Week 1 in Phnom Penh

The Asia rush first hits when you are tuk-tuk-ing through crosshatch traffic that moves with no discernible order. You feel you've arrived somehow when your lungs breathe in a heady roadway mix of exhaust fumes, frying noodles, petrol stalls and dumpling steam.

The street to the centre of Phnom Penh from the airport feels like the longest in the world. It is filled with shops which sell just TVs or motorbikes or sticks of wood or buddha carvings. There are neon restaurant signs stretching a full block and one story corrugated iron shacks shunted between folly-like bank highrises. It is a mad and contradictory stretch of road that is reflected in the seething traffic: motos are hemmed in by bumper-toothed lexus 4x4s whilst street sellers push carts filled with bananas in between.

Our first few nights are spent in a hostel by the riverside. It's a safe, lively district of tourist restaurants and bars beside the national museum as well as the tawny Mekong river itself. I wake up and can see the curving roof of the Royal Palace through my window. It looks like no other building in the world and a further little mark is made to tell my senses where I am.

With just a day to orientate ourselves and walk in hot sun whilst the humidity tussles with our hair, Monday arrives far too quickly. We travel by tuk-tuk to our new work place-the Children's Surgical Centre (CSC). The director shows us around the facilities contained in the white two story block that makes up the hospital. Staff mill around in scrubs while patients wait outside on benches and bed stands, filling the air with expectant eyes. We are introduced to the American team who are taking part in a "Sight, Sound and Smile" mission. Within ten minutes we have a referral to see an adult patient with an undiagnosed neurological condition which is affecting her swallow and communication.

There is no time to feel overwhelmed however, as sitting in our meeting-cum-therapy room is our first cleft palate patient. I am nervous and I am not sure how to wield our little tool kit of pen-torch and tongue depressor but we assess him and write notes and soon there are more and more until we have seen four patients.

The rest of the week passes in a blur of faces as we see over 20 children. There are little tinies who are waiting to have their lips repaired, as well as older patients who have had late palate repairs. Parents need advice about feeding their children, and about how to support their speech and language and we need to assess speech when possible so we can start to understand how successful operations are and decide what therapy or further surgey may be needed. Phew. It's a lot of work, but our fantastic translator helps us every step of the way and watching wide eyes smile at bubbles and small toys is enough to pick us up again for more hard work.

It rains a lot in the afternoons. Sheets fall fast and cram up drains, filling streets to their pavement brim and encouraging children to float behind the bumpers of big cars. We watch from safe steps at the CSC as our patients stand on plastic chairs, monsoon water lapping at feet. Some children smile and splash; whilst others tiptoe to the chair edge, watching their tiny nervous faces in the murky wash.