One Sokha-Sala at a Time

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Itch, itch,…scratch, scratch…. Have you ever had a mosquito bite decide that night time—when you are trying to settle down and sleep—is the best time to be unbearably itchy? You can’t ignore it, but if you itch it, it just gets worse and worse. Now, imagine that feeling covering your body, night after night—an insatiable itch, deep in your skin. That’s what many people in our area struggle with, and its source is scabies, a parasitic mite that lives in the skin and causes a horribly itchy rash. It’s contagious, difficult to get rid of, and requires specific medicine and treatment. The problem is, most people here in Cambodia don’t know what that solution is, and even the pharmacies around here don’t sell the proper medication.

We noticed that this was a need in our area almost immediately after we arrived, and we have been providing the proper medicine along with specific instructions for treatment. People come almost daily to our house, and we sell them the scabies medicine at cost. I give them the spiel about washing all of their household fabric items and putting them out in the sun, along with their mattresses, pillows, blankets and hammocks. Then they must apply the medicine in the evening and leave it on all night. The process is rigorous, but I insist that it’s necessary to fully eradicate the infestation.

Recently, we held a sokha-sala, a teaching event for our community. Our nurse friend Soty was the presenter. We prepared printed materials, and Azim translated them into Khmer. I added some drawn illustrations so even the illiterate could understand. Every team member had a part to play in the preparation, set up, and teardown. Before the event, we went visiting along our street and invited everyone. We had many responses of, “Oh yes, I have such terrible itching!” so we expected a good turnout, and we weren’t disappointed. The downstairs room of our house where we worship on Sabbaths was packed with people sitting on chairs and the floor. We used a microphone and speaker, but Soty still wore his voice out with his enthusiastic teaching. He had the crowd laughing, asking questions, shouting out answers and staying engaged. He repeated things many times in different ways so the people would be sure to remember all the steps. At the door, Azim took people’s names and handed out raffle numbers that we then picked a few from to receive some gifts. The grand prize was a water filter—a very useful item here that many cannot afford. Because of the raffle at the end, everyone who came stayed the whole time!

In order to minimize the need for us to personally sell the medicines, we outsourced the selling to our neighbor across the street, Pou Bpaw, who already has a large, established shop and is open all day. This way, no one could accuse us of profiting from the medicine.

At the event, we spotted one young boy who had a particularly severe case of scabies. His hands especially were swollen and crusted with scabies sores. He could barely use them. After the event, we walked to his house where we found his mother giving a client a massage on her mat and pillow. I cringed, knowing that that is exactly how scabies can be spread. We spoke to the family, shared some free medicine with them, and gave them further instructions.

Eric was at Pou Bpaw’s shop recently and saw the boy there, so he asked to see his hands. “Are you sure that’s the same kid?” I asked when Eric showed me the photos later. The boy’s hands were hardly recognizable, they looked so good. The family will continue to battle scabies until they properly follow the entire protocol we taught them, but I was happy to see this boy recovered from his debilitating infestation. Perhaps another reiteration of teaching will motivate them to eradicate it once and for all.

We are looking forward to doing more sokha-salas in the future on various needed topics, such as breastfeeding, postpartum care, charcoal and other natural remedies. Our next one will address diabetes, which the locals call “sweet urine disease.” I have several middle-aged women coming to me on a weekly basis so I can check their blood sugars and adjust their medication regimen. Becoming insulin-dependent is almost a death sentence here because no one can afford the insulin and glucometer. Dialysis is completely out of the realm of possibility. Therefore, we want to teach people how to prevent diabetes or manage early cases with lifestyle changes. I see children as young as three years old drinking energy drinks and eating sugary candies all day long. As you can imagine, by the time they’re 45 or 50, their pancreas has largely given up. We might think that general health principles are obvious common sense, but if you have never been told these things and don’t have access to the Internet, how can you know? Even the most basic concepts are sometimes news to our friends here.

Based on the great outcome we had from the first event, I am optimistic that we can slowly bring life-changing knowledge to our village and others, one sokha-sala at a time.

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