Saturday, November 12, 2005

Cambodia: from killing to healing

First posted 04:58am (Mla time) Nov 12, 2005
By Rafael Castillo, MD
Inquirer News Service

Editor's Note: Published on Page B5 of the November 12, 2005 issue of the Philippine Daily Inquirer

SIEM REAP, CAMBODIA--IF WE THINK WE are getting a raw deal in our own country, a visit to Cambodia and being refreshed of its history will make us feel how fortunate we still are. When we think of Cambodia, we recall the atrocities of the Khmer Rouge of Pol Pot, who seized power in the 1970s.

During his rule, two million Cambodians, representing one-third of the population, died by starvation, torture or execution. Rice fields as big as soccer fields were converted into killing fields where thousands of Cambodians including women, children and the elderly were buried in shallow graves. Trees bordering the fields held nooses for hanging.

Before the Khmer Rouge retreated in the '90s, they left in the ground 10 million land mines, one for every person in the country. In the streets, one can see a lot of land mine victims, lacking a limb or two, and they shall always serve as a reminder of the country's grim past.

It's said that the Khmer Rouge turned Cambodia to year zero. All establishments, including hospitals, were closed down. After decades of civil war, Cambodia entered a period of stability in 1993 and since then, the Royal Government has begun the difficult process of rebuilding and adequately instituting its services, including health care.

Challenge of rebuilding
We can imagine the challenges of this rebuilding process. An entire generation of doctors, nurses and other health care professionals was either killed or had fled the country during the brutal civil war.

Cambodia remains poor and has to make do with its meager resources. In the rural areas, People have to rely on local providers, like midwives and the equivalent of our herbolarios.

Traveling to clinics in cities like Phnom Penh and Siem Reap is a big problem because roads are bad.

It's amazing how people learn during adverse times to be creative and innovative. Despite the challenges, Cambodia is able to deliver basic public health care services. The government has partnered with various nonprofit health care groups such as EngenderHealth under the auspices of the Reproductive and Child Health Alliance.

Unfazed by the destruction in the public health care infrastructure, the government harnessed the traditional health care system. The alliance trained midwives and traditional birth attendants in life-saving skills.

In rural areas, women prefer to deliver at home and with the additional training of the midwives, it was made safer with less complications such as infections.

The midwives also extended their services to other health problems.

Volunteer nuns, monks
Buddhist nuns and monks have also volunteered to become community health workers. They are suited for the job because they are highly respected and are influential particularly in rural areas. They can effectively correct myths and misconceptions that lead to unhealthy health practices.

More than 2,500 religious workers have been trained as volunteers, disseminating information on the prevention and treatment of basic health problems. Close to 500 small villages are being served by these volunteers and to date, they've made over 70,000 house calls.

Village shopkeepers also do their share in this health network by selling basic medicines and other health supplies.

The Ministry of Health organized village feedback committees to encourage community participation in public health decision making. Their needs are prioritized and are promptly addressed.

Copyright 2005 Inquirer News Service. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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