Cambodian Community Addresses Health Issues

04/28/2006

By Setarreh Massihzadegan
Medill News Service
- Northwestern University, Chicago, Illinois

(Medill News Service) Nearly three decades after arriving in the U.S. as a Cambodian refugee, Saveth Yem still can see her uncles taken away to be killed by the Khmer Rouge.

“We [have a] very tough, very rough life in Chicago,” Yem said through a translator. “I want to work but I’m unable to work. I have a very emotional stress.”

Yem, who suffers from depression, said she sees her doctor every two weeks for tests but sometimes forgets to go. She also has diabetes.

Yem fled to Thailand with her five children before reaching the U.S. She is one of many reasons members of the U.S. Cambodian community conducted a video conference Monday at the Cambodian-American Heritage Museum and Killing Fields Memorial in Chicago to confront health issues among their people.

“There’s not just a problem, there’s an emergency,” said Mary Scully, clinical director of Khmer Health Advocates in West Hartford, Conn. “People are dying because they can’t access care and they can’t access care because of language [differences] and also because many providers don’t understand the trauma with high rates of diabetes, stroke and post-traumatic stress disorder.”

The National Cambodian-American Health Initiative brought together Cambodian communities in Chicago; Lowell, Mass.; Long Beach, Calif.; Portland, Ore., and central Connecticut with health experts via video to discuss increasing health concerns of the estimated 150,000 to 300,000 Cambodians in the U.S. Of those, about 7,000 are in Illinois, the Cambodian Association of Illinois reported. The meeting also was broadcast by Web to 25 sites.

Cambodians and experts present for the meeting began by discussing the trauma Cambodians suffered under the Khmer Rouge regime of the 1970s, during which survivors like Yem told their story and pleaded for help.

One other survivor said, “I’m free right now and depressed, stressed.” Khon Thang of Connecticut, speaking through a translator, added, “Sometimes I want to commit suicide myself … Everyone please help me, I don’t know how to speak English in my life, I don’t want to die,” she said to the camera.

The Khmer Rouge Communist regime, aided by Viet Cong and North Vietnamese troops, took control of Cambodia from 1975 to 1979, during which they initiated the genocide of Cambodian doctors, lawyers, clergy and teachers, among others. In all, experts say about 2.2 million people were killed.

Members of the Khmer Rouge regime are expected to go on trial for their crimes in 2007. The testimony expected at the trial may be a gateway to the truth of what happened to Cambodians, said Theanvy Kuoch, chair of the health initiative. Even so, many worry the trial will reopen wounds of the past.

“On one hand someone might naively think that was 25 years ago, but a trauma like that stays with you lifelong,” said John J. Tuskan of the U.S. Department of Health and Human Services, who was on a panel at Monday’s meeting.

April 17 was chosen as the day of national meeting because it marks the date the Khmer Rouge took over the country, Kuoch said. Both health experts and Cambodian community leaders agreed the meeting was necessary, after the Cambodian-American Health Initiative declared a state of health emergency within the community in November.

“It’s the year 2006, we have the knowledge, we have the technology, there’s no excuse why these people are suffering,” said James Lavelle, a social worker who worked to develop a training program for physicians in Cambodia. “It’s pathetic that both the mental health and physical health in [the U.S.] don’t have a systematic approach to countries that have [experienced] genocide.”

Monday’s discussion focused on how Cambodian refugees and their families suffer from the effects of post-traumatic stress disorder and other health problems. A study published by the Journal of the American Medical Association in August found 62 percent of Cambodians who emigrated to the U.S. before 1993 after living under the Khmer Rouge suffer from post-traumatic stress disorder.

Experts and health commissioners interviewed Monday spoke of Cambodians’ misunderstanding of the relationship between physical and psychological problems and Cambodians’ poor access to care as a result of language and emotional barriers, among other reasons.

“There are large numbers of Cambodians, but also other southeast Asian populations who have diabetes, high blood pressure, heart disease- chronic diseases that were not common in the homeland but are increasingly common here in the United States,” said Jane M. Kelly of the Centers for Disease Control and Prevention. “The combination of a chronic condition and mental health has a much greater impact,” Kelly said.

Many Cambodians are not aware that it is required by federal law that foreign patients have access to a translator, Kelly said. Instead, many use their children as translators, which can be very ineffective.

“Can you imagine the number of things that don’t come out if your child is translating for you?” Kelly asked. “How open are you with your health care provider?”

Cambodians are often silent about their health problems and past, and are therefore reluctant to seek help, experts said.

“There’s nothing extraordinary about it when we talk to each other,” said Prolung Ngin, a survivor of Cambodian genocide and a commissioner at the meeting. “If I were to talk to you, an outsider, it’s too unbelievable.”

Ngin talked not only about the reasons many Cambodians hesitate to share their stories, but also how the stigma of mental illness makes seeking services additionally difficult.

Ngin and her mother are both survivors. When Ngin asks her mother to get help, her mother asks: “What, do you think I’m crazy?” Ngin said she has looked for a culturally sensitive therapist without much success.

Cultural differences such as those outlined by Ngin have made for wider barriers to health care, experts have found.

Based on her work in the Massachusetts Cambodian community in 2004 and 2005, Leakhena Nou, assistant professor of sociology at California State University at Long Beach, said she found that Western health care providers were insensitive, condescending and unavailable to Cambodian patients.

“They reported that oftentimes they had a lost soul, that their soul was floating somewhere, that their job was to find their soul,” without which they could not be better, Nou said. This sentiment was not respected by providers, Nou said.

Experts and commissioners also discussed the need for more accurate and specific data related to Cambodian health, as Cambodians are often classified as part of the larger Asian-American category. They addressed the need for second-generation Cambodians to become involved in their parents’ health issues and learn about their parents’ plight.

Kuoch said she hopes the next two phases of this call to address health care will end in a congressional hearing.

Cambodians and health experts agreed on the resilience of the Cambodian people. “The word survival is not just surviving,” said Khatharya Um, associate professor of Asian-American studies at the University of California, Berkeley. “It takes on a whole different meaning when you put it in the context of this history.”

National Cambodian American Health Initiative - State of Health Emergency

04/09/2006

http://www.khmerdreams.org/projects/ncahi/NCAHI_BobChanly.pdf
http://www.khmerdreams.org/projects/ncahi/Survivor_Health_Statement_Form__Final_.pdf

On November 13, 2005, the National Cambodian American Health Initiative (NCAHI) declared a “state of health emergency” in the Cambodian American community due to increasing levels of serious, life threatening illness and diminishing resources.

NCAHI is a newly formed national Cambodian American health advocacy organization and is now reaching out to Cambodians across the United States seeking support for actions which will increase health resources for our people.

The current emergency in our community is not like the raging storm that tore apart our country in the 1970’s but more like the slowly rising flood waters from broken levees that are silently drowning our people. We are now dying from diabetes, stroke, depression and post-traumatic stress disorder (PTSD) in large numbers. What we are seeing is the ongoing degenerative effect of genocide, because these illnesses have their roots in the violence, starvation and torture of the Killing Fields.

There are no simple answers to solve this problem, but we believe that if we come together as a community to tell our stories and to search for solutions, we can begin a process of healing. We will develop the power to bring our voices to the public and claim our rightful share of the resources that are essential to saving lives.

We ask you to please join us for a National Town Hall meeting on April 17th from 11am-4pm Central Time (12pm-5pm East Coast, 9am-2pm West Coast) held at the Killing Field Memorial in Chicago, Illinois. This meeting will use videoconferencing technology to bring together our community from across the country. We are please to invite you to participate in this historic event by:

•Joining us in Chicago, Illinois
•Joining us from a satellite site in Long Beach, California; Farmington, Connecticut; Lowell, Massachusetts and Portland, Oregon. Satellite sites will have videoconferencing linkage to Chicago, Illinois.
•Participate through Internet web casting; the web casting URL will be available one week prior to April 17th.

•Send us a written testimony about the health problems of Cambodians in your area.

We have included the following supplemental documents: (1) postcards to help publicize this event and solicit community participation; (2) a listing of all satellite meeting sites and (3) a testimony form to share your community’s needs and health problems.

This meeting is the first step in a series of actions that we hope will lead to a Congressional hearing on Cambodian health. Together we can make this happen.

Should you have any questions, please call me at (860) 561-3345 or contact SivHeng Ung at (503) 234-1541 ext 209.

Truly Yours,
Theanvy Kuoch, Chair

Enclosures (3)
Cc: Steering Committee Members

 

Host Site

Illinois
11am-4pm Central Time
Cambodian American Heritage Museum
2831 West Lawrence Avenue
Chicago, IL 60625
(773) 878-7090

Videoconferencing Sites

California
9am-2pm Western Time
Cambodian Association of America
2390 Pacific Avenue
Long Beach, CA 90806
(562) 988-1863

Connecticut
12pm-5 pm Eastern Time
University of Connecticut Health Center
Henry B.C. Low MD Learning Center
263 Farmington Avenue
Farmington, CT 06030
(860) 561-3345

Massachusetts
12am-5pm Eastern Time
University of Massachusetts Lowell
Coburn Hall – South Campus
850 Broadway Street, RM 112
Lowell, MA 01854
(97 8) 746-3107

Oregon
9am-2pm Western Time
Immigrant & Refugee Community Organization
10301 Northeast Glisan Road
Portland, OR 97220
(503) 234-1541

Interview With Minister of Health on Bird Flu in Cambodia

04/08/2006



07/04/2006

Heng Reaksmey report in Khmer-download real play-(885 KB) audio clip
Listen Heng Reaksmey report in Khmer audio clip

Avian Flu
Avian Flu

Cambodian Minister of Health Nuth Sokhom says Cambodian people should be alert about bird flu after two recent deaths caused by the deadly H5N1 virus.

Officials from Cambodia’s Health Ministry and the World Health Organization say a 12 year-old boy from Prey Veng province died in Calmette hospital in Phnom Penh on Tuesday.

Tests by a Cambodian laboratory showed the child was infected with the deadly H5N1 variant of bird-flu virus. If the findings are verified by a W.H.O. laboratory, this would be the second bird-flu death in Cambodia this year, and the sixth since 2003.

A three-year-old girl from Kompong Speu province died of the disease last month.

Bird flu has killed more than 100 people worldwide since 2003.

Deaths from bird flu occur in Kampot, Kampong Speu and Prey Veng provinces. Recently Prime Minister Hun Sen has talked about the danger of bird flu and has urged the people to stay informed.

Mr. Nuth says that the Cambodian people should pay special attention to this serious problem. He also expresses thanks to the prime minister, the media, radio and televisions, and the Ministry of Health for prompt actions in dissiminating information to the people about the danger.

The local authorities and experts will go to the local areas with some volunteers to educate the people about this deadly disease. The local villagers might not hear or see anything about this disease and its danger.

Up to now, there are 6 bird flu related deaths in Cambodia. Mr. Nuth has met with donor community, with Asia Development Bank which has fund and will help should there be needs, and he has signed an agreement with the U.S.

Recently he has met with U.S. Ambassador Joseph Mussomeli and has asked him for help. Australia has also pledged some aid. There are projects and plans in Cambodia for the bird flu, which it submits to the donor community to stop bird flu spread in Cambodia.

Mr. Nuth Sokhom appeals to the Cambodian people to join in the government’s efforts, and those of the experts and local authorities so that the campaign can succeed. He says if there is any doubt, any poultry deaths or sick birds cases, to please report them to the health authorities. He also appeals to the people to wash their hands, feet, with soap and water after contact with the birds.

In Cambodia, medical corruption punishes the poorest of the poor

LICADHO dispatched a team from its Medical Office to provide emergency assistance to the small village of Phluk Thnung, in Kampong Speu province, after Radio Free Asia reported the village was suffering from a sudden increase in health and nutrition problems. They were joined by both national and international organization and provided health care services, medicine, dry food and vegetables to villagers in need.

The medical team first visited Phluk Thnung on March 5, 2006. Carrying with them basic medicine and vitamins, the field visit revealed a village plagued by poverty and insufficient basic infrastructure. Several villagers were found to be gravely ill or disabled, and lacked the resources to seek treatment.

The villagers said corruption at government health stations was the primary barrier to seeking medical assistance for problems including malnutrition, parasitic diseases such as malaria, disease from dirty water and lack of hygiene, as well as temporary and permanent physical disability due to lack of medical care after an injury. One man had suffered from an untreated broken leg for four years before receiving medical attention. Shortly after LICADHO’s visit, when he received proper medical care, the man regained mobility and is recovering well.


One of the children treated by LICADHO’s medical teamA villager from Kong Pisey district, where the village is located, told LICADHO medical staff that the provincial public health center required him to pay for services with cattle before receiving treatment. Unfortunately for most rural Cambodian’s, relinquishing even the most meager of possessions can have a huge impact on their ability to support themselves and their families.

This endemic corruption can be observed in most public services. Due to inadequate and irregular salaries, some doctors will compensate themselves with bribes in the form of livestock, money and other valuable items. These are extorted from clients before services are provided. Yet, according to the mandate of the Ministry of Health, medical care for poor Cambodians should be free of charge.

Another factor degrading health standards in Kampong Speu, is the fact that the five villages that make up the Kong Pisey district share just one well. This means approximately 1,000 families are dependent on a single water source, often far from their homes. The scarcity of water compounds health, hygiene and safety problems for villagers. Kampong Speu is a relatively economically stable province, with the means for local government to provide for its people, and yet a lack of infrastructure persists.

LICADHO’s medical team revisited patients for follow up treatment on March 12 and March 25, and noted general improvements in the health of the villagers.

While both Cambodian and international organizations have provided emergency assistance to the best of their abilities, it is inevitably non-sustainable. LICADHO urges the Ministry of Health to comply with its mandate at all levels and take appropriate disciplinary actions to end systematic corrupt practices. Furthermore, it is the responsibility of provincial governors to ensure the fruits of investment and development are distributed to small villages as well as larger cities and towns.

Dr. Richard Mollica - Harvard Ref Trauma

04/05/2006

Thursday, April 20, 2006
5:30-7:30pm

Location: Long Beach City College

    For a talk with Dr. Richard Mollica,
    Director of the Harvard Program in Refugee Trauma
    and Community Dialogue facilitated by
    NCCJ of Southern California

    A Collaboration of:

The Found Theatre
Program for Torture Victims (PTV)
Facing History and Ourselves
Cambodian American Leadership Foundation
The City of Long Beach Main Public Library
The National Conference for Community and Justice (NCCJ) of Southern California

Richard F. Mollica, M.D., M.A.R. is the Director of the Harvard Program in Refugee Trauma (HPRT) of Massachusetts General Hospital and Harvard Medical School, and is Professor of Psychiatry at Harvard Medical School. He is a world renowned expert on the Cambodian genocide and the mental health needs and treatment of Southeast Asian refugees. In 1981, Dr. Mollica co-founded the Indochinese Psychiatry Clinic (IPC). Over the past two decades HPRT and IPC have pioneered the mental health care of survivors of mass violence and torture. HPRT/IPC’s clinical model has been replicated throughout the world. Dr. Mollica has received numerous awards for his work, including the 1993 human rights award from the American Psychiatric Association. Under Dr. Mollica’s direction, HPRT conducts training, policy and research activities for traumatized populations around the world. The group’s recent epidemiological studies have demonstrated for the first time the chronic disability and mortality associated with the mental health sequelae of mass violence. HPRT’s scientific work has helped place mental health issues at the center of the recovery of post-conflict societies.

FOR MORE INFORMATION CONTACT

NCCJ at:

(562) 435-8184

or log onto:

http://www.nccjsocal.org

http://www.hprt-cambridge.org

Art tells refugee stories in Long Beach

By Kristopher Hanson, Staff writer
Long Beach Press Telegram

LONG BEACH — Between 1975 and 1979, Cambodia’s “Killing Fields” claimed the lives of an estimated 4 million men, women and children under the brutal Khmer Rouge regime in control of the small southeast Asian nation.

Among those who escaped the horror were many who came to Long Beach.
Now, a cultural project featuring the experiences of Cambodian-American women through musical performances, a photographic exhibit and lecture is under way in Long Beach.
Through art, the project tells the stories of women who experienced the Cambodian holocaust.
A play at the Found Theatre, 599 Long Beach Blvd., features the story of a young girl who flees Cambodia under the horrors of the Khmer Rouge and is adopted by a family at a Thai refugee camp. The family eventually makes their way to America, where they find life can be as difficult as it was in Cambodia.
“Journey Across the Mine Fields to America” runs through Sunday.
Based on an ancient Cambodian cultural tradition called Lakhon Yike (pronounced yeekay), the performance includes drums, dancing and singing. Chantara Nop, a local survivor, wrote the play.
On March 4, a photographic exhibit titled “Courage and Resiliency: Cambodian-American Women in America,” opens at the Long Beach Main Library with a 2 p.m. reception featuring the oral history of 10 women documented with 47 photographs.
The library, at 101 Pacific Ave., will provide gallery space and free admission for the exhibit through April 30 during regular library hours.
On March 7, Poly High School will welcome Svang Tor, Senior Clinician and Consultant with the Harvard Program in Refugee Trauma (HPRT). Tor is also a Cambodian-American survivor who is featured in the exhibit from Harvard. She will speak to students from 9:30-11:30

Finally, April 20, Harvard Psychiatry Professor Richard Mollica, who oversees the HPRT, will speak at Long Beach City College.
To contact the Found Theater, call (562) 433-3363 or visit www.foundtheatre.com. For more information about the project, call the National Conference for Community and Justice at (562) 435-8184.
Finally, April 20, Harvard Psychiatry Professor Richard Mollica, who oversees the HPRT, will speak at Long Beach City College.

To contact the Found Theater, call (562) 433-3363 or visit www.foundtheatre.com. For more information about the project, call the National Conference for Community and Justice at (562) 435-8184.