Understanding Life in Cambodia

David Muir, an international reporter, spoke at my college graduation. One of things he said was that we all have to power to be a reporter – to give a voice to those that can’t.

My first day in Cambodia I saw a really bad motorcycle accident. At first I only saw two people off to the side with minor injuries that my tuk tuk driver was helping clean out with some water. And then Alan said, “I think that guy is dead”. There was another man lying in the road.

It took Alan saying I wonder if anyone knows first aid for me to realize I’m probably the most qualified person to provide him with medical attention here – something that I’ve never actually had to do or think about in Boston, especially living in the medical district.

I ran over and the man had a huge gash in his forehead, about and inch and a half long, straight through to the skull. He was unconscious but the bleeding had mostly stopped, he was breathing, and his pulse was high but strong and regular. There was really nothing I could do but monitor him until an ambulance came.

We were in a rural village outside of Siem Reap and no one knew how long it would take. My sense of time was warped but it must have taken almost 30 minutes for help to come. Before they came, a man came up with a can of red spray paint and started spraying a line around his body.

I yelled at him and tried to make him stop. This guy is alive and now someone is spraying toxic chemicals around his open wounds. Why was he doing this? I was so angry and confused. Did he think the man was dead? Was he just marking the site for the police?

If the accident were in the US, this man would probably be fine. The most he’d have to worry about is the extent of the trauma to the brain, but he would live. In Cambodia, I don’t know if he will. I don’t know what their medical system is like, but they didn’t even stabilize his neck getting him onto a stretcher.

Do they treat him regardless of if he can pay? Will he get a fatal wound infection? Will he be fine and recover? I don’t know.

Before I left for this trip I wrote something on the front page of my travel journal from a documentary called Living on One Dollar (which I highly recommend watching, it’s on Netflix). It reads:

“What can I do as an individual? That’s the hardest thing about it. There is no one answer. We’ve poured 3-2.5 trillion dollars into international development trying to end poverty and a lot of times it just makes things worse. That’s what we are trying to prove here is the power of partial solutions. Like, there’s more people who are not living in poverty than there are living in poverty. Like, if each individual can affect and help a single other individual, we can change the world.”

About a week later I met an American expat, Brian, living in Cambodia. His wife is Cambodian but was raised in the U.S. – her family fled the country in the 70s to escape the Khmer Rouge. They’ve been living in Cambodia working on projects to help the Khmer people like building orphanages.

I asked him how they get funding to do this (grants? private donations?). They don’t really take money from anyone. They use their own personal funds to complete these projects – and they have 4 kids of their own. Right now they’re running a coffee shop (that’s how I met them) and they’re starting an import export business to gain more funds.

I learned a lot about Cambodia from him. I asked him what he thought the biggest issue here was especially pertaining to health. He said it’s the government. All they want it money and they don’t care about the people. Someone was trying to donate a hospital and the government said no, they couldn’t build it unless they also gave them one million dollars cash. Cash handouts go straight into the pockets of the elite. They didn’t care about how much the hospital was needed and could help, they just want the money.

Brian said that was common with any cash aide that’s given. Cash donations to the government are probably the worst way to help Cambodia.

The average Cambodian family lives on $60 to $90 a month. If they get sick and need medical treatment they need to take out a loan. If they take a $20 loan out it’s held against their land and they usually have to pay about $50 after interest. If they can’t pay it, which is common, they lose their land.

Also, Cambodia lacks properly trained physicians and medical staff. He said doctors from other countries have been coming in and giving Cambodian physicians further training but it’s still not enough.

So that answers my earlier question to myself about how health care works here.

Back to the quote from Living on One Dollar.

It talks about the “power of partial solutions” meaning don’t attack the whole system or problem at once but come up with small, practical solutions that help more specifically. Like Brian, personally creating small solutions despite the government.

There’s a company called Dimagi that I think does this well. I heard about them from a woman who works for them who spoke to my Health Policy class last semester. They use smart technology to assist health care workers in underdeveloped countries where the health care worker isn’t really educated to do so. They download programs onto a smartphone that can work without data. The programs will guide low literacy workers and act as a health record for population health tracking.

When I first heard about this a thought that I had and many of my classmates had was why put money into something like this when you could put money into providing more food or shelter. Now I get it – the power of partial solutions. The major problems in these countries are poverty based, a hard problem to directly solve. That’s the value in fixing little things at a time in a way where you can help people to help themselves and work around bureaucracy.

Most people I know in the U.S. are living pretty nice, comfortable lives. We are all well aware that many other people don’t have as much as we do but generally ignore it until a commercial with starving kids comes on and then after 2 minutes we ignore it again. But what if we didn’t ignore it?

What if everyone skipped their $5 iced mocha latte once a week and found an organization with a good cause and a sustainable solution to donate to instead?

Think about it.


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