The secluded nature of Kampong Damrey village in Kratie province bears heavily on its women, especially when they are pregnant. But a UNICEF-supported health outreach programme could change that. Ponlok Leng and Latifah Azlan tell why.
Khut Sokhorn is a 39-year-old rice farmer from Kampong Damrey village in Boeung Char commune, Kratie province. Though it lies along the Mekong River, her village is remotely located and difficult to reach. The closest towns are found many kilometres away, where they are accessible only by boat. This means that essential services are isolated not only from Sokhorn, but also from the 93 other families who live in this village.
In particular, the residents of Kampong Damrey village must travel long distances to reach health facilities. Aside from the high transportation costs, this journey also becomes more complicated during periods of extreme weather such as in the rainy season, when the water levels rise higher than usual, and in the dry season, when water levels are so low that boats cannot easily navigate through the river.
The secluded nature of Kampong Damrey village bears heavily on its women, especially when they are pregnant. Due to the different challenges they face in traveling to adequate health facilities, some women choose to give birth at home with the help of traditional birth attendants, who may not be well-equipped to respond to complications during labour.
Sokhorn recently found herself in this position again when she became pregnant with her seventh child. She and her husband struggle to provide for their large family. The costs of taking a motorbike taxi and subsequent boat ride to the nearest medical facility can be prohibitively high for the two of them. However, through a UNICEF-supported health outreach programme, Sokhorn was able to regularly access health services, including the opportunity to deliver her baby in a proper facility.
The Cambodian government’s Maternal and Newborn Health and Nutrition Programme, with support from UNICEF, delivers basic health and nutrition services to communities that are within the vicinity of a health centre, but are too difficult to access. Kampong Damrey, along with eight other villages in the Boeung Char commune, are part of this programme.
The services offered under this programme include providing vaccinations to women and children as well as Vitamin A and deworming supplements for under-five children; giving pregnant women prenatal and postnatal checkups; screening children for malnutrition; and holding regular health education sessions on topics as varied as pneumonia to breastfeeding and sanitation.
Additionally, commune councils designate a portion of their budget to support poor and vulnerable families in need of essential health services. This was how Sokhorn was able to afford the transportation costs of traveling to a health centre in nearby Sambor to deliver her child. She was also exempted from paying the delivery fee as well as the costs of any other treatments provided by the health centre because she carries an IDPoor card.
Sokhorn credits the UNICEF-supported Maternal and Newborn Health and Nutrition Programme for giving her the knowledge and ability to deliver her baby in safe conditions.
“Without the support I received, I definitely would have had my baby delivered at home because my family does not have any money to pay [for these services]. I may experience similar risks as the woman who died [during childbirth] in 2017,” she said.
Commune councilor Tay Siengly says there are plans to expand the financial assistance component of the programme in order to serve more families in the eight villages throughout Boeung Char commune.
“To address the shortage, we have asked each village to create a community self-saving fund. The self-saving fund will be used to assist the people in the village in the event of an emergency, especially women who have problems related to pregnancy and delivery so they can avoid risk and danger.”
Sokhorn’s son is now 8 months old. During her last pregnancy, she attended six prenatal checkups, including twice at the Kampong Cham health centre and four sessions with midwives who came to Kampong Damrey village under the health outreach programme. At each session, she received iron supplements and a vaccine that prevents her from contracting tetanus. Sokhorn’s positive experience has led her to advocate for the services provided by the programme and the local commune council.
“I will share my own experience in antenatal care to alert other pregnant women who are living near my house, so that they can understand the benefit of antenatal checkups, and if they do not have any money to go to the health centre for delivery, they should consult with Ming Tay Siengly, the commune councilor who lives in our village.”