A few thoughts at New Year

Any modern missionary knows that one of your tasks is to keep up the blog, preferably with lots of fantastic photos and inspiring stories. I haven’t even tried to write a blog in the last year. It’s not that I don’t have something to say or that nothing has happened. I just don’t know how to communicate adequately the depth of God’s work when this last year has been for me one of inner change and there are no photos to show what that looks like.

It’s also not that I haven’t been writing but my writing has been more personal reflection or for work and study. Writing something public has felt too confronting. I have this drive to be honest and vulnerable and that makes it hard to write what I imagine people want to read. In some ways it feels too much like striving to be part of a competition one can never hope to win. There is so much written now. Everyone is posting, tweeting, blogging and commenting that it feels like we are trying harder and harder to capture attention in an age of shortening attention spans and over stimulation.

Maybe I’ve just grown weary. Actually I know I have grown weary. The last 15 months have been a real challenge health wise for me. But the experience of lowered energy levels has made me search for slow and restful rhythms that are restorative and kind and I am losing interest in trying to impress anyone anymore.

The danger in being open and saying what is on my mind is that I may be misunderstood or risk rejection. If I express my frustration or rail against the injustice I see around me here in Cambodia, let alone in the news, my words may well be unbalanced, critical and unkind and 2015 seems to me like a time for greater gentleness, consideration and compassion. Maybe now is not the time for too many words.

Richard Foster, in A Celebration of Discipline, wrote “Superficiality is the curse of our age. The doctrine of instant satisfaction is a primary spiritual problem. The desperate need today is not a greater number of intelligent people or gifted people, but for deep people”.

As we start 2015 I believe we need a new depth of love and wisdom. We need spiritual discernment and to be moulded and led by the Holy Spirit. 

One way to grow in this is to delve into the riches of ancient Christian devotional practices and explore how they can be used to deepen and reinvigorate our connection with God in a new age. There is no real need to invent something new. The new is so quickly superseded these days. Something new will soon be something old.  We have a rich heritage that has been tested over the centuries. There is much to gain from those who have gone before us.

I am continuing to learn how I can take things such as the Jesus Prayer, the Examen, Sabbath, Lectio Divina and the use of daily offices and merge them into my 21^st century life with all its challenges and underappreciated privileges.  

How can you seek to grow in depth this year? 

There is an alternative

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In recent years I have become concerned that High school groups have been visiting Cambodia and spending significant time, or all their time, in orphanages ‘helping’ – playing with the kids, teaching English, and do work tasks like painting and building. 

The overall impression they get of Cambodia and Cambodian kids is very limited.  The vast majority of children in Cambodia live with their parents, extended family and community. To spend any time in an orphanage or children’s home is harmful to both the kids living there (attachment disorders and other psychological issues in the children are exacerbated) and those visiting (who develop misunderstandings about appropriate responses to poverty and disadvantage).

Trips to many other countries by Australian school groups never include visiting orphanages. When a school group goes to Europe, for example, the emphasis is language, history and culture. But rather than coming to learn these same things in Cambodia they so often follow the well-trod pathway of volun-tourism and orphanage tourism. It is easy to do, and is encouraged by the orphanage managers for whom a constant stream of visitors amuses the kids, gets a few jobs done around the property and the volunteers, emotionally moved by being with the kids, will often leave money with the managers before they depart.

Of course the volunteers are doing what seems needed and with the best intentions. But it is not all about them. It should be all about the kids in orphanages and Children’s homes and it is clear visiting such places anywhere in the world does harm to the most vulnerable kids of all.

In Cambodia, if you build an orphanage you will fill it, not with orphans but with kids from poor families sent for a “better life”. But what kind of life is it away from mum and dad, family and friends? (See website on institutional care issues internationally)

There is an alternative. Emmaus Christian College from South Australia have recently visited Vietnam and Cambodia and focused on history and social justice. During their time in Cambodia they have learnt Khmer language each day, learnt from key members of the ‘emerging’ civil society in Cambodia, and sat with young people deeply committed to empowering the youth of Cambodia to find their voice and bring change to a country desperately in need of transformation from within. In the process the students from Australia have been changed and challenged in many ways. When Cambodian people heard the students were learning ‘their language’ each day they were surprised and often asked “but why are they learning our language when they are only here 10 days? When they realized that the programme was to ‘learn’ rather than ‘help’, and to ‘engage and understand’ they were impressed.

So, Australian educators, please re-think what you do when you send a group of your students to poor countries to ‘experience’ poverty and ‘serve’ the poor.  There is damage done to those you meet and your own kids get a warped view of both themselves and their place in the world. There is an alternative.

Orphanages - an Aussie reflects

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When I was a kid growing up during the 1970’s in Blackwood, a suburb of Adelaide, South Australia, I remember regularly passing Colebrook Home.  We all understood the Aboriginal kids there didn’t have parents or family and they had been brought to the city for education  – it was an orphanage.

Years later, in the mid 1990’s, I was involved in a coalition of community groups that supported Indigenous and migrant people. I met some of the women who had grown up in Colebrook and I discovered that in fact the kids weren’t orphans but actually taken as part of what is now called the Stolen Generation. I remember the release of the Bringing Them Home report in Adelaide when Ron Wilson spoke so passionately about what the inquiry had found.

For me the news that those kids in Colebrook had been taken and were not orphans at all was staggering.  That a ‘well meaning’ collaboration between government policy and church agencies had led to this terrible outcome of kids taken from their family and community was terribly disturbing.

Fast forward to Cambodia in the 2000s and we have a another ‘well meaning’ activity also damaging kids. That is taking kids from their families and communities and putting them into institutions (not by Government policy but often through pressure and guilt laid on parents facing abject poverty).  At a time when the number of orphans in Cambodia is decreasing (due to a better economic situation generally and a decrease in the number of deaths from AIDS over the last 15 years), the number of children’s homes is increasing.

There are lots of Christians involved. For the Cambodians running an orphanage it can be a means of bringing in money from overseas and is often a good income source for pastors and churches struggling for funds. For International people a children’s home is a relatively easy thing to set up and run and you surround yourself with a whole lot of dependent kids who ‘love’ (need) you. It’s a good feeling.  It’s also a great place to have short term teams visit – church and school groups.

How will this be seen in the future? Will there be a ‘Bringing them Home’ report on this era in Cambodia and mission activities of this kind around the globe?

And now there is the Royal commission into Child Abuse in Institutions that is looking into the terrible suffering of kids in Australian orphanages last century. 

There are many Australians involved in orphanages and children’s homes here in Cambodia. Many of them are Christians.  Are we doing to Cambodian kids what we did to our own in a previous generation?  Taking them from families and putting them in institutions. We should be the most sensitive nationality to this issue.  And yet we may be the most involved nationality of all.

Why am I writing about this? I’m an Australian. I’m an International mission leader in Cambodia at this time. I remember the kids in Colebrook Home.  And tonight there are thousands of kids in orphanages in Cambodia most of whom have a home, a family and a community.

God have mercy on us all.

Check out this article from the Age and this website of Children in Families an NGO developing alternatives to institutionalisation in Cambodia.  Also a bit about Colebrook Home and the Bringing them Home Report.  Also check out the Sky Project at ICC here in Phnom Penh.

Every child needs a gift - really?

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The premise that ‘every child needs a gift at Christmas’ is flawed and needs to be challenged.  I have been concerned with this for many years but only recently I was encouraged by some Australian visitors to Cambodia to share my thoughts with a wider audience.

The desire for Aussie families to help the poor of the world, especially at Christmas, is a wonderful sentiment that should not be wasted by putting ‘stuff’ into shoe boxes and transporting it internationally.

The economic and environmental implications of this approach just don’t stack up – ie buying cheap stuff from China in Australia, then paying to send it back to SE Asia using a range of transport methods that all have an environmental impact. I know some of the items sent are lovingly handmade by dedicated volunteers across Australia, but the negative environmental impact remains.

The cultural inappropriateness of gift giving to individual kids in a collectivist social context is problematic. The message to thousands of kids that their parents are so ‘poor and useless’ that an unknown foreigner is giving them a gift perpetuates the oppressive ‘power and wealth’ assumptions the rich of the world make about the poor, and that the poor understand about themselves.

Picture for a moment a poor family in Cambodia with 8 kids - 15 years old down to 9 months – successfully creating a safe environment for their kids to grow up and trying to have enough food for them to eat each day. The kids have no toys and only one set of clothes, but they have each other and their wider family and community. One day the kids come home from school with a shoebox given by some foreigners. Full of amazing stuff like they saw in the market the one time they went to the local town a few years ago. Why haven’t their parents ever given them stuff like this before? What is wrong with their parents, because people they don’t even know are giving them gifts? Within a few weeks most of the stuff in the box is broken, spread out around the village and basically forgotten about. But their questions about their parents remain, tucked away in the back of their minds.

Or

Picture for a moment a poor family in Cambodia with 8 kids - 15 years old down to 9 months – successfully creating a safe environment for their kids to grow up and trying to have enough food for them to eat each day. The kids have no toys, only one set of clothes,  but they have each other and their wider family and community. One day the father/husband comes home with 50 ducklings for the family to raise so they have a small daily income to help pay for the kids schooling.  The children look after the ducks and sell the eggs each day from the front of the house or door-to-door around the village. The parents got this small grant to buy the ducks from a local organisation that comes by sometimes to see how the family is going. The kids don’t know where the money came from but it has made a real difference to their lives. They think their Father is amazing and he really cares for them and their Mother.

Over the years I have become aware of the pressure church pastors in Asia feel to ‘get rid’ of the boxes that are accumulating in their houses before the next installment comes later in the year.  Recently (in late May) a pastor desperate to move shoe boxes cluttering his house offered them to whoever would take them, and even thought my sons (17 and 15 years old) might like some.  No ‘good news’ message accompanied the hand out, no ‘blessing at Christmas time’, just a confused moment when random kids were given boxes.

There are the smiling faces on the video reports and all kids love to get gifts, for a few minutes at least, even though they don’t really understand what it is all about.

But talk to the pastor we met about what he really needs to ‘bless’ his ministry and he won’t mention shoes boxes. He’d love some budget to help him buy toiletries (soap, toothpaste and brushes) and some basic medicines from the local market for the prisoners he visits in the appalling conditions of the local provincial prison.  He would have a significant impact for the kingdom through these interactions and the ‘good news’ he shares would have a long-term impact on some of the most vulnerable people in Cambodia.

This is the fundamental problem with the shoes boxes – someone in the Christian West came up with the idea that all kids need a Christmas gift.  They should have asked the church in the countries they want to support (across Asia and Pacific in the case of Australia) “How can we bless you (our sisters and brother in faith) this Christmas”. I guarantee the answer would not have been “put some stuff in a shoe box and send it over”…

Almost a 100 million shoe boxes have been sent over the last 20 years.

It’s time to stop.

But what about this great sentiment to give to the poor at Christmas time? Here’s a few ideas:

·      Support poor families in Australia to provide gifts to their kids who are expecting something at Christmas time because that is the ‘culture’ in our country.

·      The ‘shoe box’ organisation does some great development work across the globe. Find out about their programmes and support them.

·      Use one of the many Christmas catalogues available from aid and development organisations to purchase gifts (like some ducks) with real impact for poor families outside Australia.

I know some will find reading this hard and I would welcome a dialogue about how we can do all this better.

Words

Do you ever feel tongue tied? Lately I’ve found it hard to make my thoughts coherent or feel confident in expressing them, especially when I speak in Khmer. I often become quite shy and introverted, not knowing what to say next, at times avoiding situations where I will be expected to carry on a deeper kind of conversation. A lot of this has to do with not having the fluency and vocabulary to express myself as I would like or to fully understand what is said to me. I am concerned that I will say something stupid or offensive because I’m not competent enough to speak sensitively in the language. I feel in some ways my personality changes in this other language and I can’t quite be myself. I guess it’s like that for others when they are speaking in a language not easy for them. It makes me wonder how I can really know people when they are relating to me in English if it is not their first or most comfortable language. How can I know their real self?

When I write in English, even though I feel confident in the language, I also hesitate out of fear of what others may think. I am concerned that I will hurt or offend or fear that I will be misinterpreted. 

Speaking or writing in a public way takes courage. There is real power in having a good command of a language in order to express and exchange ideas clearly. Teaching language, literacy, writing and confident communication to people opens up the world to them and them to the world. This is real empowerment.

I have a Khmer friend who cannot speak. She lost her speech after sustaining neurological damage in a traffic accident. It has also affected her arms. She knows three languages but can only express herself by typing on a computer with one finger or texting on a mobile phone. Although very intelligent, this accident has dramatically impacted her sense of self, her mental health and her confidence to meet people and express her ideas. My prayer is that she will grow in courage to engage more with the world that is now available to her through technology both for her benefit and also for the benefit of those who can learn from her. I want to see her empowered to find her voice. 

I wonder how we can more effectively use what skill we do have in language and communication to promote deeper thinking, greater understanding and more generous living. 

At my sister in law’s funeral she was quoted as saying ‘great words are great deeds’. She had a PHD in English literature and loved words. 

We are often told that deeds speak louder than words but in my life words have been profoundly helpful. Words have conveyed the love and the message and the ideas that have brought me meaning, comfort and inspiration for life. 

There is certainly a time for living out the words and simply being in a silent way, a time for presence. A time when no words are adequate or when the pain is too great to articulate. Words do have their limitations. We can only speak of what we understand and know. We speak in response to the words of others. Listening too is a great power. I have found that when we ask powerful questions we can draw out the ideas of others and empower them with their own words. Communication, the speaking and the listening, can be a most profound act of love.

One of the most beautiful passages in the Bible proclaims that ‘The Word became flesh and dwelt among us’ (John 1:14). Jesus is the Word. God created though His Word. God said let there be and there was. Words have incredible power and Jesus shows us in his embodiment of the Word that God longs for communication with us.

May God empower us, through His Spirit, to listen and receive. May He also release our tied up tongues and fill us with the courage to speak words of life and love.

Sitting Still

Ay is forced to be still. She sits alone for hours waiting for her mother to return from work so that she can be fed and helped to the bathroom. A progressive muscle wasting disease has left her with a little hand function and an active mind but no ability to do the things that most young women take for granted or fulfill the roles expected of her. Thankfully a smart mobile phone and facebook provide some connection with the outside world. It is also a distraction from the constant grinding and whirring of saws from the metal working shops that surround the little upstairs room she now shares with her mother and younger brother.

Not only does Ay endure this loneliness, discomfort and boredom, she carries the loss of her previous life and her family’s dreams for the future. Ay was finishing university when she became ill, progressively getting weaker and weaker. Her mother spent all their money, sold their house and borrowed from others, going from doctor to doctor both in Cambodia and in neighboring countries desperate to find a cure. When they eventually came to Mercy Medical Center they still had no clear diagnosis despite many costly investigations and useless treatments proscribed by doctors more concerned with profit than patient care. It was heartbreaking to tell them this is a progressive condition for which there is no cure and no expensive medicine will make any difference. All we could offer was physiotherapy, prayer and a willingness to be friends for the long and difficult road ahead.

There are plenty of painful and unjust situations here in Cambodia that I long to see changed. At the same time I am recognizing more and more the need to be patient and endure the frustration of going slowly so that we can learn as we go and move at the pace of those we travel with.

In a world that emphasises action, efficiency, instantaneous results and constant stimulation it can be hard to hear the call to stillness, quietness, waiting and patient endurance. The scriptures are full of these themes (Col 1:11; Ps 37:7; Isa 30:15). We are encouraged to develop these qualities and pray for the power to endure and persevere.

There is a need for wisdom and discernment about what things we are to endure or persevere in and what we are to confront and transform. I believe it is in the stillness and quietness that we find this clarity.

Recently, while visiting Ay, a Khmer colleague and I shared with her the story of Jesus at the home of Martha and Mary. We talked about how, although Martha was busy doing what was expected of her as a woman and hostess, Jesus praised Mary for sitting at His feet and being a devoted learner.  Ay had expressed her sadness at the impact her disability had on her family and how she felt she was a burden. Through this story, however, she could see that in the eyes of God she was a beloved child and a student of the Lord able to spend her days at his feet, listening and learning and this was more important that anything else she might do.

In the business, noise and demands of our lives may we also risk stepping outside the expectations of others as we take time to quietly sit at Jesus feet and learn from him.

Calling and Leading: Some reflections

I have been spending some time with a small group that came to Cambodia with Interserve for two weeks of exposure to medical mission. They were all considering whether medical mission work across cultures in Cambodia or elsewhere was for them. A great group who really engaged with everything they encountered along the way.

I reflected with them about call and leading. For me call is what happens when we decide to be Jesus’ followers. We are of course saved by grace, but there is no doubt that God has a plan for each of us to be a part of what God is on about in the world. This is our calling and I think it should remain broad, general and encouraging. But clearly it is not an option or a choice for us to decide on. It is part of the package we ‘signed on for’ when we decided to be followers of Jesus. Keith Green had a song with lyrics:

Jesus commands us to go,
It should be the exception if we stay.

These words have inspired generations of people to be part of ‘mission’ in other cultures and countries, but I’m sure left many more feeling they weren’t obedient and desperately trying to explain to others and themselves that “we all can’t go”? Keith Green’s passion and all-or-nothing approach inspired my generation but perhaps his legacy got confused in the ‘go’ and what that really meant.

Today, mission is used everywhere in the church, and perhaps it is overused and thereby in danger of losing its meaning (“If everything is mission, then nothing is mission” - Stephen Neil) but what it does do in many circumstances is make people open to how they can serve God where they are. That is, to intentionally and strategically seek to bear witness to Jesus and his ways.

Leadings are the various directions that God takes us along this journey of following his calling on our lives or our discipleship to Jesus. God leads us into various expressions of our overall calling during our lives and these are the tasks, roles, places, and ministries that we are involved with in our local communities and across the globe. God leads us where he wills and we choose to follow. We should do some discernment with our faith community, our friends and mentors. We should pray and seek clearly God’s leading for our lives. In a sense this process is constant for all who “seek to follow Jesus”, certainly something we do regularly along the way, and should be a part of the regular life of Christian communities.

Is this just ‘playing with words’? Perhaps, but the importance of the distinction becomes clear for me when people say “I don’t feel ‘called’ to mission work” (ie cross cultural mission in Cambodia). This can then lead to them thinking they are not called to ‘mission’ in general. Indeed perhaps they are not ‘lead’ to mission work in Cambodia but they are called to mission – it’s part of their discipleship. The question for them is where is God leading them to serve.

So, we are called to follow Jesus as disciples. He is the one leading us to serve in mission.

Siem Reap

Siem Reap, the home of the famous Angkor Wat temple complex, now welcomes around 2 million tourists a year and is bursting with luxury hotels, restaurants and entertainment clubs. Yet it remains one of the poorest provinces in Cambodia. Where is all the money going? I guess there are some local people working for minimal wages cleaning hotels and serving in restaurants but on the whole the money leaves the province into the hands of foreign owners or wealthy national business people. There are some serious flaws in that old ‘trickle down’ theory.

This was all starkly illustrated to me recently while on a visit to the Siem Reap provincial referral hospital with a group of doctors and medical students from New Zealand. The hospital is a 2 minute walk down the road from the key tourist strip. It’s like going from one world into another. One minute we were strolling through a trendy tourist area with scantily clad foreigners breakfasting in the open air cafés. The next we were amongst weary, confused families camping outside dilapidated wards. They looked tired and anxious as they cooked their food on little clay pots and hung their washing on any tree or post they could find. Many had spent more money than they could afford just getting their sick family member to the hospital. They then needed to pay for any procedure or medicine deemed necessary which often means selling assets or going into debt. If they can’t pay they will have to pack up their ailing loved one and head home. This major regional government hospital is very poorly resourced. They reuse gloves and needles in some wards to keep expenses down. Patients are denied blood transfusions if they cant replace the blood through a donation from a family member. There is an x-ray machine but no CT or MRI scan and very little in the way of other diagnostics. Many of the staff are poorly trained and often struggle with low morale due to their pitiful wages and lack of professional support. The intensive care unit has no ventilator machines, the nearest one being in Phnom Penh, 6 hours away by road. That’s a long time to bag air into someone who is not breathing adequately on their own. Unusually someone that sick will simply be left to die.

One of our IS team members has been working at this facility training and equipping the midwives to improve maternal health and bring down the high number of unnecessary maternal deaths. It’s been hard, frustrating and at times heart breaking work but things are starting to turn around as she gently guides and models different approaches and encourages the very poorly paid midwives to do the best they can.

I wondered how many of the tourists had any idea about the misery just down the street or thought about where their dollars were going.

If you are planning a visit to the wondrous temples of Angkor, pack a box of surgical gloves and think about sparing a litre of blood. The provincial hospital welcomes donations.

A Vision of the Kingdom of God

Here in Cambodia we talk about transformational development. We have a vision of a Cambodia where all kids can have good nutrition and grow strong. That all kids can have education and all adults can access good health care. A vision of reconciled enemies, of good parenting and peaceful communities. Where the majority poor can have access to some of the resources of the minority rich. Where people are paid a fair wage and their rights are protected. A place where people have secure tenure of their land free from the threat of eviction. I want to see people coming into a transforming relationship with God and embarking on a life of discipleship following Jesus.

This is a vision of the Kingdom of God for this place and God is at work here transforming evil into good, enmity to friendship, poverty to sustainable lives, and brokenness to fullness in Jesus. God's at work here and it’s exciting to be a part of it.

Life in the Kingdom

Henri Nowen talks about “two kinds of death” – one into the Kingdom of God and one into Hell. Dying into ‘new life’ always seems a strange way of entering the kingdom. To have life in the Kingdom we need to ‘give life away’. Jesus teaches this in a number of ways – seeds rely on death before bringing new life, coming to God in simplicity as children, ‘giving everything away’ to really know God, and selling “everything” to buy the field with the treasure or the pearl of great price.

What does this mean for us as Jesus followers?

Matt 11 came to me:
28 “Come to me, all you who are weary and burdened, and I will give you rest. 29 Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. 30 For my yoke is easy and my burden is light.”

It encourages us to take our place and be deeply connected with him and get into what is happening in his Kingdom. It’s a voice of encouragement to those of us who are “weary and carry heavy burdens” – “I will give you rest”. Not a rest of doing nothing, but rather a rest because we are yoked with Jesus. He will help us and we will get our lives aligned with him. This life is “easy and the burden light”. Sometimes it doesn’t feel so light or easy – but the promise remains.
This is life in the Kingdom.

Real Communication

Since moving here to Cambodia I have been surprised how many people in the international missions community have low-level Cambodian language skills. Even some 10-15 year ‘veterans’ can’t do the most basic teaching and training, tasks in Khmer let alone preaching and leading more complex conversations. Many can of course and their hard work learning the language, understanding culture and bringing the two together into meaningful conversations means they are confident to share at depth directly with Cambodian people.

Common reasons given are: “There was so much work to do I just had to get right into it”, “they all understand English anyway and they learn faster than I ever could”, and “I have a great translator”. All good pragmatic reasons but one wonders if they would have been more effective in the their work and ministry communicating directly into Cambodian language

Recently Rachael was asked to give a lecture at the National Physiotherapy conference. They assumed she would use English and they assigned her a translator. At just under the two-year mark she is well short of being able to deliver such a speech in Khmer so the offer was kindly accepted. Notes were sent off three weeks before to be translated and for familiarisation of the material by the translator.

She met the translator before the meeting and speaking in Khmer together it became clear he had misunderstood the key concepts of her paper. She was speaking about brain ‘plasticity’ – the ability of the brain to re-learn basic tasks like speech and movement through systematic ‘training’ activities post trauma - in the context of working with patients with strokes, head injuries and other neurological conditions. He, however, had translated the concept as having brain ‘surgery’ to correct the problem.

It showed clearly how, even in their field of expertise, many of the concepts we want translators to communicate are really tricky. Let alone the translators who are just good English speakers and have to translate in fields outside their direct knowledge area.

I have been reminded again of the importance of language and culture in communicating ‘information for transformation’. I know it makes the mission process more challenging and elongated but the outcomes just have to be better in the long run. So who wants to ‘put their hand up’ for lots of preparation and learning to come and serve the people of Cambodia?

Health: Right, Privilege or Responsibility ?

Is health a right, a privilege or a responsibility? That’s a pretty hard question to answer. Even with access to the best available health care and the most vigorous self care we may not be able to control our health status. Should I simply be grateful for the privilege of current good health or am I healthy because I live a life of privilege? Are we responsible for our own health? What about our responsibility towards the well being of others? Is a reasonable level of health care a human right? What’s reasonable when we consider the costs of global public health?

I have been thinking lately about health in terms of justice and here in Cambodia there is simply not enough of it.

The inequalities are stark.

In Cambodia it is common for families to sell land, animals or motorbikes or take out high interest loans from unscrupulous money lenders to pay for a family member to have surgery. All bathing, feeding and general nursing care is done by a relative of the patient so the family is going without two incomes. They will often need a family member to continue to be the full time carer when they leave hospital. Not uncommonly a daughter will be removed from school for that purpose. I’ve been seeing stroke patients in a government hospital and they regularly leave to go home well before they can sit up, let alone walk, because they have run out of money. There are too many stories of patients paying for unnecessary and sometimes dangerous combinations of medications with no understanding of their condition. Many people can’t afford the transport cost to a health centre, let alone the treatment, so they wait and wait until their condition is very serious and then often too difficult to treat.

An illness or accident can spell disaster for the whole family. It’s not surprising that anxiety is such a common problem and a contributing factor to ill health.

If you have money, however, most likely you will leave the country when you have a significant health problem in order to receive quality health care elsewhere. Maybe Vietnam or better yet Thailand or Singapore if you can afford it.

We have just done that. Tennyson went to Bangkok for knee surgery because our organization covers our health costs. We are also citizens of a country that has a well functioning, even if imperfect, public health system. When we were back in Australia recently our family had several doctors’ appointments, lots of health tests and a couple of small procedures and just about all of it was covered by Medicare. While I stood in line at the Medicare office contemplating the beauty of a public health system, others around me seemed very put out by the long queue. I was just so thankful that they were going to give me back all that money. It was wonderful to know that having preventative health checks and effective treatment for problems, before they become life threatening, was not going to financially cripple my family. In fact we would hardly notice it.

Bono wrote in a song ‘Where you live should not decide whether you live or whether you die’. Unfortunately it often does.
I’m very grateful for the quality health care we have received but I could do without the nagging discomfort of being one of the privileged few.

“Traffic that flows like water”

My initial reaction to hearing this assessment of the Phnom Penh traffic was to laugh and add “and goes ‘bump’ very hard”. But over time I must say “flowing like water” is the reality of how it works. The key is learning to merge, give way to the bigger vehicle, and follow the ‘actual’ road rules not the theoretical ones.

The best preparation for taking the plunge into the traffic here was the time I spent on the boys gaming console playing the game “Need for Speed: Most Wanted”. Little did I know that learning to drive on the wrong side of the road facing oncoming traffic would be a useful skill here in Phnom Penh. Dodging other traffic is one of the major skills needed to navigate the roadways.

The “flows like water” bit happens when, for example, turning left to join the traffic (which mostly uses the right side) one never stops, but rather kind of merges and mingles against the oncoming traffic until the “waters part” and a way opens up to make it across the traffic and then requires a similar merge into the stream of traffic heading left.

Confused? Perhaps this will help. There are officially two lanes of traffic with all vehicles driving on the right-hand side as in North America and Europe. So as you are driving looking forward there is the oncoming traffic on your left. Got it so far? Ok, this is where it gets tricky, there is another lane of oncoming traffic further to your right which represents the vehicles, mostly motorbikes but actually all vehicles smaller than trucks, that are trying to merge through your line of traffic to join the traffic to your left. Still with me? It is this right hand lane that does the “need for speed” thing and kind of cuts through your lane to merge with the other stream.

This is the basic ‘level 1’ context of the game and has ‘regular’ traffic – cars (some), motor scooters (lots), trucks and bicycles (lots too).

But lets play level two – this adds tuk-tuks (motor scooters pulling a carriage that comfortably seats 4 and often seats 8-10), tri-shaws (peddle powered single seated three wheeled vehicles), rubbish collectors pushing hand propelled carts around, and bicycles or scooters converted into hot food stalls fueled by hot coals.

Level three adds scooters converted to carry 44-gallon drums of flammable liquid, sheets of glass, pieces of angle iron 4-5 metres long, cupboards, double bed mattresses, and then inserts old people from the country side that are visiting the city for the first time and who randomly cross the road along the way.

Level four is the highest level and is the last test. It adds in teenagers who speed, weave in and out of the traffic, and generally create havoc by riding 3 or 4 abreast while chatting to each other. And then the last challenge - the people with mobile phones held to their ears or texting as they go along at half speed.

So watch out for the game “Need for Speed: Flows like water” at a retail store near you – $69.99. Or go down to the local market and get a pirated version for $2!

Inadequacy

When I think about our years of living in Thailand and now Cambodia, trying to learn language and engage in the lives of the people we are living amongst the word that would most often describe my feelings is ‘inadequacy’.

There is nothing like trying to learn a new language to make you feel small and childlike. Combine that with a totally unfamiliar culture, vastly different worldviews, less than ideal circumstances and a lack of resources and it’s not surprising that there are days we are left wondering about our effectiveness.

In the Mercy Medical Clinic, where I have been doing some physiotherapy, the people that I meet are often in situations that are way beyond my ability to address in any meaningful way.

This week I saw two stroke patients who were both left so disabled and so dependent that I couldn’t imagine how the families where going to cope with their care. The clinic is not a hospital for long term stays and these families couldn’t afford any other form of inpatient treatment. So they go back to their village homes to lie on the floor, being bathed and looked after as best they can by overwrought family members who will now have to give up paid work to become full time carers.

One of the patients could no longer speak and was having great difficulty with swallowing. Apart from rehydrating her in the clinic with a drip, little could be done as there was no tube feeding available. She would just have to be fed at home, very carefully by spoon, at great risk of getting the water or food into her lungs and developing pneumonia. Her devoted son said to me that he didn’t mind if she couldn’t move around or sit up. He would take care of her but he just wanted her to be able to eat and drink as he was afraid she might die. ‘Yes, exactly!’ I thought. It would have been difficult to think of something helpful to say even if I did feel more confident with my language skills..

It’s times like this that I find it hard just to be there witnessing people’s suffering. It’s even harder when I know that in another place, like Australia, there could be so much more done to help the whole family. My expertise and professional opinion don’t seem to be much help at the point where circumstances stack up against people and what is needed is comprehensive change to inadequate and unjust systems.

Although the temptation is to walk away or close my eyes to hard things, I do believe there is real value in simply being present with people in their pain even when we can’t take it away. I still, however, feel very uncomfortable with it. It regularly challenges my sense of professional efficacy, my sense of worth and identity and raises uncomfortable questions about what on earth I’m doing here.

Maybe if I did feel adequate I’d be in even more danger of imposing my insensitive responses and inappropriate ‘solutions’. Inadequacy is often an accurate appraisal of ourselves but it carries the danger of despondency and paralysis. Taken in a spirit of humility, however, the response is a greater dependence on the One who is able to do more than all we can ask or imagine.

Despite my wobbles, these weekly encounters with heartbreaking situations are spurring me on to deeper reflection on the meaning of solidarity, the ministry of presence, and above all else, a profound appreciation of Emmanuel, God with us, especially in our suffering and weakness.

A Godly Protest

Well over a month ago I started writing about Ligar. She was a bright young university student I met, who became horribly disabled and distressed from Tuberculosis in her brain. I was going to tell of the suffering her Christian family endured though her 18 month illness as they were plunged into poverty due to outrageous medical costs and the full time care she required. I was going to share the disturbing thoughts I had about her right to choose, even choose death, as she screamed in fear and disorientation, refusing any physical touch from me. I was going to ask unwelcome questions about her sudden death soon after a change in her medication that was never investigated.

But as I wrestled with my words, my questions about suffering, injustice and God’s place in this particular story where overtaken by news of a greater tragedy unfolding in Japan. And then the conflict, fear and mayhem right across the Middle East was brought to our attention.

This year has brought misery around the world on a scale impossible to comprehend. Does the everyday pain I see here in Cambodia become diminished at all in the big picture of things?

I no longer wanted to write just another sad story. What good could come of that? Does anyone want to hear more miserable tales with messy endings that raise more questions than answers?

But I remembered Ligar’s mother at the funeral and was challenged by her confident faith. She said that she had a dream in the weeks before her daughters’ death in which she felt Jesus was showing her that he would take Ligar to be with him. She said that, although she is very sad, she has peace and trusts God for Ligar. She is still convinced of God’s love and goodness.

Holding resolutely to the belief that God is good and God is loving despite being surrounded by tragedy is in fact a bold protest against the darkness of death and destruction.

We are tempted to despair but by a prayerful refusal to be dragged into hopelessness we can take our stand against all that is evil. Worshiping the God who saves and trusting in his ultimate restoration of all things becomes an act of defiance to the spirit of the age.

In confusing times such as these Peter encourages us to simply ‘commit ourselves to our faithful Creator and continue to do good’ (1Peter 4:19).

A Different Kind of Kindness

I met a man who lost his three middle fingers. Most of his right hand was gone as well leaving just a stump with the thumb and little finger poking out either side. It all started with a simple cut to his hand while doing his daily work as a cane basket and furniture maker. But the cut wouldn’t heal and became infected. (At the time he wasn’t aware that he had diabetes.) So he went to the local traditional healer who made a poultice of mysterious ingredients, most likely one of which was cow dung – a common remedy for wounds. The healer then chanted magic words, blew on his hand and sent him home.

Instead of healing the infection worsened. The hand swelled up like a balloon, all red and inflamed. Eventually he came to see a medical doctor at a government hospital in Phnom Penh. By this stage it was too late to save the hand and the man had surgery to remove the rotten flesh. I think the surgeon hoped the remaining thumb and little finger would be able to oppose and give him at least some function. But it seems they failed to send him for follow up therapy and by the time I saw him, some three months after the operation, the man’s remaining digits, wrist and shoulder where stiff and painful from immobility.

It is hard to understand how a simple cut can lead to a man losing his livelihood and becoming totally dependent on his family. The maddening thing is that a different response at any one of a number of points along his story would have led to a better outcome.

I felt angry, frustrated and quite useless as a physio trying to address this situation, knowing that most likely he would return home to his village the next day and never return for follow up treatment.

The Khmer nurse who was helping me communicate with this patient suggested in the end that we pray for him. I was all for that as I knew what I’d done so far was not likely to make any difference and the man himself was very happy to be prayed for. So that is what we did. There was no miracle cure but the long discussion that then proceeded between this godly nurse and the patient, full of questions and deep seeking, was itself a demonstration of God’s grace and love. The man left encouraged and hopeful.

Despite my exasperation at the number of the serious but preventable health problems I’ve seen I have been constantly amazed at the way the gospel is so openly and naturally shared through the staff at this Christian clinic. It did, however, make a bit more sense after our latest ‘foundation year’ morning.

We’ve been organising monthly seminars for the newer people in our team. On Saturday we heard from some very experienced people sharing their insights on Khmer culture and Buddhism. An interesting point came up about how we talk about spiritual things. Often in Western cultures we feel it is polite to be quite reserved and careful not to impose our beliefs on others until we feel the right opportunity comes along or the relationship is developed sufficiently. It seems that in this culture if you have something good or know some good news it is unkind and uncaring not to share it with others.* In this context faith sharing with people you meet is therefore seen as something very natural. I’m learning a lot from the people I meet and some of my own cultural values and assumptions are certainly being challenged.

* Maybe this is why the temple and the aerobics dancers love to use loud speakers directed outwards. It would be seen as unkind to not share their good experiences with the whole community. This puts a very annoying aspect of life here in a new light.

Sharing Good News

Nearee had a motorbike accident over ten year ago. She lost her memory, her ability to read and write and suffered disabling nerve damage in her right arm. Today Nearee is a passionate evangelist. She believes that through prayer God has restored her ability to read the scriptures and she shares the Good News with whoever she can. She has plenty of opportunity to do this in her work as a cleaner at the Christian clinic where I met her. She does a little mopping of the floor and then stops to chat to the patients finding a way to encourage them and point them to Jesus. She told me how grateful she is for this job. ‘Many other places would never employ someone like me with a disability. But I have been working here for 10 years. Thankyou Lord Jesus.’

Nearee’s lack of inhibition, probably related to the head injury, does make her an unusual person. She chats away with me in Khmer and I don’t yet understand everything she says but she doesn’t seem to notice my faltering questions and vague looks. I did understand that she lives alone in a rented room which is very unusual for people here. She only sees her siblings and parents, out in the country side, about twice a year. It costs too much in travel to see them more often. When she has some spare money to buy milk and snacks she visits sick people because you can’t go empty handed. She follows up people she has met at the clinic, some of them with HIV, and goes to their homes to encourage them and pray.

In this culture it is believed that a disability is caused by bad karma. You live with the consequences of the bad deeds you’ve committed either in this life or in a previous life. But Nearee transcends this labelling. She knows that she is one whom Jesus calls blessed and it is clear she is being used to further His kingdom in and through her life situation.

I wonder what it would be like if more of us, regardless of our limitations and circumstances, lived with gratitude and love, simply seeking each day to share good news with somebody.