Cambodia: The Lake Clinic

March 1st, 2008


The sense of time is different. “Hurry up” is a process of continual slow motion versus “normal” which is regularly punctuated with pauses for conversation, cold drinks, or simply moments of rest. In almost 14 years, Jon Morgan has adapted.

“Have you heard of CWA?” he asked.

“No matter how much you plan, how well you set it up, or how hard you push there is always CWA. Cambodia Wins Again.” He shrugged. It’s what you do afterward, he said, that matters; how you pick yourself up from the dust and go back to it. For Cambodia has changed him. (at right: Morgan on the slow boat to Moat Clas)

“I used to be a person who maintained all my relations because I never knew when I was going to be working with them again,” he went on. “But they have a saying over here; if you see a snake you kill it. Or you run away. Because if you don’t, it will kill you.”

Cambodia may win more often than not, but Morgan has shown that with tenacity, patience, and strategic alliances one can persevere. (at left: the town of Kampong Chleang. Rainy season flooding necessitates putting houses on stilts; even the road is under water making boats the only means of transport.)

Morgan and his wife Mieko returned in 1995 to Cambodia with the intention of staying for two years. One thing led to another and they’re still here. A nurse by training he has managed to reinvent himself several times. With each rebirth he has shaped himself anew, most recently in a transition from Director of the Angkor Hospital for Children (AHC) to Director of the start-up NGO The Lake Clinic Cambodia (TLCC). The Lake Clinic will use a shallow draft boat to provide medical care and education to remote communities on the Tonle Sap lake, a body of water which grows four times its size in the wet season. (at right: a child runs over a bridge in the town of Kampong Chleang. in the rainy season this bridge is under 15-25 feet of water.)

During his tenure at AHC, Morgan saw a need for capacity building in outlying community health centers. If illnesses were caught early, they wouldn’t be as acute as the cases he was seeing in AHC. Once, when he was speaking on behalf of the hospital at a meeting of NGO and community leaders, the Moat Clas village leader looked at Morgan and said “This is what my village needs. I want you to help me.” Morgan replied he would and, years later, he is nearly there.

A floating village, in the dry season Moat Clas is three hours by boat to the nearest health center. It’s another hour by vehicle to a hospital in Siem Reap. It can cost $30 dollars (US) for a local just to get ot the city. With the daily wage in these fishing communities averaging less than $1 dollar, that is a fortune. Simple health conditions are allowed to languish until they become acute. But compounding the poverty is a lack of simple health education.

For instance, some locals know clean water is better for them but they wash their dishes in the same lake into which they urinate, defecate, do their laundry, dispose of their garbage, the list goes on. It is hardly hygienic. (at left: a coffee glass is washed in the lake with water that is filled with fecal bacteria.)

The village chief has three water filters donated by various NGO’s and yet I saw him brushing his teeth with lake water. It was where I’d peed. His wife washed the dishes in the water as did the visiting boats who served ice coffee and our breakfast the next morning. They know it’s good to brush and wash, and that the lake water may not be healthy, but they don’t know to boil or filter all water they ingest. To compound this, not everyone has filters and most stoves are open flame, wood-fired.

Visiting dentist and board member Hal Kussick ate the cooked fish and rice–because they were cooked–but shunned the tomatoes washed in river water. The next morning he turned down breakfast as well, for the sprouts that went in the soup were likely washed in the lake as were the dishes. He was trying to save himself numerous trips to “the thunder bucket.” I’m not sure what he ate, for I was slightly more adventurous but didn’t eat much. Travel on the lake is almost like desert camping; you must bring everything you will eat or use with you for food and water are suspect and the locals have barely enough for themselves (save for fish, which seems plentiful). We slept on a reed mat beneath a mosquito net, a position which could have benefited from a thermarest. And, surprisingly, it was cold enough by dawn that I was glad to have brought my jacket for I was fully clothed beneath my thin sheet.

Mieko, who does water quality analysis, took samples in our departure town Kampong Chleang and our destination Moat Clas. In Kampong Chleang the fecal contaminants were so profuse her equipment was unable to count the bacteria; she had to dilute it to 10 percent before she could confirm it was a toxic organic soup. In Moat Clas, the river water also exceeded World Health Organization specified healthy levels of fecal bacteria, but not as grossly. She is unable to test for petrochemicals, but other toxic chemicals were negligible. For an anecdote, I watched a naked kid defecate into the water while his friend practiced his flutter kick beside him. Then they both went swimming with the floaters. (at right: Mieko samples water while the village chief watches.)

“We’re going to disappoint them,” Morgan said. “There’s going to be someone who will come in here with something we can’t treat or don’t know how to treat. They know me as Angkor Hospital and are expecting that kind of care.”

But because he is just starting TLCC and lacks the funding and staff to provide extensive hospital services, his ambitions are more modest. He wants to start with basic dental care–largely pulling of teeth–for the nearly immediate relief will build local trust in the organization.

“There is not one person here who is not in need of my services,” Kussick laughed. And yet with each trip to Moat Clas and other outlying communities, patients will be screened to create baseline data and allow the Lake Clinic to bring other specialists out on the lake. (at left: at dawn the breakfast boat arrives with noodles and coffee.)

“It’s all about relationships,” Morgan said. Our visit was primarily fact-finding, photography, and supporting that relationship. In a few weeks Morgan will have his first boat which will sleep five. He is currently buying the engine. Once it is piloted up from Phnom Penh, the shallow draft vessel will be put to immediate use on the Tonle Sap. The Lake Clinic will be a very real entity for the villages on the lake; we could have provided some health care on this trip but as Kussick noted, the amount of equipment we’d have had to carry out there to serve one dental patient, never mind 20, would have been ridiculous.

Morgan is confident things will come together; the donors, the staff, the community and slowly, steadily he will reinvent himself once again. Captain Morgan will undoubtedly sail the Tonle Sap, providing the preventative health care and health education he sought to do years ago through AHC’s capacity building program. He takes his CWA in stride, something I will need to learn to do. (at right: the outskirts of the floating village of Moat Clas on the Tonle Sap Lake four hours from Siem Reap.)


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Cambodia: Angkor Wat and "Thai" Vodka

February 28th, 2008


I’d like to say this was awe inspiring for me, and it might have been had I given myself enough time, but I was up at 4.30, in the tuk tuk by 5.30 with two new friends, and with the masses as the sky glowed pink.

I only had time to run through Angkor Wat to see the grounds and make some images before needing to be back in Siem Reap for a breakfast meeting. Which was about the right amount of time as the light was turning harsh, the heat was building, and I needed a coffee. I had every intention of coming back out for sunset but things led to things and I found myself watching the sun set on the tour buses and temple tops from the restaurant of a French Algerian named Matthew who at one time photographed the temples for UNESCO. Now he helps determine the wine list for the high end hotel restaurants (rooms at $800-$1500/night) and says who can and can’t be in his establishment.

Hal almost got thrown out for calling an oddly flavored Ukranian vodka “Thai Vodka” until Jon mentioned that Hal was the one who road his bicycle across Australia to raise funds for The Lake Clinic. Immediately Matthew’s demeanor changed and they were best friends.

Ah…the French. Well, we did leave with a friend discount and a case of Duvel. It was an absolutely entertaining afternoon within sight of one of the wonders of the world, one of those moments you’d never be able to imagine until you’re in it.

I’m going to have to come back, wade through the tourists, and make a real effort to see the temples. Of course, that means I’ll have to deal with the Disneyland that is downtown Siem Reap. The outskirts are different–and that’s where most of the brothels, massage parlors, karaoke, and other clubs selling sex are now. But the downtown core is a much more wholesome, tourist friendly environment–compared to the recent past. Not that selling sex is necessarily bad, it’s the exploitation, virgin sales, and captivity that many think Cambodia could do without. I rather preferred Phnom Penh; it was a shock to see so many caucasians. And while working with a health care NGO is a bit of a holiday, I could see very easily where the other part of my work lay. I just couldn’t touch it on this trip.


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Cambodia: Misc. Moments

February 27th, 2008

I’m getting a little beat down by the NGO politics, the country politics, the continual fight for access, connections, story leads; I am expanding the story and sub-stories but I have to keep circling back to make sure I’m following up with the earlier pieces.

This is a self portrait down near the Independence Monument on my way from the nearby Java Online to Freebird. Both are popular expat hangouts, both have wi-fi, but Pat and Kath were in Freebird and I’m always afraid of running into the wrong person in Java. I arrived in-country with complications and they’ve only proceeded to blossom. Yet another reason to be tired.

I was keeping a bit of a diagram on my guest house wall in dry-erase pen. One of the desk staff saw it on Allison’s last day–she was keeping stuff in my room before departure–and exclaimed “Oh my god! My boss!” but I assured him it would come off. It became a long-running joke, him threatening to visit my room and “clean” it.


I met a 13 year-old librarian the other day. She catalogs the books by difficulty, both English and Khmer. But the fact that she was once one of the vulnerable, living at the city dump, foraging for recyclables to sell, and is now living communally with other orphans receiving an education speaks volumes for yet another NGO. Even though she doesn’t know the Dewey-Decimal system, she is 13 and it is her library.


I’ve expanded my skill set to video. It’s only a consumer-grade HD camera, but it shoots video. It’s also makes my job that much more expensive to do, not to mention it’s something more to lug around. But sometimes you want a talking head interview. (It does other stuff too, as I’m learning).

Srey Neth (pronounced Sray Nite) is now on staff for Transitions Cambodia and will become a spokesperson for the NGO, not only doing home assessments and outreach, but putting a personal story to the world of trafficking and sex slavery. She was once a victim herself.

Our set up was nothing like the pared-down (a dozen) cases of gear used by the NBC Dateline crew. It consisted of a black cloth taped to the wall, a couple of florescent desk lamps, a piece of synthetic white lace, and the room light. I put a lapel mic on her, asked the other girls to quiet down at the center (and turn off the ever-present TV), killed the room fan and did take after take.

Like my difficulty with some Khmer sounds, Neth finds trouble with “V,” “X'” and the ubiquitous American “R.” But I think we did alright.


I’d never been to the “backpacker” area, the well-known “lakeside” so I went with Phnom Penh local Allie and her visiting younger sister Jessie. Allie works with Build Cambodia and is the person who introduced me to the Andoung Relocation Site. She is currently introducing her sister to Phnom Penh, trying to show a troubled 20 year-old American the depths of Cambodia and in this the possibilities within her.

We admired a beautiful sunset amongst the fisherman-pant wearing, sunburnt, budget travelers. This is the budget crowd, the most temporary in Phnom Penh. However, I’m not so sure the room rates are all that great of a deal.

On an off-color note, this is where (so I’ve been told by a source who shall remain anonymous) NGO women can go trolling for temporary dates. “Unfortunately, you have to take them back to your place and give them a shower, but the great part is they’re gone in a few days.”

Later I got to check out Allie’s well-located and quite nice pad. I was envious of her outdoor kitchen; it has been awhile since I’ve had the opportunity to cook for myself.

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Cambodia: A Ride in the Countryside

February 24th, 2008

This one is just pictures. On a recent Sunday I went with Kath out to Oudong (sp?), a pagoda about 30km North of Phnom Penh. We left in the dark, hoping for some nice sunrise pictures, but found the sky overcast and hazy. The ride there and back was a bit on the thrilling (and ass-numbing) side for me but when I mentioned some of our close calls Kath said “Dahhling, that was nothing. I’ve had much, much closer. We were fine.” Kath, is a brash, outspoken, frank Australian woman who likes men in uniform and to ride a big motorbike. If that gives you an idea.

Oudong is on a random hill poking up out of the surrounding rice paddies. To the east are the lush fields along the Tonle Sap river, to the west are fallow fields, dusty and brown. I believe some of the hilltop structures date from the 15th century and, I was told, it has the largest northward facing Buddha in the country–looking towards China. This could stand to be fact checked.

Anyhow, here are some pics.

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Cambodia: Toul Kork Brothel Tour

February 20th, 2008

This is a cursory glance at the front entrances to a variety of brothels in the Toul Kork neighborhood of Phnom Penh. Many of these are wood-shack store fronts or residences where, at night, the red lamp is turned on and the girls gather at the entrance. At some, closer to the heart of town, the pimps stand out front calling to customers while the girls lounge inside.

Doing proper night photography, what with a tripod, bracketing, waiting for the right moment, is not exactly appropriate. So I sat on the back of a moto, driven by a trusted guy, sans-helmet, with the camera ISO jacked to the max (3200), at f2.8, the shutterspeed as fast as possible (around 15/sec), and no strobe. Snap snap snap away.

It’s not my favorite way to make pictures, especially when the girls figure out what you’re doing and turn away, as it’s pretty much against the way I like to build relationships, understanding, and trust. But the avenues I’ve been trying have yet to come through. With time ticking, I went for the moto ride. It’s also a safety thing for the pimps aren’t necessarily the nicest of people.

Brothel raids, particularly for underage and captive prostitutes, have pushed traffickers’ brothels out into the fringes of town, to the provinces, or to the other main tourist hubs of Sihanoukville and Siem Reap. It has also driven them underground into smaller brothels, massage parlors, and karaoke bars. However, for the Khmer men and the sex tourists, bar girls and more traditional brothels still exist.

Welcome to Toul Kork at night.

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Cambodia: Apsara Arts Association

February 17th, 2008

Apsara Performance: A Short Media Clip (1.15min)

There is kind of a long story behind this short little piece; there is something uplifting in it but like much of the experience here, it’s hard to stop at the surface. Look once and your eyes will be opened.

It starts with a girl in her early teens, she lived at Apsara Arts Association with a bunch of other kids ranging from something like 7 years to 22 years. Apsara teaches traditional Khmer music, dance, and singing. Their troupe has performed internationally.

So the girl gets sick; she has AIDS. They put her in the National Pediatric Hospital where her health improves, and then place her about 30 minutes outside the city in an AIDS orphanage run by nuns.

Molly Jester, with Stop Exploitation Now, funded housing improvements at Apsara and pays the salary for one of the teachers. Molly met the girl on one of her previous visits and asked me to do her a favor–take a Lucky burger and a drink for each AIDS-infected kid (48) when I deliver the toys she sent.

I waited for Allison to arrive in Phnom Penh; she has a special interest in AIDS patients, and since it was early in her trip Dan was along. The kids were hungry for love, attention, anything. They fought over the toys, the fought over us, but there were a few who, in their eight or-so years of age, were looking out for the younger or disadvantaged. Like one girl in a worn-out pinkish dress who took my hand and made sure I gave the bedridden kids on IV drips a toy. I looked at the bladders; Ciproflaxin and saline.

Later that same girl came to play with me and another with a neurological disorder contorting her limbs; her knees were calloused from dragging herself around. She would scrunch up her face, pull her working arm back, and throw a hackey sack with all her might. It would drop to the ground 12 inches from her and she would laugh in a gasping fashion.

This went on for several minutes, the disabled girl, the pink-dress girl, and I playing as we fended off the desperate others. Allison and Dan had their hands full as well. In a somewhat scarring memory, Allison and I had watched this same girl pull her pants off on the floor then, half naked, drag herself over the sill into the tiled bathroom to pee in one of the unclean squat toilets. That this debilitated girl had sought me out, on hands and knees, to play catch was one of those moments you can’t turn away from. You just sit down and laugh with her. You give.

Molly’s girl, the one who was at Apsara, desperately wants to go back. The head nun doesn’t think it’s appropriate yet, as far as her health, nor does Apsara it seems. And so Molly’s girl goes to school, sleeps in a dormitory with other attention-starved children, looks forward to Sundays when Apsara teachers come out to work with the children, and watches as her fellow residents succumb to AIDS. They are all on ARV. Curiously, there is a TB ward two buildings away. The nuns seem to make do; they pray for God to provide, pray for donors, and when that fails, they go begging.

Apsara offers public performances on Saturday evenings. I had tried to make it two weekends in a row, but last Saturday I knew I could go. I just had to stop by a wedding first. I’m glad I made it to Apsara because they were considering canceling the performance, thinking that not enough foreigners might show, but Kalyan–who we met when we visited Molly’s girl–said I was showing up. The resident kids watched, as did some of the parents, but the hour-long performance was for me.

I swatted mosquitoes born from the fetid waters Apsara is built over, and thoroughly enjoyed the performance. For you climbers out there–these girls can bend their fingers backwards, creating a perfect “C.” Some can do it without using their other hand. That’s tendon flexibility.

Apsara Performance: A Short Media Clip (1.15min)

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Cambodia: A Christian-Khmer Wedding

February 17th, 2008

It’s wedding season; just about every corner of every block has the tent set up, the loudspeaker going, the non-stop 12 hours of music. (at right: the cake, the cross, the hearts.)

Jaya (pronounced like Zhaya), the director of Transitions Cambodia, invited me to a wedding on Saturday. Jaya has worked in the sex trafficking aftercare industry for quite some time and knows a lot of Khmer staff at some of the other NGO’s. James calls her his big sister and I have found her to be one of the most caring and giving individuals. And she’s a damn good cook.

The wedding was for a driver who works at Agape Restoration Center; James and Athena founded ARC with Don and Bridget Brewster. The two California couples, guided by faith and a desire to make a difference, built a state-of-the-art facility and, after extensive research into pre-existing NGO’s, designed their own aftercare programs. (at left: bride and groom with wedding guests)

Later, James and Athena started another NGO, Transitions Cambodia (TCI), built on a model intended to help 15-19 year old sex trafficking survivors to find their own voice again and recapture their dreams. Some of the older ARC girls went into the TCI program. Jaya, who had worked with James, also joined with TCI.

In some ways, this wedding was a bit of a reunion. The Brewsters and 38 of their ARC girls were there as were some of the TCI staff and girls.

It wasn’t the wedding I was expecting; I’d heard Cambodian weddings are quite the oddity–and a booze fest. (at right: the bride greeting guests)

A friend of mine, Alicia, went to one last year and said “it was definitely one of the highlights of the trip. The mother of the bride was crying and hugging us when we left, and we met the most hilarious semi-mute, flamboyant blue silk shirt with rainbow stars wearing individual. I loved the tradition where the parents of the bride and groom exchanged champagne glasses full of Jim Bean Whiskey and drank them down in one gulp. The beer girls circulating in mini skirts to keep our glasses full, and our lazy susans laden with the latest feasting course were also a classy touch.”

This one was quite different.

I toured the neighborhood–a “city” as they call it here. Essentially a gated community, it was row up on row of uniform houses and uniform SUV’s. It felt a little like suburbs in Phoenix or Vegas, except greener, more humid, with more concrete homes, steel gates, and the odd rat or two. Sewer smells escaped from the gutters drains. Eventually some guy on a moto told me to stop taking pictures. Security. (at left: the neighborhood)

I returned to the wedding, watching as the bride and groom changed outfits (at least three times in the two hours I was there), all the while greeting the flood of guests. The ARC girls sat in the back and, having filled the tables, were quickly served. Little did I know, the strategy is to sit at an almost full table if you want to be served. I eventually got the clue, but not until it was too late. I was supposed to be at Apsara Arts but was desperately hungry; I had some appetizers, a coke, and glutinous fishy soup and had to run. (at right: finally sitting down for dinner)

Mixed with all the Khmer traditional styles were prolific displays of Christian accouterments and, I could be wrong, but the recorded Khmer voice in between the songs kept on finishing with “amen.” For me it was different on many levels; for instance, at what wedding have you been asked “don’t take pictures of some of the girls. We’ve got several who are in an on-going court case with an American pedophile.” And, to top it off, there was nary a drop of alcohol. Which might have been a good thing, because it probably wouldn’t be kind to show up half drunk to watch kids perform traditional Khmer dance. (at left: TCI center director Jaya on the left and on right, resident Srey Neth)

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Cambodia: Child Safe

February 13th, 2008

Child Safe did an opening for their new public relations campaign. Some pretty cool imagery, snack ’ems on the buffet table, cold beer, but more importantly, it’s another step forward in a national move to end child exploitation.

Learn more at:
Child Safe Cambodia

And read an interview with Marielle Lindstrom with CTIP at the Asia Foundation:
Lindstrom Interview

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Cambodia: Freebird

February 13th, 2008

Just another night out, a Friday night in fact, with Allison (from Seattle), Kath (local), and what soon became Pat and Mick (more locals), and later Julie and Stuart (Seattle).

Freebird used to be a bit of a go-go bar but since its change in ownership has become more of an expat refuge, a neighborhood bar, a place where you don’t give the girls behind the bar any shit, where you can throw back more than a few and someone will get you home safely. (at right: allison and kath)

Run by a guy who is ex US Army explosive ordnance disposal (EOD) it has an interesting collection of paraphernalia on the wall and people at the bar.

Needless to say with Kath, the ultimate local, we were given the best introduction one could want. And there was dancing, though sadly Kath doesn’t remember ours. But she does remember her dance with Allison.

In the two short weeks Allison was here, she found herself a home; pretty much everyone is sad to see her head home, but she was on a flight with her boyfriend (and my good friend) Dan out of BKK by the 12th, as promised. I lost a travel partner and fellow CTIP investigator. As chief whip-cracker for the FEAR Project, Allison not only was great company, but she kept reminding me of all the things I, for some reason, couldn’t quite keep in my over-packed head.

I’m putting an 80%…no…90% chance that she’ll be back. The red dust works into your skin, the orange light saturates your vision, and the smiles fill your heart.

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Cambodia: Elsewhere, the Scene.

February 3rd, 2008

My impression is the NGO world in Phnom Penh is like high school, only the parties are better. (at left: the riverside, bar stop number four)

Of course, I haven’t collected a sufficient data set but Friday night Dan, Allison, and I tried to keep up with Charis, a lifestyle writer for Asia Life magazine here in Phnom Penh. The two are visiting from Seattle. Dan is a long-time friend and Allison is his girlfriend; she is also *the* key FEAR Project staff person and will be spending an as yet to be determined amount of time with me working on the counter-trafficking story. She’s already cracking the whip, reminding me of meetings, pushing deeper on sensitive subjects, and these NGO people seem to be falling in love with her intelligence and presence. (should I start feeling insecure?)

In a matter of fifteen days or so, I have found a community for myself, people I feel I can call up and decompress to, have a drink with, grab some dinner, or laugh at ourselves. It started with Pat, the woman working on land mine issues, spread to Kath, who works on counter trafficking in persons, Rachel, the ex-radio reporter on an extended holiday, and now several others. Of course there is James, my subject turned confidante, friend, and drinking partner and after my trip to Sihanoukville I’m adding John and Charis to the list. (at right: jockeying for drinks at elsewhere)

I’m learning who’s been sleeping with whom, which ones “prefer Khmer skirt,” who likes coke, what kind of male/female ratios I might find at which bars, and have been given the up-and-down by too many drunk (and sober) women to count but this, this one takes the cake. (at left: the elsewhere dance floor)

Culminating the seven-bar Friday night party-hop with Charis we finally ended up at “the” pretentious party everyone hates to go to (but ends up at anyway) known as “Elsewhere.” It was there, on the dance floor, a dread-locked man gently took Allison’s hand and asked “Do you fuck?”

Apparently everything here operates much faster; there are some long-time locals but often people are only here for a year or two, adding a sense of urgency to things. Or maybe a rawness. It could also be the work the NGO crowd is doing, and where their last tour might have been, for even in the short time I’ve been here I’ve personally seen how hard this life can be on the mind and body. Never mind the pollution or generally high ambient noise. (at left: hanging at the pool at elsewhere)

There’s the heat, dehydration, sickness, the work load, the kind of work; some of this is about human suffering, the rest is about money and development. So maybe that adds to the intensity, accelerating already fast relationships; you could be two ships passing in the night, but on that off-chance you connect, it seems you’ve got an abbreviated time frame to make things work.

On the other hand, if the rumors are true about the 4 a.m. nude and drunk swimmers at Elsewhere, it might be that ex-pats, especially NGO ex-pats, just like to party. Hard. (at right: a couple near the bathroom line up)

I feel old.

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