Editorial | Articles about Cambodia | Khmer

Wednesday, August 25, 2010

In Scarred Land, a Haven for Victims of Acid Burns

By SETH MYDANS
The New York Times - Trapaeng Veng Journal



TRAPAENG VENG, Cambodia — Touch Eap stroked her husband’s scarred and discolored back as she described the night six years ago when she poured a tub of acid over his head, burning off his eyes and ears and lips and leaving him as dependent on her as a child.

An acid burn victim had her blood pressure checked at the Cambodian Acid Survivors Charity while recovering from a skin grafting operation.
“I wanted to kill him,” she said. “I didn’t want to injure him. He said he would kill me, and I thought, better to kill him first so that I can take care of the children.”

She smiled ruefully as she talked; his drunkenness and threats were an old memory. Her husband, Phoeung Phoeur, 45, opened his mouth in what may also have been a smile.

“I’m sorry for him,” said Ms. Touch Eap, 46, who grows vegetables to support her husband and three children, “and I try to take care of him.”

It was a moment of domestic tranquillity here in Cambodia’s only shelter for acid burn victims, where a dozen other mutilated residents napped or sang or hung their heads backward in an exercise to help keep their scarred necks flexible.

Cambodia, along with Pakistan, Bangladesh and Afghanistan, has a history of acid attacks — a rare and extreme form of revenge or punishment.

An increase in the number of reported attacks in Cambodia, with 17 so far this year, has drawn attention to this shelter, the nonprofit Cambodian Acid Survivors Charity, on the outskirts of Phnom Penh.

The center has been advising the government in drafting a law that is making its way slowly through the legislature. The proposed law would restrict sales of acid — now widely and cheaply available — require warning labels and impose sentences of up to life in prison for the most severe attacks.

The center’s residents, who receive medical and psychological care, physical therapy, and occupational training, are just a few of the more than 280 known victims in Cambodia of a form of revenge that illustrates an undercurrent of violence that courses through this wounded society. Experts say the true number is certainly far higher.

“This is a traumatized culture,” said Pin Domnang, chief of programs and administration at the center, referring to decades of mass killings and civil war. “When something happens, the only response is violence. Violence can solve their problems. Violence can make them feel better.”

Short of murder, advocates say, an acid attack is the most devastating form of aggression, transforming the victim into a figure of horror and an outcast in a society that often sees disfigurement as a form of karmic justice.

That thought is an unexpected comfort to one of the survivors here, Soum Bunnarith, 41, a former salesman whose wife blinded him with acid five years ago in a rage of jealousy. “I ask myself, ‘Why me?’ ” he said. “But then I think maybe I did terrible things in a past life, and that thought helps me to accept this.”

Some, rejected and without family members to care for them, take their lives in despair, Mr. Pin Domnang said. “Their identity changes, their whole life changes,” he said. “It is difficult to control the food in their mouths. Sometimes it spills out.

“Their families don’t want to see them, don’t want to come to visit them,” he said. “The trauma in their spirit is like they are gone. They don’t want to live on this earth any more.”

Others, spurred by anger, try to pursue their attackers in court. Under current laws, acid attacks are generally treated as civil assault cases in which the victim must press charges. In a system governed by power, money and influence, there have been few convictions. Nevertheless, the center’s medical and legal manager, Dr. Horng Lairapo, has been encouraging victims to file new cases and revive old ones.

One of those victims is Mean Sok Reoun, 35, who was attacked and blinded by her husband’s former wife 15 years ago. Until recently, she said, her attacker had lived freely after paying a bribe to the police, while Ms. Mean Sok Reoun endured 40 operations.

“I saw her clearly running away,” said Ms. Mean Sok Reoun, whose eyes moved rapidly behind a curtain of skin as she talked. “But then I saw only shadows. And then I was blind.”

Ziad Samman, the center’s project manager, said, “The attacks are not always the products of jealous rage; some grow out of other personal or business disputes.”

Acid is widely available for uses like maintaining machinery, clearing drains and polishing jewelry. It is used in the processing of rubber, and a high proportion of attacks have come in areas near plantations, according to the center. In rural areas where there is no electricity, acid fuels the car batteries that are used to power television sets.

It was battery acid that Ms. Touch Eap said she poured over her husband’s head as he sat drinking in their home six years ago, a large knife by his side.

“ ‘Do what I say or I’ll kill you’ — those were the last words I said to her,” said Mr. Phoeung Phoeur, joining his wife in the narrative as their 13-year-old daughter, Per Srey Ai, looked on.

If he was going to live, Mr. Phoeung Phoeur said, he realized he needed his wife. As soon as he reached the hospital, he begged a friend to pay the police to set her free. Ms. Touch Eap returned to him, and she has nursed and supported her husband ever since she tried to kill him.

She was with him at the hospital when doctors told him he had only hours left to live, and she walked alongside him as neighbors carried him home in a hammock to die. She lighted incense and prayed beside him as he slipped in and out of consciousness until, defying the doctors’ predictions, he returned to life.

“We called all the family around him,” she said, remembering that dark evening. “We were all waiting around him, waiting for him to die. I was so afraid he was going to die.”

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Friday, November 28, 2008

Doctors on Stage

Doctors on Stage
The Lake Clinic Cambodia

Serving the Underserved

The Lake Clinic is a project dedicated to bringing basic healthcare, as well as disease surveillance and proper medical referrals to a severely isolated and underserved region of Cambodia -- the Tonle Sap.
Dr. Mette and Dr. Hal set up their respective areas while dental nurse, Phaly, provides oral health education to the early crowd.
Hal described his experience as "dental aerobics".

By Drs. Stein and Mette

Having passed the midway point in our two month mission to the floating villages of Tonle Sap, it is time for a first, brief summary and some reflection.

Being G.P.’s from a city-doctor-practice-in a well-developed country like Norway, we were well aware of the fact that not everything would be exactly like back home. Furthermore, we had been given valuable briefing and information by Jon and other informants prior to our first mission. The talks had been about the already existing health care system in Cambodia, which is not absent, but to the remote villages of Tonle Sap it is not easily accessible - it had been about a medical culture and thinking that is very different from the one in Norway , about illiteracy and ignorance, about TLC’s aims and goals and about our own expectations.
We thought we were to some extent prepared for the first mission.
Well, we were not really.

By the time we at lunch-time, reached the first village, Moat Klas, after a three hour ride in the village chief’s taxi boat, starting to unload our stuff, we already found ourselves surrounded by some fifty-odd villagers/patients wanting to see us. Within a few minutes we were having the first consultations, mediated by the young translator, Sothat. The patient waiting room was about 20 cm away, 50 pairs of eyes following every word and move we made, while discussing themselves in between in Khmer. Add to this a huge machine for fish-chopping in full action abut 4 meters away, and an on-going boat race on the river lake, producing a cacophony of sound rising to unbelievable peaks. We found ourselves in the middle of an absurd theater, playing the main parts.

With the help of our crew, we slowly got better organized, and we were able to communicate , understand or not understand, consider and give medication, and even to distinguish a few really sick patients whom without our presence would have been worse off.
Exhausted, excited, happy, overwhelmed and inspired we closed down the Lake Clinic at sunset the first day. An excellent Khmer dinner cooked by our midwife, Kim, finished the day, and by eight thirty, the batteries, and consequently the light (except for a spare battery serving the chief’s TV set transmitting a Cambodian Karaoke show!) went out, everybody turning to their hammock or mattress with mosquito-net, and with the help of modern pharmacy, we had a few hours’ well deserved sleep.

At this time we have completed 3 missions, whereof the last 2 on the restored TLC-1. You can imagine that the comfort is a little closer to our usual standards on the TLC-1 than on the chief’s fleet – and I have deliberately omitted the most private part of it – the TLC1 offers possibility for a cool shower and even a toilet.

Following the Hippocratic motto: Sometimes cure, often relieve, and always comfort, we realize that there is a long way to go for The lake Clinic. But everything has a beginning, and as we learn more about what is possible to obtain and what is not, as we learn better to understand and interpret the villager’s expression of health problems, and as doctors learn to live side by side with the ghosts, spirits and ancestors, we will slowly get better both in the here-and now situation, and hopefully also in contributing to basic health needs such as better nutrition, better hygiene, birth control, etcetera et cetera, the list is long.

We both feel privileged to have this unique opportunity to participate as pioneers from the very beginning in this ambitious project, - SERVING THE UNDERSERVED.

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Jon Morgan is executive director of the Lake Clinic Cambodia.

From 1998 to 2007, Jon was the first executive director of the Angkor Hospital for Children, in Siem Reap, Cambodia. More about John Morgan

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