Saturday, April 02, 2011

In Cambodia, Women Fear Death at Childbirth

By Marwaan Macan-Markar

KRAING KAOK, Cambodia, Apr 2, 2011 (IPS) - Death haunts women in this Cambodian village at a moment of happiness - when they give birth.

"Today, nothing frightens Cambodian women more than having to give birth," says Mu Sochuea, former minister of women’s affairs. "It is costly, risky and not safe for the mothers and the babies."

Cambodia has acquired the notoriety of having among the highest maternal mortality rates in the region. Five women die every day during childbirth, according to U.N. reports.

Public health experts attribute the high death toll to lack of sufficient midwives, limited health care centres, the cost of health services, and a bias in remote rural areas towards untrained traditional birth attendants.

Hak Sam Ath still fights back tears as she recalls how Ouch Lay, her eldest daughter, died at a health clinic that serves this fishing and trading community on the banks of the Stung Slot River. "She had high blood pressure at the time she had checked into the health clinic for her delivery," said Sam Ath. "But this was overlooked and she died on the night she was to give birth."


The death of mothers like 28-year-old Lay, over one year ago in this village some 60 kilometres southeast of Phnom Penh, confirms why a common saying in the local Khmer language about the dangers of childbirth still resonates in this country of some 14 million people. "The expression ‘crossing the river’ is used in Khmer to describe the moment when a woman is to give birth," says Sochuea, now an opposition parliamentarian. "It illustrates the risk and the danger of crossing a river, a totally uncertain experience, which is how childbirth is viewed by many here."

The country’s maternal mortality rates reflect this fear. There are 461 maternal mortality cases per 100,000 living births here, which is "among the highest in the region and which has not changed much since 1997," noted a report released Mar. 28 on the country’s progress towards achieving the U.N. Millennium Development Goals (MDGs) - a set of global targets to reduce poverty, ensure basic education, achieve gender equity, and overcome major health challenges.

Such frequent maternal mortality has condemned Cambodia to fall well short of meeting the fifth of eight MDGs by 2015, which specifically calls on countries to improve maternal health by reducing maternal mortality ratios. Cambodia is also trailing to meet the first MDG: slashing the number of people living in extreme poverty and hunger.

"It is highly unlikely that the original [Cambodian MDG] target of 140 deaths per 100,000 live births can be reached," revealed the ‘Cambodian Millennium Development Goals (CMDG) Update 2010’, the report that was jointly produced by the government and U.N. agencies. "The target for 2015 has therefore recently been adjusted to a more realistic level of 250, which still represents a major challenge."

To meet such a challenge in a country still struggling to rise to its feet after the 1991 peace accords - which ended two decades of deadly conflict, genocide and occupation - the U.N. has courted a prominent ally: Bun Ray Hun Sen, the wife of Cambodian Prime Minster Hun Sen. The former nurse was recognised in late February as the national champion for U.N. Secretary- General Ban Ki-moon’s Action Plan for Women’s and Children’s Health.

"We are tackling the maternal mortality issue at an extremely high level," Douglas Broderick, the U.N. resident coordinator here, told IPS. "We will be working with the first lady to raise the profile of the maternal mortality challenge in the country."

Limited numbers of midwives and skilled birth attendants in the hospitals and health centres has contributed to maternal mortality, with the rural rice- growing areas - home to nearly 85 percent of the population - being the worst hit. Nearly 40 percent of births in Cambodia are "unattended by skilled birth attendants, who could save women’s lives in case of emergencies," according to the World Health Organisation (WHO).

"Maternal mortality in rural areas is three times higher than in the urban areas," says Chea Thy, the national health advisor at the Cambodia office of Plan International, a British child rights agency. "Some health centres don’t have qualified midwives."

Midwives are paid approximately 10 dollars for assisting in a birth and the profession is struggling to attract larger and committed numbers to meet the health ministry’s national health plans. The government has set its sights on opening 1,600 health centres across the country, with each having up to two midwives. This would mark a sizeable increase from the less than 1,000 health centres that currently dot Cambodia.

The high cost of health services in a country where over a third of the population live in poverty is also fingered as an explanation of why maternal care is so poor.

"The average payment for a four to six day stay at a hospital is 130,000 riels (about 27 dollars)," Henk Bekedam, director of health sector development at the WHO’s regional office, told IPS. "That includes mothers going for delivery, a patient who has broken a leg, or somebody hospitalised for diarrhoea."

4 comments:

Anonymous said...

Koh Tral Island must not be forgotten

By Ms. Rattana Keo

Why do Koh Tral Island, known in Vietnam as Phu Quoc, a sea and land area covering proximately over 10,000 km2 [Note: the actual land size of Koh Tral itself is 574 square kilometres (222 sq miles)] have been lost to Vietnam by whose treaty? Why don’t Cambodia government be transparent and explain to Cambodia army at front line and the whole nation about this? Why don't they include this into education system? Why?

Cambodian armies are fighting at front line for 4.6 km2 on the Thai border and what's about over 10,000km2 of Cambodia to Vietnam. Nobody dare to talk about it! Why? Cambodian armies you are decide the fate of your nation, Cambodian army as well as Cambodian people must rethink about this again and again. Is it fair?

Koh Tral Island, the sea and land area of over 10,000 square kilometres have been lost to Vietnam by the 1979 to 1985 treaties. The Cambodian army at front line as well as all Cambodian people must rethink again about these issues. Are Cambodian army fighting to protect the Cambodia Nation or protecting a very small group that own big lands, big properties or only protecting a small group but disguising as protecting the Khmer nation?

The Cambodian army at front lines suffer under rain, wind, bullets, bombs, lack of foods, lack of nutrition and their families have no health care assistance, no securities after they died but a very small group eat well, sleep well, sleep in first class hotel with air conditioning system with message from young girls, have first class medical care from oversea medical treatments, they are billionaires, millionaires who sell out the country to be rich and make the Cambodian people suffer everyday.

Who signed the treaty 1979-1985 that resulted in the loss over 10,000 km2 of Cambodia??? Why they are not being transparent and brave enough to inform all Cambodians and Cambodian army at front line about these issues? Why don't they include Koh Tral (Koh Tral size is bigger than the whole Phom Phen and bigger than Singapore [Note: Singapore's present land size is 704 km2 (271.8 sq mi)]) with heap of great natural resources, in the Cambodian education system?

Look at Hun Sen's families, relatives and friends- they are billionaires, millionaires. Where did they get the money from when we all just got out of war with empty hands [in 1979]? Hun Sen always say in his speeches that Cambodia had just risen up from the ashes of war, just got up from Year Zero with empty hands and how come they are billionaires, millionaires but 90% of innocent Cambodian people are so poor and struggling with their livelihood every day?

Smart Khmer girl Ms. Rattana Keo,

Anonymous said...

that's true. cambodia should upgrade more healthcare facilities and train more midwives, etc... death from childbirth is so unnecessary in cambodia. i think education and training will improve the situation, especially for healthcare workers like midwives, nurses, etc, etc...

Anonymous said...

That's what ah youn want!

Anonymous said...

Khmer’s Actuary Financial and economic investigation found that Dr. Hun Sen and his families’ money is not less than US$ 100 billion in all around the world including banks deposited, investments and properties around the world.

All relatives of Dr. Hun Sen ( above 380 families of Dr. Hun Sen together ) is not less than US$ 200 Billion including all their properties and banks deposited and investments all around the world.

Plus the secret money such as drugs dealer, Gold, Silver, diamonds, forest trees cut down, Angkor watt and over 1000 Khmer ancient temples tourist income, oil in the year 2012...During Dr. Hun Sen’s regime, his economic miss calculation and management make Cambodia loss revenue not less that US$ 1 600 Billion to Thailand and mostly Vietnam.
Plus foreign aid Japan alone donates US$ 150 Billion so far. Where is the money? Interesting isn’t it?

Approximately 10 000Km2 to Vietnam (10 000Km2 of sea with full of sea foods protein, oil, minerals include Koh Trol)
65% of Cambodia forest trees have been cut down for private selling only.

Dr. Hun Sen and his families, relatives and friends are stealing from 90% Cambodian people that earn less than $2 per day. They steal 90% Cambodian people health, well being, Khmer dignity, cut down 90% Cambodian people life expectancy, foods...from 90% Cambodian people. Plus pump in more Vietnamese (approximately not less than 5 million Vietnamese in Cambodia) into Cambodia to make 90% of Cambodian people poorer and sufferer.

By Khmer’s Actuary Economic science internal revenue investigation,