Fish on drugs

The U.S. state of Alabama has banned catfish from Cambodia and other countries in the region.

A Stop Sale order on imported catfish and basa product from Indonesia, Thailand, Cambodia, China and Vietnam has been re-imposed by the State of Alabama.

… Sparks said the Asian fish products tested positive for fluoroquinolones.

Quinolones and fluoroquinolones are chemotherapeutic bactericidal drugs, used for eradicating bacteria by interfering with DNA replication.

The U.S. Food and Drug Administration (FDA) does not allow the use of fluoroquinolones in fish or seafood.

Despite the ominous description given by Food Safety News, the two drugs indicated are more commonly identified as “antibiotics.” The danger in eating such dope-laden fish, says Department of Agriculture chemist Joe Basile, is that “people might build up an amount of fluoroquinolones in their systems and allow bacteria to build up a tolerance to the antibiotic.”

The incident begs the question: Are local fish regularly tested for toxins? We know they die by the tons.

Dead mothers

Reducing Cambodia’s abysmal maternal mortality rate is proving wickedly difficult.

Early this year, heavily pregnant Vorn Yoeub, 37, arrived at a hospital in the western Cambodian border town of Pailin. The mother of seven other children died later that evening along with her unborn child after suffering complications from bleeding.

For most of this decade Cambodia has been trying to cut the number of deaths of women, who, like Vorn Yoeub, are the human face behind the country’s stubbornly high maternal mortality rate. The figure has been running at around 461 per 100,000 live births for 10 years, and is one of nine development objectives the country is trying to improve as part of its Millennium Development Goals (MDGs).

Five women die every day in child birth. The reasons are many. But along with access to health care and cost issues, a cultural bias against women also appears to contribute.

Speaking to IPS, the UNDP’s [Sherif] Rushdy said the “stubbornly” high maternal mortality rate has other causes too. “This is a gender issue – girls and mothers continue to be neglected,” he said. “Girls’ nutrition is the first to be cut when there are financial difficulties in households. So one root cause is a general bias against women.”

Like many of Cambodia’s problems, there are no easy fixes for this one, either. In broad terms, better education and less poverty is mandatory. But specifically, rural families need better information on the complications of child birth, as do rural midwives, and Cambodia needs more and better health care options in the provinces. And the health care sector needs less corruption. Step by step.

Except, after a decade of effort, no steps. Things are just as bad as they were 10 years ago. The one ray of hope is that programs aimed at reducing maternal mortality rates often take several years to produce quantifiable results. And experts argue that efforts of the previous decade will soon start showing up in the statistics, perhaps as early as next year. That’s potentially good news for future mothers.

Toothaches

The absurdity of government.

THE Council of Ministers has approved a sub-decree intended to encourage dentists to undergo professional training, though it does not call for any penalties to be levied against dentists who refuse to do so.

Council of Ministers spokesman Phay Siphan said he believed the sub-decree, passed Friday, would “make the people have more confidence in our dentists”.

Hem Chhin, an undersecretary of state at the Ministry of Health, said Sunday that there were 372 trained dentists in the Kingdom, but that only 200 or so were practising. As a result, the vast majority of the Kingdom’s 1,124 dental clinics are staffed by dentists who have not received formal training, he said.

The Post article does not say how many committees and sub-committees, men and man-hours, it took to pass the new dental sub-decree. But if the only result was this toothless ruling, then all of the work was for zip. Why even bother?

H1N1 spreading locally

From Xinhua:

Cambodia and World Health Organization (WHO) alerted Thursday that the country is now facing a spread of local transmission of A/H1N1 disease.

In a released statement, Ministry of Health and WHO said “although the majority of cases contacted the A/H1N1 virus in other countries or had been in direct contact with travelers, there are now indications that local transmission of the New Influenza A/H1N1 is occurring within Cambodia.”

“Five Cambodians were confirmed as having contracted the virus locally with no history of travel or contact with travelers,” it added.

All five have recovered. The mortality rate of H1N1, commonly referred to as “swine” flu, is about one percent worldwide. Of more than 210,000 cases worldwide, at least 2,185 deaths have been reported, according to the World Health Organization.

‘Chemical vegetables’

There’s something endearing in Vutha’s use of the language, the romanticizing of rural farming much less so.

At the present time, most of vegetables and fruits have been imported from neighboring countries like Vietnam and Thailand. Most of vegetables have been sprayed by pesticides and chemicals, harming the people’s health. The cost of chemical vegetable is lower than organic vegetables that are planted by Cambodian farmers. Therefore, Cambodian farmers’ products cannot compete with the imported products.

If only that were true.

Agriculture, rice in particular, forms the cornerstone of culture and food security in Cambodia, where over one-third of the population live below the poverty line, 90% of them in rural areas(1). Increasing food demands, seductive marketing and ready availability of agrochemicals have led to widespread pesticide use in agriculture. However, the majority of chemicals reaching Cambodian fields are banned because of health concerns and are imported illegally from Thailand and Vietnam. Lacking Cambodian instructions, these products are used by untrained and often illiterate farmers who are largely unaware of the risks.

Consequently, inappropriate practice is rife. UN medical epidemiologist Helen Murphy says of Cambodia, ‘I have never seen such hazardous pesticides used in any country in such a hazardous fashion’.(2)

Yeah, yeah, right — we’ve heard it all before — outrageous lies from U.N. bureaucrats pursuing personal wealth-building agendas by libeling the great Kingdom. Except this is not hyperbole. The truth is terrifying.

Products are often mixed, creating more dangerous chemical cocktails. Furthermore, the majority of users fail to protect themselves from the powerful compounds, exposing themselves to direct poisoning by inhalation or skin contact. Gloves, masks and other protective clothing are virtually absent … farmers are routinely poisoned. Nearly 90% of pesticide-using Cambodian farmers recently surveyed by the UN Food and Agriculture Organisation (FAO) had experienced symptoms of pesticide poisoning …

Mr San Kim Chhay, another farmer in Prek Lavea suffers from chronic joint pain, dizziness and skin complaints during the spraying season. In spite of associating these symptoms with pesticide use, he says, ‘Sometimes my ten year old son does the spraying.’ Such exposure of children to agrochemicals is widespread – about half of Cambodian farmers allow their children to spray crops(4). … in a different study in 2000, 51% of farmers mixed pesticides in drinking water containers(5).

Read the whole thing, if you dare

Tuol Sambo ‘AIDS’ colony

It’s going to be pretty hard to pass this one off as “economic development.”

AIDS campaigners and rights groups protested on Tuesday at Cambodia’s shunting of sufferers of the virus into an insanitary “AIDS colony” outside the capital.

Over 100 international and domestic pressure groups told Prime Minister Hun Sen and Health Minister Mam Bunheng in a letter they were “deeply disturbed” by the government’s treatment of 40 HIV-affected families.

[...]

“By bundling people living with HIV together into second-rate housing, far from medical facilities, support services and jobs, the government has created a de facto AIDS colony,” said Shiba Phurailatpam, of the Asia-Pacific Network of People Living with HIV/AIDS, in a statement issued by the groups.

Rebecca Schleifer of New York-based Human Rights Watch said: “The housing conditions in Tuol Sambo pose serious health risks for families living there.

“People living with HIV have compromised immune systems and are especially vulnerable. For them, these substandard conditions can mean a death sentence or a ticket to a hospital,” she added.

Who is responsible for this decision? The media should find out. And prosecutors should start preparing a case. Because it’s all but certain that at least one of those 40 HIV-positive people will die as a result of the move. That’s negligent homicide, at least, if not outright premeditated murder.

No AIDS until marriage

A recent survey on HIV/AIDS prevalence in Cambodia suggests that the country’s efforts to subdue the disease have been even more effective than previously documented.

Previous monitoring of the HIV epidemic in Cambodia relied on surveys in specific groups, and suggested that prevalence was as high as 24% in injecting drug users, 21% in brothel-based sex workers, 5% in men who have sex with men, 2.5% in policemen, and 2.2% in pregnant women. These surveys did suggest that prevalence had been declining since 1998, but given weaknesses in the methodology, there was an urgent need to validate the estimates of the prevalence in the general population with a different approach.

[...]

HIV prevalence in the general population was lower than expected, at 0.6% for both men and women. However it was considerably higher in urban areas than in rural areas: 1.6% in urban men, but 0.4% in rural men, with similar figures for women. (Approximately 15% of the Cambodian population lives in urban areas.)

HIV infection was largely limited to people who were married or had previously been married. Even adjusting for age, the highest rates were in people who were divorced, separated or widowed (women in this group were 23 times more likely to be HIV-positive than single women). Moreover, because women tended to marry younger than men, infection was more common in women under the age of 29 than in men of the same age group.

The survey included 6,514 men and 8,188 women nationwide. There’s further statistical breakdowns at the link.

God flu

Teen missionaries bring deadly “swine flu” to Kingdom.

Four American teens who went on a mission trip to Cambodia to help the needy, wound up needing help as they became the first cases of swine flu in that Southeast Asian country, officials with the youth ministry said Thursday.

… The teens came down with fever after arriving in Phnom Penh on June 18, according to a statement from Ron Luce, president of Teen Mania, the Christian youth organization based in Garden Valley in East Texas that sponsored the group.

… “This group raised money for months and months to go to Cambodia and serve the lord Jesus … and they’re stuck in a house in Cambodia,” said Ed Hale of Escondido, Calif., whose nephew is one of their hosts in Cambodia. “They can’t do what they were sent to do. It’s a tragedy.”

Yet another reason to give wide berth to the brimstone brigade.

Mothers dying

The BBC says five maternal deaths occur daily.

In Cambodia , five women die every day because of inadequate health care during childbirth – making it a leading cause of death among women of child-bearing age.

The government is trying to improve health services but it is proving a long slow process.

Lvea village, in north-western Cambodia, is a collection of wooden stilt-houses along a dirt track, hectic with dogs, piglets and chickens.

Most of the women here have been told to have their babies in the local health centre.

So when one woman, Low’t, went into labour recently with her ninth child, she made her way there too.

Needless to say, Low’t didn’t make it. Millions of dollars in aid could not produce a few cents worth of life-saving medicine. Go figure.

Pandemic alert

According to unconfirmed reports, two Koreans are in Calmette with the swine flu.

UPDATE: In the Post on Friday, Dr Sok Touch, director of the Communicable Disease Control Department at the Ministry of Health, says no confirmed cases of the disease have been reported.

“I want to stress that there is no confirmation of the disease here — we are simply following up,” he said.

Health-care revolution

Hospitals go private — Ka-Set has the details.

A small revolution is on its way in the Cambodian public health system. Indeed, by the end of this year, no less than four public hospitals in Phnom Penh will become autonomous. The law, which has already been adopted and enforced for several years at Calmette hospital will progressively be extended by the Ministry of Health to the National Paediatric Hospital, the Khmer-Soviet Friendship Hospital, Kossamak Hospital and the National Maternal and Child Health Centre. Consequences for those institutions are that they will be able to manage their budget themselves in a much more flexible and reactive way, but they will also be in charge of more responsibilities.

[...]

As they will remain public institutions, those autonomous hospitals will charge themselves healthcare brought to patients. But according to Say Seng Ly, this will change nothing for the poorest ones, who cannot afford to pay for hospital bills. The only difference, he claims, is that from then on, they benefit – on top of theoretical gratuity of care – from quality services. “Making a public institution autonomous is not meant to kill the poor, but on the contrary to help them. When the hospital generates money, the poor will also benefit from quality services, wards will be clean… Because we will take money from the wealthy ones to give it to the poor”, Say Seng Ly says, convinced.

While public health care is problematic everywhere, this at least sounds like a step in the right direction. These four hospitals will have more influence over how their money is spent and at the same time still be responsible for some degree of public care. The reality of it, however, appears deadly frightening. This new found autonomy will likely take what are now four public hospitals and turn them into Calmettes, where stories of patients dying for lack of money are, at least anecdotally, a lot more common than stories of indigent patients getting free care.

The beautiful Tonle Sap

Ever wonder how filthy the Tonle Sap might actually be?

Lach Mean, a 72-year-old who lives in a shack in which some of her grandchildren sell batteries to the surrounding villagers, shouts over the roar of a motorboat which has become entangled in the anchoring rope of a nearby house. She says that three generations of her family have lived here, but admits to defecating directly into the water because there is no access to a latrine. That is the way it’s always been done, she says. But this takes its toll. She adds: “Our life is very difficult. Often our skin is itchy and this can become infected for days.”

Indeed, while hygiene is being taught by the local school through the simple message of “don’t swim in the lake,” it is doubtful how much is sinking in.

It’s toxic.

Death is our business

VIA KI: Dr Margaret Chan, the director-general of the World Health Organisation, says this:

 Industrialization of food production, globalization of the food supply and its distribution and marketing channels mean that all of us are increasingly eating similar unhealthy diets. With the massive move to cities, lifestyles are increasingly sedentary. Obesity has gone global.

Chronic diseases, long considered the companions of affluent societies, have changed places. They now impose their heaviest burden on low- and middle-income countries. Here is one example. In Cambodia, a least developed country, one in 10 adults now has diabetes and one in four adults has hypertension.

Considering the level of health care in the nation — i.e. there is none — the next economic boom is likely to be in the mortuary business. Investors take note.

Foreigners made me gay

AFP takes a look at the latest Western craze to hit Cambodia: sex on the down low. Specifically, the story is about men having unprotected sex with other men, and the potential such behavior has to undermine Cambodia’s remarkable efforts to stamp out HIV/AIDS. Health workers call the situation a ticking time bomb. Oudam blames foreigners for the problem.

Needless to say, as a Khmer I am shocked and embarrassed to learn that 8.7% of Cambodian men have engaged in gay sex. In fact, there is almost a surreal quality about the figures presented in the article. I can only hope that they are not accurate.

The activities of the Western “sexpats” in Cambodia have no doubt contributed to the decline of morality in our society. Before the advent of these foreign sex deviants, Cambodia did not have a homosexuality problem.

This is, to put it charitably, just a bit off the mark. Gay is not something you catch from sitting on a dirty toilet seat. Nor is it something someone turns after catching a glimpse of the foreign devil. If Cambodia does, in fact, have a “homosexuality problem,” it lies with the ostensibly self-identified straight men who perceive it as such.

The fact remains that most MSM’s don’t identify as homosexual (understandably so, considering the pervasiveness of homophobic sentiments). That is the real problem, because these men until now have remained untargeted by public health campaigns, and the result is that HIV/AIDS awareness among this group is frightfully low. Less judgment, more education, please.

Cambodia vs. HIV/AIDS

VOA has the latest on very encouraging trends in Cambodia’s fight against HIV/AIDS.

The number of AIDS cases here has fallen in the last decade from 3.2 percent of the population to 0.9 percent today. Credit is given to condom distribution programs and education on how to prevent transmission of the virus.

The United Nations AIDS co-ordinator in Cambodia, Tony Lisle, says the government has done a good job. “I think the main reasons behind this remarkable success is the enormous commitment of government.  I think very strong partnerships between government and civil society, NGOs, and other partners to ensure that we had a very, very comprehensive program that addressed the high points of the epidemic, the epicenter of the epidemic, which is basically sex workers and their clients.”

Critics tend to paint the Hun Sen-lead government as a kleptocratic mafia family, unabashedly extorting every last riel from the country and unafraid to silence anyone bold enough to speak out. In most cases the critics are right, of course. But the government does do some positive things. And along with all its shortcomings, it only seems right to point out the government’s achievements, too. This is most definitely one of them.

Cambodia vs. the United States

The United States is often said to have the best health care in the world, and that may be true — if you can afford it. Yet in at least some instances, citizens of the Kingdom of Cambodia fare better.

West Virginia has a higher percentage of toothless older adults than impoverished countries, such as Madagascar, Gambia, Cambodia and Indonesia, according to the World Health Organization.

This is almost certainly a result of diet rather than superior dental care. And while it’s hardly a cause for celebration in either country, it’s a fact worth noting if for no other reason than to help dispel any lingering myths that everything in the U.S. is roses.

That, and it’s impossible not to note a story about do-it-yourself teeth pulling, especially one with a passage like this.

So one night last fall, after drinking beers with a friend at The Wildcat II tavern here on the banks of the Big Sandy River, Crites descended into the depths of her garage apartment below the bar and took matters into her own hands.

She rubbed her gums with hydrogen peroxide, swigged a pint of moonshine and retrieved the orange-handled pair of pliers from her kitchen drawer.

Magic mushrooms

According to DPA, Chhouk Rin is exploring the limits of the government’s inmate health care program.

Rin, who is currently serving a life sentence in Phnom Penh’s Prey
Sar prison for a 1994 train attack in which three foreign backpackers
were taken hostage and later murdered and at least a dozen Cambodians
were killed, has been said to be severely ill with HIV/AIDS for some
years.

Rin had sent the request letter to Royal Cambodian Armed Forces
commander-in-chief Ke Kim Yan but had not yet received a reply,
according to the Khmer-language daily Kampuchea Thmey.

It said Rin, 53, had requested herbal “mushroom tablets” be
supplied to help control the virus and prolong his life.

You’re so fat

Forbes magazine reports on the world’s fattest countries.

There are currently 1.6 billion overweight adults in the world, according to the World Health Organization. That number is projected to grow by 40% over the next 10 years. The following list reflects the percentage of overweight adults aged 15 and over. These are individuals who have individual body mass indexes, which measures weight relative to height, greater than or equal to 25. Obese is defined as having a BMI greater than or equal to 30.

Cambodia registers as 187th fattest country in the world. Or in other words, not very fat at all — fourteenth from the bottom, in fact. The figure, however, does not account for the country’s bloated military, its over-sized National Assembly, or His Excellency Sok An.

Cynical 7th graders

A recent survey of Cambodian school children and their knowledge of burn prevention and first aid uncovered some interesting results. Sponsored by the University of Toronto Faculty of Medicine, the survey questioned 420 students age 9 to 17. The average age of survey respondents was 12.5 years.

Seventy-four percent routinely cared for other children. Only 52% had TV at home but still 78% managed to watch TV for an average 2h per day. Even though 36% of students indicated they had received information about burn prevention and first aid, only 13% mentioned application of cool water as initial treatment, only 7% knew to roll on the ground if their clothes caught fire, and nearly 50% would pour water on a burning pot of oil. Half of students indicated that they would not believe a TV message promoting application of cold water on acute burns. Top reasons given were parental influence, belief in other treatments, and not trusting TV messages. Interestingly, 62% of these skeptics would change their mind if the TV message was endorsed by an authority figure such as a physician, teacher, parent, or the Ministry of Health.

The study estimates that Cambodia has about 20,000 burns and 2,000 burn deaths annually. Two-thirds of burn victims are children under 10. That a television campaign on proper burn prevention and care could potentially reach a majority of all school-aged children seems like money well spent. Especially if the campaign is endorsed by the Ministry of Health and other figures of authority.

Still, that half of all students surveyed tend to believe that the television is lying to them seems remarkably cynical for such a young group. But that, too, should probably be considered a good thing.

Smoking kills

VIA CSR Asia: According to a recent study by the World Health Organization and the Ministry of Health, more than 70,000 people die every year in Cambodia due to cigarette related illnesses.

Cambodia loses 38 million U.S. dollars and over 70,000 lives each year due to cigarette smoking, according to a recent survey jointly conducted by Ministry of Health and World Health Organization.

From 1996 to 2006, 82 percent of rural men, 62 percent of urban dwellers, and 82 percent of youth nationwide were cigarette smokers, said the survey.

Meanwhile, 54 percent of men and seven percent of women in Cambodia were cigarette smokers, it added.

The story doesn’t say how, exactly, WHO and the MoH arrived at the number 70,000,  but it’s just about impossible to believe that it’s accurate. That’s nearly 200 people dying each and every day, or nearly 60%  of all deaths annually. That can’t be right, can it?

The future of politics

In the latest issue of the Phnom Penh Post, Charles McDermid and Vong Sokheng talk to Mak Sarath, head of the Youth Council of Cambodia.

A well-spoken scholar of Khmer literature, Mak Sarath is hardly the picture of an angry young man. Nor is he a brash Young Turk anxious to rail against the status quo.

But he is serious; and as head of the Youth Council of Cambodia (YCC), Sarath has a firm grasp on what Cambodia’s young people are seeking from their country – and he’s eager to sit down and start talking about his generation.

“Frankly, we think the government ignores the voices of young people. We feel like they don’t listen at all. We want three things: better education, health care and jobs,” said Sarath, whose YCC is a non-partisan NGO representing a coalition of five youth organizations.

The three things Mak Sarath lists as the main concerns of today’s Cambodian youth — education, health care and jobs — are all very much rooted in the same fundamental problem: Cambodia’s dire lack of education.

Creating a better education system takes time, at least a generation. So in reality, the youth of today are not fighting to improve their own educational prospects, but that of their children, although they may not realize it yet.

It is that dismal educational system that encourages a weak economy and anemic job growth. It’s virtually impossible to lure foreign companies to a country that cannot provide a skilled workforce.

No jobs, no money. No money, no education. No education, no jobs. The vicious cycle of poverty ad infinitum.

Crafting policies to solve such problems takes not only huge expertise but the ability to see things 20 or 30 years down the road. It takes unselfishness, the wisdom to sacrifice, and the ability to work for the greater good. Things no one is going to learn from those currently in power.

So if Mak Sarath and his generation want change, they have to do more than ask Hun Sen to make it happen. They need to pursue politics, get elected and push their agendas. Not because they stand to benefit, but because doing so helps repay the sacrifices their fathers made to bring the country this far. Because doing so is the only way to guarantee a better future.

Unfortunately, it seems that Cambodia’s current crop of politicians has managed to poison the well, and Mak Sarath himself admits he doesn’t like politicians. But if he is going to change Cambodia, that’s exactly what he will need to be.

The sugar disease

Often considered a rich man’s disease, diabetes is not typically the kind of health problem one associates with rural Cambodia, so to see the country mentioned in an International Herald Tribune article about the disease was more than a little eye opening.

For decades, Type 2 diabetes has been the “rich man’s burden,” a problem for industrialized countries to solve. But as the sugar disease, as it is often called, has penetrated the United States and other developed nations, it has also trespassed deep into the far more populous developing world.

In Italy or Germany or Japan, diabetes is on the rise. In Bahrain and Cambodia and Mexico – where industrialization and Western food habits have taken hold – it is rising even faster.

As it turns out, the prevalence of diabetes in rural Cambodia is nothing less than shocking.

A 2005 study undertaken in Siem Reap and Kampong Cham provinces found diabetes prevalence — defined as the percentage of a given population effected by the disease — at five and 11 percent, respectively. By comparison, diabetes prevalence in the United States — the fattest country on the planet — hovers just below six percent.

Just when exactly Kampong Cham went “industrialized” and got a “Western food habit” is anybody’s guess. But if the Tribune story is any prediction, the national sugar coma in which the country currently finds itself is unlikely to end anytime soon, and it won’t be long before the customers at Lucky Burger are banging a shot of insulin right along with their bacon double cheeseburger and french fries.

Hip Hop Girls

The latest efforts in social programming by the BBC World Service Trust are apparently finding quick success.

A new phone-in programme, Hip Hop Girls, targeted at 15- to 20-year-old Cambodian women and presenting lively debate on sexual health and relationships, has been launched by the BBC World Service Trust.

The programme is presented by 16-year-old Ou Banung and 17-year-old Mon Savthey. In a country where women often feel excluded from radio programmes and traditionally 70 per cent of all callers to radio are male, Hip Hop Girls is already reversing the trend. In the first few programmes, 70 per cent of callers were women aged between 16 and 18.

This sounds like an infinitely reasonable idea. As just about every study ever has shown, lack of sexual and reproductive health education among teenagers results in more unwanted pregnancies and more sexually transmitted diseases, clearly two things Cambodia does not need more of.

Post-traumatic stress disorder

Marc Levy, an infantry medic during the Vietnam War, writes about the lasting effects of post-traumatic stress disorder this weekend in Counterpunch. The article offers a handful of poignant vignettes taken from Levy’s work and experience on the matter, and includes this short piece which could very well describe Cambodia as a whole.

Sihanoukville, Cambodia 1995
I can’t recall his name. He’s a short wiry Englishman. He runs a small backpacker’s guesthouse. At breakfast on the clean white porch, we sip lemonade. He tells me his wife is Khmer. She cooks the tasty meals, cleans the spartan rooms, scurries about, always busy. Her moods are unpredictable, he says. She is happy. Sad. Sullen. Quiet. She has angry outbursts. She tosses, turns in her sleep. When I ask about Pol Pot time he says she hid in the jungle, moved at night, lost her child, family, friends, to mines, Khmer Rouge, starvation. But now she is safe. ‘What’s wrong with her?’ he asks. Now she is safe but their marriage is shaky. Over perfect scrambled eggs and crisp fresh toast we talk about the killing fields, nightmares, PTSD. I tell him what I know. When I’m done talking he leans forward. “My god,” he says. “So that’s it. So that’s it.”

While exact numbers are hard to come by, PTSD affects a significant number of Cambodians. To say that Cambodia’s health care facilities are still underdeveloped is a understatement. Mental health for the most part doesn’t even register on the radar. But it’s not all bad news. As the New York Times has reported, new approaches to Cambodia’s healthcare challenges are easing the burdens for some.