“As a doctor I could help patients. As an NGO worker, I can change the health system,” says PIN worker in Cambodia
As a 13 years old child Sreang Khut had to escape to Thailand during the war in Cambodia. He lived in a refugee camp where he received his education. He strongly felt the need to help vulnerable people, especially to improve the health sector. He has worked for People in Need since 2008, since the beginning of the country’s programme.
Can you tell me how long you have been working for PIN and what your job is?
I have been with PIN since 2008 - now its around 9 years. So far we work with health centres with and also with the Cambodian Ministry of Health. At the field level we provide training to midwives to improve their capacity of maternal and child health. Also, we work with health volunteers in communities to provide them education about maternal and child heath. With this activity we aim to prevent malnutrition and ensure better care for the children.
What is the biggest problem in the health sector in Cambodia?
At the moment and even in the past, we found that the biggest problem is maternal and child health. It often happens that a child is born not breathing and midwives have no technology, education or experience to treat the baby. The second thing is the problem with delivery. Not many midwives have the experience to provide a safe delivery. So it is important to provide them with training. And the third problem is malnutrition. Up to 35 % of children are malnourished in Cambodia. So I think we have to work in this area.
Has the situation improved during your 9 years working in this field?
Of course. Especially numbers of maternal mortality have decreased a lot. About 10 years ago, the report from the Ministry of Health says that more than 470 mothers died per 100 000 deliveries. Currently the number of mothers´deaths is „only“ 160. Child mortality has decreased a lot as well from more than 180 deaths per 1000 births to now around 35 deaths for every 1000 deliveries.
Do you think it is also thanks to development aid?
On behalf of People In Need, I would like to say thank you so much for donors especially to the people of the Czech Republic who have always supported Cambodian mothers and children for better health care. And also thank you to the government, especially the Ministry of Health. Many midwives who work in health centers have also received training and they are more educated now.
In the past, people in Cambodia used to believe in many rumours and bad traditional practices. For example, that the first breast milk is not good. And a lot of women gave birth at home without proper treatment. Is this still an issue?
The situation is much better. Traditional birth attendents, uneducated villagers who help mothers during deliveries, do not work these days. They will have trouble with the law if they continue providing deliveries at home. Almost 100% of pregnant women deliver at a health center. There were big campaigns encouraging women to trust the official health system. That changed their minds a lot.
Come back to your story. What did you study?
At the moment I still study nutrition, it is my field. But I have my diploma from the faculty of medicine specializing in treatment of children. I also have experience with surgery, tuberculosis, general medicine, etc.
Have you ever worked in hospital?
Yes, I worked in the hospital around 8 years. From 1984 -1991 I was employed by the hospital on the Thailand-Cambodia border run by the United Nations, because in the 80s my family went to neighbouring Thailand. I have a lot of experience in the medical field. Lot of my patients were refugees. When I came back home I was employed in the Phnom Pehn hospital. But then I realized that as a doctor I can help only a limited number of people so I decided to leave the hospital.
Why did you go with your family to Thailand?
Of course there was the war in my country. We left because of the fighting with the Vietnamese. My family, especially my father could not stay in Cambodia. It was not safe anymore and also he worried about the education of my brother and me. So then he decided to go to Thailand to the refugee camp, then we could get a better education there. My dad always made us believe that one day we would go back home, that one day there will be no war. I stayed in Thailand for 13 years …
So during the horrific Pol Pot regime you were in Cambodia?
Yes. I remember some things, I was around 10 years old. The memories are not very nice… I had to work for another family. Children’s duties were to collect food in the forest and work in the kitchen where we prepared food for several hundred people. My family originally lived in Phnom Pehn, but during 1975 we were forced to move to the countryside in the Battambong province.
Do you remember this evacuation from Phnom Penh? In 3 days the capital with a population of 3 million people was almost empty…
During that time I saw the Pol Pot soldiers. They advertised through the microphone on the road and they told us that we have to go because Americans will bomb the city. Everyone had to run away. It was a lie. If you stayed at home you would be punished.
People who used to live in the city were forced to work in agriculture. Could your parents grow rice, etc.?
It was very difficult for my family, especially for my father who was an artist. And also for my brother. He was a monk. They had no experience in farming. My father was delegated to work there at the farm. It was better for him, he could at least grow some vegetables.
Did your family think about leaving Cambodia even at this time, to escape the Pol Pot regime?
It was not easy. You could not even go from one village to another. You could not just have a chat or walk. Everyone had to focus on the work. I know people worked more than 10 hours per day and no weekends at all.
Did you understand the situation as a child?
I understood it, even though I was quite small. We had lived our happy life, we had had food to eat, medicine, clothes, school... but during Pol Pot time we had nothing. We were often sick. We did not even have clothes. I had only one piece of clothing. I knew it is not humane living. Later on I was told that Pol Pot would like to have stronger leadership, so they had to kill educated people. Because, if educated people remain within the team, it would be difficult to lead them. Even decades later you can still see devastating impact of Pol Pot in our country.
Is this also motivation for you to work as an NGOs worker - to help your people to develop the country?
As I told you before, I had a good opportunity to be part of the medical staff in the refugee camp and I always told myself that I do not help many people there. It is not enough people for me. There are a lot of Cambodian’s who need support, especially with health care. So I decided not to work in the hospital anymore and join an NGO. Now my work has a much bigger impact. We are changing the system, so we help all people in Cambodia.