My name is Erin Deviney and I’m currently working in Cambodia as VSO Volunteer. I’ve been stationed to the (remote) North East Province of Ratanakiri to work as a Project Advisor for a Cambodian NGO working with small scale agricultural communities. But before doing this I was a staff member at the Global Poverty Project.
When I was first asked if I’d write a few blog entries during my year in Cambodia I had visions of grandeur. I thought that my first posting would be about land rights, or deforestation, or something big. But sorry folks. It’s going to be about poop – well gastrointestinal problems rather.
Let me preface what you are about to read by saying that I am not a water and sanitation expert, nor am I a doctor. What I am is a former market researcher who is a great observer who has picked up my share of diarrhoea around the globe. Most recently, I experienced my worst bout yet which nearly got me hospitalised. It got me thinking.
As anyone working or studying development or even just seen the GPP presentation knows diarrhoea is a problem of poverty. In Canada, diarrhoea is a question of inconvenience and an embarrassment but for many Cambodians it can be fatal. In fact some of the surrounding villages here have been experiencing spikes in deaths because of diarrhoea recently.
Why is something which is an inconvenience in my home country a potentially fatal affliction here? At the micro level diarrhoea is about knowledge (washing your hands), it is about sanitation (access to latrines) and it is about water (access to clean drinking water). But ultimately it is about poverty and access to resources. Unlike most Cambodians I have access to resources. In other words I have the ability to make choices when my health is compromised. Despite the fact that I am located in the most remote province in Cambodia – if I am sick enough I will be airlifted to Bangkok. Despite the fact that I am on a fairly minimal stipend I am still paid 10 times the amount of a teacher or a nurse (at least on the books) and despite the fact that I was exposed to the same infection as local Cambodians I was given a prescription by a foreign doctor who sent me to a reputable pharmacy for antibiotics.
What obstacles do many rural Cambodians face?
Distance: Where is the nearest clinic? How do you get there?
Resources: Will nurses, doctors and drugs even be there? Ridiculously low wages provide little motivation for attendance
Financial barriers: The same low wages that reduce attendance also create a need for supplementary charges from nurses and doctors. If these can’t be paid than service will not be provided.
Reliability: I read somewhere that something like 80% of the drugs in this country are counterfeit so even if you make it to the hospital, even if you receive treatment you might not solve the problem. One study found that of 133 vendors sampled in Cambodia selling anti-malarials 60% of the drugs sold lacked the active ingredient (http://www.medscape.com/viewarticle/465906). Talk about a waste of money.
So how to start solving the problem? With Doctors and Nurses Wages? With accessibility to health care? With regulation for medicines? There is no one right place to start. Hand washing has been effective at reducing water borne illness. So has building sustainable latrines.
The point is that the task is daunting but achievable.
Ta for now. Let me know if there is anything that you want to know about. |
