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Improving Healthcare in Cambodia

Healthcare in Cambodia
Healthcare in Cambodia has undergone numerous changes in the past century. Cambodia was possessed by France, which provided minimal and basic healthcare for Cambodian citizens. However, Cambodia received its independence from France in 1953. Soon after, the country became heavily involved in the Vietnam War until 1991 and then faced political turmoil. In 1997, the Cambodian People’s Party staged a coup and gained control of the government. This party still holds power in Cambodia and maintains political stability. These numerous government changes have impacted healthcare management and policies.

High Infant and Child Mortality

Cambodia has incredibly high rates of infant and child mortality in comparison to other countries. Mortality rates in Cambodia are among the highest worldwide, with 12% mortality for children under the age of one and 20% mortality for children aged one to five. Consequently, families are more inclined to have multiple children, as seen in other countries with high infant mortality. This decreases the overall quality of healthcare, among other issues. Between 40% and 50% of Cambodia’s population is below the age of 15. While these numbers are decreasing, they are still not at the level required to maximize the current healthcare system’s impact.

Lack of Access and Space

Another severe issue that affects Cambodian healthcare is disease and illness. Diseases arise from a lack of clean, running water as well as poor sanitation. Furthermore, much of Cambodia’s population lives in decentralized villages away from larger hospital systems and medical equipment. Lack of transportation and proximity hinder an individual’s ability to afford and access healthcare.

Moreover, the current healthcare system is not adequate to treat the numerous patients in Cambodia. Many hospitals turn away patients, citing a shortage of resources and beds. In fact, during the Stung Treng dengue fever outbreak, the Cambodian Red Cross had to assemble a makeshift hospital. The organization set up beds for patients, as the present hospitals and clinics simply could not accommodate more patients. This deficit is especially threatening in a country where access to clean water and sanitation services is not guaranteed.

Cambodia also has had many cases of malaria, as is typical of countries located in Southeast Asia. There is always a chance for spikes in malaria cases. Operating at full capacity on a normal basis makes it nearly impossible to handle spikes when they occur.

Improving Health

Emphasis on illness prevention, rather than just treatment, will help improve healthcare in Cambodia. The Cambodian government must identify resources that have been successful in improving healthcare systems and lowering mortality rates in other countries.

Additionally, the amount that the Cambodian government has been spending on healthcare has decreased from 7.2% in 2013 to 6.6% in 2019. Healthcare funding should increase, specifically in preventive medicine and care. Rather than viewing these funds as a permanent spending increase, the government should see that the investment into healthcare will eventually lead to lowered costs as overall health in Cambodia improves. The country has already made large strides over the past few decades. As more individuals gain better healthcare treatment necessary for a healthy lifestyle, the overall state of living in Cambodia will also improve.

Coordinating NGOs

An NGO that is making significant improvements in healthcare in Cambodia is the Health Action Coordinating Committee (HACC). This organization focuses on addressing healthcare issues primarily by coordinating NGO activity in Cambodia in order to create the best system of resources, information and services available.

HACC has worked on enhancing healthcare since 1995, after noticing the lack of NGO coordination in the healthcare field. Now, the nonprofit is able to connect with other organizations to focus on community empowerment, advocacy and networking to improve healthcare systems. So far, HACC Cambodia has brought together 78 nonprofit organizations and has succeeded in providing a platform for these organizations to unite and advocate for common goals through different training, symposiums and other conferences.

Healthcare in Cambodia has gone through many changes over the past few decades and it is moving in the right direction; however, there is still a long way to go. The country suffers from illnesses and diseases that result in high infant and child mortality, and the healthcare system is still not able to take care of an aging population. In order to address this, the government must make healthcare a priority and collaborate with NGOs, such as HACC, to provide better healthcare in Cambodia.

– Manasi Singh
Photo: Flickr

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Congressman Yoho and Democracy in Cambodia

Democracy in Cambodia
Cambodia is a country in Southeast Asia that has struggled to maintain a robust democracy for nearly its entire history. For decades, military coups and civil war have made democracy difficult to implement in Cambodia. Generally, the international community has struggled to find a way to successfully institutionalize democracy within the country. Back in January 2019, U.S. congressman Ted Yoho introduced the Cambodia Democracy Act of 2019 in order to deal with this problem. However, before delving into the details of the legislation, it is important to understand that democracy in Cambodia has a troubled history.  Furthermore, it is essential to understand how those troubles have prompted a response from U.S. lawmakers.

History of Democracy in Cambodia

Prime minister Hun Sen is a key piece in understanding why democracy has struggled to firmly take hold in Cambodia. He became prime minister of Cambodia in 1985. At the time, various armed factions had plunged the country into civil war.

In the early 1990s, a massive United Nations peacekeeping force attempted to disarm and bring ceasefire between the various factions, run national elections and promote democracy in Cambodia. Nearly 20,000 military, police and other personnel made up the force.

In 1991, the Paris Peace Accords officially brought the conflict to an end, which outlined basic protections for human rights. The agreement also promoted free and fair elections within the country.

The 1991 agreements led to the creation of the United Nations Transitional Authority in Cambodia (UNTAC). The UNTAC facilitated national elections in 1993. During these elections, guerillas carried out violent attacks on U.N. peacekeepers. The Hun Sen-led Cambodian People’s Party (CPP) engaged in a massive campaign of violent intimidation against people who might vote against them.

The royalist Funcinpec party won the majority of seats in the National Assembly. Norodom Ranariddh, the son of the former Cambodian King Sihanouk, led the party. Hun Sen and the CPP did not accept the results of the election. As such, they were able to force their way into a power-sharing agreement. This ultimately allowed Sen to serve as deputy prime minister alongside Ranariddh.

However, this agreement broke down in 1997 when Hun Sen seized power from Ranariddh in a coup. Cambodia then elected him prime minister in the following elections. The CPP would go on to win elections in 1998, 2003, 2008, 2013 and 2018. In order to preserve his grip on the country, Hun Sen has wielded increasingly autocratic power to crush the opposition. In 2017, authorities arrested the leader of the Cambodian National Rescue Party (CNRP), the leading opposition party to the CPP, on trumped-up charges of treason. Two months later, the Supreme Court suspended the CNRP entirely. In the 2018 elections, which international observers considered illegitimate, the CPP won more than 100 of the 125 contested seats in the National Assembly.

The Cambodia Democracy Act of 2019

Following Hun Sen’s crackdown on dissent prior to the 2018 elections, U.S. lawmakers became increasingly vocal about promoting democracy in Cambodia. Ted Yoho has been chief among these lawmakers. He is a Republican congressman representing Florida’s 3rd congressional district.

Yoho introduced the Cambodia Democracy Act of 2018 during the 115th Congress. The bill managed to pass in the House, but the Senate did not pass it. Yoho re-introduced the bill during the 116th Congress as the Cambodia Democracy Act of 2019. Five Democrats and four Republicans co-sponsored the bill.

According to its description on GovTrack, the Cambodia Democracy Act of 2019 aims to “promote free and fair elections, political freedoms, and human rights in Cambodia.” Specifically, the bill would authorize the president to impose various sanctions on Cambodia’s security, military and government senior officials. It would also authorize sanctions on those who might be undermining democracy in Cambodia and controlled by said individuals. The International Emergency Economic Powers Act outlined these sanctions. It includes economic sanctions such as asset freezes and visa restrictions. Penalties for undermining democracy would be the same as those under the IEEPA, which can reach fines of up to $1 million.

There is a 4 percent chance that Cambodia will enact the Cambodia Democracy Act of 2019. This is an estimate according to Skopos Labs. However, Congressman Yoho is still confident about the bill’s prospects. In a phone interview with VOA Khmer, Yoho said, “We had a lot of bipartisan support last year and I think you’ll see the same amount this year…”

U.S. Support of Democracy in Cambodia

Overall, the fact that the legislation is drawing support from across party lines is an encouraging sign that the U.S. is willing to promote democracy in Cambodia. Additionally, there is a possibility that the U.S. could pressure the Hun Sen regime to put an end to its autocratic abuses of power.

– Andrew Bryant
Photo: Flickr

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Cambodian Garment Worker Clash Turns Deadly

cambodia_garment_protest
One bystander was killed and 20 people were injured when police clashed with protesting garment workers in Phnom Penh, Cambodia on November 12, 2013.

Workers at the SL Garment Processing Ltd. Factory, one of the largest in Cambodia and a supplier to many western brands including Gap and H&M, marched from the factory towards Prime Minister Hun Sen’s Phnom Pehn home to protest unfair wages and poor factory conditions. They were, however, blocked by police at Stung Meanchey bridge. Reports differ on which side started the violence, which escalated to more than 100 police officers firing tear gas, rubber bullets and live ammunition into the crowd, who were armed mainly with rocks and sticks. Police arrested 37 people, including seven monks, who were later released.

The march marked the three-month anniversary of 4,000 workers walking out of the SL factory to protest the presence of armed military police, which they viewed as an intimidation tactic meant to expel unions. Company shareholder Meas Sotha incited rage among workers with his claim that police were only there to protect the factory. SL 2 joined the strike, demanding raised salaries as well as a $3 per day lunch stipend and Sotha’s ousting.

Conditions in Cambodia’s more than 500 garment factories, though better than in some areas of the nation, are dismal. Wages are low—workers at SL, for example, make just $75 monthly—and factories are unsafe, with poor ventilation, recent collapses and regular fainting masses of malnourished workers. About 500,000 Cambodians work in garment and shoe factories, supporting the industry that accounts for 80% of the country’s exports. In 2012 alone, Cambodia exported $4.45 billion in products to the United States and Europe.

The protests erupted at a time of international attention on the garment industry following several deadly incidents at factories in Bangladesh, including a factory collapse at Rana Plaza that killed over 1,100 people in April. According to the New York Times, many multinational organizations are now looking to Cambodia as an alternative to factory locations in Bangladesh. Unfortunately, in Cambodia, strikes are frequent, though factory concessions are small and rare.

Workers at Alim Cambodia Co. Ltd. blocked a road in Phnom Phen on November 13, 2013 also protesting for higher wages. The demonstration was short-lived, breaking up due to rain when protestors became concerned they would get sick.  The Alim protestors were demanding a $1 lunch stipend, and were angry that the factory was paying new workers $93 monthly to their $89.

The Cambodian government has made few efforts to back garment workers, and seems largely indifferent to workers’ rights. In fact, government-official-mediated talks about wages between unions and SL ended in a deadlock.  Although the Cambodian People’s Party raised the monthly minimum wage from $61 to $75 earlier this year, reports by the local Community Legal Education Center and United Kingdom-based organization Labour Behind the Label found that a single garment worker needs at least $150 monthly to cover basic needs.

The United Nation’s International Labor Organization (ILO) released a report calling for the compliance of the Cambodian government and garment companies in improving workplace conditions in the garment industry, specifically concerning fire safety, child labor as well as worker safety and health. The ILO also announced in September it plans to continue the practice of “naming and shaming” factories that violate the law.

– Sarah Morrison

Sources: The New York Times, NPR, The Cambodia Daily: Garment Worker Clash, The Cambodia Daily: Protest, AlJazeera, AlJazeera America