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Stung Treng 1

City, Zimbabwe



I’m sitting on the veranda in Helen’s house and look onto the Mekong-river and I can see the huge long brigde, which eventually leads to Laos. And here I am finally in Stung Treng.

The Taxi picked me up from the VSO office on Saturday at 4:00 am and off we were. Usually the taxi is packed, 3 in the front and 4 at the back. But Hor ( who I travelled with and whom I working with closely in Stung Treng) booked 2 seats for each of us, so we were comfortable.
I know now, why they recommend to take sport-bras with you though. The driver shot over bumpy streets and there are big holes on the way. Fortunately I didn’t see all the rather risky overtakings he did, because I was quite tired and slept a little bit on the way. The aircon was on all the time and it was really cold. But I was prepared and had my fleece and a scarf with me.
On the way half way up, the street was very muddy but the driver managed well and so we slipped ahead.
I also had my first rice dish for breakfast at 6:00 am. It was rather nice. Rice with ginger and frighed chicken and soup. I just watched how the other were eating it. They usually don’t use chopsticks. They have in the left hand the fork, right the spoon and with the fork they shift the food onto the spoon and that goes into the mouth.

We arrived in ST around 11:00. Helen was there and she introduced me to her lovely house.

I think, it is stunning.


When I looked around it I thought, this is how paradise could look like.


We had some Tuna sandwich for lunch and then Helens new friend arrived. His name is Kahn and he comes from a very poor background. But in his mind, he ever so strongly wants to become a doctor. So he started to learn English somehow and met Helen on the street. They started talking a little bit and Helen saw something in him. So she decided to help him. Every weekend now Kahn comes and one day he teaches Helen Khmei language and the other day she teaches him some medical lessons in English. He is so thankful. He is a lovely guy, very young though, but determent to become a doctor. But he is so poor and has to work hard on the fields for him and his family, that he can’t pay for professional education. Helen became friend with a monk and trys to find a way through that. He might joins the army as well and trys through the army to start a doctors carrier. If you want to sponsor him, you are more then welcome!

We then had a little tour by feet to the market and to the internet café. In the evening we went to a little food place just right next to Helens house and we had something local.

It was a very very thin big omlette with sojabeans inside and you pick it up with some salad leafs and then dip it into a watery spiced dip. I’ve never seen salad leafes like that before. But it was tasty.
I didn’t sleep well that night. It was so hot.

On Sunday, Hor picked me up on his motorbike at 8:00 and we made a tour through Stung Treng. We went to the bridge and he showed me the RTC and where to go to pay the bills, the other Hospitals and Healthcenters, Kathys house

and potential houses for me. But nothing in sight so far.

The afternoon and evening I felt quite low and depressed and I was asking myself, what am I doing here. I suppose that is the first stage of adapting. I also felt quite homesick and I really taught, if the next day is not better, I’m going back to England.

I got distructed by Helen, who told my that she invited all the other volunteers from ST to welcome me and she cooked a lovely cambodian curry from a cambodian cookbook. Not all people could come, but it was a nice little round.

They didn’t stay long and afterwards, me and Helen sat on the veranda, drinking Ankor beer and talking about everything and nothing. She is great to talk to and so interesting.
That night, I slept much better.


Monday


I am on a bit of a High now actually. I just finished my first day in the RTC and Hor just brought me back safley on his motorbike.

I attendet to this workshop, and the timing couln’t have been better. It was the six monthly preceptor meeting for Province Stung Treng. I’m going to talk now a lot about this and my placement, so whoever is not very interested in it, please skip this one.
We were a group of around 16 people, sitting in a circle in a big meeting room. No aircon and very noisy from outside. First of all the RTC director Mr.Tek Leang Seou gave an opening speech. He appears to be a fair and good man, who really wants to improve the system and the quality and quantity of the student nurses. He is also a pharmacist and he even teaches pharmacy in classes. He made a down to earth impression but also very knowledgeble..

Then Dr. Tat Souann and Mrs. Say Sophanny talked about the secondary midwifery course (ADM), which is associated degree in midwifery. The key point I got out of it was, that they have far too litte midwifes in Stung Treng Province. So apparently there are 3 midwifes only for 1000 patients. Also, there are no perceptor around at the moment. And if you do the ADM for 3 years, it is also difficult to practise in delivering a baby. The reason for this is, that each midwife gets 40.000 Riel extra payed when she did a safe delivery in a Referral-hospital. 60.000 Riel when Baby delivered safley in a Health-Centre. So the midwife of course doesn’t want to miss out on this bonus money and delivers the baby herself, rather then involving the student nurse.
Then Dr. Tat Souann talked about strengh and weaknesses of the preceptorship programme during the student placement. We would say to mentorship programme in England. Some Preceptors are not aware of the clinical Lookbook with all nursing procedures. They sometimes don’t know about the existence of certain procedures so they can’t practise them on the ward with the Student nurse. Also they mentioned the lack of resources and little motivation. They don’t have always time for their student and can’t give any feedback.
Apparently a perceptor gets $15 from VSO and 32.0000 Riel from the government per month to take on the responsibility. So they discussed that and then we had lunch.
For lunch, I met Joelle who gave me her bike. Joelle is from Switzerland, infact she is from Lousanne! She is very friendly and easy going and she also speaks German, so that is nice for me. She works here for 3 months already and works for an NGO. She introduced me to the marketfood. It was ok. We had rice with meat and lots of intestines in it. I can understand, why lots of people become vegetarin here.
Unfortunately her placement finishes next month, but she wants to cycle with me to the Mekong blue, the local silk factory.
Hor then picked me up again from home and we were off again to the RTC at 14:00 to continue with the workshop. People then had to put onto a flipchart challenges they experience during clinical placements in the Refferal Hospital (RH). Because there were Preceptors from nearly all 6 Provinces from Stung Treng, they did that for each province. Somehow I put inot my diary automatically some idears already about possible improvements, so that when suddently all heads turned to me, I was prepared. Preceptors have to face a lot of challenges, I won’t bother you now with details, it would be too long. So after their presentation and the group discussion, they wanted to hear from me some idears to contribute on improvement on those challenges.
I suggested through Hor, that Preceptors could let the student nurses shadow them at whatever they do, whenever they are too busy to teach them. Also I suggested to them to try and encourage their colleagues to take on the role of a Preceptor. Then I said that it is also useful not only to have an evaluation about the student nurse, but also to give the student a way to evaluate and feedback the Perceptor with an Evaluation form.
I could see that everybody looked blank and not interested. But then Dr. Tat Souann said the first two points, they do already but the third on was good and that they might pick up on it. Then the Vize director (don’t know his name, only found out about him afterwards) said, that he really liked the idear of an evaluation form for the student about the Perceptor and that he will forward it to the Ministry of Health and that I could think about a draft already until the next meeting in 6 month!
I didn’t know what to say. It isn’t even my idear. That is what we do in England all the time and I’m so pleased that I went onto this mentorship course there and that I had all the experiences with my student nurses and so on.
Then Hor and me tried to call some of the applicants for the VA job, there are 4 now and the interviews are on Wednesday.


And then we went home at around 17:00. I prepared some dinner, the yummi left over curry from last night and then Helen and me ate outside on the veranda.
Kahn came along and brought a giant Jackfruit. I’ve seen it in the market but never eaten it. For me it looks from the outside and inside like an Alienfruit. It tasts like Banana and Mango together. Helen and me peeled for an hour or so. We always have really nice conversations.

When I looked into one of the student classes today, I felt really happy. Mostly female student nurses, all very young looking but apparently all older then 18, they had little white aprons on ( like a school uniform) and around 25 in one room, practising something. They sat in small groups and in one group a girl was standing and practising how to put on sterile gloves. The others were watching and had to say something, when they saw a mistake. It was just so lovely to watch and I felt happy.
Also I have the sense that the people in the RTC really care and that they want to improve things. I think, Kathy had a deep impact on this, and she can be proud of herself. Hor is just amazing. He never had anything to do with nursing and translates now all those difficult words. He was an English teacher before and works with VSO now for more then 2 years and is the Provincial Programme Officer, I work closely together. He is so bright and dedicated and gives so much. I think, I can really rely on him.
So my hopelessness from yesterday has flipped over to beeing motivated and more happy.



permalink written by  katja-horsch on May 23, 2009 from City, Zimbabwe
from the travel blog: finally arrived in Stung Treng
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