Accurate statistics on disability in Cambodia are, as with most poor countries, unavailable. However, United Nations have estimated that Cambodia has one of the highest rates of disability in the developing world. Some reports suggest as many as 15% of the population have some form of disability. Estimates include around 50,000 landmine victims; 60,000 Polio victims; 130,000 profoundly deaf; 144,000 blind; with no national statistics available for either mental health or intellectual disability. Anecdotally I would hazard a guess that poor medical practices have also contributed to a considerable number of disabilities in the population, particularly “during Pol Pot”, a phrase I have become all-too-familiar with. Given that Pol Pot’s regime annihilated the country’s skilled professionals, including doctors and nurses, this is hardly surprising. In 1975 there were 450 doctors in Cambodia and 20,000 teachers. At the end of Khmer Rouge rule not quite four years later, 45 doctors survived, 20 of whom left the country. 7,000 Teachers remained in a country where schools had been completely obliterated and all books burned.
Poverty is both a major cause of disability in Cambodia as well as one of it’s major consequences, affecting as it does, a person’s ability to make a living. Despite the presence of NGOs such as Handicap International, there are few disability services and disabled people face stigma, social exclusion and isolation, and are highly vulnerable to neglect and abuse. State support for disability services is almost non existent and open to significant corruption, as with most government departments. If life for Cambodians is difficult, then life for disabled Cambodians is significantly worse.
Two days ago I received a call from Paint, the disabled carpenter whose adoptive daughter died of AIDS just over a year ago now. I missed the call and before calling him back, summonsed Chom. As I sat beside him feeling powerless in the face of untrained translation, I recognised what was happening. Paint was being cross examined by my protector. The message, after short and sharp questioning, was that he rang to say hello “so I said, is that all?”. Paint said Helen promised to visit me when she came back “so I said, she is very busy”. Paint said he just wanted to say hello “so I said are you sure that is all?”. Paint then admitted that he wants to buy a pig “so I said, she doesn’t have very much money but she tries to help people but she can only help a little bit, how much will the pig cost?”. Paint said $100. What did you say to that? “I said I would ask you and call him back”. How I keep a straight face some days, is beyond me!
We called him back and arranged to visit the next day (yesterday). As I am likely leaving the country fairly soon there are a few people I’d like to see, so we added the blind lady (Mini) to our visiting list for the day and at 8am Chom picked me up in his trusty tuk tuk. Via the rice warehouse and picking up some soy sauce, fish sauce and eggs, which I had to hug on the bumpy roads, we headed first to visit Mini. I am especially concerned for her as she has no back up system whatsoever, living with elderly parents, a crippled father and her one sister earning $95 per month which supports six people. She, her two daughters and her parents were waiting in their best attire (which for Dad, is a red checkered kromar wrapped around his waist and a stick of bamboo as a walking stick). Bottled water was presented to me and we sat inside the bamboo elevated home with a lot of animated and happy conversation between the family and Chom which I pretty much didn’t understand but enjoyed nevertheless.
Three adults and two children live in this overly-humble but typical Cambodian abode. Upon return in August/September I probably won’t be able to visit due to the high floodwaters.
From here we traveled the c.80km to Paint’s home. Along very dusty, ungraded roads Chom lectured me with shouts from the front moto through his helmet “Helen! Why do you know people who live a long way?! You should only know people about 3 to 7 kilo from town! Look at this road, it is crazy!”. At one point, keeping us both entertained, he had his legs splayed out from the moto. I was laughing happily when suddenly the tuk tuk toppled and my laughter turned into a scream. This caused even more hilarity all the way home, and in the evening he texted me from home to say that the whole family were entertained by the image of Helen screaming!
At Paint’s house more animated conversation that seemed interesting and fun to my illiterate ears followed the agreement that I purchase shares in two baby pigs which can be fattened and sold for a profit. The profit can be used for further pig purchases and further profits. It sounds like an entrepreneurship worth investing in, to me! We sat underneath the house on wooden bed frames, and Chom did his usual cross examination of Paint’s wife “why did you marry him when his legs don’t work properly” amid much laughter and the usual assurances from Chom that “for Cambodians talk like this is very funny”! We traveled home along the same appalling roads and put our plans in place for the next day.
Yesterday morning Mini traveled to town to attend the Ophthalmology Unit on a promise from me that I would attend with her. The story is that she has been blind since about 16yo when she was involved in a road traffic accident. Her now-deceased husband wanted her to have an operation on her eyes which she agreed to two years ago. Post-operatively the doctor “promised with her” to take the stitches out of her eye after a week, but her husband (who apparently had an alcohol problem) changed his mind and wouldn’t take her back to the hospital. Now the stitches were scratching her eye and she wanted to know what I thought she should do. She travelled to Shackville this morning and we picked her up to attend the hospital. A few hours later, the ophthalmologist explained that there were no sutures in her eye and that the scratching sensation must be caused by dust or other irritants. He understands she had a traffic accident but he can see that there is some eye disease present, unrelated to an injury. Her 4yo daughter has an astigmatism and I hope that it is not related to any inherited form of eye disease. Currently her sight is fine. When I return later in the year I will help her to arrange correction of this. Chom says that “in Cambodia we say that people with this are looking at the chilli but seeing the eggplant. Girls like this, cannot find a husband”.
The visit to the Ophthalmology Unit at the hospital was interesting. A lot of light hearted banter in the crowds waiting around the elevated outdoor tropical corridor around the edge of the building kept us entertained. The patients from yesterday’s operations came out of the ward together and lined up to have their vision tests and consultations. One woman was in a lot of pain, accompanied by a young adult son who attentively applied eye drops and ointment to her eye amid moans of pain beside me. Various people sat in the broken plastic chair in one corner of the building while the nurse doing vision tests stood at a door at the other end, pointing to the Snellen Chart as patients motioned with their hands which way the three legs of the E were pointing. One young woman stood up after her vision test and an elderly woman standing nearby said something which elicited laughter from the crowds. Chom translated for me that “she asked her why you do like that?”, confused at the girl sitting in the chair and waving her arms in different directions. Watching people try to navigate use of the “glasses” for their visual acuity test was equally funny and it was a really humourous couple of hours, tinged with sadness when the vision test on Mini showed that she could literally not see the hand being waved right before her face.
Visual acuity “glasses”
Visual acuity (Snellen) test used for those who don’t read
AusAID funding of the Ophthalmology Unit in Kampong Cham.
It was rewarding spending time with her though, ensuring that the hospital fees ($1), transportation to town and a meal while she was in town, all enabled her to see the specialist without any stress. We said goodbye and will see each other in a few months when I return. In the meantime I would love to think of an occupation for her which she could undertake at home to generate a small income. Options seem very limited in a remote village where few people have cash to spend.
Dara is going to Phnom Penh next week to have the bone (finally) shortened. “The doctors” were meeting him at his village home this morning, which happened to be the time Chom and I had arranged to visit to say goodbye. Again, we picked up some rice for the two families out that way and headed along the bumpy dust tracks, stopping first at the disabled man’s home about 2km from the village. We delivered some rice and sat having a talk. I cuddled the baby who landed some faeces on my thigh as a goodbye present and they talked about needing a toilet. Chom said “they know you made the toilet for Dara, that is why they ask you”. We explained that I am going away for five months and while I am away, I will try to raise funds for a toilet for them but that I cannot promise. The father is very lame and it would be great to help him have a proper toilet. Despite his disability, he was out in the fields on his walking stick, working upon our arrival.
A wooden hut in the dust, rural Kampong Cham
The dirt-floored interior. Four months ago a baby was born in this room.
We travelled on to Dara’s house where Handicap International were still visiting – the Director, a social worker, a photographer, a visitor from the French office and a driver. The French visitor has worked with Handicap International for thirty years and knows the founding members who I wrote about three days ago, very well! They are following Dara as a case study to publish in their next donor newsletter! Dara, beside himself with so much attention, was hopping around on his crutches excitedly, showing us his various moves – forwards, backwards, sideways and a very agile fall-down-in-the-dust manouver. As the Handicap International team left, we delivered 50kg of rice to grandma and entered the house to sit and chat for a while. At one point I counted 28 children in the house with us. “Helen, the whole village came to see you”! We said our goodbyes and I promised to return in August/September.
From there I had a lunch date at Phter Koma, where I met the three new resident children who all knew about me and had all been versed to say “Excellent”, our trademark English class phrase. It was nice to see the three new children happily ensconced in their new home, playing and spatting with the others as if they’ve never lived anywhere else. Once again, I said more goodbyes and promised to return for English classes during the school holidays in August/September.
I appear to have farewelled everyone who needed to know about my pending departure, offloaded the remnants of last year’s boxes of toys, and all that remains is to pack my bag and go. As yet there is no definite plan in place, but it appears I will likely go on a short assignment with MSF before heading to the European leg of my travels. It is very hard to leave behind so much need, especially as I am about to embark upon an extravagant few months of self indulgence. The contradiction between my lavish life as a “Have” and the lack of options available to so many “Have Nots” in such great need is not lost on me. By far the most rewarding aspect to being a “Have”, over and above anything else my entitled life has given me, has been the privilege of interacting with and helping those living without. Discovering this richness to life makes me even more privileged than I ever deserved to be.