Kampuchea Crossings

Bump to baby on the beaten expat track

Nathalie Abejero

Healthy baby girl, FREE to whoever can feed her

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As a mom, it tears at my heart. It was shocking at the same time that I know it meant a better life for the baby.

It’s commonplace, but I don’t often personally see or hear of it. A woman gave birth to a healthy baby girl around 7am, at a health center where we were field-testing some questionnaires. Usually anyone admitted to a facility is accompanied by throngs of family members, who provide the care to the patient that back home would be done by health staff (eg providing meals, making sure medicines are taken, changing the dressings etc). But there was no one with this very young mother. She was thin, ragged, and very weak. She breastfed the baby a bit, on prompting by the staff, but by evening someone noticed that she hadn’t eaten all day. She couldn’t afford it – not even a bowl of porridge (around 2000 Riel or US$0.50) from the lady carrying pots and bowls in baskets balanced on a bamboo pole.

The new mother asked the staff to look for someone to take the baby because she couldn’t afford to feed her. As it turns out, my colleague has an older sister who is unable to bear children, so she agreed to take the baby for her sister. She offered some money to the staff and the staff gave a portion of it to the mother.

My colleague’s sister has had the baby now for a week. She loves the baby like her own, and she registered the birth so according to official records she is the biological mother. I wondered about the poor woman, but my colleague has no plans to find her or keep in touch. I suppose that’s only natural.

As a side note, civil registration was introduced in Cambodia only as recently as 2002, and by 2005 only 5% of the population was registered. There’s no requirement on health facilities to do more than report the number of births (to the Ministry of Health). The family takes responsibility for registering the birth (to the Sangkat or Commune, who facilitates the registration with the Ministry of Interior and birth certificate to the baby). This proof of existence is a person’s ticket to citizenship and provides the evidence needed for claims to social services and benefits. A country’s database of vital events like births, deaths, marriages helps the government determine the best use of resources eg public health programming.

Happy New Year!

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It’s that time of year again… all productivity is grounding to a lazy halt across the Kingdom. The Mekong is reversing current, the air is scalding, the rainstorms are waiting on the periphery, and we’re celebrating the third New Year of the Gregorian calendar …

សូស្តីឆ្នាំថ្មី! ពីភ្នំពេញ
Chunpo Chnam Thmei!
Happy New Year from Phnom Penh!

Chlong tonle – the other side of the river is so far for some women in Cambodia

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A woman died today after giving birth to a healthy baby boy. We came to the health facility and saw her just in time to see the life fade from her eyes after hemorrhaging in the ward where there were four midwives and an obstetrician on duty. Only one staff was attending to the patient at the time of death – a student midwife. The student claimed she told the staff, but they were busy with other patients. The staff corroborated this. The fact that there was no prioritization for the emergency case is testament to how dysfunctional the health sector still is, and how poor the capacity of health staff are that this is allowed to happen. There won’t be a maternal audit, or changes to standard operating procedures, because this facility is not directly supported by a donor and the Ministry of Health is too poorly resourced and managed to do anything about just one case.

The term for childbirth in Khmer is chlong tonle, which literally means “crossing the river”; it’s dangerous and you don’t know if you’ll make it across. Death always leaves you stunned. It’s staggering when you see a case that was entirely preventable.

Read this related post written two years later on the silent courage of mothers in rural Cambodia.

US continues to be the highest donor by volume of the OECD countries

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Here’s an interactive update on ODAs from the OECD. It’s a simple, straightforward series, worth clicking through if you like seeing the big picture. The most relevant is that the US still remains the top donor in absolute terms (followed by Germany, the United Kingdom, France, and Japan – all present in Cambodia except DfID who exited in 2011). This is despite a real drop of 0.9% from 2010.

Thankfully there’s a consensus among policymakers that foreign assistance is a critical component of foreign policy, even in the midst of calls for massive cuts during this election year. Seriously, US political “debates” are like tragicomedies except it makes your head hurt because you’re aware it isn’t entertainment. But I digress.

Updating trends so that outdated cold/war priorities aren’t perpetuated, and harnessing the US’ strength in innovation, technology and product development to develop public-private partnerships are already being programmed in.

Cambodia could use a bit of these changes. I can’t see USAID funds drying up in Cambodia given the history of the two countries, plus its relative geopolitical importance in this region (ironic isn’t it). But we’ll see a lot of waste because of the China set.

Easy-peasy plain yogurt recipe my Bengali neighbor taught me

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No thermometer, no measuring cups, no heating pads, no double-boiling appartus! Of course, we’re in the tropics so it’s easier to do here than if we were back home in the temperate zone.

I love plain yogurt but for a long time the most common yogurt in Phnom Penh were the sweet flavored ones from Thailand and Vietnam. Thankfully our friend and neighbor Kishore from Bangladesh taught me how. It’s so simple, with everything just eyeballed and estimated.

Easy plain yogurt recipe:

  • ~1/2 cup plain yogurt as a starter – I use the Garden Center Cafe’s probiotic yogurt. It’s a natural probiotic yogurt with active cultures. I hear Stoneyfield is a good starter. You can use the yogurt you make as starter in future batches.
  • ~1 box of milk – The 1 liter box milk is what you usually find here, although organic and natural labels are starting to make appearances at the natural food grocery stores.

Directions:

  1. Heat the milk on the stove, med-high, until small bubbles start to form and it starts frothing. I don’t stir it, so that film forms on top. See the pic below. Turn the burner off.
  2. Let it sit and cool until the milk is about lukewarm, ~20 minutes. Again that film is on top, hardening. I don’t touch it.
  3. When the milk is lukewarm, add about 1/2 or 3/4 cup of your starter yogurt. Mix it all gently in a glass bowl.
  4. Cover the bowl and place in a warm spot, like in an oven which you aren’t going to be using, where it will be not be bumped, moved or otherwise disturbed for around 12 hours.
  5. Let sit overnight.
  6. When it has reached a solid state, it is ready. Place in containers and stick them in the refrigerator.
Heat the milk on med-high heat
Turn the burner off when the milk starts to bubble and froth a bit
Guesstimate about 1/2 or 2/3 cup plain yogurt as starter
After mixing your starter yogurt into the milk which has cooled to lukewarm, put in a warm spot

Dried freshwater clams anyone?

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It’s like some form of neurotoxic shellfish poisoning is gleefully calling my name whenever I see these big aluminum trays of clams. They get pushed around Phnom Penh’s busy streets all day under the hot sun. Photos courtesy of Keith Kelly.

My Khmer colleague calls these freshwater clams “liah”. She and others at the office love it, and whenever we go to the Ministry of Health on Kampuchea Krom Blvd we’re asked to buy some of this stuff from a particular stall a block away from the Ministry that supposedly sells the tastiest, freshest liahs in town. They’re more expensive at $1 a can than the ones sold by the pushcart sellers (I think their clams are 1500riel/$0.38 a can). I’m not much of a risk-taker in general, and with Tristan around my decisions now seem governed by a near-obsessive-compulsive level of risk-mitigation. But my colleagues rave so much about these things I had to try it.

Contrary to what I previously thought, they aren’t raw. These clams are coated in salt for an extended period and boiled. That kills off most of the e. coli and other toxins. Whew. Cuz Tristan, who wants a piece of whatever people around him are eating, managed to snag one and suck the meat out! Check out this short video made by a Khmer media student, dmcsamadee, about them: