Sok Thim Remembered

I heard by ‘snail mail’ from Bob Maat that Sok Thim has died at his home in Phnom Penh.

Thim is a Cambodian friend whom I treasure. I met him in the Site 2 Camp. My first memory was of his wide smile and his quirky sense of humour. He laughed about himself. I laughed with him, knowing that he was acknowledging a speck of truth and enlarging it until it became enormous.

Sok Thim Anne Goldfeld and Bob Maat

Sok Thim was a refugee. In a camp of refugees fleeing to the Thai-Cambodia border, Thim joined the team of medics working with with Bob Maat.  This young American was treating refugees suffering from TB. Tuberculous was rife; it spreads where there is extreme poverty. The camp was a primitive cluster of makeshift dwellings on flat land littered with spent ammunition. It offered no shelter from shelling except for a ditch which the Thais had dug to stop Khmer Rouge tanks crossing into Thailand. During Christmas time in 1981 the shelling was so relentless, week after week, that the refugees were afraid to leave the ‘shelter’ of the tank ditch.  

Bob knew that if the TB patients came off medication they would die. On the other hand, if the patients took their medication sporadically in this perilous situation, there was real danger that the virus would mutate. Bob supported Sok Thim and other refugee medics as they devised a scheme they named DOTS. Daily Observed Therapy. Each patient would name a small group of his or her closest friends. If there was only one friend, there could be friends of friends. This circle would take responsibility for the medication, give it to the patient at the right time and observe that it was swallowed. It was a social solution to a medical problem. All the patients survived.

When Site 2 Camp was closed the refugees streamed back across Cambodia. In those times I said goodbye to many refugee friends expecting to never see them again.  

Months later during the rice planting season, I was travelling by motor bike through the Cambodian countryside, marvelling at the luminous green of the fresh shoots and the rhythmic work of the men and women transplanting the rice seedlings. I heard my name called. Sok Thim was planting rice and gestured to me to wade into the flooded field to join him. This man, whom I had admired as a medic, told me he is a rice farmer at heart. He talked as he planted, working with ease and teaching me to experience the back break of it all. We talked and laughed. Thim knew then that because he studied medicine at the border his qualifications would not be recognised in Cambodia. He laughed as he said he would settle for rice farming.

This was not to be. Dr Anne Goldfeld, Professor of Immunology and Infectious Diseases at the Harvard School of Public Health invited Thim to work with her in researching and publishing the community-based approach for treating TB in a war zone. Anne’s work is as a physician-scientist at the interface of scientific research, delivery of medical care, and human rights. Anne had also worked in Site 2. Thim went to Boston and gained academic qualifications that would be respected anywhere.

Back in Cambodia he and Anne co-founded an NGO named the Cambodian Health Committee. It succeeded so well that it gave rise to the Global Health Committee. I did some work with their team and once more saw DOTS in action.

An image from a very remote village is seared into my memory. Thim is masked, with a stethoscope around his neck and sweat pouring down his face. The patient is a sixty-year-old man whose skin is tight across skeletal bones. He is suffering from multiple drug resistant TB. He squats on a bamboo bench protected by a mosquito net outside a rough timber house. Hens scratch close to his bamboo bed. Standing nearby, but not too close, are family members, neighbours and a ‘masked up’ community assistant.  This man organises DOTs. Thim leans down to the patient, relating to him as the most important person in the world. When he congratulates the patient for his faithfulness and explains the improvement in his condition, the patient beams a toothless smile. Thim shares a joke and everybody laughs.

My last meeting with Thim came when I wrote a book for Raksmey and needed those whose lives I had written about to check the manuscript before publication.

It too is etched in my memory.

EPSON scanner image

Thim has chosen a sophisticated coffee shop: huge potted plants shield the tiled veranda from the street outside. Soft jazz is playing in the background. Tim is waiting for me; he looks up and laughs mischievously. We do not usually meet in such a place. This is a day-off from his global responsibilities; after breakfast with me he will escape from the phone and head to patients in villages. As we share a plate of cut mango and pineapple, we remember an evening in Thailand when Thim shed tears over an old Cambodian woman kneeling to beg from a foreigner. On that evening he said, ‘The spirit of our people has become very low’. He waves the waiter away and we sit silently.

‘Spirit is the centre of everything’, he says. Then we laugh over many things that have happened since then. ‘Somebody who has stepped in the mud can rise up’. He points to his chest and gives a twisted grin. ‘If these things had not happened to me, I would not be me’. We are laughing as he finally leaves me and travels to far distant villages for work; a well-earned day off.  He waves, ‘To live small things deeply. A door closes, a door opens’.