I’m more often than not in the provinces for one of my bigger projects, an STI (sexually transmitted infections) survey*. I am the only foreigner, and no one on my survey teams or the provincial offices that I interact with for days on end is competent enough in English that every utterance does not need to be repeated multiple times, loud and punctuated by wild gesturing. Even my translator needs much explaining. This can be draining…
Although communication difficulties are a given, that daily reserve of energy sometimes isn’t enough to stay afloat deep waters of frustration. Especially when you are hot, tired, dehydrated, waiting to finish the day’s work, and you catch one of your lab techs taking ice out of the cold chain for his drink. Or when you find your interviewer is brokering a deal with participants on the survey incentives so your data is totally rigged and useless. Or when one of your team physicians sells some survey supplies, and you must drive an hour for a mobile signal to ask your home office in Phnom Penh to send more. Shoot me now. I find that under such moments of duress my small brain is unable to multi-cope.
I beelined for the ice cream cart when I heard the familiar bells coming down the street, my better sense seriously impaired the longer the stint in the sticks. The ice cream man sat with me on the curb in the shade listening in amusement as I prattled away, clearly not bothering to make myself understood. Out of the periphery of annoyance two of my physicians struggled to tell me something, and they were pointing accusingly at my little stick of paradise. GO-AWAY.
“For— uh, falmad— uh, folma—,” massacred fragments of English parried back and forth until finally: “Formaldehyde!” one of them spits out with glee, and they broke into contemplative debate in Khmer. I tried to educe a connection between formaldehyde and ice cream in the meantime. But the Khmers must discuss everything. At length. A simple question like “Where is the bathroom?” will provoke a drawn-out discourse if there is more than one person within earshot of the inquiry, so you start drumming your fingers, irritatedly wondering what they can possibly be deliberating. Patience for Dummies. Many sands through the hourglass later I learned that I ingested enough formaldehyde over the past few days to preserve a cow. It is used in the street ice cream industry for its preservative qualities. Forced exhale and a glare at the sky. I tell you, sometimes I just dO NOT UNDERSTAND {{down caps down}}}.
Somehow, roughing it for a backpacking trip is vastly different than roughing it for good. But I think I’m getting used to the bucket shower and squat toilet accommodations. My biggest gripe is that the mosquito net never quite manages to keep out that one endlessly active ‘skeeter. It’s quite amazing I haven’t yet contracted dengue or malaria, given the numerous angry welts my legs and arms can boast. Knock on wood.
Some of the larger problems I encounter are not the technical kind. Such as toeing the line that return-Asian females are somehow faced with: Western aggressiveness versus conventional kowtow– finding your line and getting them to accept it. We’re dealt a harsher scrutiny than Caucasian foreigners get. Another is dressing appropriately for the boonies, where the scorching sun, ever-present clouds of dirt, and endless hours on your feet make it difficult to look presentable. Of course, the gals on my team never have a problem with it. Halfway through the day when I’ve dropped ten pounds in sweat and may as well hose down at a car wash they still look dainty and fresh and perfect. Ancient Khmer secret.
Cravings of late: Chocolate– the complete absence of that rich, calorific slice of decadence is taking its toll. One of the restaurants here had chocolate fudge cake but it tasted like something *I* would make. Needless to say, my hankering is not satisfied. Put cheesecake on that list. Yogurt, a quarter pounder with the trimmings, a slice of New York pizza, bagels. . . . {{daydreaming, drooling, drooling}}} I might have to make another “civilization” run. People here frequent Bangkok for just that– to “clean themselves” and get supplies. Sounds good right about now. . .
Edited to add, since I’ve gotten questions from some family on these. Wow, I am footnoting a blog.
* Surveys are a method of providing statistical data for programmatic objectives. In research it is conducted to develop, test, refine hypotheses. To understand conditions and demographic trends of a population, governments carry out surveys every few years. Market research, opinion polls, the census are surveys. In Cambodia because of war and conflict, survey efforts have been few, making it difficult to specifically target efforts in HIV/AIDS.
The NGO I’m working with is one of the more internationally recognized leaders in public health surveillance. With the highest HIV/AIDS rates in SE Asia, information on the population’s risk behaviors is necessary for program planning purposes. FHI has partnered with the US CDC (Center for Disease Control) and the Cambodian NCHADS (National Center for HIV/AIDS, Dermatology, and Surveillance) for a nationwide survey of STI prevalence in three high-risk populations: the homosexual community, direct female sex workers, and the police (documented to frequent brothels). A cross-sectional analysis of STI prevalence can provide a quick shot of the HIV epidemic, because STI infections are of shorter duration than HIV, and risk behaviors for STIs are similar to HIV.
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