When you think about healthcare in a developing country you probably imagine pretty rudimentary equipment, long waits, questionable doctors, and lots of other challenges that might put your health at risk. I can’t deny that much of Cambodia might fulfil that vision. Healthcare is really a huge issue here. Even for me, if anything major comes up I will be whisked away to Thailand for proper treatment. But where does that leave the common Cambodian? I have heard many stories of people who simply died because they could not get to any facility. Clinics are popping up around the country, often funded through development aid projects. But building a clinic in a rural area doesn’t always override major obstacles. Last month I had a chance to learn about some serious issues in rural health and how some passionate people are really trying to use innovative ways to help their communities get access to the most basic healthcare.
During a visit to Siem Reap, we stopped in the small commune of Yeang. Yeang is string of villages a bit more than an hour away from the infamous Angkor Wat where you can see incredible amounts of money and wealth passing through on a daily basis from foreign tourists flocking to get a glimpse at the Kingdom’s glory. But Yeang doesn’t play much of a role in any of that cashflow. It’s a very poor area that has many of the same challenges as the majority of the country – including an abominably low access level to decent healthcare.
Commune councils are the closest government unit to communities and the people in Cambodia – closely equivalent to municipal or town councils. Each commune council is required to appoint one female councillor. Female commune councillors often face distinct challenges in a male-dominated council and society at large. But in Yeang, the female commune councillor has taken it up herself to show real leadership on an issue that is very dear to her – community health.
Doch Malin lost her husband a few years ago because he wasn’t able to get to the hospital in time. After struggling with his health for several years prior, Malin changed the direction of her life. She was determined to improve healthcare in Yeang to prevent others from experiencing what she had. She decided to run for the commune council, though she admits she was terrified since she didn’t know much about politics or how the local government was supposed to work. Once selected as the female commune councillor, she promised herself she would use her new role to put a focus on health for her family and her community.
Villagers know that when they find themselves in a health predicament, whether ongoing or emergency, getting to a facility isn’t going to be easy. Ambulances often don’t exist in the rural areas and the reality is that many don’t even have enough money to pay for local transport to a facility that might be relatively far from home. Malin was adamant that this common barrier was not going to continue in Yeang. She started by calling up village chiefs and different modes of transport to develop a network of transportation. When somebody needed to go to the hospital, the village chief was to be the first contact. The chief was to arrange the transport. If any issue, Malin was contacted directly and would even drive herself if needed. She developed a local fund to pay for the transport through fees collected from processing local documents. She even contributed her own personal funds if there wasn’t enough to cover a tuk tuk or motorbike ride.
What Malin did was simple. She created a contact network that had further contacts for transportation – and developed a way to fund it. Her action led to a community that no longer focuses on how to get to the hospital, but rather on the emergency or condition itself. She didn’t stop there She also improved the community’s willingness to visit clinics to prevent and treat early the common ailments that life in rural poverty can lead to through village visits and workshops. She also implored her community to support villagers living with HIV/AIDS rather than alienate them due to the common stigma that HIV can be caught from touching. She befriended a family with HIV, bought their vegetables that nobody else would, touched them in public, and showed their weary neighbours that they are as human and dignified as any other. There are so many elements in Malin’s leadership story within the larger picture of the health situation in Cambodia. The point is that healthcare is such a basic element of community and society – and sometimes it takes just some human initiative to do something to improve a basic barrier.
Yeang is still going to suffer from a lack of health infrastructure for a long time. But residents do say that not having to worry about transportation has changed their lives. Shifting the focus from simply trying to get to the hospital to more on general health issues will certainly go a long way as Malin continues her personal mission to turn her commune into a health example for the country. It was quite an interesting visit to hear about how working on the very basics in community life can affect health in such a profound way. It is something that I think about in my work here as we look at empowering not only civil society at the grassroots level, but also the local governments that serve them.
You can read more about Malin’s work in Yeang in this summary we’ve put together at WGPD.