Hello everyone! I haven't written an update for a while mainly because I've been stuck in the back of beyond at my hospital placement with no internet access. I'm writing this on an antiquated and very slow computer at the hospital, and when I get to an internet café (at the weekend) I'll upload it. I've done a week and a bit at the hospital now. I've been assigned to the maternity ward which also includes gynecology. To imagine a hospital ward in Cambodia first forget all your ideas about hospital wards at home. Then imagine a dilapidated large room full of rusty metal beds, with no mattresses, just straw mats over the springs. There are large open windows along the walls, with no glass so members of the public/family members can peer through. There is absolutely no privacy and no curtains separating the beds. There are no cots for newborns; they just lie alongside their mothers. The ward is all mixed up with women about to give birth, women who have recently given birth, women with uterine cancer, women with fibroids, women who have recently had a hysterectomy, all together. There is no running water on the ward (no hand washing) and apart from the half an hour that the doctors do their ward round it is overrun by families, who have the job of feeding, washing, toileting and clothing their relatives, cooking on fires built outside the hospital. There is a separate room in which the women deliver, which thankfully does have a sink and soap (!!) although afterwards you have to dry your hands on a filthy looking towel! It is also relatively private, and examinations are also carried out here. Most women here deliver at home, with the help of a midwife or traditional birth attendant (a woman who learns from the older women in the village) or in a health centre, and so only comes to hospital if there is a particular concern. It is relatively expensive to come to the hospital, and most cannot afford it. Also the doctors here earn a pittance working for the government run hospitals and so spend most of their time in their private practices earning a living. My daily routine is to cycle to the hospital for 7.30am, at which time all the staff line up and raise the Cambodian flag in front of the hospital. All the doctors then have a meeting where the events of the previous day are discussed. Usually by about 8 we go over to the maternity ward where the ward round takes place. I am borrowing a translator at the moment, and the doctors and midwifes are very patient at explaining things to me and answering my questions. I think I lose a lot in translation, but I can usually fill in the gaps on my own. Then any women that need to be are examined are, as are any new patients that have come to the ward. There is also an ultrasound machine, which was donated a couple of years ago, and patients from other wards sometimes come for a scan. If any operations are scheduled these happen after the ward round too. Usually all the patients have been seen by about 11am at the latest, at which point the doctors disappear, only reappearing if there is a new patient to be seen at 2pm. Yesterday at the morning meeting there were lots of boxes of drugs being opened that had arrived at the hospital marked "Asian Tsunami Relief Fund" (the Tsunami did not affect Cambodia). Everyone in the meeting was given a new toothbrush and packet of dental floss from one of the aid packages. So I hope all of you that gave to the Tsunami fund are pleased to here how your help is going to the wrong people, in the wrong country, 18 months too late! (Though all the doctors here have really clean teeth now!) In the afternoons not a lot happens, though yesterday I saw a caesarean. Usually I just read a text book, write up a case study or chat in broken English to the midwives. I am staying with a Philipino VSO volunteer in a very small town. Really living the quite life in the week and getting through lots and lots of books, which is great as I never have time to read enough at home. Next week is a big Khmer Buddhist festival, comparable to Christmas. In preparation people have to go to the pagodas to give offerings to atone their ancestors for two weeks before. The loud services which mainly consist of monks chanting and tuneless music is broadcast by load speakers which can be heard for miles around, and they start at 4 am every morning. It is really annoying now being woken up at that time everyday, but only a few days left! Last week the midwifes at the hospital took me to a pagoda in the middle of the day at work. We had to give money and also put spoonfuls of rice into different pots for our ancestors. Then there we had to sit on the floor of the pagoda and there was lots of chanting and praying. Then lots of monks in their saffron robes came in and a meal was laid out for them. There was more chanting by the monks and then after about an hour they ate their meal while we all sat and waited. Then there was more chanting (by this time I had serious cramp in my foot from sitting on it) and they all filed out. Then we all went out and sat round a table and had a meal (don't know where it came from), I was with the midwifes from my ward, the hospital director and his wife and the gynae doctor and his wife. It was lovely to be taken along to experience something like that. I hope everyone is well! See you all soon! Helen x