A Look Back. A Look Forward. A Bit Belated.

I made New Years resolutions like the average sucker, but one of those did NOT include being better about blogging about relevant things as they occur. Sorry I am not sorry. Can't snap your fingers at 12:01 AM January 1st and make magic happen. Instead I will try and be better - a more realistic goal I think. So here I am attempting to summarize all that has happened recently. I am backtracking and this is quite belated so apologies for absurd length and for inevitably leaving things out. 

NATION WIDE VACCINATION CAMPAIGN - December 1st - 18th

Back in October, the Ministry of Health announced a nationwide measles-rubella vaccination campaign that would vaccinate 4 million children between the ages of 9 months to 15 years, by the end of 2013. To accomplish this goal, "local staff of the provincial health departments had to vaccinate hundreds to thousands of children per day in each commune." What did this look like on the ground? When I arrived back to site from my parents' visit I was thrust into the middle of this campaign, tagging along with two of my HC staff (Om Phanna and Ee Chaat) for two full days of vaccinations in remote villages across the Pouk operational district. Each of the 23 HC's across the district sent 2 of their staff out each day to that day's designated target commune. Everyone would meet at 7:30am at the district hospital to gather the necessary vaccinations, syringes, syringe disposal boxes, coolers, etc. and they set off on their way. The first day I went, we only ended up vaccinating  96 children and had plenty of time for other things like learning to make oam bok (flattened rice) and go to a local palm reader. 

getting a lesson in the foot pedal to flatten rice

the palm reader told me... married by 27. dead by 74. get livin'!

The following day however we vaccinated 234 kids (whew!). No time for pictures of screaming children held down by willing mothers, aunts, grandmothers, and village health volunteers (VHVs). This campaign went on for 18 days in my district. So was it successful? For all account yes. The last reported case of measles (a serious infectious disease that can cause severe illness and complications like pneumonia and blindness especially in infants and children) was in November of 2011. But Cambodia is not certified by the World Health Organization (WHO) as measles free until the country can prove no more cases in the next 2 years. However, Cambodia is well on its way thanks to this large scale vaccination campaign (modeled after the polio eradication campaign in 1996), initiative to give two doses for every child before 2 years of age, and targeting rural areas. This is a recent article about the campaign's success. 

Something that this widespread public health effort brought up for me was what I see day-in and day-out at the health center and in my community: lack of informed consent and decision-making. Doctors and health professionals are seen as having the knowledge and you do as they say, whether you know why you are prescribed something, what it's side effects could be, what your alternatives are or not. More likely patients are not provided this information and their only power is in the decision to take and when to take the meds or not at all. The focus of this vaccination campaign was not to educate the general public about the horrors of measles or rubella or the benefits of vaccines. It was more of a production line operation. "Right arm. No your other right. Open your mouth. Hold still. Now you are protected." In essence: this is for your own good. I am not saying that this type of campaign should not be done. On the contrary, I am thrilled that Cambodia is taking big steps to improve public health. However, I think this raises questions of patient rights and power to make informed decisions about one's own body and health. Discussions that are rare here in my experience. 

CELEBRATING MY HOLIDAY TRADITIONS... KHMER STYLE. 

I got really into X-mas this year. I celebrated 2 times. Once with my host family and once in Siem Reap with a bunch of volunteers. With all the little munchkins around the house we spent evenings leading up to X-mas day making paper snowflakes and setting up "presents" (empty product boxes tied with ribbon) under a "tree" (a branch pulled off a mango tree in the front yard) and making paper ornaments. On the actual day I was able to skype home to the states and in the afternoon I found eager little kids sitting around our tree excited to open actual presents that I had placed there the night before. X-mas with the host family meant that I got a present from each person I gave a present to - none of them exchanged gifts with each other. 

my presents :)

our tree :)

In Siem Reap, the celebrating was a bit different. The weekend after X-mas was spent eating Western food and chocolate drinks of all kinds, playing group games and doing a hilarious "white elephant" gift exchange (everyone makes a gift, wraps it, puts it in the present pile, everyone picks a number, then goes around picking a gift from the pile and deciding to keep it or steal from a previous picker). I made a candle holder from my old bike parts (which I had to get replaced because of wear and tear the result of 2,206km logged on for 11 months!), and I ended up with a lot of chocolate. Before heading back to site, I strapped on some rollerblades with 2 other PCVs at a skatepark and completely Khmer teenager hangout hotspot. A couple of swollen and bruised sitbones and elbows are still with me weeks later. 

just like the 90's :)

swollen elbows :(

Compared to the way I rang in the New Year last year (with Cori at a monk blessing ceremony and dancing in the streets of Siem Reap) this year was quite calm. My host family went to Siem Reap and left me behind so I spent the evening watching the sunset and darkness roll in while reflecting on 2013 and looking ahead to 2014. I made a wish, lit it with a match and watched the wish float heavenward. It would have been nice to have toasted the new year with a flute of champagne in hand and hearing it clink against another, but there will be such occasions in the future I am sure. I don't really like New Years resolutions as I think that each new day should be a time to improve self and strive toward goals, but I found myself making some anyway. But this time around they have taken a different focus. I wrote weekly and monthly goals relevant to my life in Cambodia: go to the market, do laundry, go for a run, finish a book, etc. Realistic and achievable. Small steps. But all for Cambodia. The year 2014 brings with it my close of service (COS) only a few months off. And with that is a major transition that will call for new resolutions. Before I know it I will be writing entirely different expectations for life post-Peace Corps which is something that 2014 will bring, for better or for worse. Here's to new adventures, smooth transitions and staying in touch throughout it all. Happy 2014.  

sending a wish on the wind.