Oh I see! Interview with Weh Yeoh – promoting speech therapy skills in Cambodia.

Weh Yeoh – the objective is not to build an NGO, but to get results. In this interview he describes how he is helping facilitate a local solution to a problem that affects 600,000 Cambodians – those with speech or swallowing difficulties.

Weh Yeoh, is an Australian on a vivid mission in Cambodia. He is Managing Director, OIC: The Cambodia Project and this comparatively recent NGO start-up is worth paying attention to – not only for the work it is doing – with a focus on training speech therapists, but in the manner it has structured itself to operate.

Recently I interviewed Weh to ask him about his work and about his operating philosophy.

1. First of all, congratulations on starting OIC. These things don’t happen overnight – how did you personally get involved and what motivated you to start this work in Cambodia?
I’ve always been enamoured by the power of local people in poor countries to create change for themselves. In my first year in Cambodia, I worked with CABDICO, a local disability organisation, and I realised how few resources these organisations have. And yet, the best work is being done by these people.

While first working with CABDICO, I met a child named Ling two years ago. He’s an outgoing, intelligent child, in a poor village in rural Cambodia. Ling has cerebral palsy, damage that occurs in a young brain around the time of birth. As
a result, he had problems speaking to the point where his language wasn’t clear at all.

When I met Ling, he was 10 years old and he had never been to school. He couldn’t read or write, or even bathe himself. He couldn’t communicate clearly and was completely dependent on his family.

Those around him labelled him “chqoot” – a Cambodian word meaning “stupid” or even “retarded”. Simply put, without help, Ling’s only way of earning an income would be a life of begging.

Around the same time, I also met Phearom, Ling’s community worker from CABDICO, who visits him at his home every few weeks. As part of our pilot program, we trained Phearom on speech therapy. This training taught her how to treat Ling’s communication problem. It has had a truly life-changing impact on his life.

For the first time, Ling could speak with his family. But Phearom didn’t stop there. She brought Ling’s teachers together to discuss how to get Ling into the classroom. After months of hard work, Ling is now going to school, but not only that, he is coming number two in his class. He dreams of one day becoming an architect. Ling now has a future, because of speech therapy.

Meeting Ling two years ago taught me a valuable lesson. There are children all over Cambodia whose potential is being untapped because of a communication or swallowing problem. Often, all it takes is a little bit of help and a child’s future can be improved dramatically.

That’s why, with the assistance of a small group of dedicated Australian speech therapists lead by Dr Chyrisse Heine, I began the first pilot program in speech therapy in Cambodia with CABDICO, a little over a year ago. The program has now evolved to be OIC: The Cambodia Project. “OIC” refers to that moment when you suddenly understand something that you didn’t before. Oh I see, you would say. My idea was never to start another non-profit organisation when there are so many goodCambodian organisations doing great work. Hence, the project is part of CABDICO’s existing work.

2. Tell me a little bit about speech and swallowing difficulties. What are the various causes for these – and are there cures, or is it more a case of assisting children to live and cope with these difficulties?
There are many causes of communication and swallowing disorders, including intellectual disabilities, brain trauma and strokes. These kinds of problems can affect anyone from a child with autism, to a middle-aged motorbike accident victim, to an elderly person who has had a stroke.

Because of the diversity of these disorders, there is no one “cure” and the goals of treatment are different for every person.
As one famous example of someone with a communication problem, James Earl Jones, the voice of Darth Vader, grew up stuttering. Though he has obviously had a lot of success in overcoming his stutter, he says he still stutters and he doesn’t say he was cured. But he is certainly able to communicate like anyone else.

Obviously, this a less severe example of a communication problem. On the other hand, for someone who has an intellectual disability and can’t speak, success may look like teaching them how to use various communication aids so they can still communicate with others. It really differs from person to person.

With swallowing difficulties, again the range of causes is very diverse. Whether it is a physical problem or a problem with the nervous system, the person’s ability to swallow food or liquid in a way that you and I take for granted is impaired. This means that often, the substance will go into the lungs, and the person is at risk of contracting pneumonia. As a result, they’re 13 times more likely to die young.

For people like this, their ability to swallow may improve, but otherwise, speech therapy works to mitigate some of these risks through altering positioning, or the consistency of food or liquid, for example.

3. You publish a very frightening figure – 600,000 children in Cambodia have speech or swallowing difficulties. Where does that number come from? – health statistics from Cambodia are not always reliable.
As you rightly point out, health data in Cambodia is often poor. However, there are some good statistics about the number of people with disabilities who have communication problems as a percentage of the total population with disabilities in Cambodia. According to the World Health Organisation, at least 15% of people in any country have a disability, which means that 2.1 million out of Cambodia’s 14.3 million people have a disability of some kind. Cambodian official statistics state that 5% of people with disabilities have a speaking impairment, and 20% have a hearing impairment. There is no data on swallowing impairments. Applying these percentages to the 2.1 million people with a disability, we can estimate that there are at least 600,000 Cambodians (including both adults and children) with a communication or swallowing problem.

This figure represents 4% of the population, however it is probably a conservative estimate, given rates of disability are higher in developing countries. In my own country of Australia, the estimate is somewhere between 4 to 8% of the population. In order to address this population, Australia has over 6,000 speech therapists. However, in Cambodia, there are none. There is not one university-trained Cambodian speech therapist.

4. Children with real communication difficulties can be hard work for their families. What is the general story for these children – are they well supported by their families?
Great question. For disability workers, it’s incredibly important to work with the families as well as the children; in fact, it’s just as important as working with the child, given how much more time children spend with their families. I think many families who have children with disabilities can feel overwhelmed and helpless.

They don’t know how to best care for their children. It’s often an incredible relief when they receive support from disability workers, and I think they find it very encouraging to learn how they can best support their children. Many of the families are incredibly patient and supportive, such as Mai’s family, which we’ve written about on our website.

5. Before forming OIC you ran a pilot scheme with local NGO: CABDICO. What did the pilot scheme teach you? How did this modify your approach?
Well, the first thing we learned is that speech therapy really does help. Preliminary research we did earlier in the year showed us that speech therapy increased the number of children who could communicate with their family most of the time from one in five to four in five. That’s a huge jump.

We’re currently undergoing an independent evaluation of our program, and will use these lessons learnt to inform the next stage of our work in Cambodia. It’s important that we use this evidence based approach, because we’re doing something that has never been done before. We want to evaluate the effectiveness of speech therapy in Cambodia, to show that it can help that enormous population of 600,000 people who need it.
6. What are the main objectives of OIC?
We have two goals:

1 – to provide training in speech therapy services across Cambodia
2 – to graduate the first generation of Cambodian speech therapists from a Cambodian university

As you know, we’ve already begun training in speech therapy, and we are in the early stages of discussing with a Cambodian university beginning a speech therapy program.

7. You and the team have a very clear mission not just to work with individual children, but to effectively multiply your skills – by training local Cambodians in speech therapy. How did you arrive at this strategy? Did you work with local Cambodians to develop the strategy?
Since I arrived in Cambodia, the one lesson I’ve learnt the most is that it is Cambodian people who are creating real change in this country for themselves. Our role as foreigners should be to support them as best as possible. My colleagues who have had decades of experience working in disability have told me since day one that the lack of speech therapy is the biggest gap in health and disability services in the country.

My goal is to work our team out of a job. If our long term vision is for delivery of speech therapy services in Cambodia, this means that as foreigners, we cannot be the ones implementing speech therapy. In order to do this, we’ll need to train local Cambodians on speech therapy.

But to take that one step further, it’s even better if Cambodians are training other Cambodians in speech therapy. Our training program will use a train the trainers approach, where we will train local Cambodians to be the trainers. Eventually, we’ll have Cambodians teaching the university course as well. Once the entire teaching team is run by Cambodians, we’ll have a sustainable way to spread this knowledge in Cambodia. Then, we won’t need foreign volunteers to train Cambodians on speech therapy. It will be Cambodians, learning from other Cambodians. We don’t just value Cambodian input – we know it’s absolutely critical to the success of the project.

8. In terms of mainstream teaching, the styles of teaching differ quite widely when you compare Khmer and Western approaches. Have you in the team discovered differences between the Australian approach and the way locals operate?
What we’ve noticed in our training sessions is that the Western inclination is to start from a fairly academic, theoretical perspective, while Cambodians prefer very practical approaches. We’ve had to make sure we adapt so that they can take away the practical skills they need to immediately improve their ability to deliver speech therapy. It’s interesting too to see how speech therapy changes dependent on the culture and context.

As one example, there is an Australian list of the 50 first words a child learns to say. This list cannot just be translated into Cambodian, as words like “water buffalo” are on the Cambodian list but not on the Australian one. Again, this goes back to how important it is to have Cambodians involved in every aspect of the project. Taking an Australian speech therapy resource or program and transplanting it in Cambodia is not going to work.

9. How much of a support network does OIC enjoy in Phnom Penh? Do other NGOs contribute in the overall dialogue – or are you mostly head down working on your own program?
The key to our success is in working with Cambodian organisations that already work in this field. We don’t implement services; we train people at organisations that are already providing services. This means strong relationships with others, including non-profit organisations, hospitals, and government departments, is essential. They have the disability workers, the relationships in the community, and the knowledge of Cambodia. Up to two years ago, all they were missing is knowledge of speech therapy.

We want to build on the great work these organisations are doing, rather than create another NGO.

10. How can speech therapists (or speech pathologists) reading this best assist you and your work at OIC. For example if I was a speech therapist wishing to volunteer, what would be a suitable and realistic time frame?
There are a whole range of ways that speech therapists can get involved. We need help with training, curriculum, research, resources and fundraising just to name a few areas. Though I’m not a speech therapist myself (I originally trained as a physiotherapist a long time ago), I’ve come to appreciate just how generous speech therapists are with their time and energy. We’ve already benefitted from the generosity of speech therapists all over the world, and this is just the beginning. Depending on their availability, we’d welcome speech therapists interested in volunteering from home or in Cambodia. We’d love them to get in touch via our website.

11. Weh – your work and approach are remarkable. When did you realise that foreign service was your calling?
Though I really appreciate the compliment, I don’t consider anything that I do to be particularly remarkable. What is more remarkable is to see what Cambodian people can do for other Cambodians.

I spent six months of my life, in 2006, volunteering in an orphanage and adult shelter for people with disabilities in Vietnam. It was disastrous. I was a young, naive 24 year old with good intentions but no clue of what I was doing. One year later, I went back to Australia and started working with a great little organisation that helped people with disabilities. More importantly, I went back to university to study International Development, to try and work out how to do this thing – “helping people in poor countries” better. I learnt a huge amount that I didn’t know when volunteering in the orphanage. Since coming to Cambodia, I’ve realised that there are so many challenges to overcome here. And yet, colleagues of mine, like Phearom, have shown me what they are capable of doing with very little resources, very little pay but a lot of energy and passion. What Phearom has been able to achieve with Ling is simply remarkable.

There is a pervasive myth that it is foreigners like myself who are creating change in poor countries. The reality couldn’t be further from the truth. I tried to be the person making the change while volunteering in the orphanage. That didn’t work. Studying development and working in Cambodia has taught me that my role is to support those people making the change, like my Cambodian colleague, Phearom.

Once this became clear to me, there was no other way to work anymore. OIC’s approach builds very much upon this philosophy, giving Cambodians the tools and resources to help other Cambodians.

12. OIC Cambodia Project. The name suggests a finite lifespan for the organisation. At what point do you say, right, mission accomplished?
We absolutely want there to be a finite lifespan for the organisation. When there is speech therapy knowledge within the country, and when Cambodians are able to train other Cambodians on speech therapy, we are no longer needed. I can’t wait for that day, when every one of the 600,000 people who need access to these services will be able to access them – and from Cambodian speech therapists, who understand their language and culture.

And who knows, then it might be time for OIC: The Laos Project!

  • For further information about the OIC project: a Cambodia-based charity helping Cambodians with communication and swallowing problems. Click here: http://oiccambodia.org/
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Learning through play – 70% of Cambodia’s poorest children have no toys.

Mind the gap. Two thirds of the infant children of Cambodia's wealthiest 20% will attend pre-school.

Mind the gap. Two thirds of the infant children of Cambodia’s wealthiest 20% will attend pre-school.

One of the first impressions I had of infant children in Cambodia was formed in 2004 when I first visited Siem Reap. Each day as I travelled to and from the Angkor temples – I had a wonderful guide named Joe Topp – we would pass small villages and farmhouses, and standing outside these places were young children, listless, just watching the world go by.

Their blank faces haunted me: these children seemed somehow disengaged from the world around them: I realised I saw very few children actually playing. They weren’t pushing toy trucks through the mud, or sploshing merrily by the pump – they were just standing there.

In a couple of posts recently I have talked about pre-school education, and I was rightly critiqued by one reader who reminded me that early childhood education isn’t simply a matter of formal classroom interventions, but is a whole process of socialisation and engagement – very often through play.

So I wondered if there were any figures around this usually elusive topic. UNICEF is where I started, and sure enough I got from their website the figures which populate the chart above. Here, they compare the likelihood that young children from the poorest 20%, and from the richest 20% of Cambodian families – will attend formal early childhood education.

Yes, but what about toys or books? After all, one could have a perfectly fantastic upbringing in a home where children are encouraged to take part – for example in the way my mother used to encourage us kids to get involved whenever she was making biscuits. We were given the task of cutting the dough into shapes.

Well, here’s one indicator; again from the UNICEF website. Below, we compare the presence of books and learning materials appropriate for young children in the homes of the poorest 20%, versus the homes of the richest 20% of Cambodian families.

ECE 20 CHART2

Here the gap (12.5%) isn’t so wide, partly on account of the fact that so few of any Cambodian homes have learning materials suitable for the youngest members of the household. Only one relatively wealthy home in every eight has such materials available for their young kids.

The UNICEF surveys also asked about playthings, and here the figures are somewhat better.

  • Some 30% of the poorest 20% of households have playthings at home for the children.
  • Of the richest 20% of households, those with kids that is, some 57% have playthings available for their children.

Perhaps the gap doesn’t sound so bad – but what this still means is that 7 out of every 10 children in poor regions don’t have toys.

I would caution readers who take this as an open invitation to flood Cambodia with just any old toys. Toys should be sturdy, versatile, educational and encourage imagination. In Phnom Penh, the day after I visited S 21 I happened to walk past a toy store which seemed, unfortunately, to specialise in plastic replica guns. These looked like the real thing, and it struck me what a wicked thing to encourage kids to play with – especially  for the generation born within years of the National Holocaust.

Is the wealth gap growing in Cambodia?

Flagging a problem. Is the wealth gap growing in Cambodia?

Flagging a problem. Is the wealth gap growing in Cambodia?

I must admit a personal distaste for “get rich” seminars that seem well designed to excite people into parting with their hard earned cash. There may be merit in the teaching of Mr Rich Dad Poor Dad Robert Kiyosaki, but there was something obscene about the advertising for his course being run in Phnom Penh this year. Kiyosaki wasn’t presenting in person – the seminar would be taken by a multimillionaire who got that way by adopting the methods that had been taught since the Rich Dad Poor Dad franchise began in 1992. The banner is what put me off: How the rich get richer!

This is a problem for Cambodia, because in the years since 1979 while the economy has grown for this little nation, basically starting at ground zero, there is still a significant problem of poverty. A visitor spending a day or two in Siem Reap might not notice; after all the hubbub of traffic and commerce is headache inducing. Or go to the Phnom Penh, and the skyline is dotted with cranes, and new buildings are changing the skyline. The question is, with growing GDP, where is the wealth heading? Is it trickling down? Or trickling up?

First let’s look at the productivity per person in Cambodia. Measured in the international currency of US dollars this has grown. Figures from the International monetary fund – the IMF.

  • 2009 when it was $1,942.74
  • 2010 when it was $2,068.02
  • 2011 when it was $2,239.24
  • 2012 when it was $2,402.33
  • 2013 when it was $2,579.06

That’s a 33% growth in just four years, enough to nudge Cambodia from From being the 38th poorest nation in the world measured in these GDP terms in 2008, to become the 43th poorest nation in the world by 2013.

The income distribution is far from equitable in Cambodia. World Bank figures suggest that the wealthiest 10% in Cambodia earned approximately 30% of the total income – a figure that has slipped slightly between 2004 and 2007.

Meanwhile the bottom 10% of income earners earn around 3% of the total national income. This figure has hardly moved between 2004 and 2009. Put another way, using UN estimates, in 2004 Cambodia’s richest 10% earned 12.2 times more income than Cambodia’s poorest 10%.

This ratio of 12.2 is comparable to many other countries – 12.5 in Australia example, or 15.9 in the USA (estimate in 2007) where the CEOs of large firms seem to routinely earn multimillion dollar salary packages.

But there are some signs that the situation is getting worse in Cambodia. This is due to several factors including:

  • Poor health conditions.
  • Malnutrition.
  • Financial barriers to advanced education.
  • Environmental vulnerability – floods, storms or droughts can cripple farmers incomes. I have noted elsewhere in this blog that Cambodia has been independently rated amongst the world’s most ecologically vulnerable nations on this planet.
  • The commodity nature of rice farming in Cambodia – where farmers are priced takers, and do not have premium product with which to make greater margins.
  • The taking of farmers land by large corporations.
  • Extensive ownership of capital by foreign controlled entities.
  • Corruption at all levels.

This overall situation creates an air of hopelessness for the rural poor. How can they ever succeed if they cannot send their children to school, if they cannot afford your equipment, or if they lose their land.

I was pondering how this hopelessness begins at a very early age, especially amongst children and families so poor that starvation or malnutrition is a serious problem.

Two Hong Kong academics wrote a report in  2009 concerned with early childhood education. They were examining the weak infrastructure around pre-schooling – noting that while the Ministry of education youth and sport (MOEYS) is committed to the idea of preschool, to help give young Cambodian infants head start educationally, in practice there is scarce public funding for such a strategy. This has been left up to the communities to provide. A case I suspect, whether rich get richer, and the poor don’t even get a start at all.

Here’s what they said in their report:

Exclusion on the grounds of poverty.

No one is more likely than a child to live in poverty in Cambodia
(UNICEF & RGOC, 2006). The representation of the poor is much greater in the primary than in the secondary or tertiary student population. In Cambodia 20% of primary students but only 2% of upper secondary students are drawn from the poorest 20% of the population. In contrast, 61% of the upper secondary students come from the richest 20% of the population. The representation of the poor in tertiary education is zero whilst the richest 20% account for 57% of tertiary level students.

As has already been discussed, poor children are currently rarely found in preschool provision and the MoEYS has identified them as a target group on which to spend its limited resources for ECCE in order to ensure equity of opportunity. It acknowledges that this is likely to be challenging as the poorest communities lack good models, infrastructure and experienced providers.

Preschool and Preparation for Primary School

It is widely accepted that preschool experiences, by preparing the child academically and socially for school, lowers repetition and drop-out rates. The benefit is felt most by children in the poorest communities. Yet in Cambodia, children with the greatest need of the chance to learn in groups, mix with others, acquire pre-academic and language skills before they begin primary school are the ones that have the least access. Thus ECCE is not only intrinsically important but is needed to provide experiences and preparation that gives a child a much better chance of succeeding in school and completing at least six years of primary school. ECCE is a vital component of a successful Education for All strategy.

Although the initial enrolment in primary school has improved significantly, the drop-out rate remains stubbornly high and one of the main reasons is poverty. Families are often unable to pay the cost of schooling that can amount to 79% of per capita nonfood expenditure of the poorest 20% of families.

Another significant concern regarding children in Cambodia is that at the formal age of enrolment into primary school, many are too immature in their physical, social, linguistic and cognitive development. This is reflected in delayed enrolment and high repetition rates in Grade 1 leading to high dropout rates (RGOC, 2003). They are simply not ready for school as a result of malnutrition and lack of preschool experiences. Only 58% of Grade 1 students are six years old, the prescribed school entry age.

Only 45% of children in Cambodia who start primary school will complete Grade 6, and only 38% will enter lower secondary school. It takes an average of 10.8 years for a child to complete the six-year primary school cycle (UNICEF & RGOC, 2006).

Early Childhood Care and Education in Cambodia by Nirmala Rao Veronica Pearson, The University of Hong Kong

(International Journal of Child Care and Education Policy Copyright 2009 by Korea Institute of Child Care and Education
2009, Vol. 3, No. 1, 13-26) For A PDF of the report CLICK HERE

I accept that many of the figures I have highlighted for emphasis have improved somewhat, since these figures were first collected, but they highlight why free education is so valuable for poor rural areas.

Imagine that – just 2% of those who make it to grade 12 at high school, come from the poorest 20%.

Last week Savong sent me the list of students from his school who have progressed through to  winning University scholarships – a program we instigated four years ago. The first two graduates have already come through, and their two cohorts have both taken up teaching jobs, just a few papers away from completing their degrees.

Meanwhile more recent scholarship winners are attending Angkor University, and studying computer science, tourism (which has a strong management component) as well as English. these students have a lot of pressure on them in some ways. They know their families will depend upon them, and they know there are up against much more privileged students from the city.  When Rao and Pearson wrote their report, at that stage less than half a percent –  statistically 0%- of tertiary students in Cambodia came from the poorest 20%. And at that stage less than 10% of teenagers were progressing through to University education. so if you allow me to roughly play with figures, that makes the chances of producing graduates from Bakong something like 1000:1.

Those are the kinds of odds that families are up against in poor rural areas within Cambodia. Those are the odds that Savong and his supporters, and his staff, are working hard to beat.

For more: Let’s not forget the costs of poverty – and the pressure it puts on young people

Savong’s School – Primary school classes are open

DSC_0819

Savong’s school now serves primary school-aged children, Grades 1 through 5]

Over the past 12 months in this blog I have called up statistics from the Ministry of education youth and sport (MOEYS) which highlights the pressing shortage of primary school resources for the burgeoning young population of the nation. Teacher to student ratios are unwieldy –  1 teacher for every 47 young children, nationally. The need is similar in our community of Bakong. Another issue is that the state system has a tendency to charge families for what ought to be a free service. In some respects this is understandable, given the low levels of government spending toward education: low by global standards. Other critics however refer to school fees fundamentally as a bribe.

Savong’s school has always operated on the basis of providing free education. For the past nine years the school has focused on teaching languages and computer skills to older students grade 6 through to great 12. This year the decision was made to open up the school to serve primary students as well.

It was a practical decision; the senior classes run in the later afternoon and buildings were sitting quiet for a good part of the day. So why not open to classes up to teach the local community of young children who don’t get taught at the regions primary school. Five teachers have been recruited – all females as it turns out – and enrolments of local students took place in September. The local community is always wary of new services, and they want to know that their children are going to receive a quality education. So our starting figures are modest, and we’re going to build from here.

A total of 39 students, 19 girls and 20 boys, have been enrolled at the school and with teacher to student ratio of one to every eight, we can expect some pretty good results!

  • Why not share the joy of participating in this project by helping sponsor the teachers? If you’d like to find out more, please email me duncan@kudos-dynamics

A teenage tragedy – a sad loss of life

This week the children at our school were rocked by the sudden death of one of their fellow students, a teenager who took his own life one evening. Nobody saw it coming. Today as I write this, there is a full-scale funeral for the boy and those attending include fellow students, teachers and other staff who have been involved in the care and teaching of this young man.

The event may have been triggered by another suicide, also involving a teenager from the same village one month earlier: I can’t be certain of this.

The sad news prompted me to research the incidence of suicide in Cambodia, and to examine some of the attitudes surrounding this.

Ten years ago when I first came to Cambodia I asked about attitudes to suicide, thinking that perhaps Buddhist attitudes might be more accepting of this, compared to Western religions. Not so: it appears all major religions in the world are agreed that taking one’s own life is a tragedy best avoided.

But avoiding suicide amongst teenagers is a difficult thing. My own country, New Zealand, holds one of the worst teenage suicide rates in the world, and in 20 years I’ve not seen any convincing program to deal with this problem. More likely, the story is more granular and complex – with many many good interventions effectively saving lives but going unreported while meanwhile a bigger avalanche is still occurring.

In Cambodia psychologists have in recent years turned their attention away from the stress disorders resulting from the Pol Pot years, and started to focus on the issues faced by the burgeoning young generation aged under 30.

Here the figures get murky. According to government reports, for example in 2013, there were some 600 suicides in Cambodia, up by 13% over 2012.

But these figures are hotly disputed by university psychologists who have studied the issue in depth. They say 600 is a mere fraction of the real numbers. One issue is the lack of autopsy and official record-keeping associated with deaths in highly rural Cambodia.

And as a researcher I know how hard it is to otherwise calculate these things. You can’t just conduct a survey and ask people on a scale of 10, how close they have come to taking their own lives. Ms Sek Sisokhom, head of the Royal University of Phnom Penh’s psychology department suggests that the government figures woefully under-report the true state of affairs. Using rigorous research, and representative sampling, her research calculates that among adults the rate is more likely in excess of 40 individuals per hundred thousand (42.35 reported suicides per 100,000 of the population in 2011.)  This puts Cambodia right near the top of the ladder in terms of global figures, unfortunately. See Phnom Penh Post.

The under-reporting, which is clearly happening, reveals something of the attitudes towards suicide – and a lack of concerted effort to do something to prevent young people taking their own lives. If society was committed to solving the problem, then it would begin by measuring it and looking for patterns.

As it stands, the existing research reveals the following:

  • Young people under the age of 25 are the most susceptible to thoughts of suicide.
  • There is a clear gender split – young men much more likely to contemplate suicide compared to young women.
  • There are societal causes implicated including unemployment and poverty.

Psychology studies in Cambodia (see also) conclude that young people are poorly equipped when it comes to discussing the problems, or knowing where to go should they need help. Like young people in many places, the young adults of Cambodia tend to bottle-up their feelings, often hiding their true state of mind.

As social workers worldwide recognise, suicides can occur in contagions – with one event at a high school triggering others. Whereas western schools are, more and more, putting grief counselling processes in place – or having access to these – the same is not true in Cambodia. Yesterday I spoke about this with a friend of mine, Royce, who actually comes from the same village as the boy took his own life. He recommended that we get in contact with an organisation, an NGO, that specialises in social counselling: TPO is the organisation, and while their main focus was historically on postwar stress disorders, their services now include grief counselling.

This week is very sad, but we should use the opportunity to increase our understanding of the issues, and raise the level of grief counselling intervention to help prevent another contagion.

The government crackdown on school exam cheats

CAMBODIA PLUS BACK TO WORK MAY 09 097

A fishy pass rate in 2013 – virtually halved after a crackdown on Grade 12 cheating.

It is interesting to consider the extent – rife by any measure – of high school exam cheating in Cambodia. the figures are stark: 2013 the Grade 12 exams were wide open to cheating, and 83% passed. In 2014 following a crackdown on cheating, just 39% passed. Ouch!

How and why should cheating be so widespread in a land where there is a fairly strong religious moral code at work?

  • For one thing, there is a desperate profit motive – and a widespread form of cheating was always made possible by the willingness of some teachers to copy and sell answer sheets for the exams.
  • Second, as in countries like Italy, (or, dare I say, in New Zealand or the USA,) there is a distinction made between personal morality versus one’s stance towards a government which is largely distrusted. You wouldn’t cheat your family, but you might happily ‘beat the system.’
  • Third, the high-stakes for the grade 12 students. Passing those exams is like a gateway to a better future. Failure at this point has huge long-term repercussions. The small act of cheating today has had little downside, while it has potentially massive upsides: the risk is worth it.
  • Fourth – very poor exam supervision. In 2013 newspaper reports quoted students as saying they actively passed notes and answers around to their fellow students. There were an inadequate number of independent monitors, and of course some of the teachers who were doing the monitoring were the same teachers who had previously sold the answers.
  • Fifthly, nobody foresaw the ease with which social media could be employed to share the answers around the exam hall. With the ownership of smart phones being so high, it was easy for students to create Facebook pages dedicated to sharing answers among friends. Phones were allowed in the exam rooms.
  • Finally, and I don’t want to make this sound like an excuse, but the culture of Cambodians is very us oriented, rather than me oriented. In the classroom, students actively help each other. They are not out to succeed at the expense of their classmates. Exams are not a competition so much as a team exercise.

In 2014 the Ministry of Education Youth and Sport staged a well executed national crackdown on school exam cheats. They enacted a strategy designed to prevent teachers and examiners from publishing in advance the exam questions and answers. Given this was never going to be the whole answer, the Ministry also conducted body frisks on students entering the exam rooms. They confiscated cheat sheets and telephones. Lots of them! Finally, the authorities conducted much more rigorous supervision during the exams. Students who were used to whispering answers to friends remained quiet in 2014.

The crackdown in 2014 was a great step forward for a transparent and fair education system. Yes, many students learned that old-fashioned study and hard work are the most certain ways of graduating from grade 12. Ironically, the group who had in the short term had most to lose, were the tertiary institutions. Enrolments were down sharply for 2015, causing an unexpected cash flow problem for several universities.

See also: Exam result show dive in 2014.

See more education facts and figures.