Kampuchea Crossings

Bump to baby on the beaten expat track

Cambodia

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.

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:

Scene in Sihanoukville

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I was browsing through Keith’s photos of Sihanoukville (the above are cropped by me). I’m not much of a beachgoer, and dislike the in-your-face sexpat scene on the most touristed beaches on this coast (thanks to tightened regional visa restrictions). But if you avoid Serendipity and move farther east along Ochheuteal Beach there are less sexpats and more local crowds, so it can be a nice day trip from Phnom Penh for the family. Most of the other beaches have been / are being privatized, with fees to enter those areas. They’re nice and quiet if you really want to get away from people.

Khmum Ang (Bee larvae cake)

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This is a bee larvae cake, a dish from the ever-popular Sovanna restaurant (No 2C St 21, just south of Sihanouk Blvd). It’s steamed with spices in banana leaves, and picked at like a snack. We had a friend visiting Cambodia who wanted to sample Khmer cuisine, and what better way to do that than to get a big group together so you can toss something like this into the meal mix? ;-) It has a gummy sort of texture, and the larvae pop like a pocket when you bite down on them. It’s got a nutty taste, a little sweet, with a hint of honey. No one disliked it, though it won’t be something we will normally order. Photo from Keith Kelly.