Transition

Levin - a view from the trig

Last week, as we said goodbye to 2017 and  our family and friends also said goodbye to my father. He was the first of his siblings to go, the first and only if them go get a tertiary education, and the only one that still had any teeth remaining in his mouth!

The call came through while I was in Nepal and I’d been planning to go to India that day but dragged my bike and my three sets of clothes back to NZ so that I could participate in the transition that was my father’s farewell. He didn’t think he was going to die any time soon and we’d begun to believe him! But there it was, Dad in a calico lined eco coffin ready to be shipped off to eternity. What was his favourite scripture? No idea? That guy loved the whole book! Who should take the service? He could have whipped a plan up in an hour. Where was his pounamu? Who should speak? What were we doing?

What about all those grand ideas? What a great pursuit. What do we do with them now? It’s a transition from present to past tense. He is bit now he was. They are his and now they were his.

It wasn’t an easy journey with you Dad. I think you know that. Turns out there are no fairy tail endings but we’re ok and I guess I’d want you to know that I have no regrets. 

Each of my family members feel the transition, perhaps none more acutely than the legend that is my Mother. I’m in transition too. Now that I have been in Cambodia for around 4 years it’s time for me to consider engineering a change. The PhD should be done soon and I’d like to mix things up. What would happen if there were a day job? or a someone special? or maybe a new Bike? At the very least I’ve got to sort out that dirty old student loan! 

My plan is to stand up the projects I’m involved with so that they don’t need me so much and to renegotiate what I’m doing. It’s time for the next phase, 2018 is a year for being open.

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For those that are interested here is what I shared at the funeral:

These are the things I’d like to emulate about my father

Curiosity - this was seen in his book collection and his research online. If there was a book that he ‘needed’ then there would always be a way that he could find it... this curiosity was the driver for life long learning. 

Belief in change - he always believed in the ability of a person to transform themselves, That nothing was stagnant that he could form new habits. He believed that through God, he could renew himself day by day. This belief in change was the driver for his refreshed interest in washing dishes after his retirement. 

His steady love for my mother - there was never a question in his mind about the fact that they were meant to be together. In many ways they have opposing personality traits, and while others might say that this was a recipe for conflict, all he saw was that they would compliment each other. When he came over to Cambodia with me in 2011, he shared a lot about his story, about his feelings and experiences across the years. I think that one of the things that struck me most was the way that he described the feeling of being near her. He loved the sound of her pottering, of her preparing a meal, of her fluffing about. That sound of her in the next room. That sound or feeling of being near her was something that he didn’t feel he could live without. 

So now dad, it’s time for me to give thanks for what you brought to my life and how you shaped me. I hope that curiosity will drive my Research to find new knowledge, that I would be continually transformed and that those around me might feel the love that I feel by being in their presence. Thanks Dad. I’ll catch you in a bit... 

S***t just got real

Greetings all. Its been a while since I posted here and there is a reason for that. I've been exhausted! I'll make up for it now by assaulting you with a longer-than-usual blog. Its now more than three years since I shifted my life to Cambodia and it feels as though things are really shifting in terms of what our network is able to achieve around oral health and Early Childhood Caries. It feels as though there is a real, tangible, chance that we will make a dent... provided that the elections go OK in the next 12 months!

Of course there are still challenges, I remain vigilant in pushing the reactive-proactive paradigm towards the later and it is a constant challenge to allow people to solve their own problems. When you give them a chance, they really can! Obvious to some I know, but others like my self are slow learners on that one!

So to check off the updates, I thought I'd drop a few lines about the key things in my life; travel, research projects, people, and bikes. On the research front. SEAL Cambodia is all but finished, data are collected and to be analysed over the next 6-months. Healthy kids (the school project) is firming up and I'm hoping that we'll get an addition to our team to work on the social engineering part of the project to strengthen networks and increase community engagement. The Cambodia Smile pilot (the early childhood project) has been completed and data collected. My students were totally relentless and they did me proud in searching villages and rice patties until they got a 80% follow up rate. That S**t blows me away!

Data collection with my heroes!

An example of the paradox of life here comes from the Cambodia Smile project. One day I brought my PhD supervisor out to the field to see the data collection process. The day started with my students telling me about the previous day when they had gone to the home of one child to find that the child had passed away only months before. Five hours later we came to the home of one of our participants to find that there had been two marques and multiple A2 sized framed images of him set up for his second birthday. That s**t is real.

Nepal - The Himalayas, Karen and I in a sweet sari to celebrate the New Year, The Jevaia team,
 Keri and I in one of the health posts. 

In terms of travel, I've been to NZ, Australia, Nepal and the US since my last blog. I was convinced that I was trying to tone it down last year but I still ended up in 10 different countries! In Australia I went a whole week without riding a bike and in NZ I rode my bike so much that it took me a week or so back in Cambodia to recover! I do miss my mountain bike. In Nepal I had a lovely time with a team who are doing a great project in rural health posts creating a sustainable solution to realizing the right of every person to have access to care. It was this team that I chased down again in the US after the conferences in San Franscisco.  I snuck over to New York to oggle at the craziness of Manhattan and then barged my way into the lives of Laura and Keri in Connecticut so that we could talk strategy and (more dominantly) the realities of life whilst consuming Cambodian rum! I also had the pleasure of hanging out with Saoirse who is by dental-geek-sista-from-anutha-mista and Karen who is one of my favorite mentors (my favorite) that I met when I was in Ecuador in 2013. Who needs money when you have friends like that! That S**t is real.

Lady Liberty, Ladies Keri and Laura, and Lady Saoirse; New York, Connecticut, and San Francisco

Another thing that happened recently was that we found a tumor in my Fathers brain. It has been operated on, he is recovering well, and he'll start chemo/radio in a few weeks. That Sh*t got real because I really thought that guy was going to out live his father's 101 years and that I could leave them alone for a few more years. I guess we'll have to wait and see. In the mean time thoughts and prayers are deeply appreciated.

So now its that part in my blog to look towards future directions. First things first. I NEED A NEW BIKE. For these two reasons (1) the correct number of bikes for any given cyclist is n (being the number of bikes currently owned) plus ONE and (2) Because I am going to be doing 'Tour Aoteroa' during February/March next year and I'm riding with Sarah who is a machine and I don't think I'll be able to keep up with her on my current mountain bike! I don't want that S***t to get too real.

Other things going on over the next few years are a new longitudinal study partnering with UNICEF and The Burrows Foundation to examine the cause-effect relationship between severe dental caries and failure to thrive in preschool children. We are also looking to kick off a social enterprise (PRO Health Cambodia) which will initially import and distribute low-cost toothpaste in order to promote school tooth-brushing programs. Eventually we hope that we will be able to manufacture and we are exploring investment options with a group in NZ.

Cambodia life, the city under construction, day trips, bike trips, dental hygienists... business as usual

As to where I will live after then next 12 months, that remains open to discussion. Next year I'll be in Cambodia for at least 6 months out of the year and we'll see what happens after that. Regardless of where the majority of my bikes are stored, I'll be invested in the projects here in Cambodia for another 3-to 5-years.

That s**t is real.

Girl Power

This last month there has been another adventure... bear with me... I've been travelling... it all started in Korea, then Greece, then England, then Israel. This month has been a month of girl power because I've been able to catch up with some really strong, fascinating, intelligent, inspiring, make shit happen kind of women who are kicking ass and taking names! Its been great!



Highlights (in chronological order)
- Hanging out with Kate in Cambodia and Korea and blowing her mind with acient
- submitting mount Olympus with Felicity
- Going to Bath with Rachel (and hanging and climbing and going to IKEA)
- Adding another continent to the list of rondesvos spots with Zowie
- Catching up with my cousin Kellie in London
- Hanging with Jaqui and Katrina at the Croydon markets
- Work out with Emily et al (Israel)
- Hanging out with the Rayza and family in Israel

Don't worry team... I have been doing work... I've had conferences all over the place and tried to get a bit of writing and analysis done while I was sitting at a desk in Kings College (London). Forecast for the next few months is mainly planning, writing and data analysis. My dental students will be on holiday and so there will be no lecturing. Holiday for dental students means lots of volunteers to help me collect data for my PhD. I'm planning to head back to Melbourne for a few weeks in October and jump the ditch for a few days to wellington to join a community dentistry meeting (maybe see you there?!)





Turtle out.

Redundancy

Within any system, there needs to be some element of redundancy.  Redundant systems are what allow us to function when things don't go to plan, it means that you plan for more than you need. It is an essential part of development work. Sometimes it means that you are a little bit slower but you will have a higher chance of getting there with everything you need. Kind of like a cargo bike. I don't need all 100 cm of space on my tail but if I need to pick up 12-instruments or 500 tooth brushes, I can. I don't need all 29 inches of wheel but it feels better when going over bumps.


I've gotten good at building redundancy into my projects (and my bikes). The projects don't fall over. I'm not very good at building redundancy into myself and so the project succeeds at my expense. This last 12 months since I started my PhD has been an exercise in expending all redundancy. From early last year I have been working in intensive 2-to 3-month bursts to scramble, get to a conference, catch up, scramble, travel again, scramble...fly... scramble... work... scramble... catch up... and scramble. Its true that you can do more with a team. Except when the team don't play the game then you just end up with multiple broken projects and it is my personal redundancy that is spent. Ever optimistic, you think that the next 3-month burst will be different that it will be the last but when you end up at the end of nearly 12-months with spaces of just a few days in-between each burst and then you become empty. You can feel the cortisol petering out, the adrenaline is finished, and its like being in the last hour of a 7 hour bike ride in 35 degree heat, that feeling of chills and shivers except it lasts for days at a time. It can cripple you if you let it. I won't let it. And I won't continue like this.

There are many wonderful things that have happened in the last year but I'm struggling to make progress with my language lessons, I haven't been inspired to take photos for months, I haven't been on a decent weekend trip in months, I haven't sent a post card, I haven't met my new nephew. I am now in the process of building redundancy back into my system. Setting boundaries around my time. Giving myself permission to have fun. The new system is being tuned to create quality turtle-time... maybe next month... just kidding!

So quick update on the main projects as they stand:

Cambodia Smile (PhD project) - the children are now over 1-year of age and we have some challenges with recalls that we are working through but initial findings around improving oral hygiene habits are encouraging. There has been alot of progress in terms of recognizing the issue of early childhood caries at ministry of health level both in Cambodia and in our neighboring countries. That means that there is now a higher chance that oral health will be integrated with maternal-child care in Cambodia in the future.

Seal Cambodia - we have 2000 of 60,000 children left to 'seal' and we are in the process of doing follow-up on two different cohorts; a three-year cohort and a one-year cohort. Some challenges with finding children as they change schools, schools go bankrupt or they just change their name. The dental students from my university have been working hard to track them down and hopefully we'll get an acceptable recall rate.

Healthy Kids - This the new generation of Seal Cambodia. It works on the premise that we shouldn't be doing stuff to kids until we have worked with their social and physical landscape. We want to create a social and physical environment in which it is easy for healthy activities to occur. We are in the process of tying up a project agreement with the school health department. Right now the program covers 30000 kids and we are building a data base that can track participation. By this time next year we expect that 10,000 children will be covered. At the moment we are working with a bit of a set back because Colgate Cambodia don't want to sell us tooth brushes at wholesale price anymore and so that almost doubles the cost of the intervention. We are trying to negotiate again and are looking for other providers. Effectively we will buying 20,000 tooth brushes with tooth paste to match so surely we should be in a good position to buy!

We're getting there team... just keep sending those positive thoughts!!

Chameleon

A view from the trg point close to my parent's house

Presenting in BKK 

It's been a while since my last post, I guess the reason is that I've had trouble finding the head space to think about what to write.... I've had a few wee adventures since the last post. On the work front I've snuck over to Bali for the International Association of Dental Research meeting then Bangkok for the world dental congress. In both conferences I presented a little bit of the work that we are doing to some good critical feed back... I have to say that I was a little bit emotionally fatigued by the time I got back to Australasia where I did some army stuff and managed to get covered in a sufficient amount of mud whilst riding my trusty mountain bike!

View of Melbourne from my morning run 

With a little bit of mental reprieve I was able to reflect on some of the riches of life; being able to hang out with my long suffering friends is right at the top of that list. In Auckland I saw my mate Bakes... I was a little bit exhausted and I totally mumbled my words but she knew exactly what I was saying, what a relief after months of clear deliberate speaking. In Melbourne I got to hang out with RG and delve into 100 different ideas and conundrums... A practice we've engaging since we were 8 or 9 years old! In Brizzy I got to celebrate birthdays and argue with one of my BFFs... in a good way... (you know who you are :-p). In Wellington my dear CB made a trip up especially so we could be a little bit dorky together... Pauline opened her house and shared her trampoline, Razya found time despite sick kids and imminent field exercises, Monte put up with my driving while we tried to find a climbing spot, AK especially went out of her way to deliver a birthday package to the little sister,  Dors cooked a great curry, and the parentals lent me the car and made sure that my favorite feather pillow was available for sleeping! There are countless others that I ache to see, my friends, you thank you so much for still being there! you are truly the jewels that adorn this lifestyle that I have chosen.  

This lifestyle where I posses the qualities of a chameleon... Its in the way that I dress and the speed that I talk and the activities that I undertake. I can still put on my military uniform but in Cambodia I wear skirts. I can still talk at 100 miles per hour but in Cambodia no-one will understand me. I can still dance badly but I need to do it more often...  I guess I'm still getting used to adapting my life across Cambodia (work) Australia (study) and NZ (home) but I'm getting there... 

So whats coming up in the next few months?

- In December; the new graduate dentists from my private practice will be presenting at their very own conference, we'll collect the follow-up data on our new Sealant Protocol, I might take a few days off for Christmas

- In Janurary we have alot happening; two more groups kicking off with the 'Healthy Kids' Strategy making a total of 3500 participating children, the babies in my pilot study (for my PhD) will be 12 months, we'll have sealed 60,000 children and my head might fall off!

- In February I'll need to head back to Melbourne to confirm my candidacy for my PhD... 

A trip like no other: PP-SFO-MELB-WELL-MELB-PP

It's the beginning of a new era for me. I've begun my PhD and I've bought a folding bike named Earl! To kick it all off I tied in a trip to San Francisco to hang out with the team I worked with in Ecudador and to speak on a 'voices from the field' panel at a UC Berkley conference. This was mind boggling for me because in the space of just a few days I got to meet some of my true heroes in public health dentistry *swoon* I got to actually talk to them and get a feeling for their opinions beyond the print of the journal articles that I had read (for some reason it didn't seem right for me to get them so sign a copy of my journal... Go figure?!). It really brought home to me how phenomenal it is that America can create such think tanks where minds such as these can come together... It is a reason that I would consider returning... That and the wonderful hospitality of my friends, I was overwhelmed by their generosity and it felt incredibly normal!

From San Fransisco I managed to be in both Melbourne (to start the PhD) and Wellington (for a short conference) within 7 days... Interesting that these three cities are often compared as being quite similar in terms of life style. I reckon all three are liveable cities and there were plenty of great bicycles to perve at so I'll go with that ;-) Regardless of similarities, It was incredibly gratifying to be able to pop home for a wee bit and see some (but not all) of my favourite people on the planet. It was also nice to be home with a purpose and very settling to know that with my work/study in Melbourne then it will be much easier to nip over for birthdays, and weddings, and just because! I even managed to sneak over to go kangaroo hunting with the nephews in Canberra... Pretty cool!

Through out my time in Melbourne I have been using 'airbnb' which has worked out well. The first place had bombed out cars in the front yard and expletives graffitied on the toilet wall but the dude was a genuinely lovely, intuitive, and a great host. The second place I stayed was with Jacki, her lovely wife (a guest who was staying after her husband had written to make the booking for his 'lovely wife') and her lost girlfriend (an ex boyfriend chased her all the way from Germany to win her back, he didn't succed but the 'lost girlfriend' decided that she quite liked his lodgings and moved in after he left). The final place that I stayed was with a Australian/Indian couple. He had won her from her auzzie boyfriend when she went on an OE to India. Three kids and eight houses later the rest is history!

So there it is: my life in the last month or so. I just wanted to finish by saying that it wasn't Pepsi who came up with the idea that we have to live life to the max. Good ol' JC had that squared away a long time ago (John 10:10) and for that I am grateful every day. Not that it is roses and butterflies, this lifestyle can be lonely and frustrating at times! It's more that I feel like I'm where I should be... and for the next few months that is Phnom Penh!

Some things change some stay the same

It's been a while since I've taken to the blogosphere... I guess I didn't quite feel ready... Since my last post I've been and gone from NZ but I haven't yet started my PhD! It's been a bit of a journey, one of the strange things about going home is realising the small ways that I had changed. Yes there are more kilometres through the legs and a few more wrinkles on the face but there is more. It's the way that your thinking changes when you move from one phase of life to another. It's funny how going back can make you realise how you have moved forward.

Once in kiwi-land I made my way from South to North via bike, bus and boat. It really wasn't long enough and I just wanted to spend about two more days at each place. It was unsettling knowing that a lot of these beautiful places and beautiful faces I might not be able to see for a while. When I think back I can't believe how far away I am as I write this. I had a blast!

Now, back in Cambodia things are ticking along ok. The early childhood caries program which is to be the topic of my PHD has been going for two months now. The midwives seem to be doing well and they are telling me that the mothers are happy to be part of the whole thing... Early days but I'm almost letting myself be a little bit optimistic. I'll go to Melbourne for the first time in May (via California) and I'll begin the grunt work or should I say 'geek work'. It's all a-go!

In other news, I've got a few other things brewing in the back ground; a school based health program in Takeo, lecturing at the university, running a new graduate program for the junior dentists at my private practice, pushing through with the Seal Cambodia project and still trying to string a sentence together in Khmer! No rest for the wicked as they say! 

So just incase you are wondering... Big invitation is still wide open so hopefully see ya-all here or in Melbourne!