Education And Debate

Cambodian health in transition

BMJ 1995; 311 doi: http://dx.doi.org/10.1136/bmj.311.7002.435 (Published 12 August 1995) Cite this as: BMJ 1995;311:435
  1. Mam Bun Heng, under secretary of state for healtha,
  2. P J Key, deputy head, health and population divisionb
  1. Ministry of Health, Phnom Penh, Cambodia,
  2. Overseas Development Administration, London SW1E 5JL
  1. Correspondence to: Dr Key

    As conflict and suffering in Bosnia, Chechnya, Rwanda, and Zaire continue to be at the forefront of world attention, some countries seem to be largely forgotten. It is timely to take stock of conditions in the small country of Cambodia as it struggles to take its place after a long period of isolation. Countless Cambodians and ethnic Vietnamese have died there this year and during the past 25 years, victims of senseless killing or preventable disease.

    Early in 1975 one of us (PJK) led a relief team of 200 health workers, 190 of them Cambodians, taking medical care and food supplements to a million or so women and children who were refugees in besieged Phnom Penh. Later that year all expatriates were evicted from the country by the advancing forces of Pol Pot. On re-establishing contact in 1980 we found that only 12 of the original Cambodian team had survived. Their stories of suffering and killing, and of escape and survival, under the murderous regime that followed are harrowing. Cambodia now has a fast growing population of around 9 million, a fifth of whom are children under 5 years old. Their health and safety are still precarious.

    Background

    The past 20 years of Cambodian history have been characterised by civil war and terrible brutality. In the early 1970s the country suffered intense bombing by the United States on its western border with Vietnam. The fall of Phnom Penh to the Khmer Rouge marked the beginning of four years of genocide under the rule of Pol Pot; the country was turned into a “killing field,” with up to two million people dying as the result of violence, starvation, and disease. In 1979 the Vietnamese ended Pol Pot's rule and installed a hardline socialist regime. Over the next 10 years Cambodia suffered a …

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