Understanding Trauma in Cambodia Handbook (fully in Khmer and English)

Cambodia seeks way out of post 'killing fields' mental health crisis

Reuters | 5 October 2015

PREAH AONG KAR, Cambodia (Thomson Reuters Foundation) - Hing Phon thought she was losing her mind when night after night terrifying nightmares jolted her awake as she dreamt of her husband, eldest son and 18 other relatives being killed by the Khmer Rouge during their brutal reign in Cambodia.


Pitting poorer farmers against richer ones, the Khmer Rouge inflicted extreme cruelty and violence on people in her village in the southern province of Kampot when they took control of the area in the early 1970s.

"So many nights I could not close my eyes because the memories of my loved ones would haunt me," the 81-year-old said, resting in the shade outside her house in a hamlet some 120 km (75 miles) south of the capital Phnom Penh. 

"We lived through a nightmare," she said, her back stooped from years of forced labor in the fields during Pol Pot's "year zero" quest to create a classless, agrarian society.

During the regime's genocidal wave of terror from 1975 to 1979, at least 1.8 million people - about a quarter of the population - died through torture, execution, disease, overwork or starvation.

It is a legacy that left millions of Cambodians with psychological scars the impoverished country is ill-equipped to deal with due to deep-rooted mistrust and a lack of money for reconciliation and mental health treatment, experts said.

Cambodia has one of the highest suicide rates in the world, a study by the Royal University of Phnom Penh said, with 27 percent of those surveyed suffering from acute anxiety and almost 17 percent from depression.

It also has more people suffering from post-traumatic stress disorder than any other nation, with estimates ranging from 14 to 33 percent, compared to a global average of less than 0.4 percent, according to a study by the U.S.-based Leitner Center for International Law and Justice.

Even though Cambodia is training more health professionals in post-conflict trauma, there are fewer than 50 psychiatrists in the country of 15 million people, the study said.

LIVING CHEEK BY JOWL WITH THE ENEMY

One of the locals who joined the Khmer Rouge was Pen Lay, the son of a poor farmer in a village just a few minutes' drive away from Phon's.

Lay said he was recruited by force and had no choice but to arrest villagers before they were executed by the Khmer Rouge.

"They ordered me to do these things. I had to do it or die myself," said the frail 58-year-old, speaking in his native Khmer through a translator. He smiled nervously as he related how he almost starved when the Khmer Rouge forced him to clear forests.

Experts say that throughout Cambodia villagers are living side by side with the alleged killers of their loved ones.

Despite Buddhist teachings that help to contain conflict many find it hard to accept that the guilty walk freely among them.

A 2011 study by the University of California, Berkeley found two thirds of Cambodians would like to see perpetrators "hurt or miserable" and that one third would seek revenge if they could.

Amid this apparent desire for vengeance, the "Victim-Former Khmer Rouge Dialogue Project" is a rare attempt to reconcile villagers and heal society.

Run by the local charity Kdei Karuna and the Transcultural Psychosocial Organization Cambodia, the project brought former Khmer Rouge soldiers together with civilians in a seven-month-long reconciliation program. 

Tim Minea, executive director of Kdei Karuna, said the process was fraught because of decades-old hostility.

"It is difficult, especially to take the first steps, because often people don't even want to talk to each other," the sociologist said.

Reconciliation is further complicated by the fact that many former Khmer Rouge soldiers see themselves as victims too, a fact many survivors find hard to accept, he added.

"I also lost my father and my brother. My youth was severely disturbed and then I lived in fear (of retribution) for so many years," said Lay, the former soldier.

For Phon the most salient moment in the reconciliation process was when Lay said his actions during the Khmer Rouge regime were wrong and immoral. 

JUSTICE BUT NOT RECONCILIATION

A handful of Khmer Rouge leaders accused of atrocities during the 1970s "killing fields" era are being tried by a U.N.-backed tribunal in Phnom Penh. It kicked off in 2006 but has so far only secured three convictions. 

While the tribunal has helped to bring some justice, Cambodia still has a long way to go towards reconciliation, said Youk Chhang, director of the Documentation Center of Cambodia (DC-CAM), the country's leading research center into the Khmer Rouge atrocities.

"We're stuck in the victim/perpetrator view of our history," he said.

A textbook about the genocide published by DC-CAM and distributed to schools in 2009 has helped to improve understanding but only a few international donors have earmarked funds for reconciliation projects, he said.

Seventy percent of Cambodians were born after the genocide but almost everyone has a family member who was killed, tortured or forced into hard labor by the Khmer Rouge.

PRAYING TOGETHER

Four years after the end of the reconciliation project, participants say it has helped them come to terms with the past and improved relationships between the villagers.

Phon says she still has some sleepless nights but feels more at peace now thanks to the project and her Buddhist faith, which was banned by the Khmer Rouge.

"We all share the same blood. There can't be harmony for future generations if we don't reconcile," she said, watching some of her 21 grandchildren play in the garden.

This month the villagers will gather at the local pagoda to mark Pchum Ben, an annual festival honoring their ancestors, and pray at a stupa built to commemorate the killing of 400 people there by the Khmer Rouge. 

Tes Ding, a 65-year-old former monk defrocked by the Khmer Rouge and forced to work in the fields, wants to find funds to extend the area where people can sit to pray around the stupa, surrounded by paddy fields the Khmer Rouge used as mass graves.
"Our country will never be at peace if we feel hatred towards each other," he said.