback when I saw how poor the people of Cambodia are. The only relative poverty I had seen previously, were the projects in the Bronx. I realized when seeing these “houses” made of cardboard, I will never, ever in my life make a joke about someone living in a cardboard box. People really do live like that, and it is nothing to joke about.

When screening week first started I was a little nervous. All my nerves slipped away when I grew accustomed to the people of Cambodia and their warm and gentle spirit. During the first presentation we made, I had a few butterflies, but when the kids laughed everything was fine, and after that every presentation got easier.

The surgeries were the most amazing thing I have ever seen. I had the pleasure of bonding with a several kids; bringing them all the way through the surgical process until they arrived in post op. It is an amazing experience being with the parents when their child came out a transformed person.

I will definitely travel on another Operation Smile mission. The two weeks I spent in Cambodia were probably two of the best weeks in my life.

Friday, March 21, 2008

LAST SURGICAL DAY - FRIDAY, MARCH 21ST

Friday, March 21, 2008 5:00 PM Cambodia


Well, we are done. We only had 10 surgeries scheduled for today so that we could be finished operating by 10:30 AM and have everyone out of the recovery room by noon. All the surgeries were simple. At 12:30 we had a closing ceremony with several dignitaries from the Cambodian government. They were very appreciative of all that we have done.

So, some final statistics:
We screened (full physical and dental examinations) 284 children and adults. Many of them had speech evaluations as well.
We performed 133 total surgeries in 4 ½ days.
Most of the surgeries were for cleft lips, palates and other complications associated with that condition.
We also did a number of surgeries on children who had been badly burned.
Carlos, our dentist, extracted more than 100 teeth.

Overall, we are tired and hot and many on the team have been quite ill. But, it was so worth it. We have truly made a difference for all of these people. It has been life changing for both of us.

We are off to the final party in a few minutes. More photos and some final words when we get home.

Thanks to all of you for your messages back. They have meant a lot to both of us.
M&B

Thursday, March 20, 2008

4th SURGICAL DAY - THURSDAY

New Photos Below

Thursday March 20, 2008 8:30 PM

Brian
Today at about eleven, the student team went to a local school. During the week, the children live there, while they travel home for the weekends. Jean, the head translator, told us that some of the kids who attend the school bribe their parents with rice so they will let them go. Some of the kids that attend are children that live on the dump that I went to yesterday.
You wouldn’t believe what the children have at the school. Each child has access to his or her own laptop computer. And, they have more computers for general use. The first thing we did when we got there we did our medical presentations to the kids. The picture below is of us doing the dental hygiene one.

There was one kid who lived at the dump who needed a cleft lip repaired who was screened on Monday. When Jean called the school to set up our visit, the lady who runs the school said she wanted to send a kid to us. His picture is below – it is the one with me.

The kid whose number was 207 did have surgery today. He was one of the first to go in. When he came out of the OR into the first recovery room, Sarah who developed a very close relationship with him, held him in her arms the entire half hour he was in there. The picture of the two of them is below.

I just realized that in no part of this blog have I mentioned my documentary. I have shot about five hours worth of tape and probably in the next three days use another hour at least. Not all of the tapes will be used, like the third tape was exclusively about the days off we had. I have shot roughly two hours of footage that will be cut down into 25-30 minutes. I included many shots of the OR, screening process, recovery room, post-op, and interviews with many team members. Because of sound, I have decided to use a voice over to explain some stuff. It will sound a lot better, and I can capture the raw sound of the mission.


Margaret
Today was a little less hectic for the medical records team. We were able to get caught up on our paperwork as we didn’t have too many new patients come in to be screened today. The little girl that I posted her before picture yesterday with me got operated on today. Her after picture (with me) is also below.

There was a little girl who was operated on yesterday – she is about 10 years old. She had her nose completely redone. She is the prettiest thing and her parents were so sweet. I really bonded with all of them.

We did 31 operations today including one on an older man (59 years old) who showed up today for the first time. He had a huge scar (I think from a burn) on his face. The scar tissue was pulling down on his eye so he looked just terrible. His brother told me (through our interpreters) that he has had the scar since he was a teenager. David, one of our surgeons, gave him a complete face lift and he looks amazing. He didn’t want me to take his before picture. His brother said he was so embarrassed. So, I can’t show you the difference. But trust me, it will change his life.

One more surgical day tomorrow and it is only a half day with only 10 surgeries scheduled. Then we need to pack everything up and there is a final party tomorrow night with a lot of Cambodian governmental officials. Rumor is that we are going on a dinner boat cruise down the Meekong River.

Good night.
M&B

Wednesday, March 19, 2008

3rd Surgical Day - Wednesday

Wednesday March 19, 2008 11:30 PM

Check out the new photos!

I’m back

Let’s just say that I am feeling much better. Also, I am never eating in a restaurant that has lizards that hang out on the sides of the walls.

To clear something up, I went to the hospital on Tuesday, got three IV’s right away after I threw up four times, and then went back to the hotel. There I slept from about 8:30AM till around seven. The IV’s make you really tired, and make you go to the bathroom a lot. Other than sleeping for eleven hours, I was getting up to go to the bathroom. Today, I am so much better.
The role of the students during mission week is simple. Entertain the kids so they don’t get anxious before their operation. A lot of times we can bring them right to the Operating Room. (I vomited all over my new scrubs yesterday, we threw them out.) On all of the days during surgery week the student team goes out in the afternoon for different things. Yesterday I missed the orphanage so we don’t have photos from that, but I heard it was great. Tomorrow we go to a school for a few hours, and today was the most exciting of all. Today we boarded the van lent to us by the head translator and headed for the 2nd largest dump in all of Southeast Asia. This place is the lowest you could get on the poverty line. Thousands of people actually live on the piles of trash in huts, while you can literally see the toxic fumes coming out of the garbage. There was also a school about 10 yards outside of the dump where we stopped to hand out some small gifts.

The second place we went was the infamous killing fields of the Pol Pot regime. The killing fields were the location of about 20,000 silent killings. The innocent victims were tortured and beaten to death because gunfire would raise suspicion among other citizens. The slayings of the Pol Pot regime are considered by many to be worse than the Holocaust due to the intensity of the deaths. While Hitler gassed his victims, he never tortured women by electrocution, nor did he beat children against trees. The mass graves which were excavated in the 80’s are the big holes in the ground. (See pictures) In the center of the field was a huge monument that contained every single skull that was found on the site. In some spots, the clothes of victims were still visible in the ground.

On the brighter side, some of my favorite patients had surgery today; you can see their after pictures below.


From Margaret –
Things were busy in the medical records department today. We spend 14 hours at the hospital. And, believe it or not, today was the hottest day yet. I wouldn’t have thought that was possible. We operated on 31 people today. We have a lot of pictures. The power goes out in the hospital every day between 10 and 11. There are regular power outages every where in the country. So, we have our own generators in the OR to keep the machinery going. Out front in medical records, we make do without. When the fans go off, it gets pretty ugly.

There are many families who have been in the hospital all week – they came together from 500 miles away (almost into Thailand) and several are having surgery all week so they stay in the hospital. One of the boys has been hanging around with us every day. He is 8 years old and has never had his palate closed – his lip was done last year. He will have surgery first thing tomorrow. He is an amazing kid – so happy considering how poor he is and how little he has. He has worn the same clothes all week. He still is wearing his sticker on his shirt that has his number on it so he doesn’t miss out on his surgery. He is number 207. At first they weren’t sure they could operate because his cleft palate is so big. But the team ultimately decided to do it on Thursday. Please pray for him that all goes well.

We had a little trouble with the schedule for tomorrow, so that was why we were so late getting home. We are getting to the end, so we are trying to squeeze everyone in. I am actually posting this on Thursday early in the AM. The Internet wasn’t working last night.

Until later.
M&B

Tuesday, March 18, 2008

Tuesday Night - 2nd Surgical Day

Tuesday, 10:20PM Cambodia

Check out some new pictures posted today!

Well, today we operated on 32 patients. A very long day but some amazing results. The bad news is that I (Margaret) am writing this because Brian has gotten sick. Actually, we have had a lot of members of the team get sick. Yesterday we had about 8 "throwing" and today a couple of more. So, Brian ended up in one of the recovery room beds on an IV. He is better now tonight, they are pumping him with antibiotics. So, that mystery food I keep talking about - I haven't eaten much of it and so far I have been OK. So, I have no intention of eating anything I can't completely identify. Today for lunch I ate pringles and peanut M&Ms. It seemed much safer than the other 'stuff' they were serving for lunch.

So, again, it was HOT today. The recovery room is so hot, the patients' mothers spend most of their time fanning the babies coming out of anesthesia. But we got some good pictures (including one of Brian on the table). Today, we operated on this 62 year old guy who had the largest growth growing off the side of his face. It hung all the way down to his neck - they say it weighed almost 3 pounds. He now looks like a new person. His two sons were with him and they wept uncontrollably when he came out of the OR. It was truly remarkable. We also operated on a lot of very cute babies who are now even cuter.

Brian has a new friend - patient #262 - he is the one with the bubbles in the picture below - will post his after pictures tomorrow.

Again, thanks for all your messages, we read them all every day! Tomorrow we have 37 patients on the schedule - will be another long and hot day.

Love to all.
M&B

Monday, March 17, 2008

Monday, 1st Surgical Day

Monday Night 11:00 pm Cambodia

Well, this entry will have to be short because today was pretty rough. We left the hotel at 6:30 this morning to go to the hospital and didn't get back until 8:30 tonight.

We operated on 28 people today. They are all in one big post op room tonight. The beds have no mattresses and the IVs are hanging from wire strung from the ceiling. We also had 40 new patients come in to be screened today. Several of them will get operated on later in the week.

There was so much confusion today - we are all exhausted. I'm sure that tomorrow will be better. We will try to put up some before and after pictures tomorrow night because they are AMAZING. Today, we operated on a 21 year old man who had never had his lip fixed. He looks perfect now. His mother was crying she was so grateful. She hugged me so many times.

Brian was so busy today - working with kids waiting for surgery who are hungry, tired and hot. It is so HOT. Brian got to go in to the operating room to see a couple of surgeries. He will write about it tomorrow. I am hoping to get in to watch surgery tomorrow when things are a little less hectic.

We love to read your replies, so keep them coming.
Love,
M&B

Sunday, March 16, 2008

Sunday, Day 4

Sunday, March 16th. 6:30 PM

Check out all the photos at the end of the blog!

Today was our vacation day! We all got on a bus this morning and went to the Royal Palace. It was really beautiful. The buildings are full of gold and silver - seems odd considering the poverty here. After the tour of the Royal Palace we went to the National Museum. It was very interesting. It was full of Buddhist statues and it had beautiful gardens.

Next we went to an authentic Khmer restaurant for lunch. It was really good. There were a lot of things to eat that were "mystery food" but for the most part it was good.

After lunch we went to the Khmer Rouge prison. It was very sobering. It was such a terrible time for Cambodia. In fact, a large percentage of the Cambodian population born between 1950 and 1960 were killed during their regime (1975 - 1978). The prison had amazing photos and most of the cells are still in tact.

After the prison we went to the Central Market (different than the Russian Market). The shopping is incredible. You can bargain for everything. Mom bought so much stuff and I think she only spent $25. We rode the Tuk Tuk back to the hotel - always an adventure - you take your life in your hands every time you get in.

We have a meeting tonight that starts at 7PM. We go over all the surgeries for tomorrow and review the operating room procedures. We are all ready to go!

M & B

Saturday, March 15, 2008

Saturday, Day 3

It’s Brian again. Quick question, is it really true that the Red Sox cut Doug Mirabelli?

Since the students are the ones doing the entertainment for the kids, the job settles down after a while. We left the hospital on the second day of screening earlier than the rest of the team. Early in the day, there were a little of kids and it was hot. We were doing our best to keep them all happy.

Yes it is true I did get a massage on Friday night and it was awesome. It made me sleep better than the first two nights, when I was getting up every hour. I went shopping with Sarah, Dash, HJ, and two other team members on a Saturday morning to a huge market called Central Market. It was a little better than the Russian Market because it was twice as big, and it didn’t smell.


Saturday – from Margaret

This morning was intense. When we got to the hospital at 8am we brought out these big boards with the numbers (each person got a number when they were screened) and names of the people who are going to get surgery. There were people who were crying because they were so happy and others crying because they were so sad. Many of the ones that are getting surgery are staying at the hospital because they live so far (many traveled as much as 10 hours to get to the hospital).

After the hospital, a bunch of us rented a car and went to this orphanage (really just a hut for street people) - it was amazing. It was right on the Meekong River. Anyways, we talked with the children for a long while, they are learning English in their school, the first floor of the hut. This hut they are living in and go to school in didn't have a roof over the kitchen. So we made a $100 donation between all of us, and that will build them a roof. All the children, ten total, sleep in one room on the second floor – and they share one bed. They were so grateful.

Later Brian went with a group of people to see an authentic dance show and dinner, I went with a different group to the Buddhist monastery to meditate with the monks and then we all went to a Thai place for dinner. Food was great. And by the way, you can great a great meal here for less than $6 per person with tip.

It is so very HOT. You can't even believe it, and almost nothing is air conditioned. Thank God the hotel has air conditioning or it would have been impossible. None of the restaurants have air and the hospital doesn't either. Today it was 105 degrees, and it felt worse than that.

Anyways, tomorrow we have a tour of the Royal Palace and Museum and then we are going up to the killing fields. And then on Monday AM, the surgeries start for five straight days.

More later.
M & B

Friday, March 14, 2008

Screening Day 2

Screening Day 2 – Friday, March 14, 2008

I (Margaret) am actually writing this on Saturday morning as we never got to it last night. We screened another 125 children on Friday, so in total we have about 250 people looking to get surgery. Only 125 got put on the schedule last evening before we left. Tomorrow (Saturday) they will post a huge board down in the lobby about who will get surgery starting on Monday and on what day. It is heartbreaking to think that a lot of these people will have to wait. Many of them are just too young, so they will get surgery next year when Operation Smile comes back. And, many of them are just not candidates because their problems are more extensive than can be handled by us in a few days.

The children are so small, they need to do the cleft surgery a little later than would typically happen in the US. One of the things that has impressed me in the first couple of days is how tiny the children are. When we start their chart (my job with the interpreters), we get their age. It was impossible not to question some of them, because the children were just so tiny. Many of them are malnourished and most are so dirty. So sad.

We saw some terrible cases today – kids with tumors and several that they physicians explained last night can not possibly live – they tumors on their face and head are so large they have metastasized to their brains and we can’t possibly help them here.

The poverty in this country is severe. You just can’t believe how and where these people live. Many of the children we saw yesterday had traveled more than 10 hours to get to the hospital. They live out in remote villages – where the poverty is worse than here. That is hard to imagine. Many of the guardians of the patients we saw yesterday could not write to sign the consent form, they would just make an ‘X’.

We spent 12 hours at the hospital today – because after we screened we needed to determine which kids will get surgery. I think it was actually hotter than the first day. I would not have thought that could be possible – but it was.

After we got back, about 15 of us went out by (Tuk Tuk) the crazy carriages towed by motor bike to a pizza restaurant. It was crazy. Gecko lizards climbing all over the walls – and in the middle of serving our dinner – the power went out so we sat in the dark for a while. There are so many people everywhere, all over the streets all the time. The traffic is crazy. After dinner, several went to get massages (including Brian). $7 for an hour massage.

Saturday, we go back to the hospital to notify the patients about who was chosen and to set up the operating and recovery rooms. Helen and I (the medical records team) have to get all the charts ready for surgery on Monday morning. It should only take a few hours and then we have the rest of the day off. We have a lot of things planned. Will write about those next time.

M&B

Thursday, March 13, 2008

Thursday, Screening Day 1

Thursday, March 13th. 9:00PM Cambodia

So, today we saw 133 children and adults at the screening. The youngest one was 2 months old and the oldest was 56 years old. It was 100 degrees outside and even hotter in the hospital. And we spent roughly 11 hours there. So, we were all very sweaty, and very tired.!! Each person had to be screened by a variety of different specialists (anesthesia, nurses, dentists, plastic surgeons).

I have in my mind one of the most important parts of the mission. The two other students and I spend the entire day entertaining kids. You could imagine that after waiting in the hot sun for that long would make a lot of those kids unhappy. One of the things that always seems to work is bubbles. Bubbles will make the unhappy children suddenly happy again. There were a lot of kids that cried only when we weren’t blowing bubbles.

There was this one kid that the student sponsor Sarah, and I loved. We couldn’t understand his name due to his cleft lip so we called him buddy. In the morning I gave him a kite that Sarah had brought and he spent the rest of the day running around the entire hospital with it. It was sad though because he probably won’t get surgery because the required procedure needs to be moving his entire upper jaw forward and it would be too complicated to be done here.

Mom was in charge of paperwork. She had a bunch of boys from the Mormon Church as her translators. She got to see and talk with every single patient. That made her happy.

We had a team dinner tonight, the food was strange – fish with heads, and lots of other stuff that you couldn’t even recognize. And again, we come back to talk about the traffic and the roads – it is the most amazing thing. Today we went to the hospital on a full size bus; we don’t know how we didn’t get in an accident.

One more thing, the showers in our hotel rooms are a mess. Every time you use it the water runs out onto the floor and creates a mess. It’s sort of annoying.

We will try to post photos tomorrow or Saturday. We are so tired tonight and the Internet here is very slow, so everything takes a long time.

M & B


P.S Emily, I want two Italian Cheese bagels, with an orange mango Nantucket Nectar.

Wednesday, March 12, 2008

We Made it

Wednesday, March 12th 2008. 6:15 PM Cambodia.

We made it! Wow, what an incredibly long journey. From the time we left Boston until the time we got to our hotel in Phnom Penh, we spent 32 hours traveling. The first flight from Boston to LA was great; almost empty, plenty of room to stretch out. The second flight from LA to Taipai, Taiwan was completely full. It was the biggest plane, we have ever seen. It had 70 rows and there were 10 seats across and it had two stories. I have to say I (Margaret) was a little worried about whether they were going to be able to get that thing off the ground.

Anyways, we met up with Lindsey (the photographer), Dash (one of the other students working with me) and Sarah (the student sponsor) in LA. There is another student working with Brian named HJ who will be getting to Cambodia at around 10 tonight. We then caught up with several others in Taiwan.

The ride to the hotel was amazing. You can’t believe the poverty even in the heart of the city. It is very scary. The hotel is OK. We will get by; no complaints.

After several of us got checked in, we headed out in these little carriages pulled by motorcycles – they are everywhere. And as far as we can tell; there aren’t any rules about driving. You can drive on the left side of the road; or the right; whatever suits you at the time. So, if you can picture thousands of bikes, mopeds, motorcycles pulling these carriages all going every which way – you just about have it.

13 of us went out to the Foreign Correspondent Club for lunch. The food was pretty good. There were a few things I couldn’t recognize, but all in all it tasted OK. Then, we went to the Russian Market – it was insane!! You can’t believe everything they were selling in this place and it is hard to describe so I hope I can post some of the pictures. I bought some little gifts for everybody. And my mom bought some small oriental purses/plates etc.. My mom said that this place would of been great for her and her friends. We met this little boy named Dar at the market, he was our negotiator - we ended up buying him a new pair of adidas - he said it was the best day of his life.

Anyways, it was also about 100 degrees – and hotter inside the market. So, we aregrateful that our hotel has air conditioning while we are sitting here typing this.

Thanks for all of your messages so far. More tomorrow after we meet our first patients.

M & B

Thursday, March 6, 2008

WELCOME

Welcome to our blog! We will chronicle our Operation Smile trip daily through this website. We hope that you will follow our story and leave us your messages.