As Traumatic Stories Reach Wider Audience, Some Healing

https://www.youtube.com/watch?v=3vm-Xrtw2Mg

Journey toward healing

Sam Keo speaks earlier this year about his experiences in Cambodia and his subsequent battle with post traumatic stress disorder.Photo courtesy of Sam Keo

Cambodian immigrant to speak in Stockton about struggles with PTSD

May 21, 2012
By Elizabeth Roberts
Record Staff Writer

At a glance

Author Sam Keo will speak, in Khmer and English, from 10 to 11 a.m. Friday at Stockton's Park Village Community Center, 3830 N. Alvarado Ave. Copies of his 2011 memoir, "Out of the Dark: Into the Garden of Hope," will be available for sale and signing afterward.

More information: (209) 944-1700.

STOCKTON - Under the murderous Khmer Rouge that ruled Cambodia in the 1970s, it was his entertaining storytelling for regime leaders that helped save young Sam Keo's life even as his father died after being severely beaten and four of his younger brothers succumbed to starvation or disease.

Years later, safe in the United States but racked by violent nightmares and crushing guilt, he had a post-traumatic stress disorder breakdown and twice came within seconds of committing suicide.

This time, it was telling his own story, more compelling than his most fantastic of tales, that helped save him: His 2011 memoir, "Out of the Dark: Into the Garden of Hope," was written after years of therapy, medication and soul-searching.

While his book joins a growing body of memoirs recounting the horrors of life under the communist Khmer Rouge regime, his is one of the first treatment-based approaches aimed at addressing Cambodian immigrants' struggles with post-traumatic stress disorder resulting from those experiences.

Dr Sam Keo Hopes To Shed Light Khmer Rouge Trauma

http://www.youtube.com/watch?v=mIaMgUYZwZo

Author Hopes To Shed Light Khmer Rouge Trauma

“Out of the Dark: Into the Garden of Hope” by Sam Keo, a Cambodian psychologist. (Photo: Courtesy of Dr. Sam Keo)

Thursday, 26 January 2012
Men Kimseng, VOA Khmer | Washington, DC

“The disease that we endured during the genocidal Khmer Rouge regime cannot be completely healed.”

Click the control below to listen to the audio program:

Click here to download or listen to the audio program in MP3

Cambodians who survived the Khmer Rouge will have to live with the emotional scars of the regime, but staying positive can help them move forward, says Sam Keo a Cambodian psychologist who has written a new book.

“Out of the Dark: Into the Garden of Hope” is an attempt to help Cambodians move past the trauma, he said on “Hello VOA” Monday.

“The disease that we endured during the genocidal Khmer Rouge regime cannot be completely healed,” said Keo, who is a clinical psychologist in Los Angeles. “It stays on. But we can help them work as normal for certain periods of time, until they run into big stresses.”

Past War, Continued Poverty, Add to Mental Illness: Professor

Ka Sunbaunat, a psychiatry professor and dean of the faculty of medicine at the University of Health Sciences, in Phnom Penh, spoke to VOA Khmer recently.

Wednesday, 26 October 2011
Phy Sopheada, VOA Khmer | Washington, DC

"Currently, the main misery of [many] people, who have just recovered from war and violence, is poverty."

[Editor’s note: Mental trauma remains one of the main issues for Cambodia, a legacy of the Khmer Rouge and the country’s conflicts. Ka Sunbaunat, a psychiatry professor and dean of the faculty of medicine at the University of Health Sciences, in Phnom Penh, spoke to VOA Khmer recently. He says the lingering problem should be a top priority in a developing country like Cambodia.]

Cambodians suffered severely during the Khmer Rouge, so how does this affect the people and society today?

Cambodia was at war from 1970 to 1975, and under the Pol Pot regime from 1975 to 1979. The western part of the country continued to suffer by war, and it was not until 1998 that the country was totally at peace. This produces psychological effects, such as anxiety disorder, depression, and post-traumatic stress disorder, in Cambodians who directly suffered during those periods.

Due to the delay of its treatment for years, or even decades, PTSD has become another kind of disease. The symptoms are stomachache, headache, body-ache, depression and high blood pressure. For those who experience depression, they drink alcohol to release their depressed feeling, and this will affect society.

Cambodia's long-ago trauma leaves a 'haunted people'

Relatives of Saroeun Phan, who fled Cambodia, say she could become agitated and fearful, reacting to the sound of gunfire in a video game. (COURTESY OF TONY SUN)

Mental-health providers, citing privacy laws, could not talk about Saroeun Phan, who killed three family members and wounded her daughter on Thursday before committing suicide. But they say the events Phan and the thousands of refugees experienced in Cambodia still haunt them and can exacerbate underlying mental health problems.

September 25, 2010
By Carol M. Ostrom
Seattle Times health reporter

Like thousands of her countrymen, Saroeun Phan fled Cambodia's genocide in the late 1970s, hiking through the jungle for days before reaching Thailand.

She left behind the horror of Pol Pot's Khmer Rouge, which exterminated as many as 3 million people through execution, torture and starvation, forcing many into labor camps.

Local mental-health providers, citing privacy laws, could not talk about Phan, who killed three family members and wounded her daughter on Thursday in her West Seattle home before committing suicide.

But they say the events Phan and thousands of other refugees experienced in Cambodia still haunt them and can exacerbate underlying mental-health problems. And because of a stigma many feel toward mental illness, refugees like Phan often have difficulties seeking help or sticking with treatment.

Family members said Phan, 60, had struggled with depression and schizophrenia for years. They were unsure whether she'd been taking her medication in the past few months.

"I don't think anybody can really appreciate the horror that was Cambodia," said Dr. Carey Jackson, medical director of the international clinic at Harborview Medical Center. Studies showed the average Cambodian refugee family experienced seven traumatic events — more than twice as many as other Southeast Asian refugees — including torture, rape, watching the torture or rape of a loved one, imprisonment and warfare, he said.

"They frequently don't talk about it," said Jackson, an internist. "There's nothing there they're particularly proud of, so they don't pass it on to their kids. They sublimate it; they push it down ...

"They are literally haunted people."

Phan's family members recalled how she would become agitated and fearful, reacting to the sound of gunfire in a video game, thinking someone was trying to kill her.

She was mugged recently on Beacon Hill and became fearful of going out alone, said her husband, Chhoey Sok. She took a self-defense class and learned to shoot a gun, he said.

Cultural differences

Researchers say Cambodian women in particular are at greater risk for developing serious mental-health problems.

"It is reality for many of our community members who have to relive that traumatic situation," said Yoon Joo Han, director of the behavioral health program at Asian Counseling and Referral Service.

For some Cambodians, the Asian counseling center may use nontraditional techniques such as acupuncture or enlisting a shaman, she said. The challenge is made more difficult by the stigma many Southeast Asian refugees feel about mental illness. That, coupled with schizophrenia's very nature, "makes it very hard for our clients to take medication," Han said.

Some of that reluctance is based on history, she said. Many have come from cultures where, in the past, "if you have mental illness, you were taken involuntarily and locked up forever, with no treatment and no rights."

It's more difficult for people from Southeast Asian cultures, she said, to see mental illness in the same way they see physical illness — as something that, if treated, can get better.

"That understanding of mental health needs to happen in our community," she said. "Unless people gain insight to their status and need for the medication, it's always hard to convince people to take medication."

For older people, there's also a certain amount of pride, said Sopha Danh at the White Center Community Development Association. "They think they should be wiser than to have such problems," she said.

Phan had received some type of care at Harborview Medical Center, but she hadn't been seen there for about seven years. The family last week was unable to share any details about her recent treatment.

"Very difficult" for elders

Mental-health providers also said modern life is difficult for Cambodian elders, even without diagnosed mental illness. While older people are respected in traditional Cambodian culture for their wisdom, older refugees who resettle often find themselves lost in their new life.

The farming skills they once mastered — reading the wind and weather — aren't helpful in a new and foreign urban environment.

"All the things that they knew were useless here," Han said. "The family is broken down. It is very, very difficult."

Here, many refugees also face financial hardships that make it difficult to get treatment or medication. Mental-health providers said all services are squeezed by budget cuts and the many people seeking treatment.

When an illness causes a patient to begin skipping medication and other help, intensive follow-up is needed, said Jackson, of Harborview Medical Center.

"Those services are eroding," he said. "It's harder in the community to get both primary care and mental-health services for the chronically mentally ill. There are a limited number of providers and limited numbers of resources for managing issues of language and culture."

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com

Information from Seattle Times reporters Lynn Thompson and Christine Clarridge is used in this report.

Khmer Rouge Tribunal indictment after 31 years

This combination shows file photos of four top surviving leaders of the Khmer Rouge regime. From left to right: Nuon Chea, 84, the group's ideologist; former head of state and public face of the regime, Khieu Samphan, 79; former Foreign Minister Ieng Sary; and his wife Ieng Thirith, ex-minister for social affairs, both in their 80s. Photo: AP

Phnom Penh, September 18, 2010
Parvathi Menon
The Hindu

The indictment pronounced by the Co-Investigation judges of the Khmer Rouge Tribunal against former Khmer Rouge leaders comes 31 years after the fall of the regime, and 12 years after its military and political structures were finally dismantled

The indictment pronounced by the Co-Investigation judges of the Khmer Rouge Tribunal against former Khmer Rouge head of state Khieu Samphan, Foreign Minister leng Sary, Social Action minister Ieng Thirith (wife of Ieng Sary and sister-in-law of Pol Pot), and Nuon Chea (known as Brother No. 2 in the Khmer Rouge hierarchy) comes 31 years after the fall of the regime, and 12 years after its military and political structures were finally dismantled. Kaing Guek Eav, alias Duch, the notorious head of the S-21 prison was tried and convicted separately by the Tribunal on 26 July 2010.

Their crimes include extermination, murder, enslavement, deportation (of Vietnamese people), imprisonment, torture and persecution on political, racial and religious grounds, rape, and other inhumane acts. According to the Extraordinary Chambers in the Courts of Cambodia (ECCC) between 1.7 and 2.2 million people died under the Khmer Rouge regime, and around 800,000 of these were violent deaths.

It is a phase of Cambodian history that has passed an entire generation of young Cambodians by. They know of it only through their parents, and memorials like the Tuol Sleng Genocide Museum in Phnom Penh where the chilling history of that period is brought to life. The innocuous school building in which classrooms became torture chambers, and where 17,000 Cambodians were killed, is today a place where that past is relived.

“There are mixed feeling towards this trial,” said a judge from the Asian region who is on the Supreme Court Chamber of the Tribunal, known as the Extraordinary Chambers in the Courts of Cambodia for the Prosecution of Crimes Committed during the Period of Democratic Kampuchea. “Some people want justice, others do not want to rekindle the past. The procedures followed by the Tribunal is based on the French legal system which makes it very slow, and will prosecute only the “most guilty”.”

Unforgettable mental trauma

Kay Kimsong, Editor-in-Chief of the Phnom Penh Post dismisses the view that time has erased collective memory. “There is a great deal of public and media interest in the cases,” he said. “Justice may be delayed but this trial is very important for the Cambodian people. Many young people cannot believe what their parents tell them, but here is documentation and evidence, here is Duch confessing to his crimes. My parents and everyone in their generation lost one or more family members, everyone suffered acute mental trauma. They can never forget.”

The ECCC was established in 2001 by a law passed by the Cambodian National Assembly. On Cambodia’s request, the United Nations agreed to participate, and the ECCC became fully functional in 2007. The five-tier tribunal has both national and international prosecutors and judges.

The ECCC is only prosecuting the top leaders of the Khmer Rouge, those who planned and gave orders and who are guilty of the most serious crimes. Of this group, Pol Pot and Ta Mok are dead, and the rest are old and frail.

The court’s second trial is likely to take place in the first half of next year, giving rise to fears that the accused may not survive that long. “Cambodians want the courts to move faster,” said Mr. Kimsong. “The prisoners have been getting excellent treatment and good medical care in custody. We want to hear them speak and defend themselves, we want to know what went on behind the scenes.”

Cambodia's dark past clouds minds

A young boy sits next to the body of former Khmer Rouge military chief Ta Mok after it was brought to the northern Cambodian city of Anlong Veng, July 22, 2006. Though only about a third of the 14 million Cambodians alive today lived through the Khmer Rouge, its dark legacy still affects the population at large. (Chor Sokunthea/Reuters)

One of the worst mental health crises in Asia gets precious little attention and money.

March 18, 2010
By Aubrey Belford
Special to GlobalPost

PHNOM PENH, Cambodia — Psychiatrist Sotheara Chhim has given more thought than most to the mental burdens carried by Cambodians.

Pointing to a glass of water on his table, he describes how the legacy of decades marred by war, genocide and enduring poverty still help push so many here over the edge.

“I think every Cambodian is like a glass carrying some water, meaning the traumatic past,” he said. “If more water is put in, the glass fills easier than an empty glass.”

In many ways Cambodia appears to have turned a corner from its dark past, with big cities booming and millions of foreign tourists visiting the country every year. A flood of foreign aid has even seen scourges such as HIV/AIDS finally under control and uneven progress made against poverty.

Cambodia, however, labors under the burden of one of Asia’s worst mental health crises, driven by the ghosts of its history and the stresses of living in a rapidly changing but still desperately deprived country. And unlike so many other problems in a country flooded with foreign NGOs and international organizations, the issue gets little outside attention, and precious little money.

Comprehensive figures are thin on the ground, but those that are out there point to a grim situation. A study by the Holland-based Transcultural Psychosocial Organization (TPO) found 35 percent of Cambodians suffer from some kind of psychiatric problem and 45 percent suffer from “psychosocial problems” — a broad term embracing everything from grief to stunted emotional development.

At the same time, the country suffers from a dearth of treatment. Only 1 percent of the government’s health budget goes to mental health and only 0.1 percent of the population access mental health services every year.

Cambodia is home to 14 million people, 5 million of whom are survivors of the 1975-1979 reign of the Khmer Rouge, in which up to 2 million died. For that whole population, there are only about 40 psychiatrists, and only around 10 of them outside of the capital.

The results can be seen in Cambodia’s impoverished villages, where the severely mentally ill are often found tethered and caged in hidden recesses beneath stilt houses.

Kevin Conroy, an American Catholic priest who teaches psychology at the Royal University of Phnom Penh, carries in his cell phone the photo of one such woman, a 45-year-old recently found north of the capital.

“It was the smell of urine, feces, all that stuff. That’s the part you don’t get from the picture, it’s the smell that’s there,” Conroy said.

“It sounds inhumane in some ways to people but, in a way, what other alternatives do the people have for somebody that’s having difficulties, screaming and running around and things like that? There’s not a treatment center for people like that,” he said.

Even when there is treatment, many Cambodians rarely seek it out, opting instead for temples and traditional healers.

“There’s a stigma in Cambodian society. If someone talks to a counselor or goes to a psychologist or psychiatrist, [then people say] ‘Oh he’s crazy, what’s wrong with him?’” said Sathya Pholy, a counselor at the Phnom Penh Counseling Center, a service run mostly by, and for, foreigners.

Apart from stigma there is also the fact that most Cambodians don’t see mental health through the prism of Western science. It’s a factor that cuts both ways, affecting both when and how Cambodians see themselves as sick and the effectiveness of treatments developed to deal with illnesses — from schizophrenia to depression — originally defined in a Western cultural context.

“[Cambodian culture’s conception of mental illness] goes back to animism and Buddhism and Hinduism, where most illnesses come from the unbalance of the wind, the soil, the fire and the water,” Sathya Pholy said.

“Also, if you offended the spirits of the mountains or of the trees, then the spirit will try to get you back, have revenge, make you sick.”

Amid such a grim situation, most of the burden of treatment falls on foreign-funded NGOs. Even the government, which aims to train 10 new psychiatrists every year, freely admits it relies on foreign funding.

The global recession, and the relative obscurity of mental health issues, means much of that money is drying up. Sotheara Chhim, who runs TPO’s local affiliate doing mobile outreach in Cambodia’s villages, said funding cuts from donors including the Dutch government forced him to fire 50 staff members late last year.

“I think mental health gets less attention, gets left behind in Cambodia,” he said with visible exasperation.

“There is no funding, I think, I don’t know why. The government has no funding and not many donors are interested in mental health.

“If I try to get funding from donors to provide mental health services, no one will give it.”

Cambodians testify for war crimes tribunal

In this photo taken Friday, Sept. 18, 2009, Leakhena Nou, left, a Cambodian-American sociology professor at Cal State Long Beach, comforts Roth Prom, 63, during a workshop at the United Cambodian Community Center in Long Beach, Calif. Prom, is one of dozens of Cambodian refugees across the U.S. who are sharing their memories of Khmer Rouge atrocities with a legal team so they can be used as evidence in an international war crimes tribunal underway in Phnom Penh. (AP Photo/Damian Dovarganes)
In this photo taken Friday, Sept. 18, 2009, Cambodian-American Sam Oeun York ,71, whose husband was killed by the Khmer Rouge, tells participants at a Long Beach, Calif., workshop how she survived the atrocities in Cambodia. York is one of dozens of Cambodian refugees speaking publicly _ many for the first time _ about Khmer Rouge atrocities so a legal team can use their testimony in an international war crimes tribunal underway in Phnom Penh, the Cambodian capital. (AP Photo/Damian Dovarganes)
In this photo taken Friday, Sept. 18, 2009, Cambodian-American Nhen Chheng, 70, who survived the rath of the Khmer Rouge, wipes tears away as she recalls her experiences to other survivors during a workshop in Long Beach, Calif. Prom is one of dozens of Cambodian refugees across the U.S. who are sharing their memories of Khmer Rouge atrocities with a legal team so they can be used as evidence in an international war crimes tribunal underway in Phnom Penh. (AP Photo/Damian Dovarganes)
In this photo taken Friday, Sept. 18, 2009, Cambodian-American Chorn Van wipes away tears as she listens to Khmer Rouge survivors document their stories of war crimes to others during a workshop in Long Beach, Calif. Van is one of the many Cambodian refugees across the U.S. who are sharing their memories of Khmer Rouge atrocities with a legal team so they can be used as evidence in an international war crimes tribunal underway in Phnom Penh. (AP Photo/Damian Dovarganes)
In this photo taken Friday, Sept. 18, 2009, Cambodian-Americans Rany Ork, left, and Chanthan Pich, foreground, who survived the wrath of the Khmer Rouge, wipe tears from their eyes during a workshop in Long Beach, Calif. The two survivors are some of the many Cambodian refugees across the U.S. who are sharing their memories of Khmer Rouge atrocities with a legal team so they can be used as evidence in an international war crimes tribunal underway in Phnom Penh. (AP Photo/Damian Dovarganes)

Saturday, September 26, 2009
By GILLIAN FLACCUS
AP

LONG BEACH, Calif. — The tiny Cambodian woman trembled slightly and stared blankly ahead as she told the story that has haunted her for half a lifetime: her parents and brother died in Khmer Rouge labor camps. Her baby perished in a refugee camp.

Roth Prom has wanted to die every day since and had never spoken those words so publicly until last week, when five minutes became the chance for justice she has longed for silently for so many years.

"I'm depressed in my head, I'm depressed in my stomach and in my heart. I have no hope in my body, I have nothing to live for," she said quietly. "All I have is just my bare hands."

As the tiny woman in the polka dot blouse slipped back to her seat, many of the nearly two dozen other Cambodian refugees in the room began to weep. They know Prom's pain. They were all there to tell stories just like hers.

Prom, 63, is one of dozens of Cambodian refugees speaking publicly — many for the first time — about Khmer Rouge atrocities so a legal team can use their testimony in an international war crimes tribunal underway in Phnom Penh, the Cambodian capital.

From Virginia to California, refugees have spent the past few months pouring out long-suppressed memories to volunteers who fill notebooks with reports of gang rapes, execution, starvation, forced labor and brutal beatings. They attach names of dead relatives, sometimes a half-dozen per person, and scrawl out names of labor camps and far-flung villages where they lived for years on the edge of starvation.

The Khmer Rouge is implicated in wiping out an estimated 1.7 million Cambodians, nearly a quarter of the population, during their rule from 1975-79 under Pol Pot. People died from disease, overwork, starvation and execution in the notorious "killing fields."

Cambodians who fled their homeland decades ago relish the chance to participate in the war crimes trials unfolding thousands of miles away. The tribunal, a joint court created by the Cambodian government and the United Nations, allows Khmer Rouge victims to participate as witnesses, complainants and civil parties.

Depending on the stories, the accuracy of their memories and their own willingness to participate, survivors could be called to testify for the prosecution or defense and those filing as civil parties could be entitled to reparations. At a minimum, all filings will be archived and reviewed by those collecting testimony from survivors.

Leakhena Nou, the Cambodian-American sociology professor at Cal State Long Beach organizing the U.S. workshops, said submitting evidence forms is cathartic for victims who have often kept their trauma secret from spouses and American-born children. Many suffer from post-traumatic stress and have symptoms of severe depression, including memory loss, flashbacks and suicidal thoughts.

"They have a sense of powerlessness, but they have a lot more power than they realize," said Nou, founder of the Applied Social Research Institute of Cambodia. "Most of them have not even talked about it for 30 years. They've been silent for so long."

Last week, testimony in Phnom Penh concluded in the trial of Kaing Guek Eav, who commanded the S-21 prison where up to 16,000 people were tortured and killed. Eav, also known as Duch, was the first to go before the tribunal and is charged with crimes against humanity, war crimes, murder and torture. More than 23,000 visitors attended his trial, which continues in November with closing arguments.

Four other senior Khmer Rouge leaders are in custody awaiting trial set for January. Any testimony submitted by the end of the year can be used by prosecutors to bolster those cases.

The U.N. and Cambodian branches of the tribunal did not respond to e-mailed requests for comment.

Grassroots organizers with backing from the Asian Pacific American Institute at New York University have been building trust within the Cambodian-American communities for nearly two years but still expected many to shun the process out of fear and suspicion. Some victims believe the tribunal is run by the Khmer Rouge, while others fear if they speak out they could endanger relatives still living in Cambodia.

But Nou said turnout has been high, with some people even traveling from Arizona to share stories at the Southern California workshops held at a Cambodian community center.

"Before, they assumed that no one wanted to listen to them," she said. "They'll say, 'We thought that no one cared, that no one wanted to listen. But now that I know people want to listen, I have nothing else to lose. I've lost everything else already.'"

So far, the team has collected more than 100 statements from Cambodian expatriates at workshops in Virginia, Maryland, Orange County and Long Beach — home to the largest Cambodian ex-pat population. Future sessions are planned this fall in Oregon, Northern California, Massachusetts and Pennsylvania.

They've uncovered chilling stories along the way.

One woman in Long Beach told of being gang-raped from dawn to dusk by Khmer Rouge cadres while 6 1/2 months pregnant. She never told her husband and only came forward last week because he had passed away.

Another recalled being held at gunpoint with her brother and being forced to watch as her father was executed and then disemboweled, his heart, liver and stomach ripped out by soldiers. The woman, now in her 50s, told the story to a volunteer in three distinct "spirit voices," as if to detach herself from the painful memories.

For Prom, the recent workshop in Little Cambodia was a chance to honor the memory of her loved ones — and to get justice for the brutal crimes that ruined her life and so many others. The Khmer Rouge split up her family, she was forced to pull a plow through rice paddies like an ox and her child died later in a refugee camp.

Prom harbors thoughts of killing herself and suffers from memory loss. She's terrified of the night — the time when Khmer Rouge soldiers would take neighbors away without explanation, never to be seen again.

"I try to forget, but it's hard to forget," Prom told a translator who dictated it to a volunteer law student. Prom had already penciled her story on paper in the rolling script of her native Khmer.

"I want to find justice for myself and for the Cambodian people," she said. "I'm here to teach history to the next generation, so this horrific crime will never happen again."

On the Net:
Extraordinary Chambers in the Courts of Cambodia: http://www.eccc.gov.kh/english
Asian Pacific American Institute at New York University: http://nyu-apastudies.org/new/index.php

A Quarter of Adults Suffer Lasting Trauma: Doctor

By Men Kimseng, VOA Khmer
Washington
07 September 2009

Click here to listen to the audio program in Khmer

Around 23 percent of Cambodian adults suffer from stress disorders related to trauma experienced under the Khmer Rouge, a psychiatrist told “Hello VOA” Thursday.

Muny Sothara, a technical advisor at the Transcultural Psycho-social Organization, said the Khmer Rouge continues to have an impact on Cambodian society, families and individuals.

“The impacts either directly or indirectly still exist until the present,” he said.

A number of factors can help, he said, including receiving a sense of justice, finding employment, education, and living in an environment free from fear. Social support networks too can help survivors recover from their trauma, he said.

Asked whether the UN-backed Khmer Rouge tribunal might bring justice to survivors, Muny Sothara said if the court “ultimately finds justice… subsequently the justice will help in the healing process.”

Children of Trauma Face Their Own Struggles

Welfar of children By Nuch Sarita, VOA Khmer
Original report from Washington
31 August 2009

According to studies, children of holocaust survivors have reported feeling lonely, confused and burdened by their parent’s trauma, due to communication that is often avoided in lieu of reliving horrific events. Studies also indicate that children of survivor families are more likely to develop depression, anxiety and low self-esteem.

Kara Uy is a domestic violence counselor at the Asian Woman’s Home, in Santa Clara county, California. She said recently that more than half of school-aged children in domestic violence shelters show clinical levels of anxiety or post-traumatic stress disorder.

“Without treatment, these children are at significant risk for delinquency, substance abuse, school drop-out, and difficulties in their own relationships,” the Cambodian American social worker told VOA Khmer at her office in San Jose.

As a family counselor at a residential domestic violence shelter and an active volunteer in the community, Kara Uy has worked with many families from all walks of life, under many circumstances.

“The pattern that I see most prevalent among these families is the cycle of domestic violence that stems from psychological and environmental factors,’’ she said. “I think almost all survivors that I’ve worked with have expressed that their mother or primary guardian raised them in an environment where abuse was tolerated. And many have also conveyed the deep-rooted affects of impaired self-esteem, anxiety and also depression. With domestic violence victims that I work with, many have mentioned that they’ve noticed unhealthy patterns of behaviors in their own children.”

While many sons were emulating abusive behaviors of their fathers, daughters began to relate to them with alarming ease, she said. Studies show that 50 percent of boys raised in abusive homes become abusive themselves, but 60 percent of girls become victims themselves.

“Children may exhibit a wide range of reactions to exposure to violence in their home,” said Vinita Kylin, Cambodian liaison for Franklin McKinley School District in Santa Clara. “Younger children do not understand the meaning of the abuse they observe and tend to believe that they must have done something wrong.”

Self-blame can precipitate feelings of guilt, worry and anxiety. Children, especially younger children, typically do not have the ability to adequately express their feelings verbally. Consequently, the manifestation of their emotions is often behavioral. Children may become withdrawn and non-verbal and exhibit regressed behaviors, such as clinging and whining. Eating and sleeping difficulty, concentration problems, generalized anxiety, and physical complaints such as headaches are all common.

“The pre-adolescent child typically has a greater ability to externalize negative emotions,” Reaksmie Om, a case manager for domestic violence programs in Long Beach, Calif., said. “In addition to symptoms commonly seen with childhood anxiety, sleep problems, eating disturbances and nightmares, victims within this age group may show a loss of interest in social activities, low self-concept, rebelliousness and oppositional-defiant behavior in the school settings.”

It is also common to observe bad temper, irritability, frequent fighting at school or between siblings, lashing out at objects, threatening of siblings with violence, and attempts to gain attention through hitting and kicking.

Incidentally, girls are more likely to exhibit withdrawal and, unfortunately, run the risk of being missed as a child in need of support.

“Adolescents are at risk of academic failure, school drop-out, delinquency, and substance abuse,” said Sony Pream, a domestic violence program coordinator in Long Beach. “Some investigators have suggested that a history of family violence or abuse is the most significant difference between delinquent and non-delinquent youth.”

For some children questions about home life may be difficult to answer, especially if the individual has been warned or threatened by a family member to refrain from talking to teachers about events that have taken place in the family when there is suggestion of domestic violence with a student, consider involving the school psychologist, social worker, guidance counselor and/or a school administrator.

“Although the circumstances surrounding each case may vary, suspicion of child abuse is required to be reported to the local child protection agency by teachers and other school personnel,” Vinita added. “In some cases, a contact with the local police department may also be necessary. When in doubt, consult with school team members.”

Children exposed to domestic violence often suffer psychological and behavioral difficulties that if left untreated can severely impact their lives and may ultimately result in the perpetuating of an intergenerational cycle of violence. With help, many children can be saved from a downward spiral. Community leaders, particularly police chiefs and mental health service directors, must help.

Kara Uy said working with diverse groups and helping people rebuild lives free of violence has prepared her to be adaptive and versatile. And she said such appalling statistics have really stirred her interests in a possible doctoral dissertation focusing on disorders in children raised in unstable environments and in families with a history of trauma, which is very common in Cambodian community because many suffered from the Khmer Rouge period and the war.

Cambodians Still Traumatized

Former Khmer Rouge prison commander, Kaing Guek Eav (C), sits in the Extraordinary Chamber in the Courts of Cambodia in Phnom Penh, Feb. 17, 2009. (AFP)

2009-08-27
Radio Free Asia

Will the long-awaited trial of Khmer Rouge leaders ease Cambodians' trauma, or stir painful memories?

PHNOM PENH—A Cambodian psychiatrist has testified at the trial of a confessed Khmer Rouge torturer that up to 40 percent of Cambodians suffer psychological trouble as a result of the faction’s brutal four-year rule.

“According to research conducted after the Khmer Rouge period, two out of five Cambodians have [suffered] mental problems and psychosocial crises. This figure is high—up to 40 percent” of the population, Chhim Sotheara said.

Studies this year also found that some 14 percent of Cambodians aged 18 and older have suffered post-traumatic stress disorder (PTSD), Chhim Sotheara testified at the trial of Kaing Guek Eav, alias Duch, who commanded a Khmer Rouge torture center when the group was in power from 1975-79.

“During the Khmer Rouge regime, people were trained not to trust each other. This has continued among Cambodians today,” said Chhim Sotheara, of the Transcultural Psychosocial Organization, which promotes community mental health programs,

He added that Duch’s trial offers a chance for Khmer Rouge victims to heal through the administration of justice.

Painful memories

The Journal of the American Medical Association this month published new research by experts at the University of North Carolina that found most Cambodians feared the tribunal would stir up painful memories.

Those who most wanted revenge were also likely to suffer PTSD, they wrote.

Some 87.2 percent of Cambodians 35 or older believed trying Khmer Rouge leaders would stir painful memories, they found, adding, "Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health."

Duch is the first of five senior Khmer Rouge figures scheduled to face long-delayed trials and the only one to acknowledge responsibility for his actions. His trial, which started in March, is expected to finish before the end of the year.

He could face life imprisonment. Cambodia has no death penalty.

Original reporting by Leng Maly for RFA’s Khmer service. Translated by Sothea Thai. Khmer service director: Sos Kem. Executive producer: Susan Lavery. Written and produced in English by Sarah Jackson-Han.

The Khmer Rouge Tribunal: the start of a very long reconciliation process?

Kambol (Phnom Penh, Cambodia). 25/08/2009: Sotheara Chhim, psychiatrist, during his testimony on a screen in the press room on Day 64 in Duch’s trial at the ECCC 
(Photo: John Vink/ Magnum)

25-08-2009
By Stéphanie Gée
Ka-set

Sotheara Chhim, Cambodian psychiatrist and director of the Phnom Penh based organisation TPO (Transcultural Psychosocial Organization), was heard as an expert on Tuesday August 25th. A testimony that was necessary to assess the trauma of the victims of the Khmer Rouge in the Cambodian society and its impact, both individual and collective. Unfortunately, the interpretation struggled, as some of the doctor’s answers were cut and the technical vocabulary was confused. The expert explained how the Khmer Rouge Tribunal could represent a starting point for healing and reconciliation and believed this process must be completed by another – later – mechanism on reparation.

The Khmer Rouge’s work of destruction

Dr Sotheara Chhim started by painting a very dark picture of the social situation under the Khmer Rouge, marked by a climate of distrust and fear resulting from a people categorisation in particular, the destruction of Khmer culture and its religious foundations, the ban on the freedom to worship decided by the new rulers of the country, keen to erase the past. “Cambodians thus suffered a massive psychological impact. People used their beliefs as a basis to solve their problems and confer a meaning and logical explanation to what happened around them. But the destruction of these beliefs resulted in a psychological deficit. So, when they encountered a problem, people could no longer find any solution. The Khmer Rouge did not allow them to pay tribute as they were taught by tradition or to practice their religion. The Khmer Rouge also forced families to separate. 
Children were taken away from their parents. While at a young age, they need their parents’ love, they were deprived of it. In addition, people were tortured, deprived of food, and this also contributed to the trauma. […] [Children] were also forced to spy on their own parents and some of them even killed them. This experience left a more than bitter taste in the mouth of these children, because the Khmer Rouge destroyed the health of each of these beings by forcing them to work excessively and not giving them decent enough accommodation. Also, there was the state of constant fear in which people used to live, over a long period of time.”

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Tribunal Will Help Treat Victims: Psychiatrist

By Chun Sakada, VOA Khmer
Original report from Phnom Penh
25 August 2009

Cambodian psychiatrist Chhim Sotheara told the judges at a UN-back tribunal Tuesday that the trial of senior members of the regime will help treat mental wounds of the survivors of the regime.

The doctor was called as a witness in the trial of Duch, who is charged atrocity crimes allegedly committed when he ran two infamous Khmer Rouge prisons and an execution site on the outskirts of Phnom Penh.

“The victims from S-21 are still suffering, remembering the past killings and torture, having nightmares and depression, and difficulties of this lack of recovery affects their current living,” Chhim Sotheara said, referring to Tuol Sleng prison by its Khmer Rouge nomenclature.

Two out of five Cambodians suffer psychiatric problems as a result of the Khmer Rouge, Chhim Sotheara said.

“Our victims have suffered from various psychiatric problems, such as [post traumatic stress disorder], depression, pressure, bodily suffering and other troubles, including high blood pressure, chronic disease and diabetes, concerning the killing and torture by the Khmer Rouge,” he said.

“The trials can reduce the depression of the victims,” he said. “The recovery of psychiatric conditions of the victims of the Khmer Rouge depends on the loyalty of the accused, the former senior Khmer Rouge leaders to come out. The knowledge of facts, the acceptance of real justice and apologies are important factors helping treat the conditions of the victims.”

Duch, 66, whose real name is Kaing Kek Iev, faces charges of war crimes, crimes against humanity, torture and murder. Prosecutors say 12,380 people died in his prisons.

Duch told tribunal judges Tuesday he was “completely responsible” for psychological problems brought on by practices of the Khmer Rouge.

Psychiatrist says Khmer Rouge trial can help heal

2009-08-25
By SOPHENG CHEANG
Associated Press

A psychiatrist testified Tuesday that prosecuting the former leaders of Cambodia's Khmer Rouge can help ease the mental trauma of hundreds of thousands of victims who suffered under the brutal communist regime three decades ago.

Dr. Chhim Sotheara of the Transcultural Psychosocial Organization _ which promotes community mental health programs _ testified at the trial of Kaing Guek Eav, also known as Duch, who commanded a Khmer Rouge torture center when the group was in power from 1975-79.

A U.N.-assisted genocide tribunal is seeking justice for the estimated 1.7 million people who died in Cambodia from execution, overwork, disease and malnutrition as a result of the regime's radical policies.

Chhim Sotheara said according to his research, 14 percent of Cambodians, or about 800,000 people, suffer from post-traumatic stress disorder related to the Khmer Rouge's rule. The destruction of families and communities deprived people of their traditional pillars of psychological support, he said.

"The trial of the former Khmer Rouge leaders is an opportunity for the victims who had suffered and who have been traumatized for many years to overcome their trauma through justice," Chhim Sotheara told the tribunal.

He said the government should also hold public reconciliation forums to help heal the victims' pain.

Asked for comment by the judges, Duch (pronounced DOIK) agreed that people's psychological damage remained a problem.

"The consequences are tremendous and extensive and long-lasting. Even at this time, the consequences are still ongoing," Duch told the tribunal.

Duch is the first of five senior Khmer Rouge figures scheduled to face long-delayed trials and the only one to acknowledge responsibility for his actions. His trial, which started in March, is expected to finish before the end of the year.

He could face a maximum penalty of life imprisonment. Cambodia has no death penalty.

KRouge trial can help trauma

Aug 25, 2009
AFP

PHNOM PENH - THE trial of Khmer Rouge leaders is a chance for the regime's victims to overcome their lingering trauma, a psychological expert told Cambodia's UN-backed tribunal on Tuesday.

Dr Chhim Sotheara was testifying at the trial of Duch, whose real name is Kaing Guek Eav and who stands accused of overseeing the torture and execution of roughly 15,000 people at Tuol Sleng prison during the regime's 1975-79 rule.

But the expert, who is director of Cambodia's Transcultural Psycho-social Organisation, noted that the victims' trauma seemed to reoccur after they observed the court proceedings.

The denial by some Khmer Rouge leaders of their roles in the atrocities also created more pain for the victims, he said.

Dr Sotheara said that people were traumatised throughout the nation after the Khmer Rouge destroyed the country's infrastructure and created an 'environment of fear'.

He told the court that Cambodians could cope with their three-decade-old trauma only when justice had been served and the truth behind regime was revealed.

'The trial of the former leaders of the Khmer Rouge is an opportunity for the victims who have suffered and who have been traumatised for many years to overcome their trauma through justice,' he said.

'It will be very helpful to heal the wounds, the suffering of those victims,' he added.

Dr Sotheara told the court that for every five Cambodians, two had developed trauma, while 14 percent of country's population aged over 18 had experienced post-traumatic stress disorder.

Led by Pol Pot, who died in 1998, the Khmer Rouge emptied Cambodia's cities in a bid to forge an agrarian utopia, resulting in the deaths of up to two million people from starvation, overwork and torture.

Several senior officials from the regime face trial.

Cambodians unsure tribunals will heal wounds of mass killings, JAMA study suggests

Source: Washington U. in St Louis (USA)

Aug. 21, 2009 -- Lessons learned from research into the societal effects of post-Apartheid "truth and reconciliation" hearings in South Africa are now being applied to a U.S. National Institute of Peace-sponsored study of the long-term mental health impact on Cambodians from human rights tribunals targeting the killing of millions by the nation's former Khmer Rouge regime, says James L. Gibson, Ph.D., a professor of political science at Washington University in St. Louis and co-author of a study published Aug. 6 in the Journal of the American Medical Association (JAMA).

"This study is a collaboration between medical people, who are interested in problems like PTSD (posttraumatic stress disorder), and political scientists, such as me, who are interested in transitional justice," Gibson explains. "This initial paper focuses on PTSD, but the larger project (funded by a grant from the National Institutes of Health) addresses as well the question of whether the tribunal will create a collective memory in Cambodia and whether that memory will lead to some degree of reconciliation, both with each other and with the past."

Gibson, the Sidney W. Souers Professor of Government in Arts & Sciences at Washington University and a Fellow of the Centre for Comparative and International Politics and Professor Extraordinary in Political Science at Stellenbosch University in South Africa, is the author of "Overcoming Apartheid: Can Truth Reconcile a Divided Nation?" (2004, Russell Sage Foundation). He's been in South Africa this summer conducting further research on issues related to the truth and reconciliation process.

The JAMA study, which Gibson describes as "preliminary to our large, NIH-funded panel survey on the tribunal," explores a central medical question: As leaders of the former Khmer Rouge regime testify in a human rights tribunal, in harrowing detail, for the killing of more than a million Cambodians from 1975 to 1979, will the trials help a society heal or exacerbate the lingering affects of widespread trauma?

The study offers insight, but sustains the paradox: more than 75 percent of Cambodians believe the Khmer Rouge trials, formally called the Extraordinary Chambers in the Courts of Cambodia, will provide justice and promote reconciliation, but more than 87 percent of people old enough to remember the torture and murder during the Khmer Rouge era say the trials will rekindle "painful memories."

"Cambodians have high hopes that the Khmer Rouge trials will deliver justice. However, they also have great fears of revisiting the past," says Jeffrey Sonis, M.D., M.P.H., an assistant professor in the departments of Social Medicine and Family Medicine at the University of North Carolina at Chapel Hill School of Medicine, lead author of the JAMA study. "We just don't know how tribunals affect a society, whether they increase mental and physical disabilities or relieve them," Sonis says.

Sonis, Gibson and their colleagues are now conducting a longitudinal study, funded by the National Institute of Mental Health, to measure the effects of the trials on Cambodians over time.

Preparation for the trials, cosponsored by the Cambodian government and the United Nations, began in 2006, 26 years after the collapse of the Khmer Rouge under its leader, Pol Pot. The first public trial, of Kaing Guek Eav, leader of the notorious Tuol Sleng prison, where thousands were tortured and killed, began earlier this year. Accounts of the genocide estimate between one million and two million people were killed to create an "agrarian collectivism," a communist concept for an ideal society.

Between December 2006 and August 2007, Sonis, Gibson, and an international team of colleagues, including researchers from the Center for Advanced Study in Phnom Penh, conducted a national survey of more than 1,000 Cambodians age 18 and older; 813 were 35 and older and would have been at least 3 years old when the killings began.

Other co-authors on the JAMA study include Joop T. V. M. de Jong, M.D., Ph.D., a professor of cultural and international psychiatry at Vrije Universiteit Medical Center, Amsterdam; Nigel P. Field, Ph.D., professor at the Pacific Graduate School of Psychology; Sokhom Hean, Ph.D., president of Center for Advanced Study, Phnom Penh, Cambodia; Ivan Komproe, Ph.D., of HealthNet TPO, Amsterdam.

More than 14 percent of respondents over age 35, and 7.9 percent of people 18 to 35, suffered from "probable PTSD" (respondents met the criteria for PTSD on a common questionnaire, but did not receive an official clinical diagnosis), which resulted in significant rates of mental and physical disabilities. Previous studies have reported higher rates of PTSD in Cambodians, but were mostly conducted among Cambodia refugees, an atypical population. The rate (11 percent) of probable PTSD among all Cambodians over the age of 18 was more than 5 times the rate among U.S. adults, based on the National Comorbidity Survey.

Among the older group, half said they were close to death during the Khmer Rouge era and 31 percent reported physical or mental torture.

Respondents who did not believe justice had been served, up to the time of the survey, and those who felt the need for revenge were more likely to have PTSD. Also, people who had more knowledge of the trial had higher rates of PTSD. Yet most Cambodians had highly positive attitudes about the trials.

Another paradox emerged from the respondents: Almost half of the respondents in this overwhelmingly Buddhist country thought the trials "go against the teachings of Buddha." However, when asked about attitudes toward the Khmer Rouge, 63 percent of respondents strongly agreed, and 21 percent agreed with the statement, "I would like to make them suffer."

Tribunals to assess crimes of war and crimes against humanity are becoming more common. In June, Charles Taylor, former president of Liberia, answered questions in an international courtroom in Paris about his alleged role in genocide in Sierra Leone in the 1990s. The International Criminal Tribunal for the Former Yugoslavia, a UN-sponsored trial, has been underway since 1993 and the International Criminal Tribunal for Rwanda since 1995. The Nuremberg Trials is perhaps the most well known.

The Khmer Rouge trials offer the opportunity to better gauge the efficacy of these trials, and those lessons hold relevance across a spectrum of injustice. Sonis, Gibson, and their colleagues interviewed 1800 people earlier this year and will re-interview them this fall and again next year. They are currently at work analyzing the first-wave data.

"The larger question raised by our study is whether attempts to promote justice for survivors of violence — whether en masse or inflicted by one individual to another — can help lessen its psychological toll," Sonis says. "We simply don't know the answers yet."
# # #
Editor's Note: This release includes material provided by the news office of the University of North Carolina. For media assistance there, contact Media contact: Clinton Colmenares, (919) 966-8757, ccolmena@unch.unc.edu.

Khmer Rouge trials - will they heal or exacerbate affects of trauma

5 August 2009
News-Medical.net

As leaders of the former Khmer Rouge regime testify in a human rights tribunal, in harrowing detail, for the killing of more than a million Cambodians from 1975 to 1979 a central medical question remains unanswered: will the trials help a society heal or exacerbate the lingering affects of widespread trauma?

A new study offers insight, but sustains the paradox: more than 75 percent of Cambodians believe the Khmer Rouge trials, formally called the Extraordinary Chambers in the Courts of Cambodia, will provide justice and promote reconciliation, but more than 87 percent of people old enough to remember the torture and murder during the Khmer Rouge era say the trials will rekindle "painful memories."

"Cambodians have high hopes that the Khmer Rouge trials will deliver justice. However, they also have great fears of revisiting the past," says Jeffrey Sonis, M.D., MPH, an assistant professor in the departments of Social Medicine and Family Medicine at the University of North Carolina at Chapel Hill School of Medicine, lead author of the study that appears in the Aug. 6 issue of the Journal of the American Medical Association.

"We just don't know how tribunals affect a society, whether they increase mental and physical disabilities or relieve them," Sonis says. Sonis and colleagues are now conducting a longitudinal study, funded by the National Institute of Mental Health, to measure the effects of the trials on Cambodians over time.

Preparation for the trials, co-sponsored by the Cambodian government and the United Nations, began in 2006, 26 years after the collapse of the Khmer Rouge under its leader, Pol Pot. The first public trial, of Kaing Guek Eav, leader of the notorious Tuol Sleng prison, where thousands were tortured and killed, began earlier this year. Accounts of the genocide estimate between 1 million and 2 million people were killed to create an "agrarian collectivism" a communist concept for an ideal society.

Between December 2006 and August 2007 Sonis and an international team of colleagues, including researchers from the Center for Advanced Study in Phnom Penh, conducted a national survey of more than 1,000 Cambodians age 18 and older; 813 were 35 and older and would have been at least 3 years old when the killings began.

More than 14 percent of respondents over age 35, and 7.9 percent of people 18 to 35, suffered from "probable PTSD" (respondents met criteria on a common questionnaire, but did not receive an official clinical diagnosis), which resulted in significant rates of mental and physical disabilities. Previous studies have reported higher rates of PTSD in Cambodians, but were mostly conducted among Cambodia refugees. The rate (11 percent) of probable PTSD among all Cambodians over the age of 18 was more than 5 times the rate among U.S. adults, based on the National Comorbidity Survey.

Among the older group, half said they were close to death during the Khmer Rouge era and 31 percent reported physical or mental torture.

Respondents who did not believe justice had been served, up to the time of the survey, and those who felt the need for revenge were more likely to have PTSD. Also, people who had more knowledge of the trial had higher rates of PTSD. Yet most Cambodians had highly positive attitudes about the trials.

Another paradox emerged from the respondents: Almost half of the respondents in this overwhelmingly Buddhist country thought the trials "go against the teachings of Buddha." However, when asked about attitudes toward the Khmer Rouge, 63 percent of respondents strongly agreed, and 21 percent agreed with the statement, "I would like to make them suffer."

Tribunals to assess crimes of war and crimes against humanity are becoming more common. In June, Charles Taylor, former president of Liberia, answered questions in an international courtroom in Paris about his alleged role in genocide in Sierra Leone in the 1990s. The International Criminal Tribunal for the Former Yugoslavia, a UN-sponsored trial, has been underway since 1993 and the International Criminal Tribunal for Rwanda since 1995. The Nuremberg Trials is perhaps the most well known.

The Khmer Rouge trials offer the opportunity to better gauge the efficacy of these trials, and those lessons hold relevance across a spectrum of injustice.

"The larger question raised by our study is whether attempts to promote justice for survivors of violence - whether en masse or inflicted by one individual to another - can help lessen its psychological toll," Sonis says. "We simply don't know the answers yet."

http://www.med.unc.edu/

Escaping the Khmer Rouge --- and building a new life

St. Anthony parishioner Mara Doung.

Friday, April 10, 2009
By Doris Benavides
Tidings Online (Los Angeles, California, USA)

To Mara Doung it seems it was yesterday when he told God he was not ready to die, but in reality 33 years have passed.

"It was 7 p.m.," Doung clearly recalls. The then-15-year-old boy had been hiding for three days at a coconut farm in his native Cambodia. He was separated from his family by the Khmer Rouge, the communist forces led by Pol Pot that took over in April 1975.

Doung's great grandmother Prak Him, with whom he lived from the ages of 5 through 12, had taught him that there is only one God --- and he was not Buddha, as most Cambodians believed.

Doung is one of a very small number of Catholic Cambodians. Most of his countrymen practice Theravada Buddhism, their country's state religion before Pol Pot's rule. He is a parishioner of St. Anthony Church in Long Beach, a city that is home to the largest Cambodian community outside Southeast Asia (more than 100,000, including about 17,000 Cambodian-American).

Thousands of Cambodians, including Doung, fled to the United States in the late 1970s and early 1980s, escaping a communist regime that oversaw what is regarded as one of the worst genocides in human history. Its victims included Doung's father and a sister.

Growing community

About 95 percent of Cambodia's population of 12 million is Theravada Buddhist. Only 19,000 are Catholic. But though most immigrants to the U.S. adhere to the Theravada Buddhism of their homeland, the percentage of Christian (and Catholic) Cambodians is growing.

The genesis of this conversion locally took place in the 1970s, as Sister of Charity Lucille Desmond led an effort to establish an outreach program to newly-arrived Cambodians who settled in Long Beach. With the growth of this immigrant community, in 1992 a group of Catholic lay men and women started Our Lady of Mount Carmel Cambodian (parochial) Mission, to provide spiritual support to Southeast Asian citizens.

The majority of these refugees had arrived in Long Beach with nothing more than what they were wearing. They had been drawn here by family and friends, the potential for jobs, the coastal climate, and the Port of Long Beach's Asian imports.

Most of them, like Doung, had lost at least one close relative during the four years of the Khmer Rouge's genocide, and after the Vietnamese invasion in 1979 (by which time an estimated 2 million people had died).

Today, at Our Lady of Mount Carmel, a few blocks away from St. Anthony Church, recently-arrived Cambodians learn to adjust to the American way of life. Mary Blatz, the mission's coordinator and one of its cofounders, helps them navigate through the immigration, health and educational systems, and teaches English as a Second Language.

Blatz, a Columbia University graduate in International Education Development, helped begin the parochial mission in Long Beach at the request of Cambodian Bishop Yves Ramousse (whom she had met in previous years while he was living as a refugee in New York,) and with the sponsorship of the late San Pedro Region Auxiliary Bishop Carl Fisher.

Blatz had started working with refugees in 1979, training teachers who taught English to other refugees. In the early '80s she traveled to Hong Kong and Indonesia, where she continued working with refugees.

She still teaches ESL, advises on employment and refers people to a network of employers and attorneys she has built throughout the years. Her services, she said, are available to everyone, regardless of their faith.

But her main task is to provide spiritual and emotional support to the people with whom she has a special bond.

"It is my concern they know about God and the faith," Blatz said. "Most of the Cambodians, especially the elderly, fell in a strong depression as a result of the atrocities against them by the Khmer Rouge and during their stay in refugee camps in Thailand or Indonesia."

To help alleviate their burden, Blatz let the elderly build a Cambodian-style vegetable garden in the mission church's backyard that keeps them busy and helps them with their tight household budget.

Since its 1992 founding, the mission has grown, funded through grants, fundraisers and financial support of parishioners of St. Mary Church, Blatz's home church in her native Colts Neck, New Jersey.

Traumatic memories

Many times Blatz has also served as an intermediary between the oldest generations and the younger generations, Cambodian-Americans who only speak English and only know about the genocide through the stories told by their parents or grandparents. Some others barely remember their stay at the refugee camps.

"A vast majority of Cambodians lost a close relative, which left them with emotional wounds difficult to heal," Blatz noted. Many children lost one or both parents from the genocide which targeted religious people, professionals and intellectuals, those considered threats to the government.

Those who were not assassinated left the country and established in Long Beach, Boston, Virginia, Texas, Rhode Island and Washington. (A smaller percentage settled in Canada, France and Australia.) Locally, Catholic Cambodians are scattered in Long Beach, San Diego, Santa Ana, Pomona, San Bernardino and Los Angeles.

David Hort, now 33, arrived in the U.S. with his parents when he was 8 years old after living in a refugee camp in Thailand for several months. The family was among the few Cambodian Catholics.

Now a parishioner at Our Lady of the Rosary in Paramount, Hort recently married Sothea Keov, in her 20s, a Cambodian Buddhist he met in his native country. Marrying her fulfilled a dream, he says. Another is his desire to maintain Cambodian values and traditions, including close family relationships and respect for the elderly, values he fears may be vanishing among the younger generations.

Better days?

Today's Cambodian immigrants celebrate the church's "restart" in Cambodia, which began in the early 1990s, thanks to a youth wave that is changing the face of the church. There are struggles: the majority of catechists are between the ages 18-35, and they do not have any formal catechetical certification, because the local church has no official catechism school. But the situation is better overall.

Mara Doung has observed the change in trips he has made to his homeland, and is trying to help it along. With the support of his family in Cambodia, the businessman (he is a former owner of two restaurants and an importing sports business) started a nonprofit that helps the poor in Cambodia and helps law students to stop corruption, which is high in the Southeast Asian country.

He says he learned this from his great grandmother, who woke him up early every weekend to go feed the poor in a neighbor village.

"She woke early to cook noodles and rice," he said. "I used to ask her 'Why do you do this for no money?' She would answer me, 'When you grow up you will understand.'"

The father of five is now trying to instill the same values and beliefs on his children. Three of them attend St. Anthony Elementary School.

Still, the scars left from his years of hiding and escaping the communists affect on him. He remarried after two divorces, but had to quit his job due to sporadic panic attacks for which he is receiving psychological treatment.

In the meantime he went back to culinary school. He started Bible study with other Cambodians. And he hopes, he says, to become a deacon.

For more information about Our Lady of Mt. Carmel Cambodian Mission, call Mary Blatz at (562) 394-2216.

As Tribunal Nears, Trauma Surfaces

A nurse gives medicine to a woman at Cambodia's largest mental health care facility in Phnom Penh, Cambodia - one of the world's most psychologically traumatized populations due to decades of war, genocide and loss of home and family. (AP Photo)

By Poch Reasey, VOA Khmer
Original report from Phnom Penh
09 March 2009

When the trials of former Khmer Rouge leaders start, former victims of the regime will have to relive the nightmare. The proceedings will be aired on televisions nationally and internationally. Already, the proceedings are starting to affect survivors of the regime.

Van Nath lived through incarceration at the infamous Tuol Sleng prison known as S-21. He will be one of the witnesses when Tuol Sleng prison chief Kaing Kek Iev, also known as Duch, goes on trial March 30. He told VOA Khmer that he felt unsettled as Duch’s trial approached.

“I have waited for this day for 30 years,” he said. “It’s natural that as the end is near, I feel unsettled. I cannot sleep at night. I keep waking up at night. And I ask myself why? I can’t find an answer.”

Thousands of miles away, a Cambodian-American author feels the same. Him Chanrithy lost both her parents and several siblings under the Khmer Rouge. Him Chanrithy, the author of a memoir, “When Broken Glass Floats,” told VOA Khmer she is trying to avoid news of the Khmer Rouge tribunal.

“On Feb. 17 when I heard from my friend in California about the initial hearing on Duch’s upcoming trial, I tried not to read about it, because it reminds me of the hardship under the Pol Pot regime,” she said. “It also brings back the nightmares.”

Kimlong Ung also lives in Oregon. When the Khmer Rouge took over Cambodia in April 1975, he was only 15 years old. He lost both his parents and a sister. He loses sleep, he said, tribunal or no.

“Whether there is a trial or not, I always have this feeling,” he said. “So when I go to bed, I often have nightmares. Sometimes I only sleep three or four hours.”

Dr. Kar Sunbaunat is the leading psychiatrist in Cambodia and the director of the Natural Program of Mental Health in Cambodia. Kar Sunbaunat said Cambodians suffered mentally starting in the late 1960s, as the Vietnam War spilled into Cambodia. But the most serious damage to their mental health really started during the Khmer Rouge regime.

“The Khmer Rouge tribunal is not the only reason to remind people of their past trauma,” he said in an interview. “Whenever they see images of people being killed anywhere in the world, it will remind them of what happened to them under the Pol Pot regime, and the symptoms will come back.”

Kar Sunbaunat said the Cambodian government anticipated the problems even after the tribunal and has trained about 35 psychiatrists to deal with the need. He said about 150 doctors have been trained on how to deal with mental health patients.

Helen Jarvis, director of public information of the tribunal, said her office is sending workers to remote areas to educate people about the importance of the Khmer Rouge tribunal.

“The court itself is making every effort to deal with people we come into contact with, so anybody who is called as a witness or anybody who is interviewed, we are doing our best to give them support,” she said.

Besides government services, there are a few non-governmental organizations in Cambodia that provide mental health care.

Dr. Chhim Sotheara is the director of the Transcultural Psychosocial Organization, one of the country's few mental health facilities. He said recently his organization has signed an agreement with the tribunal to provide mental health support to witnesses and victims of the Khmer Rouge.

Chhim Sotheara tries to remind people that it’s normal to have nightmares. His center has set up hotlines to consult people who need help.

“As we have predicted before, many Cambodians have come to us for advice on how to deal with the trauma that has started to come back as the tribunal nears,” he said. “A number of people say they have nightmares, that they see their dead relatives calling for justice. So the trauma is coming back.”