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 http://tinyurl.com/y8duql9

Below if a follow up from the family:
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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 www.sharethehealthcambodia.org

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

Two Decades of Resource Development Questioned

By Im Sothearith and Men Kimseng, VOA Khmer
Original report from Washington
12 October 2009

[Editor’s note: VOA Khmer recently spoke with specialists in the field of natural resource management in developing countries and learned that Cambodia is not alone in struggling to use natural resources to benefit its citizens. The resource curse, where natural riches fail to help the poor, is a worldwide scourge, the global experts told VOA Khmer in numerous interviews. Below is Part Six of the original VOA Khmer weekly series, airing Sundays in Cambodia.]

Cambodia’s natural resources were not heavily developed during years of internal conflict, but significant exploitation in the last two decades has been questionable in bringing revenue to everyday Cambodians, and the nation’s gemstones, forests, oil, natural gas, even fish, are more likely to benefit the elite.

Over the last three years, London-based Global Witness has issued reports severely criticizing the government for mismanaging natural resources, claiming Cambodia’s elites are able to diversify their commercial interests to reap all forms of the country’s assets. The government denies these reports, which are also banned in the country.

Eleanor Nichol, a Global Witness campaigner, told VOA Khmer in an interview in Washington that the group’s goal was not to publish anti-government material, but the truth inevitably affected a few officials.

“We’ve become increasingly outspoken at the very high-level, institutionalized corruption, which we’ve come across in Cambodia’s natural resource sectors,” Nichol said. “And what we do is publish information on that high-level, institutionalized corruption. It’s not anti-government information. But what happens is, actually, that it tends to point back to members of the Cambodian government, because they tend to be using their positions of power to exploit their country’s natural resources. So, inevitably over the period of time, it has brought us into a conflictual relationship with the Cambodian government.”

Nichol said despite the angry response by the government to the reports, Global Witness is still willing to work with its leaders and officials.

“We would still like to work with the government, and we’d like to see them comment in a serious manner and respond in a serious and considered manner to some of the failures in government which we’ve unveiled in Cambodia’s oil and mining industries,” she said, “mainly because it is so crucial to the economic future of the Cambodian people.”

In the “Cambodia’s Family Trees”, published in 2007, and “Country for Sale,” published in 2009, Global Witness severely criticized the government for mismanaging its natural resources.

The rich and powerful have diversified their commercial interests, so that natural resources like beaches, forests, islands, land and mining are controlled by a handful of government-affiliated tycoons, high-ranking police, military commanders and family members, Global Witness reported.

Om Yentieng, a senior adviser to Prime Minister Hun Sen and head of the government’s human rights body, is named in “Country for Sale,” reportedly benefiting from the work of a mining company active in Cambodia, Float Asia Friendly Mation.

Global Witness reported Float Asia as extracting marble from the protected areas of Phnom Aural Wildlife Sanctuary and the Central Cardamom Mountains’ protected forest.

Om Yentieng dismissed the report as “stupid” and “nothing new,” saying Global Witness had accused Cambodia of wrongdoing “for years.”

“If their report is true,” he said, “then Cambodia is a hell, with no development, no double-digit development for five years, like this.”

Global Witness has also indicted high-ranking members of the military in its reports. In a visit to Washington and the Pentagon in September, Defense Minister Tea Banh told VOA Khmer the organization tended to “exaggerate the truth,” discrediting itself.

“One day the truth will be revealed, and their credit will be undermined,” he said.

Nguon Nhel, a prominent National Assembly lawmaker and stalwart of the Cambodian People’s Party, said the 123 representatives of the body are tasked with providing credible criticism of the government.

“We accept criticism and investigate whether the criticism is true, but some criticism is unacceptable,” he said.

Son Chhay, and opposition lawmaker for the Sam Rainsy Party, said the government should pay attention to detailed cases written in the Global Witness reports and respond with productive follow-ups.

Instead, the government has drawn criticism by silencing critics with lawsuits and jail terms, he said. They have filed no lawsuits against Global Witness, he noted, indicating to him the veracity of its reporting.

“The National Assembly seldom uses information from such organizations as Global Witness,” he said. “In principle, when we see such a report, we must go to the field accounted in the report, such as extraction mines in Kampong Thom and Ratanakkiri provinces.

“Of course it hurts that the report names those individuals,” he said, “but it’s an opportunity for the government to use the report as a benchmark to improve these irregular situations.”

Yim Sovann, spokesman for the Sam Rainsy Party and a lawmaker, told VOA Khmer by phone that so far concessions were not issued transparently.

“Every concession of natural resources, especially mines, must be publically handed out, so that people know where the government has allowed private companies to exploit, where mines are located,” he said. “They must have inventory and announce publically so that all companies have equal opportunity to auction. If we hand out concessions to a company secretly, without transparency, we lose a lot of national income.”

Government figures show that $3.6 million went into the national budget in 2008 for sales of forestry and mining concessions, with income from these expected to increase to $4.6 million in 2009. A Finance Ministry official said this was due to sale of concessions only.

Cheam Yeap, a member of the Cambodian People’s Party and chairman of the National Assembly’s finance committee, said incomes from natural resources are put back into the national budget for public spending.

“We have separate incomes generated from the investment of natural resources and other income, and a set percentage for investment and for other public spending,” he said.

Another official said the government had managed the country’s forests by ceasing timber export and replanting 49,000 hectares of trees.

Ty Sokun, director of Ministry of Agriculture’s forestry administration, told VOA Khmer that forests were still abused by local poor, private individuals and the armed forces, but on a small scale the government is cracking down on.

“We have strengthened law enforcement, sharpened technical skills and carried out international forestry management strategies for ASEAN,” he said. “We are leading and actively participating in carbon forest credit, so that it contributes to reduction of climate change and green house gas. In addition, it is noticed that while abuses decrease, wildlife increases. We have collected weapons to be destroyed.”

Cambodia was to be a model for post-conflict nation-building, following the introduction of peace and democracy in 1992 by UNTAC. However, Global Witness said, it turned into Southeast Asia’s newest kleptocracy, its reputation marred by corruption, human rights abuses, impunity, repression and undemocratic government.

Instead of using millions of dollars from natural resources to alleviate poverty, the reports said, the government could follow the example of Burma, where a handful of elite use money from the country’s natural resources to accumulate wealth and consolidate political power.

International experts working in Cambodia told VOA Khmer that they acknowledge the challenges Cambodia has faced over the past decades, but they are looking to the government to make more efforts to improve the management of natural resources.

This could benefit Cambodia in the long term, they say, especially with strong laws related to the environment, forestry, fisheries and mining, and as a younger generation rises in the government.

Impunity Hurting Political 'Maturity': Official [-Amb. Sichan Siv should tell these facts to the Hun Sen regime]

By Poch Reasey, VOA Khmer
Original report from Washington
19 November 2008

Click here to listen to the Khmer audio program

Cambodia has the potential to be an industrialized nation, but corruption and impunity have kept it politically immature, a former US ambassador said.

Sichan Siv, who serverd as US ambassador to the United Nations, said Cambodia has slowly overcome its problems since the early 1990s, but certain impediments remain.

“The problems of corruption, crime and impunity still exist in Cambodia,” he told VOA Khmer. “However, I believe that when the government and society can solve these problems, our country can achieve political maturity.”

The former ambassador was at the George Bush Presidential Library and Museum in Texas last week, where he paid a call on former president George HW Bush and addressed 200 Boy Scouts on leadership and patriotism.

“I have hopes that Cambodia has the potential to become industrialized, because Cambodian people are hard working, have a strong culture and have a strong civilization,” he said. “Our ancestors built the Angkor temple. This is a symbol of our strong civilization.”

Sichan Siv also said Cambodia could industrialize thanks to the Cambodians’ love of study.

“Just look at the French language,” he said. “Everyone my generation speaks French. Now people speak English. Cambodians like to learn what’s new, to adapt to change.”

Cambodia had enjoyed the double-digit economic growth for the past several years, but the global economic slowdown has drastically reduced projections for 2009.