Transitions

Posted on May 8, 2012

Fiona has been keeping me up nights.

Well, Fiona’s jetlag if I must be completely accurate. Actually, both of our internal clocks are completely out of whack and we are reacting in vastly different ways. I’m waking up totally disoriented and Fiona’s waking up with a serious case of munchies and ready to snack on whatever is handy. The first night I woke up at 2:40am convinced we had slept right through the next day. Sadly, I’d actually only been asleep for about 4 hours and my disorientation was due in part to an incorrectly programed cell phone (damn 24 hour clock feature ) and the fact that all the lights were on while Fee was happily sampling the complementary tray of cookies and sticky rice treats housekeeping had left. While my befuddled brain tried to remember who, what and where I was, she offered up half a chocolate brownie bite and asked if I could remember what day it was.

The 2nd night Fiona tried to not rouse me when she found herself wide awake and hungry again at 2:30 am. She kindly snuck outside to the patio couch but a frisky cricket drove her back inside again where she managed to rustle up a bag of chips which she was happily munching while reading The Hunger Games when my eyes cracked open. Desperate to try and kick my irregular sleep habits, I staggered over to my bag , snatched up a bottle of Melatonin and took a big old swig. Note to self: never overdose on Melatonin at 3am after a big late night scotch and very little food while suffering from jetlag. I spent the next two hours wracked with gut cramps. Luckily, I happened to have a nurse with a great bedside manner sharing the same room.

Adapting to the Cambodian time zone hasn’t been the only difficult transition this trip. Safe Haven is in the midst of some fairly big changes and the growing pains are difficult. For the past two years, Safe Haven has been a part of CFI or Community First Initiatives, a 501c3 not for profit program in Cambodia that focuses on building self sustaining villages through programs in the areas of clean water, job training, education, health and agriculture. CFI was founded by my dear friend John Whaley. Over dinner one night in 2009, we were discussing the great need to get Safe Haven up and running because there was a very real possibility that many of the children I wanted to help would not live long enough for me to go through the long process of becoming my own independent non profit program. It was a point that was painfully brought home by the death of my Cambodian son Sum Namg. John graciously offered to bring Safe Haven into the CFI fold as part of their health care initiative so we could begin working right away and not lose any precious time. Thanks to his generosity, we were able to implement the Safe Haven Outreach program in October of 2010. Over the course of our first year we experienced many highs and lows. We saw the lives of children who had never had access to basic health care or surgical intervention transformed. We also witnessed the dignity of another family who had to bury their child too young when he died from complications related to Cerebral Palsy and felt the deep gratitude of his mother when Roza, my project manager, visited a month after his death to let her know he was important to us and give her a photo of her son.

Without John shepherding us through our formative year under the umbrella of CFI, Safe Haven would not have been able to grow into the success it is today and it has become a program that needs to leave the nest and strike out on its own. So with deep affection and a lot of gratitude, I sat down with John a few months ago as we came to the conclusion that Safe Haven was ready to become its own full fledged non profit. For me, it has been as daunting as stepping off a cliff. Having the safety net of CFI has made it possible to get to where I am and going to the next level on my own gives me heart palpitations and has me reaching for a large glass of whiskey. Prior to arriving in Cambodia on this trip, I received my California state non profit status for Safe Haven and submitted the final paperwork for my federal status.

Normally, when I get to Cambodia I hit the ground running with field work out in the villages and in the hospital. But these first couple of days have been filled with a lot of practical administrative type stuff. Not as glamorous as traversing sketchy bridges and dodging water buffalo on moto bikes out in the countryside, but equally as necessary as we begin transitioning towards independence.

My friend Chitra was gracious enough to rent me two rooms on the 2nd floor of a building she recently bought so we could set up a temporary office. To say we are cozy is an understatement. Roza has masterfully managed to fit three desks into the first room but Pheakdey, my physical therapist, practically needs to be shoe horned into her space. Luckily, she weighs about 90 pounds and can easily be shot putted into place if needed. Jess (my nurse) and I are sharing one desk as neither of us is there full time.

We are using the 2nd room as a conference area/storage space/kitchen/medical room. On the bright side, it is certainly going to encourage all of us to spend more time in the field with the kids. Given the choice between risking Tuberculosis, Dengue Fever, Trauma by Moto Bike or being in the claustrophobic office, I’ll take the former afflictions in a heartbeat. Actually, between Fiona, Roza and I, we’ve actually covered all three already.

But this morning there was no escape. My intrepid staff and I crammed ourselves into the conference room and begin to go through our roster of kids to determine who needed to be scheduled for surgery, who was in need of medical intervention, review speech and/or physical therapy progress reports and decide which children were ready to be released from our Safe Haven program. Some of the reasons for releasing a child are difficult. Several of our kids who could really use continued care have left the country. With no way to feed their families and support themselves in the villages, many of the parents have opted to try their luck crossing the border into Thailand. There is little we can do except let them know if they return, they can call us anytime. But chances are we will not hear from them again. Sweet little 5 year old Mesa, who suffers from CP, is one of the children who is no longer in Cambodia. Early intervention with a child like Mesa is key, in particular with physical therapy, which can help her develop the ability to gain strength in her weaken torso and limbs. We had high hopes for her to be able to eventually learn to use a walker. She had recently started to crawl and pull herself up into a standing position. We can only hope her parents will seek out continued care for her in Thailand.

On the other end of the spectrum is 18 year old Tola. We simply cannot do anything more to help him. Tola is an extreme example of a child who never received any medical intervention and his deformed body continued to grow and twist until he was permanently in a hunched up position. Over the last year, we’ve worked with Tola and his parents on basic physical therapy techniques they could do to relieve some of his daily pain. But our limited capabilities and his extreme condition left us with very few options. Early on we consulted with several surgeons but received the same hopeless answer. Tola, now an adult at 18, is a very sweet young man. The reality is, there is simply nothing we can do for him.

Not all of the assessments for children leaving the program are grim. Most are massive success stories. There is 10 year old Soth, blind from birth, who now sees due to surgery on his eyes. He just started school for the 1st time. 8 year old Kea, after enduring almost a year of surgery and rehab on her clubbed feet, is also in school and walking flat footed for the first time in her life. 5 year old Vannack can now hear. 7 year old Von has recovered from his orthopedic surgery on his backwards knee and is now walking normally with a leg brace. Sona and Raty, two kids with Down Syndrome who previously spoke very little have flourished with speech therapy. Like Safe Haven, they are ready to take new steps towards independence and a brand new future.

These are the transitions to celebrate.