THE PAHSA CAMBODIA SHORT PROGRAM

The Cambodia Short-Term Study Program took place from 7-16 March 2013 at Paññāsāstra University of Cambodia. As well as peace and human security, there was also a special focus on the unique health issues that are faced in Cambodia.

This is the story of the program as told by PAHSA students from Japanese universities

DAY ONE — FUMIKA HASHIBA

The first day of the study tour in Cambodia was full of interesting lectures and there were lots of active discussions with both the speakers and also with the Cambodian students who joined the sessions. Particularly interesting for me was Professor Koum Kanal's lecture about how Cambodia had managed to improve the maternal and child health status quite dramatically in recent years.

Last year I worked as a JICA project intern in Ethiopia for eight months and I experienced working with community members. So, I know how difficult it is to change people's attitudes and behavior.

Cambodia has committed to improve the status of maternal and child health, and it is the clear that the administrative systems and structures that have been put in place have made the policy work effectively. Given what we have found out, I am very curious to see this policy working in the community.

The Cambodia short-term study program is providing me with a good opportunity to understand public policy and related subjects through the case of Cambodia. Looking around the city, I feel Cambodia is a very dynamic country and am very happy to get the opportunity to learn here.

SEI HATAKEYAMA

On the first day of the PHASA Short-term Study Program in Cambodia, after the opening speech by the President of PUC, Dr. Kol Pheng, there were three lectures; the concept of public policy, maternal and child heath (MCH), and community participation policy.

During the lecture on community participation policy in the field of health, Dr. Mao Heng and Dr. Sok Sovannarith explained about the Village Health Support Group (VHSG) which may prove to have great potential in bridging the gap between communities and health facilities. As a health system at the community level, the VHSG has a similar role to the Community Health Workers (CHWs) that provide primary health care in many developing countries. But the VHSG is different from CHWs in that it mainly gathers and then shares the health information of villagers with health facilities and doesn't provide medicine itself.

One of the reasons why the VHSG system was established was probably because of the serious shortfall in healthcare resources and information at many levels. Such an approach at the grass roots, like is being seen with the VHSG, still faces teething problems and challenges, yet these efforts have great potential to reduce regional and gender disparities in health. If there is an opportunity on a future trip, I would hope to experience the situation on the ground in the rural areas first-hand.

DAY TWO — KYOKO INOUE

Today's lecture by Dr. Kasumi Nakagawa's on "Policy making for the prevention of violence against women (VAW) in Cambodia" was absolutely fascinating. Her explanations were coherent and helped us understand the present condition of domestic violence in Cambodia. Dr. Nakagawa is Japanese and she was able to draw comparison between Cambodia and Japan in regards to gender issues. Her experience of growing up in Japan brought home the points with a good deal of clarity.

I was a little surprised to find out that the Cambodian administration has a Ministry of Women's Affairs (MOWA) which has been advancing a National Action Plan to prevent violence against women (VAW). Cambodia also added its own goals and targets in regards to VAW as part of its Cambodian Millennium Development Goals. Dr. Nakagawa said that Cambodia was the first country to set its own goals and targets on VAW in the MDGs.

For many of the Japanese present, it came as a surprise to learn how "gender awareness" at the policy making level in Cambodia, especially in regards to violence against women, is in fact ahead of Japan. It became clear that VAW is equally as ubiquitous in developing nations as well as in those that are developed.

While it seems to be difficult to obtain accurate statistics on such violence due to its "invisibleness," efforts need to be refocused in these areas. More specially, to prevent VAW, we should continue to research how violence against women affects women's health in the long-term, and what kind of social background or gender perspectives are related to occurrence of violence.

We should also continue to explore how we can help victims from all over the “invisible” world.

"The problem of VAW is not exclusively women's,
but also men's."

XIAO HANG, OSAKA UNIVERSITY

The statement from Dr. Kasumi Nakagawa seemed to be very different in its approach to gender from what I had come across in other lectures. Normally, people emphasize that it is women who, by being silent, connive with men who abuse their power and tolerate unfair or even violent situations. There are groups with a focus on teaching women how to protect themselves or how to win their rights and on empowering them against unequal relationship between men and women. However, such groups often appear to overlook the importance of changing men's way of thinking, which, in my opinion, is a crucial point.

For example, the problem of domestic violence (DV) is generally more serious in Asia than in Europe. I think the basic attitude that brings this difference can be found in the way men treat women around them. For many European men, having a nice balance within the family and respecting each other and loving each other can bring more happiness to them than behaving like "king" of the family. I think this is the attitude that is lacking in many Asian men, although for example in Japan, that is exactly what women want and expect. Women want mutual love and respect in a relationship. Regrettably, traditional male roles are still prevalent in Asian societies.

During the program I also observed that a commitment to gender equality has no direct relations with wealth. In Cambodia, the International Women's Day is celebrated as a national holiday. (We arrived in Cambodia on that day!) However, in the much wealthier Japan the commemoration of the Day is almost invisible. A friend from Rwanda said to me once, "I will protect my wife and treat her as a precious partner, because she will be my other half for the rest of my life". Although this is just an anecdote, I think it is not naive romanticism, but a sign of respect that can exist regardless of culture or wealth.

"Barbed wire was used to prevent desperate prisoners from committing suicide. They were not allowed to end suffering by themselves."

AHMED SAJJAD

During our study tour, on March 11 we visited the Tuol Sleng Genocide Museum (former security office 21), which was created on the orders of Pol Pot (Sa Lut Sor) on April 17, 1975.

Today, what remains of Office 21 (S-21) lays bare the atrocious and dreadful acts against humanity that took place in the past; these were in terms of inhuman detention, interrogation, torture and the brutal massacre that took place during and after the confessions of innocent men, women and children.

Inside Tuol Sleng Genocide Museum 20,000 people are estimated to have been killed. Every single picture and all the evidence in the museum (torture tools) spelled out the ferocious and painfully sad stories of the detainees.

The museum also shows how the massacre was painstakingly planned and how so many people of Phnom Penh city went on to be brutally slaughtered. There were countless questions in our minds about what took place and some were addressed to the Cambodian students at Pannasastra University of Cambodia (PUC) in the hope that they could shed light on how this was permitted to take place. For example, when the massacre was occurring why did the United Nations and other human rights champions appear to overlook the atrocity or seem to do so very little?

The museum, by its very silence or non-existence of narrative and also by showing the things that took place there, is hinting at the deepest darkness
of human nature.

DAY FOUR — MINORY KOBATASHI

Both of the lectures on the fourth day were very informative. Ms. Leslie, in her session, explained how Pol Pot succeeded in bringing the Cambodian people under his domination. He used simple slogans like "fight against USA which bombs us," and also proclaimed that he would create a society where the top is not the king but people. This kind of rhetoric was easily accepted by the people and led to him building an extraordinarily strong power base.

Today in Cambodia, we were told that 70% of the population is under the age of 30. The reason why there are so many more young people than elders is the Khmer Rouge mass killings. However, the older 30% still have a good deal of authority and are the leaders today. It is suggested that those elder leaders often don't listen to the opinions of the educated young. She said that this tendency is very strong. Therefore, it is very difficult to say something or change the political structure in Cambodia.

However, I think that for Cambodia, now is the time for transition. At Pannasastra University of Cambodia, we had vibrant discussions with local students. They were really concerned about the situation in the country and we discussed seriously Cambodia's actual problems. If young people like them continue to commit themselves for their country, they will be a hope for the future of Cambodia.

FUMIKA HASHIBA

Venerable Penh Vibol talked about the role of Buddhism in peacebuilding in Cambodia. I agree that it is very important to have "inner peace" - peace inside one's heart. And I also believe that inner peace would lead to world peace if every single person was capable of finding inner peace. Yet unfortunately, I think that it is almost impossible to achieve it in our complex world. It is human nature to have greed, anger and ignorance, things that prevent us from realizing world peace. People have different backgrounds and it is not easy to understand each other.

Believing in a certain religion is possibly one way to achieve peace at the individual level. It is, in other words, one’s spiritual development or personal development. However, I think that the fulfillment of basic physiological needs, safety and education are preconditions to realize such development. Suppose that one were born in poor circumstances and had to struggle for daily survival - sufficient food, safety and education - do you think that one would instinctively care about others? If I were faced with this situation, I would not be so sure.

Through Venerable Penh's lecture, I understood how complex it is to undertake peacebuilding as it has to deal with human nature. Inner peace is very important but so are effective policies. Without these, peace in the real world cannot be achieved.

THE KHMER ROUGE TRIBUNAL

On 13 March we visited the Extraordinary Chambers in the Courts of Cambodia (ECCC) or popularly known as the Khmer Rouge Tribunal. It was established in 2006 as a Cambodian court to prosecute the most serious crimes committed during Democratic Kampuchea (1975-1979). Because it is new, both national and international tribunals mixed, it is called a "hybrid court." Public Affairs Officer Ms. Yuko Maeda and Legal Officer of the Office of Co-Investigating Judges Dr. Meas Bora received us.

The most prominent feature of the ECCC is its "hybrid" nature, namely a mixture of international and Cambodian prosecutors and judges. For the readers from some countries, the pre-trial system also will seem to be unique. The pre-trial is a stage of the legal process to judge whether the case can go before the court. The existence of Investigating Judges is also unfamiliar to some legal systems. At the ECCC there are two co-Investigating Judges, one Cambodian, one international, and their duty is to conduct independent judicial investigations based on the proposal of the prosecutors and then decide whether to dismiss the case or issue an indictment and send the case to trial.

People have shown a strong interest in the ECCC. The sessions are broadcast live, and the gallery is always full. Most of the court documents are accessible on the website of the ECCC.

Village Phrek Bongkong

The meaning of this village name is "Lobster." In the afternoon we visited this settlement to see the silk industry at work. It took an hour by boat from Phnom Penh to reach our destination which is on the bank of the Mekong River.

Upon arrival we first went to the temple of the village. Although an old temple, it is very dynamic. A monk of this temple designed a special Budha statue and villagers carve trees based on the design and can earn money from this.

70% of the villagers make a living from the silk industry. They raise silkworms, weave cloth and sell the products at a shop which is popular among tourists. A nearby school teaches English to children and young people and we were surprised to find out just how many of the youths spoke English.

The volume of silk production in a small village like this is certainly limited. But their cottage industry is well organized and productive. We ended up buying inexpensive but very smooth silk shawls enthusiastically, and we left the village as happy customers.

Professor Akihisa Matsuno, OSIPP, Osaka University

DAY FIVE — AHMED SAJJAD

On March 13 we went on to visit the Extraordinary Chambers in the Courts of Cambodia (ECCC) or what is commonly called as the Khmer Rouge Tribunal. The ECCC was established in 2006 with the aim and objective of bringing the perpetrators of Pol Pot's regime before the court in order to find the truth of the cruel and ruthless massacre that took place during 1975-1979.

At present five major cases are proceeding and one of them, the former Chairman of Phnom Penh's security prison S-21, Kaing Guek Eav Alias Duch, has been convicted for 35 years in prison – a life sentence. There are other cases in front of the tribunal and are at different stages of prosecution and trial.

Alarmingly, the current situation is that the ECCC is facing a financial crisis. To date the ECCC has spent around US$ 186.8 million, and approximately US$44-46 million is required annually to proceed further. In fact, the Cambodian government is financially incapable of funding this alone and is looking towards international donors to accomplish the ECCC motives.

It is plain that the tribunal trials are playing a vital role in exposing the ruthless and brutal actions of the past and in bringing some late justice to the victims’ families. Certainly, this will offer a degree of closure to some, but somehow the feeling remains that true reconciliation sometimes contradicts what some see as true justice and this may lead to further societal differences in the days ahead.

DAY SIX — LECTURE ON HEALTH

On 14 March, we had a lecture on "The National Health System in Cambodia" by Dr. Sok Sovannarith, a public health consultant. His talk covered a wide range of topics from the history of health system development & reform, the current health policy including health-financing programs, to the challenges ahead in the health sector.

During the Khmer Rouge regime (1975-79), the health infrastructure was completely destroyed and fewer than 50 medical doctors survived. After a period of fragile public health infrastructure and services during the subsequent socialist regime, the health system started to be strengthened in the 1990's with increased external funding and a growing private sector. The introduction of user fees in 1997 marked a great step forward in health sector reform. Concurrently, various types of health financing policies were put in place including those which aim at responding to the needs of the underprivileged. The Health Equity Fund, which began in 2000, is one such scheme.

Achievements in terms of health indicators such as the reduction of maternal mortality ratio over the last decade are impressive. Yet, there are many challenges still ahead to achieve health sector reform. Despite the government's efforts in human resource development in health, trained health professionals, particularly midwives, are far from sufficient. Disparities between urban and rural areas have been widening. Corruption and misuse related to safety net programs prevent the poor in the most need from accessing the health services they require.

The lecture was followed by a lively question and answer session. The sincere responses of Dr. Sok based on his extensive work experience at the community level helped us comprehend the complex reality of health issues in Cambodia.

"Next to the center stand huts of squatters. When the government moved evacuees here, other squatters followed them and built huts here."

Visit to Anlongkangan Health Center

We visited the Alongkangan Health Center located in the north western part of Phnon Penh. It is a semi-urban area where people were moved to following demolition by the government of some of the central parts of Phnon Penh. Since more people moved into this area than had been planned for, many families have become squatters in impoverished living environments without safe drinking water or proper waste systems.

The Alongkangan Health Center has 18 staff; two medical doctors, one secondary midwife, two primary midwives and others. It serves a population of 8,608 from eight villages.

The head of the Operational District Office, the director of the health center, the members of the village health support group including a female staff of a local NGO working for the Health Equity Fund, all welcomed us. They gave us a briefing on center activities and we toured the facility.

Professor Akiko Matsuyama, Nagasaki University

The program in Cambodia has come to an end.

The President of PUC, Dr. Kol Pheng, gave the students from Japan certificates of completion of the program. Thank you very much, Professor Gilberg, for your efforts in realizing this program. Thank you too, Sothet and Sroy, for your hospitality.

Special thanks also must go to the PUC students - your engagement in the program was impassioned and insightful. You are the hope for the future.

Akihisa Matsuno
OSIPP, Osaka University

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