ចំណេះដឹងពិតប្រាកដជាអ្វី ? - What is true knowledge?

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Reading the Patterns of Life

First published in October 2008. In order to read the patterns of life well, I am reminded again today of St. James' letter to Christians in the 1st century -- "everyone should be quick to listen, slow to speak and slow to become angry" -- in the brilliant facilitation of Caby Verzosa and Eric Henry at the workshop sponsored by the Asian Development Bank, the World Bank and the Affiliated Network for Social Accountability in the East Asia and Pacific (of which I am an Executive Committee member) here at the ADB headquarters in Manila.

A managing partner of CMPartners LLC, Eric reminded us of our biases and perspectives we bring into any situation by making this indelibly clear in our group's viewing of a video clip and asking us to focus on the number of complete basketball passes the team in white is making as another team in black is weaving among them...we were so attuned to the white team and counting their passes that we missed completely the black gorilla walking across the scene - all 9 seconds of the 29 second film; of the 40 of us in the room, only one person noticed the gorilla !!

The video serves as another wake-up call for us to be cautious of our biases and colored perceptions and to be re-reminded of the need to be open when we encounter any and all situations. We were reminded (or quickly convinced!) how each of us has an "internal voice" which is also actively at work when we encounter another person or group of people. Of course in life, we live within a set of operating assumptions (e.g. that gravity will not fail us). But certain assumptions can blind us, particularly for task-oriented individuals. The whole discussion was framed in the larger context of effective communication and negotiations. When we go into negotiations, it is important to quiet our "internal voice" in order to be able to hear more effectively what the other person is truly saying. (Meditation is one effective way to quiet the internal voice.) Especially, when there exists differences in positions, it is the more critical to check one's own impulses and position by speaking less and listening more. Normally, when there exist differences, we tend to do the opposite - by advocating harder and raising the volume.

All to say, it has been an invaluable workshop with life's lessons for me to be implemented. And through it all, may we be more wise and effective in reading the patterns of life. - thearyseng.com
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Reading the Patterns of Life

I recently addressed a conference organized by Youth for Peace in Siem Reap of 300-plus young people. I saw in their eager faces a deep thirst to know and to understand – themselves, their society and the world around them. I have seen a similar hunger and thirst for knowledge and understanding among my relatively young staff at CSD. This thirst is reflected in their daily conversations and by their pursuit of overseas trainings and night/weekend classes.

Wisdom is reading oneself, others and the world with insight and acting with integrity, writes Dr. Mark Strom.

I believe in - and aspire to - this definition of wisdom. I believe that this is what I detected at the conference and within my staff - the pursuit of wisdom. Whereas some young people are satisfied only to be filled with information that can be obtained with a formal education, these young people wanted more. This means to understand and to act on this understanding with integrity. Or if we are to apply Dr. Strom's definition, they wanted to be able to read themselves, others and the complex world around them with insight, and in doing, to act in accordance with their values and principles.

Roadblocks to wisdom

There exist many roadblocks to their pursuit of wisdom in this society. At the conference, as with my staff, I detected a deep frustration on many of their faces, underlying their deep yearning to be able to read the patterns of life to their satisfaction. I believe that this frustration stems from their inability to meet their hunger for knowledge and understanding adequately. It is as if they are living in a shroud of murkiness and entanglement, surrounded by an invisible wall of indirection, confusion, noise and overwhelming information, which remains unframed and unattached to the larger picture of life.

I empathize and sympathize with these young people because I see myself in them. Like them, I grew up with a desperate desire to understand and to make sense of myself, others and the very confusing and complex world around me. I wanted clarity and sense to replace the entanglement of my accumulated experiences of loss, trauma and the drastic, fast-paced changes of an introduction to a new American culture, and the larger globalized world. Almost 38 years later. I am still pursuing wisdom – that is, learning how to read the patterns of life in depth, and in the process, to act in accordance with the dictates of my conscience. I believe it is a pursuit which will follow me until the final hours of this life, with much more clumsiness and inelegance still abounding, I am certain.

Reading the patterns of life

I believe that to be able to read the patterns of life thoroughly and with care, honesty is first and foremost required. There must exist a genuine and deep desire to want to know and to understand. This honesty can only be tested and known by the pursuer of knowledge. False modesty, which exists too abundantly in our culture, must be extinguished. Dishonesty, even if in modesty, must be discarded. I am convinced that the truth will set us free. True honesty further requires the acknowledgement of one's own ignorance as a first step to wisdom; the ancient philosophers understood this well. We in modem times have forgotten this fundamental paradox.

Here in Cambodia, wisdom is automatically and unquestioningly equated with age and experience. I wholeheartedly believe that age allows for experiences which, when honestly and thoughtfully appraised and reflected upon, can truly serve as a beautiful tapestry and resource for the obtainment of wisdom. My grandmother Yi Hao was the embodiment of wisdom arising from age and experience.

On the other hand, because one is old does not mean that one is wise. Wisdom derived from age requires a shrewd and honest reading of life's diverse and challenging experiences, and is realized through further implementing the lessons learned in one's future actions.

The best lessons to learn come from one's own experience, and the more rich, challenging and diverse they are, the more powerful and insightful the lessons gained will be.

A diverse and broad reading of books - philosophy, biography, history, fiction etc. - will also accomplish similar goals, but only if one is reading with an eye and heart attuned to understanding. This is why I mourn the limited materials available and pervasive non-culture of reading that exists here. How are we able to see the patterns of life meaningfully and in depth, the expanding multitude of cultures and centuries of custom, if we are limited to just our own experiences?
Hierarchy of ideas

I beseech the parents, civic leaders, teachers and other policymakers to pay more careful attention to creating an enabling environment for our children to learn - not only through quality formal education but through attention to life's experiences. Policies must be developed under which creativity and imagination are encouraged and fostered, where questioning is welcomed and habitual. I have seen firsthand how the process of critical questioning and the search for truth - the Socratic-Method, most famously used in American law schools - is helpful to move on from opaque muddiness to clarity, from vagueness to precision, in thoughts and ideas. It can be deceiving to think that we are learning, and thus wiser, because of the inundation of information we experience living in this modern hi-tech age.

However, not all ideas are equal; there exists a hierarchy of thoughts and ideas - first principles, whereby other thoughts and ideas are built upon. The process of questioning and creativity/imagination will allow us to penetrate the saturation of cluttered junk into clearer thoughts and thinking.

In another column, I will address the Khmer language issue. I believe the Khmer written language particularly is in disarray, in need of updating and development as it is currently not conducive to clear expression and clear thinking.

Theary C. SENG, a member of the New York Bar Association, former director of Center for Social Development (March 2006—July 2009), founder and Board of the Center for Justice & Reconciliation (www.cjr-cambodia.org), founding adviser of the Association of Khmer Rouge Victims (www.akrvc.org), is currently writing her second book, under a grant, amidst her speaking engagements. For additional information, please visit Theary's website at thearyseng.com.

Doctors export their skills so others can finally see

May 4, 2008
Story by Kawanza Newson and Kristyna Wentz-Graff
Milwaukee Journal Sentinel (Wisconsin, USA)

Phnom Penh, Cambodia - The halls of Preah Ang Duong Hospital are filled with hundreds of people hoping that the doctors who have just arrived will treat their eye problems.

They are young. They are old. Some have bare feet.

Most traveled for hours, even days, just to be seen.

Among them is Loy Sry, a blind rice farmer who lost his vision 10 years ago. Loy can only see shadowy shapes and light, and he is afraid that doctors won't give him surgery. Or if they operate, the procedure won't restore his sight. Even worse, that he'll lose his land because his problem is inoperable.

"They will run out of patients, and I'll get other problems," said the 32-year-old, who walks hunched forward with his arms outspread to make sure nothing is in his way.

This December 2007 trip is the 100th journey for the ORBIS Flying Eye Hospital, but it is the first time the group of international doctors has been to Cambodia. The country, which is one of the poorest in Southeast Asia, is rife with eye disease and has a critical ophthalmologist shortage. Most of its professionals, including eye doctors, were killed in the late 1970s during the Khmer Rouge's genocide, leaving few doctors to care for citizens and train more doctors.

Currently, there are only eight ophthalmologists and 40 eye doctors to provide care for the entire country. Most practice in urban areas, while 85% of the population lives in rural areas. They have limited access to eye care when they're infected or injured, usually during agricultural work.

Sharing knowledge

For the next two weeks, those doctors and others from nearby Laos and Myanmar will receive intensive training and ophthalmologic equipment to help improve treatment in the region. They'll work alongside an international ORBIS medical team - including an Appleton ophthalmologist and a Marshfield nurse - who will teach them to perform eye surgery and manage at least six common ailments.

"The goal is to upgrade their skill set," said Brooke Johnson, spokeswoman for ORBIS, based in New York. "A lot of times we train the more senior doctors because they're already in a position to train others. The hope is that they'll train younger doctors and that the skills will trickle down."

Since 1982, ORBIS programs have helped more than 6.8 million people in 86 countries and trained more than 195,000 health care professionals, she said. Cambodia was the 75th country visited by the Flying Eye Hospital, one of several programs designed by the organization to prevent blindness worldwide.

A Boeing DC-10 was renovated to function as a fully operational surgical center.

Before the plane's arrival, Cambodian doctors scouted their practice areas for patients who could be treated by the ORBIS doctors. That's how Loy found out about it - a local doctor examined his eyes and told him to go to Phnom Penh to be considered for a corneal transplant.

Journey for sight

Loy made the 12-hour trip from Kratié Province to Phnom Penh with his brother Loy Srom, 28. They walked, took a bus and rode on the back of a small motorcycle to get here.

When the plane arrives, the siblings had been in Phnom Penh for eight days. It was a long trip, but Loy told an ORBIS interpreter that it was something he had to do. Today, Loy waits nervously in the darkened examination room, continuously rolling medical papers in his hand.

"Making the trip was important to me," he said. "I hope to have my life back. Not being able to see or help my family makes me feel dead at times . . . helpless."

Appleton ophthalmologist Michael Vrabec has volunteered with the ORBIS program since 1990, when he spent three weeks in Ibadan, Nigeria, as the only cornea surgeon. Since then, he's been on about 20 trips, including journeys to Bangladesh, Paraguay and Morocco.

"I have the same idea of trying to save sight worldwide," he said.

Vrabec said volunteering has greatly improved his skill level because the international cases he treats are always more difficult than what he sees in the U.S.

And he pushes the local doctors to immediately begin to use what they learn, typically allowing the local doctor to perform most of a surgery because "when the plane leaves, the plane is gone."

Over the years, Vrabec has learned to travel lightly. For this trip, he packed a small suitcase with a few shorts and T-shirts for himself; two large bags of medical supplies to donate to the local hospital; and a small blue insulated lunchbox with three corneas donated by the Lions Eye Bank of Wisconsin for transplantation. Each cornea costs about $2,400.

Vrabec, who is also an assistant clinical professor at the University of Wisconsin School of Medicine and Public Health, has performed thousands of corneal transplants and can quickly spot a case that can be used for training.

A reason found

As he performs Loy's examination, Vrabec is surrounded by a dozen local doctors who listen intently while he explains that Loy's corneas were infected and scarred, likely from his agricultural work.

The cornea is the clear surface at the front of the eye that protects it from germs, dust and other harmful materials. It also helps the eye focus. When the cornea becomes injured or infected, a person's vision is dramatically reduced.

Corneal transplantation is one of the most frequently performed human transplant procedures. Since 1961, more than 700,000 corneal transplants have been performed, according to the Lion's Eye Bank.

Recovery of the donor eye tissue takes place within hours of death and excision, and preservation of the cornea must take place within 18 hours of death. A corneal transplant typically is performed within three to five days after donation, though it can be done up to 14 days later if the donor cornea is stored properly.

Jerry Rabbach, community relations specialist for the Wisconsin eye bank, said 42,000 corneal transplants are performed in the U.S. each year.

Of the 1,011 eyes that were donated to the Wisconsin eye bank for transplantation last year, only 187 were transplanted outside the U.S., he said.

Vrabec, who sometimes travels to Madison to pick up corneas for his operations, tells the local doctors that Loy is an ideal candidate - he is young, blind in both eyes, has parents who depend on his work for survival and cannot afford to have the surgery otherwise.

Loy is then sent for an exam to make sure he can handle anesthesia and then to meet with more doctors who explain the procedure and give him a wristband displaying Vrabec's name.

A life changed

A few days later, Loy and other patients are transported from Preah Ang Duong Hospital by ambulance to the airport for their procedures aboard the plane.

Loy does not smile. His brows are furrowed as he listens to the talk around him and tries to understand what is going on. He knows that he will have surgery aboard an airplane, but he has never been on or seen an airplane up close before.

Once aboard, he is escorted into an exam room and a large "c" is written above the eye that will get the transplant.

Loy is one of the first patients in Cambodia to receive a corneal transplant and his procedure is broadcast live to local doctors on the plane.

"The second stitch is the most important stitch in determining whether or not we'll have astigmatism," Vrabec tells the crowd.

He also tells them to save the old cornea "just in case" and not to touch the tip of the needle during surgery because it will dull.

In about an hour, his transplant is over, and Loy is sent to the recovery room before heading back to the hospital.

The next day, his eye patch is removed at the hospital. Loy returns to the plane a day later for a follow-up exam and is able to count fingers that a doctor holds up for him while standing across the room.

He also finally sees the flying hospital.

"This plane is so big, I don't have any words to describe it," he says.

Since his surgery, Loy has a new appreciation of life. A month after his transplant, he returned to Preah Ang Duong Hospital to meet with ORBIS doctor Wenhua Li from the Shanxi Eye Hospital in China. During that visit, he told the doctor that he has been very careful about following the doctor's instructions and using his eye drops. He also said he's decided to change careers and to try to start his own family.

"I want to be a taxi driver now to make more money for my family and to find a girlfriend," he said.