April 7, 2001
To whom I may concern, please don't let me.
I have arrived in Cambodia, and it feels like home.
To the recipients of my last email, which called for unbridled optimism regarding the ultimate fate of mankind, I am unsurprised to report that I have come full circle and hate everything again.
Here is the plan. On Wednesday, I head down to the south, to Koh Sla. It is a valley about 50 km, or an hour and a half, from Kampot, populated with the last of the Khmer Rouge defectors. It consists of 18 villages, 6 of which are accessible by road; to the others I will have to take a 4 × 4 vehicle. As far as I know, I'll be the first foreigner, certainly the first doctor, that many of these villagers have ever seen. I will conduct medical clinics from the back of my truck in as many villages as I am able. I've been given the use of a Land Cruiser, a translator named Bohntuen, and some snake antivenom (4 deaths this year in Koh Sla), and I have sorted out a place to stay in Kampot. I've been advised to stay in a hut nearer the villages; I'm pretending to consider this.
Today I spent the day combing through about 10 boxes of half-full bottles of drugs, deciding which I might need and knowing that I haven't a clue. Right now I have about 4 boxes of pills. I have to buy the rest on the black market tomorrow. It's helpful that the market is actually called “The Black Market;” this avoids any confusion.
I'm planning to meet Colonel Chan, commander of the Koh Sla region and former Khmer Rouge head honcho. He is guaranteeing my personal safety in the jungle, and I hope he likes me.
April 7
Rules for living in Cambodia:
1. Everything's a bug. Even things that aren't bugs, are.
2. SPF 40 protects you from the sun like glaze protects a ham.
3. Right of way is directly proportional to the size of the vehicle, or of the person.
April 8
Koh Sla is home to approximately 12 000 people in 18 villages. These people were some of the last Khmer Rouge to “defect,” i.e., give up, in 1997. Before that, they lived in the jungle and fought the government, the Vietnamese, the Americans, and then each other, for 30 years.
The road through Koh Sla has just been completed, and people are finally beginning to build homes and to carve rice patties out of jungle thatch. Their health is abysmal. Lots of malaria. Many kids have worms. The village chief earns about $27 a year and has enough rice for 8 months. The poorest woman I saw has no money and enough rice for 4 months. The other months they beg from neighbours in return for labour, or eat roots they find in the jungle. Water comes from a dirty pond, and there is little fuel for fires. Many are scared to clear more land for fear of mines. None have seen a doctor.
A few jungle medics left over from the war serve the valley. They have little money for medicines and no money to get to hospital, let alone pay for the stay. Transport to hospital, for those who have money, is by ox cart or, if they're lucky, moped.
The Khmer Rouge killed 2 million of their less fortunate or less able countrymen: one of the largest acts of genocide in the history of the modern world. Anyone who has travelled here knows the “Khmer stare.” Blank faces watching you pass. But Cambodian smiles are there; it's just that they're deep down. The trick is to keep on smiling at them.
One thing that both the Cambodian people and I agree on is that there is no longer a defining genre to characterize the music of today as dangerous and new. They argue that this is because musical tastes are more refined and diverse, that distinctions are blurred, with jazz being found in drum'n'bass, hip-hop in ballads. It is difficult to imagine something coming along and revolutionizing the way we think about sound. Unless we begin to enjoy the subtleties in the noise modems make when they connect. But, if I were you, I'd begin to invest heavily in the soon-to-be-the-next-big-thing: Khmer music. I heard a track today called “soooyyounnn-maaahhhh-laaahiiiiiiii-reeeeeeeeeeeeeeeee” that bumps. I have found the best way to dance to it is to toss and turn in your bed and wrap pillows around your head as tightly as possible.
I am alone down here, excepting Bohntuen, my translator–driver–facilitator. I have to be careful with him; he is clever, but on the make. Yesterday he said, “This lady says she has fever at night, pain in her stomach, maybe some diarrhea, and it is because she has worms … I give her medicine now.” I had to say, “Okay, Bohntuen, is that bit about worms hers or yours”? His. Anyway, you've got to feel for him. He has to translate me. I have enough trouble understanding myself.
April 9
I saw my first guy in the jungle with a gun today. Went to a village that was also off-road and, once we got there, they told us that we had driven right by a mine. Taking the road less travelled in this place was clearly the wrong choice. I'm growing weary of the isolation three-word sentences brings. I go now.
April whatever
Thoughts on staring at my feet for five hours, hanging over a Cambodian toilet, or, Zen haiku on the importance of maintaining right-mindedness
One begins to think there is nothing left inside and surprises oneself.
April 16
In Phnom Penh now, heading down to Kampot for another couple of weeks. Excited to get out of the city and back to the countryside. I had a run-in with the police yesterday. They stopped me for no reason, sat me on the side of the road and didn't speak. I waited patiently for their demand, and it came after about 10 minutes: $20. A fine for no crime; a police tax. It's an odd thing to be in a country that may not be the safest, and whose security force is something best avoided. In Kampot, partly because I have the safety of a big red cross on the front of my Land Cruiser, and my trusty Khmer companion, I feel more secure.
In 1975 Phnom Penh was evacuated by the Khmer Rouge, its population moved into the rice fields and forced to work. When the Khmer Rouge entered the city on April 17, they were greeted with cheers and jubilation. They were going to fight the imperialist on all sides — the evil Americans, the greedy Vietnamese, the powerful Chinese — and restore the glory of the ancient Khmer kings. But, the people were told, the US was about to bomb their city. They must leave immediately. Those who did not want to leave were killed. Soon the city of 2 million, once the pearl of Indochina, was reduced to fewer than 50 000. The rest were marching to 5 years of hard labour, many to death. Anyone perceived as a threat to Pol Pot's regime was killed. Lawyers, doctors, teachers, singers, writers, reporters and people with glasses. Books were burned, traditional artifacts destroyed. The year was zero and every day was Monday. Money was abolished. No one had a home. The Khmer Rouge were trying to make the leap to agrarian communism without having to do “the unnecessary small steps.” Many urbanites were killed or made to toil on projects that would serve the population. There is a dam in Koh Sla, 30 feet tall at points and 20 km long. Hundreds died building it. It came 3 km from being completed and still sits there, useless.
I would have been 2 at the start of those years. Khmers older than me lived through it. Many I talked to lost their entire family. The moto driver last night lost his parents and 4 brothers. The doctor I talked to in Chóuk on Friday lived because he threw away his glasses and pretended he was a farmer.
Too often we pretend that society is something that happens to us, instead of because of us. The end to war will come when we accept that there is a part of us all that is warlike. We must each solve that. There is war inside me. I would go to war for my family, for my friends, for my ideals. When I see the atrocity that war brings, I know that it is not enough to interpret it as a horrible thing committed by evil men and women, or something that is happening to people. Atrocities arise out of something very deep and very old. But the push toward peace strengthens our capacity for it. There is success in every failure. Each of us must work toward it, or we will never get there. No struggle is too small.
That being said, I cannot find any part of myself that could do what was done here. And I've looked hard and long. It must be there, and I am just missing it. I know this because I have met and worked with KR. They are not bogeymen, nor can you tell them by an evil glint in their eye. They are simple and hungry and get sick with malaria. Their babies smile when I play peek-a-boo; their children gather when I get out the Frisbee. They offer me food, invite me into their simple homes, and listen intently to the tinny music that pours out of my Discman speakers. I don't yet understand it all, but I feel closer.
April 17
Having my translator and me in the village is the event of the year here. In all of the villages except one, I am the first foreigner these people have ever seen. Everyone gets dressed as cleanly as possible, then gathers around as I ask personal questions, perform a modest physical exam and then decide on the colour of the pills to give each patient. Kdow (fever) gets yellow pills (quinine), hat (exhausted) gets brown and red (iron and vitamins). Once the pills are handed out they are compared for their colour and quantity and then swapped. Those with the diagnosis “viral infection” are disappointed because they get no pills. “Did I mention that I have kdow, they say, and have abdominal pain?”
I was told of a woman who was bitten by a snake earlier in the week and was suffering at home. She had seen a traditional healer, whose treatment for everything was to induce vomiting. Her limb from the knee down was tense and swollen. I agonized over taking her to the hospital; these people have no money to pay for the treatment, nor anyone to support the family while they are away. She did not want to go, and her husband didn't want her to, either. Finally, I insisted that she come to the hospital and that I would pay.
We arrived, after a couple of hours, at a hospital ward full of people. Apparently, the night before someone had thrown a grenade into a party not far from my house, killing 5 and injuring 24. Many suspected that the police were responsible because they were not getting an appropriate cut of the gambling going on therein. The place was jammed full with the injured, and body bags were in the hallways. My friend and local surgeon, Chanta, was going into the hospital for his sixth laparotomy in a row and had not left the hospital, nor had anything to eat, in 35 hours. But he offered to admit the woman if I could give the antivenom.
April 20
Went to a village about 5 km off the road, on ox-cart paths. Got deliciously stuck in thick mud and spent an hour working our way out with sticks and rocks.
Talked with the commune chief, a big cheese in the Khmer Rouge. We sat and chatted in the shade of his house, his grown hawk tethered to the rafters above me, as he lamented the fact that the government took away all of the guns, apparently not noticing the AK-47 wedged in the rafters above. He then asked me about his cough. Viral infection, I said. No medicines needed. He countered that he thought it very strange that I had come all this way to work in his valley and couldn't even give him some medicine.
“I don't tell you how to run your commune, and you don't tell me how to be a doctor,” I replied. My wise translator refused to translate and changed the subject.
April 23
My last day in Koh Sla. I tried to suck up with my hoover-eyes every last fleck of rusty dust from the now- familiar road that I travelled for the last time. It is a lovely place, simple and magical. Life is so obvious here; it makes it seem cleverly hidden at home. In Toronto, when I pause to watch people pass during rush hour, I always think to myself, “What on earth do all these people do?” Here, I know. They work to get food, stop when it is dark, and start again when it is light. They laugh with their friends, try to laugh with me, celebrate when they can. In the West, as we distance ourselves from the whims of nature, we suffer from a lack of conflict that it provided. We begin to manufacture our own. More money, better cars, smaller phones. Our desire to succeed is confused with a capacity to exceed.
April 30
Endings are harder to sort out than beginnings. Endings are clouded. You are unsure if they are really a finish, or only a lull in the story. From endings, new beginnings jump off and start to run on their own. Usually, we try to sort out a finish line while we're still crossing it.
One of the most uncomfortable things that endings demand is reflection on wisdom gained. It is simple to begin something, as 85% of guitar owners will attest. Even perseverance is quite straightforward. Fortitude seems best tested once all of this is completed, when the transition from doing to done demands that we ask, “What happened?” and, worse, “What now?”
The last few days I spent in Koh Sla were good. We visited a relatively wealthy village, one whose proximity to the road and cleared land allowed for a noticeable difference in the quality of houses, health and living. The people I saw were, for the first time, actually all sick.
At one point, a father wheeled his son into the small yard on an ox cart, where the boy had lain for 10 years. The child was conscious, 14 years old. He was contractured from the lack of movement, and his thin frame was crawling with flies. They crawled into his nose, his ears and his slow blinking eyes. My best guess was that he had developed cerebral malaria at some point, or meningitis, or encephalitis. He was normal until 4 years of age and then, after a big fever, became as he was now. His father cared for him alone, turning him to prevent bedsores, feeding him rice, covering him with a mosquito net at night. He laughed, cried, recognized faces. His father hoped that I would be able to help him do more. We both looked at my little pill box, full of quinine, antibiotics, antacids. I offered my empathy.
My last morning I drove through the rusty dust of Koh Sla road for the last time. I asked Bonthuen to go slowly. He has an uncanny knack for choosing speeds that are exactly contrary to the ones that I want. If I am late, water buffalo pass us as he daydreams. If the road is muddy or fraught with curves, he taps the wheel to whatever Khmer tune is on the radio and floors it. This time, we were in agreement. We wanted this place to be one we could return to in those snatches of reality that occur just as we fall asleep. You know — all of a sudden, you go from thinking about breakfast tomorrow to the rising sun over a rusty road, small children jumping into a muddy pond as they hear our Land Cruiser, and swimming with the glistening water buffalo. We crawled home, stopping to take photos. I waved to children for the last time and, as on the day I arrived, my waves were met with stares. It takes longer than a month to prove one worthy of trust.
The first thing I remember about Koh Sla happened just after we stopped the truck and I met Colonel Chan for the first time. We pulled up behind Chan's Toyota, got out, bowed, and shook hands. He invited us in for lunch, and as we were walking toward the hut an old truck drove up. In the back sat 3 people. Chan chatted with the driver and turned to us. Bonthuen translated,
“Do you want to see patient now? They take old woman with fever and bleeding from nose to hospital.”
I walked around to the back of the truck. There was an extremely ill, febrile woman in her 50s, with blood streaming from both nostrils. From behind me, I heard Jim, a surgeon who had accompanied me from Phnom Penh for the afternoon, say, “No, we start after lunch. Tell them to continue on.”
I thought, “No shit.” Take her away from here. Take her away from me. I can't deal with this. How the hell am I going to make it on my own out here, in the jungle. Hemorrhagic fevers, snakebites, guns, mines. The afternoon I spent with Jim sped by, and he was gone in a flash. And then it was up to me to do what I was able.
It took some time before I began to enjoy myself, before I felt I was becoming good at it. My heart leapt every time someone waved me from the road, because that meant “emergency.” But, whatever I did was better than what they had before. And when I made a follow-up visit to a village, instead of seeing 60 people, I would see 6. The little girl, crying inconsolably, who had scabies so severe that she had scratched her hair off and into a nasty skin infection was now shyly peeking out from behind a tree stump trying not to smile. A little boy so sick with malaria that he could not stand, kept trying to sit on my lap. The poorest woman in the valley, whom I had spent some time with and who gave me the only fruit she had in the house, went from being an outcast to a minor celebrity simply because I honked every time I drove by and took tea with her every now and again.
When I ran the New York marathon, I told friends that I wanted to high-five 100 kids. I did that in the first 3 miles, and then my hand got sore. This time, I wanted to teach them to wave. The first time I drove through Koh Sla I waved, and they stood by the side of the road and stared straight into my eyes without cracking a smile. It was as if I had dropped out of the sky. Even after a month of incessant flailing, most of my waves remained unreturned. But, that is how it is here. I know we helped, and I know they appreciated it. And, in the end, this end, it doesn't matter. Because of that month, and because of these emails, there are already 2 residents who want to go to Koh Sla to work. The University of Toronto is hoping to make it a focus. I know that by the time I go back there will be waves.
So, that's it. It will take me more time to figure out what I have learned from all of this. I find it a bit disheartening that I can give an answer to the question “What do you want to do with your life?” that I would have been embarrassed to give 10 years ago. It seems that I have grown wiser and stupider. I kind of just want to save the world. I think that, the first few times I travelled, I discovered new pockets of myself. There were constant epiphanies, moments of clarity. This trip didn't have that as much. Instead of finding new places to dig, I think I just hollowed myself out a bit more. Now I am back in TO, and it seems like it didn't happen at all.