As we leave Phnom Penh mini vans pass by crammed full of workers, children are litter picking and early morning construction workers head off to work in the unforgiving hot sun. As we leave the city life behind beautiful green rice paddies roll on for miles and miles with palm trees scattered across the horizon.
The team is heading to Tboung Khum province located on the central lowlands of the Mekong river. Before we arrive we stop off for an early lunch at a restaurant in the neighbouring province Kampong Cham. Koy Phallany executive director of
Khemara organisation informs we are stopping off for an early lunch because there is little food and water in Tboung Khum. Initially I think this may be an exaggeration and there must be some access to food and water nearby. But as soon as the drive towards the network of villages begins we see less and less shops, vendors and rows of stilt houses with nothing else around. I realise access to basic necessities is a daily reality for the families who live here.
Our first few stops are visiting a few families and each house we go to is as heartbreaking as the next. An orphan teenage girl who lives with her Aunt is desperate to go to school but her family are struggling to pay for her school books and uniform. We drive around the corner to visit a Grandmother who lost her daughter and one of her granddaughters a few days after childbirth. She sits cooing the remaining twin sister, the family are struggling to make ends meet even though the father has gone to a nearby province as a labourer sending money when he is able to. With a family of five to feed everyday is a struggle.
Unfortunately neither of these stories are unique with high unemployment rates and the area vulnerable to annual flooding the local people are stuck in a unapologetic cycle of poverty. In Cambodia, as in most parts of the developing world, poverty is recognised to be a major cause of disability. According to a recent DFID report by the age of two, half of all Cambodian children are stunted and malnourishment is a major cause of developmental delay and long-term intellectual disability. The findings are alarming but sadly unsurprising when I visited this rural province the report was contextualised and I realised the harsh reality the people here deal with on a daily basis.
One of our final stops of the day before visiting Khemara's daycare centres we visited a teenage boy called Sothea. At the age of six Sothea suffered from frequent seizures for a month which has now left him with a permanent physical disability and speech impairment.
His mother Huy travelled to the capital to see the doctor but could not afford the hospital fees and had to go back to Tboung Kham with her son. This isn't an uncommon problem Cambodians spend a high proportion of their income on health- approximately 10% and health expenditure is a major cause of personal debt. Because poor people lack access to basic healthcare many illnesses and injuries often result in long term disability.
Grinding poverty is not only a cause of disability - it is also a major consequence of disability. The majority of disabled people are often much poorer than their non-disabled peers. Disability impacts on a person's ability to work and earn a living. In Tboung Kham the majority of families are employed in agricultural activities, and with a mild or moderate physical disability this can limit an individuals capacity to work in the fields which has a consequent impact on the household income.
As Sothea reaches adulthood he will struggle to find employment in the local area. He has never attended school even though he is a bright young boy with a wicked sense of humour. As part of our visit we asked one of his friends to read to him when she gets home from school. We are looking to build him a Augmentative and Alternative Communication (ACC) device so he is able to communicate with the local people as he is often left alone for long periods of time whilst his family goes to work in the fields. But I leave feeling very defeated I'm unable to do more.
Although there has been some strong developments in disability care in urban areas of Cambodia access to care in rural provinces is still non-existent. There is limited or services provided for children to go to school or a rehabilitation centre often leaving disabled children with no care during the day. Families are far too often stuck in a perpetual cycle of poverty which is exacerbated by their socio-economic position and limited access to healthcare.
During my short stay in Tboung Kham I realised with disappointment in my heart that the problems of these villages will not be solved in the near future. The socio-economic and environmental issues which plague the local community will need a coordinated response from government organisations and NGO's developing a sustainable and viable plan for the local people. If and when this happens I hope that disabled people are factored into this development plan so young people such as Sothea are able to contribute to the development of this beautiful country.
If you would like to find out more about Khemara please visit their website and to donate please visit their JustGiving page.
* Names have been changed.
