Kampuchea Crossings

Bump to baby on the beaten expat track

Dark hours in Burma

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Design prompted by disturbing news from friends in Burma.

After decades of proclaiming itself the protector of Buddhism (to secure legitimacy), this regime repeatedly brutalises its peaceful, devout people. International pressure for concrete action is increasing, especially among ASEAN, which considers Burma strategically important. Its policy of non-interference may soon change as state failure carries widespread ramifications for the geopolitical stability of the region.

From within, severe economic contractions, rapidly deteriorating humanitarian conditions and a highly fragmented population are buckling this fraught state. Policy differences are rife within the junta, including growing competition among the ruling elite’s heirs. The one remaining institution allowed, Sangha (buddhist community), is not united. The political opposition represents few if any of the over 100 ethnically-riven communities. The current movement against the SPDC perhaps carries sustainable energy: despite a daily onslaught of arrests and killings, corroborated by state crematoriums running overtime, the protests continue…

There are no easy answers, but awareness and recognition of developments by the global community, given previous actions by this junta (e.g. the crackdowns of 1974, 1998), is one step in a helpful direction…

Where Have All the Leaders Gone?

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Remember Lee Iacocca, the American industrialist who rescued Chrysler Corporation from death throes? Here are some excerpts from ‘Where Have All the Leaders Gone?’ (c)2007.

“Am I the only guy in this country who’s fed up with what’s happening?… We’ve got a gang of clueless bozos steering our ship of state right over a cliff, we’ve got corporate gangsters stealing us blind, and we can’t even clean up after a hurricane much less build a hybrid car. But instead of getting mad, everyone sits around and nods their heads when the politicians say, “Stay the course”

“I hardly recognize this country anymore. The President of the United States is given a free pass to ignore the Constitution, tap our phones, and lead us to war on a pack of lies. Congress responds to record deficits by passing a huge tax cut for the wealthy (thanks, but I don’t need it). The most famous business leaders are not the innovators but the guys in handcuffs. While we’re fiddling in Iraq, the Middle East is burning and nobody seems to know what to do. And the press is waving pom-poms instead of asking hard questions. That’s not the promise of America my parents and yours traveled across the ocean for. I’ve had enough. How about you?

“We’re immersed in a bloody war with no plan for winning and no plan for leaving. We’re running the biggest deficit in the history of the country. We’re losing the manufacturing edge to Asia, while our once-great companies are getting slaughtered by health care costs. Gas prices are skyrocketing, and nobody in power has a coherent energy policy. Our schools are in trouble. Our borders are like sieves. The middle class is being squeezed every which way. These are times that cry out for leadership.

“But when you look around, you’ve got to ask: “Where have all the leaders gone?” Where are the curious, creative communicators? Where are the people of character, courage, conviction, omnipotence, and common sense?

“In my lifetime I’ve had the privilege of living through some of America’s greatest moments. I’ve also experienced some of our worst crises: the Great Depression, World War II, the Korean War, the Kennedy assassination, the Vietnam War, the 1970s oil crisis, and the struggles of recent years culminating with 9/11. If I’ve learned one thing, it’s this: You don’t get anywhere by standing on the sidelines waiting for somebody else to take action. Whether it’s building a better car or building a better future for our children, we all have a role to play… So let’s shake off the horseshit and go to work.

“You can’t call yourself a patriot if you’re not outraged.

Staying informed

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Ah, to have your quality of life ranked barely a notch better than that of someone living in Tehran… I do wonder about some things.

How do people here stay competitive given that our work is in/with the least developed part of the world? I can imagine one day returning to “civilization”, in which case running descriptives on SPSS as the extent of my statistical skills might not be sooo impressive. If I were to go into the commercial sector would I be marketable?

On another note. Given that Cambodia is slow on the uptake of adopting technology for mass consumption, I’m feeling left out of the cultural loop. There was also an article in The Economist on the virtual epidemiology research conducted in the synthetic worlds of Second Life and World of Warcraft. I barely have a moment’s internet time to sign up for Facebook let alone check out the allure of these communities. Meanwhile the IRS is exploring tax opportunities in these economies. And Reuters even has bureau chiefs there.

Wow.

Phnom Penh ranks in bottom 10th for livability

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Phnom Penh ranked 125 out of 132 cities recently surveyed by The Economist for livability. Criteria include recreational and cultural activity, crime rate, risk of political instability. Just a few changes in the environment can make a big dent in that score, especially with growing interest on attracting foreign investments. People can be especially enthusiastic advocates of change when money is in the horizon. Let’s start with joining the 21st century by improving the communications infrastructure …

Read it here: Where the Grass is Greener

Faces: why we’re here

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Boy and grandmother, courtesy NGO GRET.


This is a family in Kampong Thom who has purchased community health insurance. They are categorised by programmers as “near poor”. Health financing efforts are aimed at those below the poverty line and also those just above it who are at risk of a financially catastrophic event. Photo courtesy NGO GRET.


Khmer kids from the boat communities just across the Tonle. Their desperately poor communities can be seen from the Royal Palace riverfront.


One of the hospitals in the capital city of Phnom Penh, where there is a Safe Motherhood Programme being implemented. Cambodia’s very high Maternal Mortality Rate (MMR) of 472/100,000 did not improve between 2000 and 2005 despite millions in aid money and technical input.


“His Excellency” Tep Lun, the Director General for Health, Cambodia, visiting a hospital.


Yii Chhi are female members of the Pagoda’s community, much like nuns in the West. Pagodas can be a place of refuge in the later years, if women have no family left or if they are escaping problems such as an abusive environment. This Yii Chha is wrapping a beetle nut in a leaf. It is chewed much like tobacco, and has a mild stimulant effect. I’ve only ever seen old rural men and women with this habit, and their teeth and mouth after many years have blackened/ rotted unattractively. Photo by H Kiss.


These Yii Chhi don’t live in the pagoda, and instead traveled there on the 8th days of the Buddhist calendar to make their offerings. After about an hour of prayer and light activity in the pagoda’s Sala Chan (smaller wooden structure on the compound for eating and community activities) they lay down and take a rest. Photo by H Kiss.

just the basic human rights, please

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It seems common sense, but it takes a policy document to implement this mindset. Imagine not knowing your basic human rights. In the health sector the patient-provider relationship inequality foments a host of problems in this area. Because patients are dependent on the provider they don’t question the diagnosis and decisions, or expect (much less demand) safe, quality care. Given their status, providers feel their judgment ought not be questioned. The cycle perpetuates unethical behaviour and promotes dangerous practices in medicine.

Cambodia is just now introducing, in two provinces in the country, the concept that people are entitled to a set of fundamental human rights when seeking health care.

Right to equality
Right to information and health education
Right to health care
Right to privacy
Right to confidentiality
Right to choice and informed consent
Right to express opinion and to participation

Generating demand is one of the approaches to improving proper, safe, quality health services. Developed countries took centuries to develop the level of competence and standards of quality in health care that they are now at. In Cambodia and other poor countries development goals aim at fast-tracking that pace.


A series of workshops were held in the communities within the catchment area of our project intervention health facilities, to disseminate information about Clients’ Rights. Invited are the community leaders such as Commune Council members, Village Chiefs, Womens’ Association representatives, etc. Participants register to receive their per diems, or travel allowance, to attend the workshop.


Low-tech presentation to the community at the meeting hall of a Pagoda in Chakreyting Village. At this site we did not have electricity to conduct the presentation by projector.


At the workshop in another Pagoda in Troey Koh Village, Kampot Province, a facilitator conducts a group pre-test. The pre-test was designed as a questionnaire, but even though all participants are literate, the concept of questionnaires pose difficulty if they have never seen one. So the facilitator obtained answers by show of hands. Ideally, after the day-long workshop a post-test is also conducted to see if participant knowledge increased as a result of the presentations and discussions.
Photos courtesy H Kiss