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Everyone at RDIC is getting excited about the EWB Challenge for first year engineering students in Australia! Hannah, Sophie and Da sure are! Several nights prior to her death, Buddhist nuns were invited to the house to sit outside and under the stilted house with her and her family to pray and chant for several hours. Cables were set up to allow outside lighting. We were asked to turn on our outside light to assist the ceremony. The night of her death a similar process was held. Many friends and family attended the house and ate and talked. The night had a strange feeling. Whilst the chanting filled the air, all else was silent and respectful. Our neighbours sickness and death was shared with all of us. We were all affected by it.
Health care is not a given in Cambodia, it is a battle. There is no system to cover diagnosis and medicine. Some medical visits are available for free, but for the most part to attend a doctor or a hospital, means to outlay significant money. So people often don’t.
When a family member is seriously ill, families then have to consider selling their home and land, as the battle is waged between helping family members and the realities of doctors bills, expensive medicines, and the risk of financial insecurity into the future. A future where there is no unemployment benefits or pension. In Cambodia, your entire life is entirely in your own hands.
Our neighbour was the mother of an RDIC staff member, whose husband also works here. Whilst an elderly looking lady, I found out later she was just 57 years old. Since January, two good friends at RDIC have had to battle with death and illness of similarly young parents. In many cases the outlay of money will not even get you the help you need in Cambodia as it lacks many medical facilities offered even by neighbours Vietnam and Thailand. Families are required to make decisions about possible diagnosis and treatment in Vietnam or Thailand. Expats regularly go to Thailand for treatment and diagnosis, but for Cambodians it comes at great financial risk. For example, just to get a Cambodian passport, you need to pay $150US. With an average salary of $30 per month, this is a significant burden.
Late diagnosis seems to me to be a regular scenario. Disease is not really identified until extensive physical signs are evident, and by that time, even the most expensive medical options may offer limited hope. ...but others know more about this than me.
RDIC faced a similar challenge when assisting and implementing arsenicosis. A disease identified first in Bangladesh caused by prolonged exposure to high levels of arsenic in water. A number of communities in Cambodia have been hit hard by this disease after they accessed new deep water reserves with wells, that were unfortunately contaminated with naturally high levels of arsenic. RDIC was involved in efforts to identify whole communities with this cancer causing disease. However, in many cases diagnosis would not be confirmed until significant external signs were evident. These communities are isolated and are rarely visited by doctors or health workers. Missing a diagnosis, means missing opportunities to treat and manage the illnesses.
Healthcare is a vastly different experience in developing countries. When I pass my neighbours who live simply but communally, with limited possessions I am sometimes challenged to think what it is about their lives that we think needs to change. The ability to access health care, and opportunities for preventative health interventions like water and sanitation, is right up there on the list!
