One foot in front of the other
Trip Start
Jan 24, 2007
1
32
49
Trip End
Ongoing
Siem Reap, Cambodia
Wednesday, April 4, 2007
The centre of Siem reap is a thriving mass of people, the sick,lame and poor, who work, beg or sell and the rich tourist juxtaposed in the same street. There is a market with the usual hustle and bustle selling eveything from moped spares to fine silks, dried fish to engraved silver, and then there are the eateries, stacked to the nines with french cafe's and khmer restaurants, street vendors and posh bars. All very palatable and with the two cultures symbioltically thriving by each other. As the tourist sits for his meal he/she is given the opportunity to buy books about cambodia or cd's or crafts, mostly peddled (and pedaled!) by the amputees of UXOs (unexploded ordinances). We perused the town finding a place to have lunch and noticed a sign for the Rehab centre of Siem Reap.
Well, as dutiful physios, we were keen to get a look at how a system survives with such numbers of amputees (900 new cases in 2006) so we visited the atached information centre followed by a tour of the facility. It is a relatively small rehab centre with small dorm facilities for male and female patients (about 20 of each), where patients come for a week at a time or just a few days if they're for a refitting. The limbs are made on site and all personnel are cambodian, most physios and prosthetists educated in phnom penh. It has a gym area which is amazing in its progression, with patients required to walk over rocks, balance beams, climbing frames and suspended walkway! somewhat more advanced in difficulty than the rehab of the predominantly elderly population we see back home.
The overall population of cambodia has a large percentage of people under the age of 20 and the same is true of amputees. Most are from mines and road accidents, with large numbers of children and young adults. A lot come from rural areas (cars, vans are poorer quality, roads worse, and shortage of affordable land forces the poor to chop wood in forests laced with mines), and after an accident they are restricted in how much they can work (and as many 15yr olds can be primary bread winners the future can look very bleak indeed) forcing them to beg or starve.
Thankfully there are a number of charities working these groups and we visited a shop round the corner where the work is done by the disable with all the money raised ploughed back into community programs and back-to-work programs. Many disable work by pedalling hand bikes selling books which is considerably better than begging and gives them a far greater sense of self-worth. The government does little to actively rehab people but it supplies some funding though the majority is raised by NGOs and other foreign charities. The centre also has counselling services helping to focus on the equally important aspects of psychological rehab and self-worth/esteem, which can be as damaging or more so in the long term.
All-in-all it was a rewarding experience and one that we will cherish, though I amagine for every patient through the doors there's another unable to get in and waiting. One other thing to note was the incredible array of homemade prostheses made of any metal wood or other material available- it must be some experience ot be providied with a proper prosthetic!
