3015884    ประสาทศัลยศาสตร์ฉุกเฉิน 1    Emergency Neurosurgery I

ความรู้ในการประเมินทางคลินิก การสืบค้น และการดูแลรักษาเบื้องต้นสำหรับผู้ป่วยที่มีปัญหาฉุกเฉินทางประสาทศัลยศาสตร์ ได้แก่ การบาดเจ็บที่ศรีษะและสันหลัง เลือดออกในสมอง การแตกของเอนเซฟฟาโลเมนิงโกซีลและมัยอีโลเมนิงโกซีล

(Knowledge in clinical evaluation, investigation and initial management of patients with neurosurgical problems: head injury, spinal injury, intracerebral hemorrhage, ruputed encephalomeningocele and myelomenigocele.)

(3015884 จุฬาลงกรณ์มหาวิทยาลัย)

3015889    ประสาทศัลยศาสตร์ฉุกเฉิน 2    Emergency Neurosurgery II

ความรู้ในการประเมินทางคลินิก การสืบค้น และการดูแลรักษาดยการผ่าตัดสำหรับผู้ป่วยที่มีปัญหาฉุกเฉินทางประสาทศัลยศาสตร์ ได้แก่ เลือดออกในสมองจากความดดันโลหิตที่อยู่ลึก การตัดลามินาสำหรับไขสันหลังถูกกดและผีในช่องนอกเยื่อหุ้มไขสันหลัง บาดแผลแทงทะลุศรีษะ เลือดออกในสมองจากเนื้องอก ภาวะแทรกซ้อนหลังผ่าตัด

(Knowledge in clinical evaluation; investigation and surgical management of patients with neurosurgical problems; deep spontaneous intracerebral hemorrhage; cord compression and spinal epidural abscess; penetrating head trauma; bleeding intracranial tumor; postoperative complications.)

(3015889 จุฬาลงกรณ์มหาวิทยาลัย)

3015906    ศัลยศาสตร์ฉุกเฉิน 1    Emergency Surgery I

การปฏิบัติงานในหอผู้ป่วยในและแผนกผู้ป่วยนอกทางศัลยศาสตร์ฉุกเฉินทั่วไป ได้แก่ การซักประวัติ ตรวจร่างกาย ตรวจทางห้องปฏิบัติการ วินิจฉัยโรค วางแนวทางการแก้ปัญหา ช่วยผ่าตัด ตลอดจนติดตามผลการรักษาอย่างใกล้ชิด และปฏิบัติงานที่จำเป็นในการดูแลรักษาผู้ป่วย

(Management of patients with acute general surgical problems as in-patients and out-patients including history taking, physical examination, laboratory investigations, diagnosis, determining solutions to the problems, assisting operations, follow-up of the results, and necessary procedures for careful treatment of patients.)

(3015906 จุฬาลงกรณ์มหาวิทยาลัย)

3015907    ศัลยศาสตร์ฉุกเฉิน 2    Emergency Surgery II

การปฏิบัติงานในแผนกฉุกเฉินและหอผู้ป่วยในของหน่วยศัลยศาสตร์อุบัติเหตุ ได้แก่ การซักประวัติ ตรวจร่างกาย ตรวจทางห้องปฏิบัติการ วินิจฉัยโรค วางแนวทางการแก้ปัญหา ช่วยผ่าตัด ตลอดจนติดตามผลการรักษาอย่างใกล้ชิด และปฏิบัติงานที่จำเป็นในการดูแลรักษาผู้ป่วย

(Management of patients following trauma in an emergency room and in-patient department including history taking, physical examination, laboratory investigation, diagnosis, determining solutions to the problems, assisting operations, follow-up of the results, and necessary procedures for careful treatment of patients.)

(3015907 จุฬาลงกรณ์มหาวิทยาลัย)

3015920    ศัลยศาสตร์ฉุกเฉิน 3    Emergency Surgery III

การปฏิบัติงานในหอผู้ป่วยในของหน่วยศัลยศาสตร์อุบัติเหตุ ได้แก่ การวินิจฉัยวางแนวทางการแก้ปัญหา และการผ่าตัดรักษาผู้ป่วยฉุกเฉิน โดยเฉพาะผู้ป่วยฉุกเฉินในระยะที่อยู่ในความรับผิดชอบของศัลยแพทย์อุบัติเหตุ

(Practical session in an in-patient ward of an emergency surgical unit : including diagnosis, treatment planning and operative management in trauma patients.)

(3015920 จุฬาลงกรณ์มหาวิทยาลัย)

Alright, here is the second part of the blog about sings. This will finish them up for this time at least until I find more that I can share with everyone. Have fun!

Please comment I would love the feedback

If it is not in use, then why is it there?

if there is a sign, is there not already a problem?

invisible what? People?

hahaha wow

where are we not supposed to swim?

where am I supposed to park my flying car?

what to say about this one...?

100...mph?

to..ease congestion?

keep left...when there is a huge hole there?

have fun with this one

hahaha wow

evil construction workers..

even though this is not a sign, it is still amazing

how do I get in?

better hope it is not to serious

I am glad they made it plain

watch out for those dangerous gravestones

All customer complaints should be taken care of this way

I hope they have a cell phone

Thanks to whoever made this bilboard

poor cockroaches...:(

what is this gate guarding?!

does this guy still have his job?

bummer, I wanted to cross when cars were moving

does the local trafic have flying cars?

only in America

but...I don't speak dog!

but I already gave my arm and leg last time I got gas!

can buggies go 55?

fine failure

3019864    ภาวะฉุกเฉินทางโสต นาสิก ลาริงซ์วิทยา    Emergency In Otolaryngology

ศึกษาวิธีการวินิจฉัย การรักษาเบื้องต้น และการรักษาเฉพาะในผู้ป่วยฉุกเฉินทางโสต นาสิก ลาริงซ์ เพื่อลดภาวะการคุกคามต่อชีวิตและความพิการต่าง ๆ

(To study the methods for diagnosis, first aid and definitive treatments in otolaryngologic emergencies in order to reduce the life threatening conditions and deformities.)

(3019864 จุฬาลงกรณ์มหาวิทยาลัย)

3020704    ภาวะฉุกเฉินทางประสาทวิทยา    Neurologic Emergency

การวิเคราะห์ปัญหา การักษาขั้นต้น หลักเกณฑ์การรับผู้ป่วยภาวะฉุกเฉินทางประสาทวิทยา เข้ารักษาในโรงพยาบาล หรือส่งกลับบ้านด้วยความปลอดภัย

(Problem analysis, primary management, criteria for hospitalization of neurologic patients in emergency condition or safe discharge.)

(3020704 จุฬาลงกรณ์มหาวิทยาลัย)

So, I’ll be honest–this blog is probably going to be extremely boring.  I’m not one to write boring blogs, but this one is really being written out of necessity.  Now, I could just go ahead and write this out on paper…but since I’m a geek, I figured one online would be more interesting.  In addition to that, I figure that, for at least SOME people, it could be informative as well, which is always good.

Here’s my little intro, and a description of my whole ordeal up until this point:  Hi, my name is Renae, I’m 20 years old, and I get migraines.

And not just those “oh my god, my head is KILLING me” migraines–I mean, I DO get those–but I get optic migraines as well.  Most people don’t know what these are (honestly, neither did I until about 5 months ago), so I’ll explain.

Basically, an optic migraine is kind of what it sounds like–a migraine with your eyes.  But the ones that I get (and this is, apparently, how they usually occur) don’t have any pain associated with them.  I’ll basically get a horizontal lightning bolt-like flashing in my eyes…kind of like when someone takes a picture of you, and you get the camera flash stuck in your eyes.  It makes it so that I can still see, but I can’t focus on words very well, and it lasts for about 15 minutes or so.
If you have a very severe one–which I did, in April of this year–it can even affect your speech.

I work in customer service (doing troubleshooting and taking orders for kitchen appliances over the phone), and in April, I got my first–and so far, only–severe optic migraine. 
I had gotten optic migraines before, but only with the flashing in my eyes.  I associated it to dehydration, and didn’t really think anything of it.  I would just drink a lot of water, and of course, after about 15 minutes, it would go away.
With this one, though, I was in the middle of talking to a customer, taking their order, and I started slurring my speech and mixing up my words and syllables.  I was trying to tell them the total of their order, and I just couldn’t get the numbers right.  I don’t remember what their actual total was, but, for example, if their total was $56.22, I kept telling them their total was $26.52, or “25. 62″…that sort of thing.
Eventually, I concentrated extremely hard, got their CORRECT total out, and put them on hold…at which point, I proceeded to freak out.
Everything in my head felt okay–I was able to comprehend everything that I was saying and everything that was going on around me–but for some reason, it was like my brain had been rewired, and I couldn’t say out loud what I was thinking inside my head.

After talking to my supervisor, and telling her what was going on, they called the paramedics.  By the time they got to my workplace, the optic migraine had ended, so when they checked all of my vitals, nothing seemed out of the ordinary except for an increased heart rate (which is to be expected, granted the circumstances).  I opted not to take a ride in the ambulance (which can cost a lot on a medical bill, depending on your insurance), but had my boyfriend pick me up and take me to  the ER, just to make sure that I hadn’t had a mini stroke or seizure (or possibly something worse). 

The ER doctors examined my eyes, gave me a CAT scan, a basic blood test, and a urinalysis, and the results?

Nothing.

They said that everything came back completely fine, but they suggested that I go see my PCP the next day for a follow-up, which is exactly what I did…and she couldn’t find anything, either (although, I DO have to give her SOME credit–she said she really didn’t know what it was, but that there was a possibility that it was migraines…or a mini seizure). 
So she referred me to both an ophthalmologist and a neurologist, and she also told me I should get an MRI done, since a CAT scan isn’t as in-depth as an MRI.
If you’ve ever had a neurologist appointment, you’ll know that it’s not an easy feat to accomplish.  You have to schedule the appointment at LEAST a month in advance.  So, I wound up getting the MRI the same day I saw my PCP, and saw an ophthalmologist a week or two later.

Results from the ophthalmologist?

Again, nothing.  She said I had no disease in my eyes, and couldn’t understand why this had happened to me, but said that I should definitely see a neurologist.

Finally, the neurology appointment came, about 2 months after the whole ordeal started.  I go into the office, sit down, and wait for the doctor.  She comes in, looks over my MRIs, and tells me that she doesn’t see anything abnormal on them.  I described to her the symptoms that I had, and after about two seconds, she told me that I get “complex migraines” (another popular term for “optic migraines”), and proceeded to explain to me what they were.

So, after thousands of dollars in medical bills and two months of thinking I might be dying, I found out that I got migraines.

Needless to say, I was pretty pissed off.

But definitely glad to have an answer.
The neurologist, Dr. Lara Katzin (an extremely nice woman), told me to pay attention to these migraines over the next few months, see if they become more frequent, and she scheduled a follow-up appointment with me.

Which brings me to the reason why I have started this blog.
The follow-up appointment was this past Tuesday (Nov. 24), and yes, I have been getting them (along with traditional headache-like migraines)  more frequently.  I started out getting them maybe once or twice a month, and now I get them about once or twice a week.  Dr. Katzin prescribed a migraine medication to me (don’t know the name of it off the top of my head, and I don’t have the paperwork in front of me…if anyone’s interested to know what it is, just leave me a comment, and I’ll get back to you later), and suggested that I start a “migraine diary,” seeing as optic migraines, like traditional migraines, can be triggered by different things such as lights, sounds, and smells.  That way, I can see if there’s something triggering them, so I can possibly control them (and therefore, not have to be on medication).

And, here we are.
My Migraine Diary.

I’ll be documenting each one that I get, and what I was doing at the time, to see if there is any kind of pattern to it.
I figured I would make it public so as to try and help people, like I said before.  Because I’m sure that there are people out there who, just like me, get optic migraines, but don’t have any idea what they actually are (which can be pretty terrifying).

If you have any questions for me, feel free to ask–I’m an open book, honestly, and I’ll tell you all that I know!

-Renae

3020775    การดูแลผู้ป่วยอายุรศาสตร์ในห้องฉุกเฉิน    Medical Care in Emergency Room

การควบคุมดูแลรักษาผู้ป่วยในห้องฉุกเฉิน ทีมีปัญหาทางอายุรกรรม

(Management of patients with medical problems in the control emergency room.)

(3020775 จุฬาลงกรณ์มหาวิทยาลัย)

Let them cars share traffic information.

Introduction

Business to business (B2B) and Business to Customer (B2C) principles are well known. This article will investigate some aspects of a car-to-car network connecting wirelessly to enable car computer users to share timely traffic related information.

Background

The evolution of Global Positioning Systems (GPS) communities created repositories of tracks, routes and points of interest. These are mainly to date static in nature.

One such repository is of traffic cameras, others for business and resources like fuel stations and places to eat. Many a category exists.

Dynamic categories to date have not been deemed feasible due to the time dependence or duration of the event. Categories that are identified as dynamic may include the following:

• Vehicle accidents
• Mobile speed traps
• Broken traffic lights
• Traffic congestion
• Road blocks
• Fire
• Natural disasters

These categories are location dependant and therefore needs to have a GPS location associated with it.

Approach

Benefits of having real-time data during navigation allow the driver to evaluate alternative routes during periods of transport. Radio stations broadcasting traffic reports over the air undoubting may use the information as well.

To a lesser degree emergency services may verify calls for assistance, while tow trucks may benefit more from the real-time information of accidents available.

Hardware

In its simplest form a PC104 form factor with rechargeable battery pack and a GPS/Wifi module would suite the minimum requirements. A touch screen to view, mark and cancel traffic related events is needed.

In the near future a cellphone will have the required hardware for this system.

Software

Navigational software would be required to display information received from other cars, and an interface to mark traffic events as they are identified by the user, or as they are cleared.

Architecture

Firstly a open ad hoc network configuration is needed. Additionally to that a predefined port, and a protocol for communicating propagated and locally identified traffic data. A simplified Peer to peer (P2P) file sharing methodology can be used to transfer information.

Functionality to upload dynamic traffic data to a community website would enable users contribute and increase to the overall usability of the system. The duration of events can be used for statistical purposes on a national level.

The System can be extended to propagate other categories of information than dynamic traffic events, and display that information on navigational software.

Legal

The system will have the ability to propagate police activity such as roadblocks. This would be detrimental to the efforts of crime prevention.

The theoretical use of data injection to decrease the integrity of the system is possible. For example as a roadblock is identified and marked, an official at the roadblock can cancel the event on the network by merely connecting to it and canceling the event. This can be done programmatically and would allow for the success of the roadblock.

On the other hand verification, fuzzy logic or other algorithms can be used to determine the integrity of data in the event of inaccurate data injection, spamming or attempts to overload the system.

Conclusion

The ability to share non-static points of interest is plausible and achievable. In certain situations the real-time propagation of information may have a negative effect on crime prevention. Extension of the system to allow for other categories is a reality.

Links

Embedded PC Mobile PC  Solutions
Car Computer
Distributed Information Sharing
Car-to-Car Cooperation
Intelegent Transportation Systems

3100607    คลินิกฉุกเฉิน    Emergency Clinic

ฝึกปฏิบัติการตรวจ วินิจฉัย และรักษาสัตว์ป่วยหนัก และสัตว์ป่วยฉุกเฉิน

(Practice in examining, diagnosing, and curing animals of various species in the hospital, on farms, and in rural areas; medicine, obstetrics, surgery, and pathology; disease control and prevention; animal health and client relationship.)

3100607 จุฬาลงกรณ์มหาวิทยาลัย)

By yesterday morning, the bed of my thumbnail had morphed into a hideously bulbous thing, and in its nearly infectious state, caused me much consternation. An embedded thorn that I’d removed had apparently traumatized the nailbed. So my dilemma was this: do I stay home, suck it up and hope that, with time and care, the healing will happen on its own; or do I brave the inevitable crowds and head to the nearest walk-in clinic or (lord help us all) emergency room?

I chose the latter. Big mistake.

By ten o’clock in the morning, I’d paid a visit to a clinic with which I was familiar. Mindful that school being in session and people not yet on lunch break, I hoped the wait would be short. HA. As I walked in, a quick glance around not only hinted at the impending waiting time, brought on added dread: every single seat was taken. “About three hours,” said the receptionist.

Ok, so H1N1 madness has swept the nation and swine flu vaccinations are in full swing. On my way out I see kids coughing, babies crying and others suffering from varying levels of pain, despair or boredom.

Next stop: A clinic run out of a physician’s home basement. I call first, asking about the wait, because I am recovering from an accident, I have alot of pain and I can’t sit for long. “No problem,” she bellows over the phone in a Russian or Bulgarian accent, “no long wait today. Doctor will see you soon when you come over. You come now.”  So there I am in the car again, whizzing off through an enclave of homes, into which is tucked this nondescript home and hidden office.

I knock on the door, and hearing silence, I walk in, half-expecting to see an empty room, smiling secretary and doctor waiting for me. HA. Meeting my shocked gaze as  I entered the darkened room were no less than a dozen weary-looking people of all ages, stuffed into heavy couches, among them a smart-ass who, noticing the pillow I carry around as a ’sitting assistive device’ exclaimed all too jovially, “so you brought your bed with you too?”

Quickly informed by the chorus that I had to add my name onto the list, I took a look around and asked who had been waiting the longest. A timid, wigged-out, mousey-looking woman eventually piped up: “Almost three hours.” Another one dead in the water. Off I went.

Then, off to a government-subsidized (oh-oh!) clinic housed in an office tower. Much recommended. On the phone, I was convinced to come in right away because there was no wait. Not possible, thought I. Sure enough, when I arrived, only one other person was in the reception area. Once I got to see the nurse I understood why: the doctor is not in today. Excuse me?? Which basically meant that the nurse could do absolutely nothing but ship me off to yet another clinic. Ah, the wonders of our healthcare system.

That was it. My body couldn’t take it any more. Three strikes, Hippocrates, and you’re out.

Or so I thought.

I momentarily forgot that I had an evening appointment with my newest addition to the practitioner-bunch, Claudia (more on her later). Arriving earlier than my scheduled time, I entered a ground-floor walk-in clinic in her building, a large sign outside advertising that  emergency cases without appointment were accepted. Great, I thought, this is it.

Not a chance. The minute I walked into an empty waiting room, my heart sank. Immediately I knew it was a bad sign. Sure enough, the receptionist, at the end of her rope at the end of a long day, quickly brushed me off, assuring me that walk-ins were no longer welcome.

As if 8:30 PM, post-treatment, wasn’t late enough to call it a day, a decision was made to drop in at an ER to check on the situation. I promised that if told the wait would be longer than 1/2 an hour, I’d return the next day. Almost verbatim, here is the conversation that transpired:

AJ: Hi, can you please give me an idea of how long the wait will be?

Nurse: Not too long, take a seat.

AJ: Well, that’s just the problem, I can’t sit for long because it’s painful. You see, I’m recovering from an accident, and if you tell me that it will be longer tonight than, perhaps, tomorrow morning, then I’d rather not have to wait.

Nurse (looking out at the filled-to-near-capacity waiting room): No, the line is moving along pretty well. A triage nurse will see you very soon and then a doctor a short while after.

AJ: OK.

Famous last words. A triage nurse did indeed see me within minutes. As for a doctor… I finally heard my name called three and a half hours later.

In retrospect, I should have known better. As a trained lawyer, I ought to have insisted that the nurse sign a contract stipulating that, due to my pre-existing condition,  I would be seen within the half-hour (or hour, let’s be lenient here); otherwise, the responsibility would be with the triage staff to find me and suggest that I return another time. Or, they might have offered me a stretcher to lie on…

Voila, welcome to the Medical Circus, aka our medical system and its phalanx of acrobats. Overtaxed.  Magic tricks. Sleights of hand. Juggling too many balls. Throwing us to the lions. Forcing patients to walk sky-high tightropes or wait interminably in the wings. When or how will this madness stop?

Last night at around 8pm, I was talking on the phone and couldn’t get a breath. I could breathe, but my chest kept tightening up so I couldn’t get a deep breath. Earlier that day, I was swelling up a lot: legs, hands, etc. I’d gained ten pounds in 24 hours!

I do take a fluid pill in the morning, and when I called the doctor, he advised taking another to help control it, and to come see him next week. But that evening, it didn’t seem to be doing any good, yet. With all the difficulty breathing, I called my mother for advice and she was worried that fluid was around my heart and told me to go to the emergency room.

So I did, and it was weird being the one looked at instead of Robin. They checked me over: EKG was good, lungs looked fine, and I was getting plenty of oxygen. With the critical stuff ruled out and the swelling finally starting to go down (I’d also put compression stockings on), they discharged me.

Today, my chest hurts like hell. I haven’t worked out since last week because I’ve been in too much pain with the bad weather, so it wasn’t anything like using muscles too much. I have been getting a lot of muscle spasms in my arms and legs these past few days. Again, it’s the weather. Doc says that my arthritis is pulling my muscles. I can sit still and see my arm muscles vibrating, which isn’t painful, just weird. But simply lifting a jug of tea makes the muscles feel like they’re pulling hard. That is painful. Plus random sharp pains all over.

But anyway, I wonder if it wasn’t chest muscle spasms or the like, tightening up so it was hard to breathe. Can you get arthritis around your ribs? They were among the many things injured that cause pain elsewhere. In ‘92, my rib cage was rotated and stayed that way for three years, plus a steering wheel was bent forward with my chest and face (I really need to blog about all that someday).

Anyway, I’ll find out when I see the doc next week, but at least I know it was nothing life threatening.

3020859    ภาวะฉุกเฉินและวิกฤตทางโรคติดเชื้อทั่วไปและโรคเขตร้อน    Emergency in Infectious and Tropical Diseases

ลักษณะทางเวชกรรม การวินิจฉัยโดยวิธีเร่งด่วน และการรักษาภาวะฉุกเฉินของโรคติดเชื้อทั่วไปและโรคติดเชื้อในเขตร้อน

(Clinical manifestations, rapid diagnosis and emergency management of severe infectious diseases and tropical infectious disease.)

(3020859 จุฬาลงกรณ์มหาวิทยาลัย)

3020870    สัมมนาทางอายุรศาสตร์ฉุกเฉิน    Seminar On Emergency Medicine

การอภิปรายเกี่ยวกับการดูแลหรือให้การรักษาผู้ป่วยกรณีฉุกเฉินได้ทันท่วงที

(Discussion on treatment of patients in case of emergency.)

(3020870 จุฬาลงกรณ์มหาวิทยาลัย)

3020872    ภาวะฉุกเฉินทางปอด    Emergency Pulmonary Condition

การวินิจฉัย การดำเนินโรค การตรวจทางห้องปฏิบัติการ การรักษาขั้นต้นของภาวะฉุกเฉินทางปอด หลักเกณฑ์การรับเข้ารักษาในโรงพยาบาลหรือส่งกลับบ้านด้วยความปลอดภัย

(Diagnosis, investigation, clinical course and primary treatment in emergency cases; criteria for hospital admission and safety discharge.)

(3020872 จุฬาลงกรณ์มหาวิทยาลัย)

There is something distinctly unsettling, albeit fascinating, about reliving the day of my accident through another person’s eyes. Michael’s eyes, I knew, had experienced the episode from a different perspective. He might shed some more light. After searching fruitlessly for the card on which he’d jotted down his email, and suddenly finding it among piles of paper last week, we connected via Skype this afternoon.

The slow ride to Battambang

Michael and I met on a bus. An Israeli youth trip organizer and schoolteacher, he was traveling solo through western Cambodia and Thailand. We compared notes during the long and dusty ride from Siem Reap to Battambang.

Upon arriving in Cambodia’s second-largest city, we lugged our backpacks around for over an hour before finally settling on a guesthouse not far from the market. We headed out to explore parts of the city, after a bite of local fare.

How well they match

We took a leisurely stroll by the river, stopping to watch and play with a group of street kids. There was widespread commotion, people setting up kiosks for the fair marking the start of the Chinese New Year.

Smiling street boys

The next morning, I rose early and headed out to rent a bike. A few hours later, I landed in hospital and a few hours after that, Michael appeared at my bedside. I remembered very little from his visit, my memory tainted by pain and shock.

And so we spoke, I asked many questions and he shared…

Hearing a knock on his door, Michael opened it and someone handed him a message. It was delivered by Mauro (the Emergency Hospital logistician) and briefly stated that I was hospitalized due to an accident. With directions in hand, Michael rented a scooter and came out to see me. Where was the hospital in relation to our guesthouse, I wanted to know. About 10 minutes away, once you crossed the river.

Michael said that what he remembered the most, when he first saw me, was how much pain I was in.

What about the bicycle, I asked. “I showed you pictures of the bike, don’t you remember?” he asked. No, do you still have them? “They got erased…” I wanted to know what it looked like when he found it. The police had picked it up and by the time Michael and Mauro arrived to cart it away, it was mangled up beyond use, the whole front rim and tire utterly crushed. Michael went to Moto Gecko, paid for the bike, picked up my passport and then, together with Mauro, found a second-hand bike shop where he unloaded it for half the price he paid for it. It’s true I suppose, there’s always some use for damaged goods.

Bicycle built for two?

The following day, Mauro lent Michael a truck, which he used to transport my bags from the guesthouse to the hospital. Michael said he was surprised and impressed at the care and attention that the other patients and I received at this hospital. He said he’d heard about the Khmer woman who lived near the bridge, that she had been summoned and ensured that I was transported to Emergency Hospital, where she worked. Yes, I knew about and remember Keo Vich. One of my guardian angels.

And that was that. A few more pieces of the puzzle, but not yet the whole story. Perhaps this is as much as I will ever know. Or just maybe, not.

The Mirror, Vol. 13, No. 640

“Phnom Penh: Cambodian families lose between US$35 and US$40 million because of the global economic crisis, resulting in unemployment for 20% to 30% of the workers in the garment and construction sectors, and in tourism. As it is mainly the poor who are facing the impact, the United Nations released a report offering suggestions that can help reduce those impacts.

“In the statement, the UN said that what Cambodia can do to reduce the impacts of the global economic downturn becomes more an emergency topic, as the basis of fast economic growth in the past in the garment industry and in tourism is suffering from the recession of the global economy. 20% to 30% of the workers in the garment and construction sectors and in the tourism industry lost their jobs since late 2008, making them lose between US$35 and US$40 million to be sent to their homes. Impoverished people, mostly women in the garment sector, suffer from the declining economy.

“From a small village in Kompong Cham, 30% to 40% of the people had left their village to Phnom Penh and Siem Reap to find jobs, but now they gradually return home. After two years in Phnom Penh, Mr. Chun Phon and Rany, his wife, lost their jobs at a construction site. They had earned about US$150 per month and could send about US$100 back home to support their children in the village. Rany said, ‘The money that we can now find is just enough only to survive.’

“Such cases are occurring all over the country, while foreign investment for construction projects is decreasing, buying orders for garment products drop, and the number of tourists is declining also. This downturn is not only a challenge for individuals, but also for the growth of Cambodia to achieve the Millennium Development Goals.

“The most serious impact from the economic downturn is happening to poor people and to people living near the poverty line, especially those having debts to repay face more difficulties. Such cases happen mostly in rural areas, from where many vulnerable people migrate to the cities to seek employment. Women are among the most vulnerable people, suffering from the impact of this crisis. After they lose their jobs in garment factories or in the construction sector, because of the lack of other professional skills, most women who continue to live in the city have no choice but to work in the entertainment service industry. The report pointed out that also the children of those women suffer under the burden of the impact of the economic downturn.

“The UN had conducted a study to learn more about the impact of the global economic downturn in Cambodia, as well as to identify different measures to reduce the impact on human development already achieved, and to restart development to alleviate poverty, and to be prepared for the future. This report estimated the impact caused by this crisis at the national level as well as the impact on individual Cambodians. The report mentioned policy choices that can help to minimize the impact, including equal rights to receive incentives through lower taxes, structural reforms to improve the competitiveness of the country in the world, and reforms to develop mixed systems for national social protection, to lessen the impact of the economic downturn in the short term, and to bring sustainable and equitable growth back in the long term.

“The UN Resident Representative for Cambodia, Mr Douglas Broderick, noticed, ‘A social safety network is no longer considered as a luxury, as before, where only rich countries had the ability to maintain such networks. Such networks are also related to the success of not-so developed countries.’ However, he remarked, ‘On average, the expenses for safety networks in developing countries are from 1% to 2% of the GDP, but the resources allocated at present in Cambodia are less than 1%.’

“The global economic downturn creates also opportunities to accelerate reforms to prepare for the future, and to improve the competitiveness of Cambodia in the world. Recent events encourage such reforms. The UN vows to cooperate with the Royal Government of Cambodia to accomplish the country’s development goals. The global economic downturn poses new obstacles and political challenges, but provides also opportunities that cannot be overlooked.

“Phon and Rany are so worried about what to do in the future. Rany said, ‘We do not have rice fields, and now we only have little money… we need it for everyday expenses and for our children.’” Rasmei Kampuchea, Vol.17, #5057, 26.11.2009

Newspapers Appearing on the Newsstand:
Thursday, 26 November 2009

Areyathor, Vol.16, #1420, 26-27.11.2009

• Cambodia and Laos Signed a Border Agreement [during the visit of the Laotian Prime Minister Bouasone Bouphavanh, both sides decided to consider many temporary border markers as final border markers]

Deum Ampil, Vol.3, #346, 26.11.2009

• [Twenty one] Japanese Investors Visit Cambodia [to study the potential of the economy and of investments in Cambodia]
• Corruption of Tens of Thousands of Dollars Disclosed at the Chamkar Doung Royal University of Agriculture [lecturers, civil servants, and staff of this university had came to the headquarter of Deum Ampil to discribe the corruption of the rector, Mr. Chan Nareth, accusing him of being involved in corruption, taking US$300,000 to US$400,000 each year]

Kampuchea Thmey, Vol.8, #2108, 26.11.2009

• [Former Tuol Sleng prison chief] Duch’s Lawyers Suggested to Include Armed Conflict [between Cambodia and Vietnam] into the Case 002 [but not in Duch's case, claiming that Duch was not involved in war crimes]
• [Philippine President] Gloria Macapagal Arroyo Promised to Find Justice for the Victims of the Massacre of 52 People [related to elections]

Khmer Machas Srok, Vol.3, #1820, 26.11.2009

• [Chairperson of the Commission on Economy, Finance, Banking and Audit of the National Assembly] Cheam Yeap: The Government Is Preparing a Law to Collect House and Land Taxes
• The Government Should Reduce Advisers, but Should Keep Contracted Teachers [according to the Sam Rainsy Party and the Cambodian Independent Teachers' Association - the Ministry of Education, Youth, Sports ordered to reduce the number of contracted teachers by 50%, more than 10,000 teachers, in 2009 and 2010]

Koh Santepheap, Vol.42, #6815, 26.11.2009

• The Court Hearing of the Tiger Head Group That Planted a Bomb in Front of the Ministry of Defense Is Delayed until 3 December 2009
• During a Two-Days Crackdown on Hectic Wood Transports, Three Cubic Meters of Wood and an Old Car Were Seized [Kompong Chhnang]

Phnom Penh Post [Khmer Edition], Vol.1, #54, 26.11.2009

• Prosecutors at the Khmer Rouge Tribunal Asked to Jail [former Tuol Sleng prison chief] Duch for 40 Years for His Serious Crimes [where 15,000 people were killed]
• The Kompong Thom Authorities Delay Using Force to Evict Disabled People from the Kraya Commune [to take the land for a Vietnamese company]

Rasmei Kampuchea, Vol.17, #5057, 26.11.2009

• Cambodian Workers Lose Up to US$40 Million Due to the Economic Crisis
• Five Foreigners [three Thais and two Chinese] Are in Debt because of Losing while Gambling in a Casino – They Were Detained in a House in Poipet [three suspects were apprehended and two others escaped]
• The President of the National Assembly, Samdech Heng Samrin, Asked Luxembourg to Expand Investments in Cambodia [the export of Cambodia to Luxembourg amounted to more than US$10 million in 2008 while the import was only about US$7 million]

Sereypheap Thmey, Vol.17, #1820, 26.11.2009

• A Committee Demands the Release of [11] Villagers [arrested in a land dispute in Kraya commune in Kompong Thom; while local authorities plan to arrest 20 more villagers]

Have a look at the last editorial – you can access it directly from the main page of the Mirror.
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