Monday, November 16, 2009

Follow up from the American family reported by Khmer Intelligence

On 14 November 2009, Khmer Intelligence published the following report:

Tragedy of an American family in Cambodia (2)

An American family who have come to help Cambodia and made big sacrifices to run a medical clinic providing basic health care to the poor, are victims of corruption and violence, which characterize the prevailing political system.. The e-mail we publish here has been circulating among their countless known and unknown friends who are deeply moved by their tragedy and revolted by the Kafkaesque situation they are facing. You can read their story by clicking at

Below if a follow up from the family:
Dear Khmer Friends,

Thank you everyone for your patience with us, considering the ramifications of our story.

If you your site could use the information in this letter to make a difference in the corruption rampant in the medical field in Cambodia, please contact me to discuss how we can cooperate. This is a bit long, but please bear with me.

We came to Cambodia to save lives, but because of our outspoken stance againt this corruption, we became targets and nearly lost our lives.

Yes, we managed to escape Cambodia, thanks to supporters of our NGO who used their personal funds and air miles to arrange a ticket. We have nothing left but our suitcases, and must start over here in the US. Cara is still unwell, and will require continued medical care for some time.

For your patience I'll provide you the details, but please be aware this is not a simple story of another assault. As they say in Cambodia, there is little random violence. There IS violence, but nearly all of it is for a reason. It's the reason for the attack that had us so worried.

The initial details of the attack are outlined in the forwarded letter below. It wasn't until a few days later that we put the pieces together to realize this wasn't random.

Since we arrived in Cambodia this past March, we had been working at a small clinic in Kampong Thom Province. At the request of National Assembly Representative from Kampong Thom, His Excellency Nhem Thavy, we were given a closed down Community Health Center. Using our own funds, we renovated and restored the clinic. We were incredibly successful, seeing up to 100 patients a day, who often came hundreds of K's and waited days to see us, as we were the only reliable and available care in the provinces. It reached the point we were getting busloads of sick people arriving daily from past Siem Reap, Kampong Cham, and kampong Channg. As long as we were spending our own cash, we were fine. We had opened on the advice and request of the Ministry of Health while awaiting our MOU to be finalized by the Ministry of Foreign Affairs. We had thought that it would be completed shortly, but as of Oct 12, the day of the attack, it had not yet been approved. We had been told by many other NGO's that a significant "donation"(bribe, specifically cash, a nice camera, or laptop) needed to be paid to get our MOU cleared, but we refused to pay. Therefore, we were told repeatedly by the MFA that our MOU wasn't good enough- basically our budget was under $100,000- too small for their % cut. We were given odd reasons, like we dated it before it was signed, then we removed the date, then it was declined because it didn't have a date. We had used the old Min of Health Logo. We used blue ink on the stamps, and red ink is supposed to be used prior to approval. Then, they didn't like our date. Then, our typeface was too small. We kept making these ridiculous modifications to appease them, until finally, "the ink on our logo was too bright". It reached the point the Secretary General Leng Peng Long, Vice President Nguon Nhel, the Assembly President and finally Minister of Health H.E. Mom BunHeng all appealed to the MFA and we still never got approved. And all this time we were still saving the lives of 100 people a day from our little clinic.

That was the big corruption we were dealing with, but not the most deadly. It was the little guys who we believe came after us. In the Baray-Santouk referral district of Kampong Thom Dept of Health, there are 19 health care centers just like ours. Almost like our, that is. They are all boarded up, shut down, and non-functioning. Some see a few patients, but not many people go to them because they have no medicine and no staff. At the Baray-Santouk Referral Hospital, there are 10 paid doctors and 37 paid nurses on staff- but me made a practice to bring by every international visitor and challenge them to find a health care worker on the grounds. Not once in 8 months was someone working there. They average 3 to 5 patients a day, and most are never given the medications they need. We would often visit there, and on occasion gave money to the patients to catch a bus to Siem Reap so they could actually get treatment- if you didn't have $50 cash, you couldn't take one of the three empty ambulances sitting there.

But it wasn't the lack of treatment and staff that was the big problem. Each of the other 18 closed down health Care centers in the District were reporting to the Regional Director Dr. Meas Cham that they were treating 900 patients a month. The medicine for these imaginary patients was being shipped there, stolen, and sold by the staff. Every week we would submit our legitimate medication requests, only to be told "we don't have any". Our patients were dying over 50 cents worth of Cipro, and we were quickly running out of our own funds to purchase medicine. We finally confronted Dr Meas Cham and his Supervisor, Dr Vao Lough Kuhn, Kampong Thom regional Director, over this issue, and were told we were going to be reported (to the Ministry of Foreign Affairs!) over our outrageous behavior.

Every time we demanded we be sent the even the basic medication that they were already listing as being distributed to us, we were told they had just run out, or that our "MOU wasn't completed so they didn't have to send us anything". We did not receive one dose of vaccines for 6 months when we were seeing over 1800 patients a month. They had run out every single month. At one point we contacted the head of the Cambodian Red Cross, HE Ho Noun, who paid a visit to our clinic. She was very impressed, and we had a big media day, but still no medicines came. Every now and then we would get a box with 10 IV's, and a few bottles of the stuff that no one could sell (Vitamin A and Birth Control Pills), but never Paracetemol or Antibiotics.

The situation was becoming critical, and we began to put more pressure on the district. We staged a visit with "simulated" visitors from World Health, who asked about why vaccines weren't being delivered. Dr Meas Cham walked out on them, so we called some friends and were arranging an actual aduitor come visit to help out. AT the end of September, we had to close the clinic. We were out of our personal money, and without our MOU, could not even apply for grants and loans. We did get some funding from the Camkids Charity (Dominique and Benita Sharpe, very nice people), but could not operate without adequate supplies. We hoped closing for a few days would put pressure on the MFA and MOH to get our papers completed so we could operate. That's when the top level of the Nat'l Assembly began to put on the pressure. It looked like we might finally get it done, and the local Min of Health would be forced to give us the required medications.

And that was precisely when Cara was attacked.

You see, a lot of people were making a lot of money off of those stolen medications. A lot of staff had very nice Camrys, and a Lexus or two, and without that extra cash, they could lose them. Most importantly, if two westerners could legitimately open and operate a clinic, and treat 2000 patients a month with almost no money, then they might be expected to improve THEIR standards a little bit.

So we were battling corruption everywhere- the MFA at the top, the MOH in the middle, and the thieving doctors at the bottom. This was never our intent- we just wanted our medicine so we could save lives.

We asked for help, and told of the corruption- asked for help from the Red Cross, from Parliament, from UNICEF and World Health, but it seems everyone has their finger in the pie, and everyone had a lot to lose by us succeeding. We were succeeding, and with a completed MOU would have the clout to get around these hurdles.

What's also implied is that many of the larger NGOs in Cambodia are aware of this situation as well- we sat through endless lectures on Child and Maternal Health from UNICEF, when it struck us that they were getting their statistics from the same people who were forging patient records to get enough medicine to sell so they could make their car payments. How many children die every year in the jungles? Who really knows, because I swear every statistic is made up by the other 18 boarded up health care centers that never actually treated patients. Take a drive up Road 6 one day, or any of the tiny villages, and spend 5 minutes visiting the little "Blue H" signs. Do you see 900 patients a month being treated there? Maybe at Sihanouk inPP or Angkor in SR, but not where these statistics are coming from. We can tell you that despite the MOH charging 28000 Riels to deliver a baby, the midwives are charging them $75, so they never come, deliver alone at home, and die a few days later from the jagged episiotomies, the inevitable blood loss or infection, or the tetanus that follows. But UNICEF doesn't see that, they just take the fabricated numbers, spend $3 million on writing the nice powerpoint report, and never see the dying children who never got the stolen tetanus shots.

Someone needed to stop us. So we got what they consider "a warning" in Cambodia. Those details are outlined below.

We are grateful we got out alive- Cara was never meant to survive this attack. We are most grateful it wasn't our children (Samantha, 13, and Moira, 10) who were injured- we don't know how we would have recovered from that.

So we hid for a week, and got a donated flight out of there. We stayed a few days in NY, then a week in Ohio to get Cara medical treatment near her family. We are finally back in South Carolina, and hope to put our lives back together. We will keep our NGO "open" long enough to recover some of the costs for getting home and Cara's medical expenses, and would be grateful for any donations to our website

We hope at some point to find the right people to go to with this information. As you know, Cambodia receives close to $1 BILLION in foreign aid, much of it for health care. When the world discovers NONE of that money or medicine actually makes it to the people who need it, things may change. Even telling this story puts us in more danger, but we came to Cambodia to help the people, not to buy Camrys for corrupt doctors. When Ho Noun came to visit us, the staff at Baray-Santouk heard she was coming and washed the walls in the front rooms, and hired people from the village to pose as patients so it looked like they were functional. It was a good ploy, because no one ever really checked. Somehow and somewhere, we'll find the right people who are interested in where all that money goes. Maybe then, the people who need the help can actually get it.

Several people have asked me if I'd ever consider returning to Cambodia. I say yes, with a bullet proof vest and a team of inspectors and auditors from the UN intent on cleaning up corruption. I personally saw too many children dying over 50 cents worth of antibiotics while the people that were getting these millions to care for them were laughing and sipping coffee.

We were careless in speaking openly about corruption while we were still in Cambodia. That was our mistake. When they tried to kill my wife, they didn't get the job done. That was their mistake.

James Garcia
Share the Health Cambodia


Anonymous said...

First step, For the whole world who are trying to help those poor Khmers, need to bring those two Dr, Meas Cham and Vao Lough Kuhn to the court of law for justice may be then Hell will breaks loose.
these so same to the Khmer government and the leaders.
When it going to stop.
Best wishes to you and your family Mr, Garcia.

Anonymous said...

I just want to wipe out every cpp goons. They are not politicians but gangsters. You have to fight fire with fire, and if you can't beat them, then join them.

Anonymous said...

You simply cannot change the corruption practises in Cambodia without changing the government, the mentality of the so-called educated workers and cleaning up from the top down.

The question is how you are going to do that.

There has always been and will invariably be Cambodians who are willing to serve the interests of Cambodia's neighbors to the west and east, of course, at the expense of their own motherland in order to sustain their power and wealth. Therefore, the current regime will stay for a long time to come as long as they play their card well with Vietnam and the situation in Cambodia will continue to be the way it is for so many years to come.

Cambodians, by themselves, are too passive, weak, poor, uneducated or ill-informed and indifferent to changes to do anything about the current condition of their society; after all, they had lived their lives through worse period. The most important thing for them now is to survive day by day.

Call me the pessimist, as far as situation in Cambodia is concerned, as I can't see anything better going to happen in the next 10 years.

Anet Khmer

Anonymous said...

Don't waste your time and money to perform job that could destroy your life. As long as the current leaders still rule the country, there is no justice for all. And you cannot find justice for Cambodian people until they understand and find it by themselves.

Anonymous said...

In medical field, assistances are provided based on humanity.
Very sad that those cambodians who are in needs are neglected by own government. So many NGOs have tried to help cambodia back on recovery from the trauma of KR.

Corruption becomes normalised in particular in RGC's officials. This has led cambodia to an era of uncertainty and impedes the process of reconcilliation took place in 1991, according to peace Accords.
Unless there is an intervention from international communities, to force current RGC to put effort to real reform,then the plague of corruption still destroys cambodian social infrastructure.
Why not NGOs report these incidents to administration of president Obama? So that issues can be raised to the international Human rights body. The UN convoys already had reports, just push the Un to recognise that so that the job of UN is not half done.
It has been long enough for cambodian to endure for the real change taken place.

As you can understand, over 10 years RGC has not been able to produce corruption laws, petition of over one millions cambodians signed. In normal circumstance, it does not need to get that grand demand from from rooted level, but the pressure of corruption and impunity prompted that petition.

Cambodians has done that, NGOs reports all those irregularities/incidents, the UN envoys noticed that, it is only awaiting from international communities bound by Peace accords agreement to fullfil their obligations to complete their initial effort to bring real peace to Camboians.
Cambodia can't change from small scale.

I am so saddened that the incident took place,and soft diplomatic relation still persists after nearly two decades of that suffering.

I, myself was a nurse for the RED CROSS in khao I Dang in surgical area, as well as trained and worked as a nurse again in Canberra,Australia for 12 years.

All in all, I am thankful for your courage and your assistance provided to both Kg Thom and Kg Chhnang to those poor and under previledged cambodians.

I wish Cara will do well for her recovery, and thank you James Garcia.

Anonymous said...

Terrorism in Cambodia.
Killing at least sixteen innocent men, women and children.
Hun Sen's personal Bodyguards Unit (Brigade 70) was the suspects and was order by Hun Sen.

An FBI investigation concluded that Cambodian government officials were responsible for the attack.

The U.S. Senate Foreign Committee concluded that Cambodian government officials were responsible for the attack.

Leader of the Free Trade Union of Cambodia
The Cambodian government officials attempted to assassinate Chea Vichea on March 30, 1997 Grenade Attack.

Leader of the Free Trade Union of Cambodia
The Cambodian government officials are responsible for assassinated Chea Vichea.
The Cambodian government officials are working hard to cover up the real assassins.
Born Samnang and Sok Samoeun were convicted as scapegoats in the absence of compelling evidence and testimony.
The Cambodian Court convicted innocent peoples instead of the real assassins.
The Cambodian Court have no shame at all.

Leader of an Opposition Party of Cambodia
The Cambodian government officials attempted to assassinate Sam Rainsy on March 30, 1997 Grenade Attack.

Apsara Dancer and Movie Star
The president of the Red Cross of Cambodia (Bun Rany) had order Hok Lundy to murder Piseth Pilika (Hun Sen's affaire).
Source:  Statement of Heng Peov

Heng Peov hold position as the chief of Bureau of Anti Narcotic in Phnom Penh, Cambodia

Anonymous said...

Dear James,Cara, and the kids,

I am truly sorry about what happened to Cara....and what you and your kids are going through in Cambodia. Hopefully, she has enough strength to survive and get back home.
Hun Sen and his punk ass Government are NOTORIOUS for corruption, injustice, and violence of any kinds. You are well understood this than anyone....that Hun Sen and his Government don't give a dunky..Ass..about what happens in Cambodia and let alone helping you resolve such issue.

Cambodia is a place for Hun Sen breeding his gangs. Kind and generous people like Cara and you SHOULD NEVER BE in Cambodia....but I do understand your desire to help poor Cambodia by sacrifying everything and almost your life.

I am like you (James) and Cara. I wanted to go to Cambodia to build schools for poor Cambodian in the rural areas, but after I found out how corrupted, injustice, and violent Cambodia is. I decided not waste a penny in Cambodia. Hun Sen and his Government don't care for his own people and why should we.....!

Hopefully, those who raped Cara will die of car rash or some forms of brutal and violence death.....!

Anonymous said...

Get well Cara. What you and Jamese have done in Cambodia will not go to waste...!

Also, I meant to say violent death..and not violence death.

Take care of Cara...and the kids...James!

Anonymous said...

and CPP's achievements? you clowns don't know cuz ur too blinded by your jealousy and hatreds. U clowns have no idea how to run a country, if u did you wouldn't be living outside of ur motherland. SHAME ON U!!! So unless u got some clues on how to make the country better SHUT DA FUCK UP.

Anonymous said...

3:07 PM,

Hey mother fucker useless punk! what ta fuck r u barking about...your breath smell too much pa hoak...shit head...go fuck ah kwack's ass....fucker!

Anonymous said...

I am a member of an opposition party in the National Assembly. I wonder why Sam Rainsy usually watch out only eastern border? By contrast himself and his owner party never raised about border dispute between Cambodia and western country? Not only this they have closely relationship with and strongly support Thai Yellow. We have never seen a small piece of letter or a word to condomn Thai Yellow whose ruling party has been established by Coup Detat, Abused International Convention and Cambodia Territory. If Sam Rainsy is nationalist, WHY HE DO LIKE THIS ? who SRP's supporter can clear ? I am waiting for your reply.

Anonymous said...

I can only say - 'Welcome to South East Asia'...

One reason the corruption is so bad in Cambodia is due to the Khmer Rouge killing everyone with an education. The result is a society that is upside down, with a false sense of right & wrong, of their history, of proper practices, etc...

Currently, poorly educated Cambodian officials are working to steal more land from Thailand, precisely because thay want to believe the lies repeated in their history. They do not care that other countries have helped them recover, they just want more, more, more...

Unknown said...

Seems that Cara Garcia should be treated with suspicion.

She stole morphine from her hospital in South Corolina for her own use. As the link above explains.

The whole story is very shonky and probably a hoax to get your cash.

Anonymous said...

Please visit the Khmer440 blog on this topic for more details on this. This incident happened many years ago, and does not reflect on the current situation.

Anonymous said...

Karma's a bitch isn't it? what goes around always comes back around...glad it finally happened.

Anonymous said...

Karma for who? For Cara? Because she took a couple of pills from a cabinet in 2003 she deserved to get raped by three Khmer and beaten half to death?
And you are glad this happened? You are one sick son of a bitch and deserve to remain anonymous.
It's freaks like you that prove the point everyone else here has said, that Cambodia will remain corrupt and unsalvageable for another generation.

Anonymous said...

I know you probably wrote this years ago. But thank you for sticking up for her. I am actually one of the children, James is my father and cara is my mother. I can guarantee this isnt a hoax. Im 15 now. Although there were bad times, the corruptions, rape and mental illness. There also were good times. But thank you for standing up for her. You are a kind person, I might add my mother is much better. It was from isolation more than anything else. Thank you.