Battambang Hospital, Cambodia

Clear Path Co-Founder Imbert Matthee is leading a group of CPI supporters across Vietnam, Cambodia and Thailand. He has filed this report.

My Cambodian friend Sary has been telling me for years that I should go visit the hospital in Battambang, the second-largest city in Cambodia. �They do not have anything,� he keeps saying while shaking his head. That�s followed by another statement along the same lines and a short laugh that implies I can�t possibly imagine how deprived this medical facility is. It wasn�t much of an exaggeration.

What�s true for many hospitals in the developing world is true for western Cambodia. If they have equipment, it�s very old and patched together like Cuban cars. It�s one of the reasons we started a medical equipment donations program at Clear Path four years ago. If you have ever wondered why your medical premiums are so high, it�s partly because there is an enormous amount of equipment turnover and waste of supplies in the health care industry in the U.S.
Technology, government regulations and medical methodology keep changing, but the surplus that results is by no means obsolete at a hospital like the one in Battambang.
Take the OR. It has one functional surgery suite that serves hundreds of thousands of people living in three border provinces: Pailin, Battambang and Banteay Mancheay. And, frankly, I am not sure I would want to submit to an operation there myself.
The �ambulance� is a rusty old Japanese pickup truck. There is virtually no emergency room equipment. Beds are old steel monsters without mattresses. Of course, there is always the suspicion that the good machines from government support are diverted to private clinics, so we won�t ship anything here until our Cambodia partner organization has a regular presence in the province and can make sure the items stay where they belong.
Since 2001, Clear Path has sent 34 containers of equipment to hospitals in the developing world. This capacity-building program largely for landmine-affected countries has served hospitals in Vietnam, Cambodia, India, Colombia, Peru, Ecuador, Guatemala, Brazil, Jordan, Iraq, Afghanistan, Congo, Uganda, Thailand and the Philippines.
Just last week, with help from Sary, we shipped three containers of exam tables to Cambodia�s Medical Volunteer Association in Phnom Penh, which will distribute them to Battambang and other hospitals we will follow with.
One of he next shipments will have other items the 32 docs here can use: beds, gurneys, OR equipment, oxygen tents, defibrillator, gloves, dressings and all kinds of surgical supplies. The donation will give us some leverage too. In exchange for saving on his acquisition budget, we are asking the director to pay more attention to the landmine accident survivors we will probably refer to the hospital once the training center near the border is up and running (see the blog about Phan Thong Kam).

Bomb Explosion Kills Two Children in Vietnam

Thanks to Hugh Hosman for forwarding us this report. CPI staff will repsond in the coming days and we will have an update.

Source: Agence France Presse -- English

May 16, 2005 Monday 5:40 AM GMT

LENGTH: 184 words

HEADLINE: Vietnam War-era shell kills two children, injures two

DATELINE: HANOI May 16

Two children were killed and two others seriously injured when a Vietnam War-era grenade exploded, doctors and officials said Monday.

The blast occurred Saturday when the four siblings were playing with a shell they had found near their house in southern Vietnam's Kien Giang province, a commune official told AFP.

The oldest girl aged 12 died on the spot and her seven-year-old brother died in a hospital, the official said.

"The two girls who survived in the accident, aged 10 and nine, are in stable condition now," said a doctor from the provincial hospital.

Their village, Phu My, bordering Cambodia, used to be a target of American mortar and shells during the Vietnam War.

Since the war ended in 1975, more than 38,000 people have been killed and over 100,000 injured as a result of unexploded ordnance, according to Ministry of Public Security figures published by state media.

According to the United States military, more than 15 million tonnes of bombs, mines, artillery shells and other munitions were used during the Vietnam War.

It is estimated that as much as 10 percent of this failed to explode.

Mine Survivor Phan Thong Kam

Clear Path Co-founder Imbert Matthee is leading a group of CPI supporters across Vietnam, Cambodia and Thailand. Photo by Erin Fredrichs.
Phan Thong Kam�s household grows rice to make a living. But the 39-year-old farmer from western Battambang Province who stepped on a landmine while taking some cows to wash at the lake, says it�s not enough to survive.

He lost his left leg above the knee and fragmentation injuries to the right leg make it hard for him to use it properly. He can only get around on crutches. His wife and 14-year-old son tend the rice fields on the family�s two-hectare plot (about 4.5 acres).

Kam himself does some mechanics, mostly futzing with motos. Occasionally, he can help fix the low berms framing the fields or transplant seedlings, but often he feels less than useful and he would welcome a chance to change that.

Enter Clear Path and its partner, Cambodian Volunteers for Community Development.
Our ambitious plan is to set up a training center near Kam�s village of Ampil Pram Doem at the heart of one of the most heavily mine-contaminated chain of districts bordering Thailand. Each one has hundreds of survivors making a very marginal living.
First, CVCD would work with disabled survivor families and vulnerable households like Kam�s to create a cooperative of rice growers in the area. Their skills and yields would be improved by initial training in the field.
Then, the two organizations would build a rice mill on a plot of land, where we would also build a training center like the one we have had in Kampong Cham Province for the past several years.
A specialist would train two or three mine survivors in the art of running a rice mill, whose various products � rice, bran and animal feed � would be sold to the slum communities CVCD provides education and training to in Phnom Penh. CVCD already sells about 30 tons of rice a month to these and other customers in the city.
Once the mill is running and generates revenues, CVCD would expand its agricultural skills training by offering classes to survivors in
animal husbandry, vegetable gardening and fruit-growing. Plus, it would start a course teaching other survivors the art of small-engine repairs and possibly electronics.
Within about five years, the training center might be expected to pay for itself and possibly make a contribution to other CPI/CVCD efforts to improve the lives and livelihoods of disabled landmine survivors and other vulnerable groups, such as divorced single mothers.
Kam says he would be very interested in the animal husbandry program because raising cattle or other farm animals is something he can do to become a more valuable contributor to his household.
�That would make our income higher,� he says. �That would be very good for us.�

The New Road Seemed Like a Good Idea

Clear Path Co-Founder Imbert Matthee is leading a group of CPI supporters across Vietnam, Cambodia and Thailand. He has filed this report. Photo by Erin Fredrichs.


At Clear Path, we say we pride ourselves in reaching out to landmine survivors. But what does that mean? Well, our group got a taste of it in Cambodia.

In our three project countries --Vietnam, Cambodia and on the Thai-Burma border -- it�s our staff or partner organization who work with the survivors on a daily basis.

In Vietnam, it�s office staff of five: Toan, Chi, Phuong, Duc and Nhi. They cover a territory of 14 provinces along the central coast. Sometimes, the outreach is done remotely, through banking wires and local agencies that dispense our assistance to the families involved in the accidental explosions in this big area.
But most of the time, the staff responds directly to accidents and personally assesses the needs of existing survivors all over the former DMZ area. And they are fast. Thanks to a growing network of reporting relations, they get news about an accident within hours of its occurrence.
Says Dave Greenhalgh, project manager at Mines Advisory Group, the British mine-clearance organization whose office is next-door to ours in Dong Ha: �I will hear about an accident in the morning and the CPI staff will already be at the hospital by lunch. They are amazing.�
Duc gets behind the wheel of the Nissan Patrol, a sturdy 4x4, and heads off to where the team is needed with Chi and/or with Toan or Nhi. Since the territory we cover runs up to the mountainous border with Laos, reaching survivors there isn�t a stroll in the park.
Even a Patrol gets you only so far. Paths to the farms can be narrow, so they have to get out and walk. Some of the hill tribe villages are only reachable on foot. When I was going through some shots the staff sent recently, I caught an image of the team hiking through a rolling green sea of jungle mountains wearing their rain coats and looking very determined to let nothing stand in the way of CPI outreach!
In Cambodia, our partner organization � Cambodian Volunteers for Community Development � faces an equally challenging task reaching out to landmine survivors. Both countries are largely rural and a big number of survivors live out in the sticks.
Sarath but mostly Chanthon, who represents CPI at CVCD, travel for miles on the dusty rutted roads in Kampong Cham Province to reach out to potential students for or to keep track of graduates from our vocational skills training center for landmine survivors in Stoeung Trung.
The road is pretty decent from Phnom Penh to Kampong Cham City: asphalt with potholes and dips sprinkled throughout. There used to be a boat up to Stoeung Trung, but since they built a road to this town on the wide and sluggish Mekong River, the boat owners were forced out of business.
That new road sounded good to us before we first saw it. We discovered it�s a glorified dirt strip meandering along the riverbank through the many Cham villages. We were told there were plans to improve it further, but in the last election these villagers voted for the Sam Raimsey Party instead of the Cambodian People�s Party of Prime Minister Hun Sen so road improvement plans here got pushed to the backburner.
You have to remember this is the dry season in Cambodia. Even with that, the road had some serious mud ponds. At one of them in the middle of a village, there was simply no other way but to go through it. There were huts and vegetables gardens blocking any path around it.
These hovels are photogenic to say the least: homes with thatched roofs or rough teak sides built on stilts in a traditional style to escape annual flooding in this flat land near the Mekong. Except for the occasional homeowner who can afford paint, the tones of the huts, the oxen carts, ruddy road and grazing water buffalo are beautifully monochromatic. It�s visually held together by a �glue� of fine red-brown dust that settles on everything after traffic passes.
Our minivan driver, who was phenomenal during all of our four days in the countryside, took a running start and headed for the pond. But even for him, this was an insurmountable obstacle. Sure enough, we got stuck right in the middle, gears grinding, wheels spinning, villagers watching and gesturing in animation.
We had to get out, which was tricky. Erin, the photographer, stepped deep into the muck to the delight of the onlookers. Good-hearted Cham women nonetheless offered to rinse off her chocolate-colored sandals and feet. The driver tried again, but to no avail. We needed a hand and got one after we offered to pay some sinewy young Muslim men and boys a price in Riel for getting us out of our predicament.
They got behind the minivan, stepping deep into the soft goo and started heaving the once-white back hatch until it started moving forward, spinning and fishtailing out of the pond. I couldn�t help feel there was some planned entrepreneurial aspect to the speed at which the strapping backs came to our aid. But the rescue was worth the toll.
A little further down the road, we were asked to make a financial contribution to a village effort to fill the many bone-jarring holes and treacherous puddles -- something I thought imminently more constructive. Of course, any constant care of this road has to be a labor of love since the slightest subtropical rain washes the handiwork away.
I can only imagine what all this looks like when the monsoons arrive in the coming months.

Effie Posts from Cambodia

Effie is a massage therapist travalling with Imbert Matthee, co-founder of CPI, across Vietnam Cambodia and Thailand. She posted this report. Photo by Erin Fredrichs.


On this trip, I�ve been searching for opportunities to work with landmine victims. I�ve wanted to help ease some of the physical and mental pain that remains long after their explosive accidents. We traveled to a small community center in the Bovel District of Cambodia. It is there we are met by three landmine-affected men, all have families, all are rice farmers. After the initial meeting, I ask, �Have you pain?�
�Yes,� they say. Their spines and femur bones hurt.
�May I help?� I ask, and indicate head and base of spine. They smile nervously, titter and tell us they want lunch first.

Quietly, without notice, it is decided who will try, Mr. Phan Thong Kam. I had been enjoying Mr. Kam�s broad smile and strong, wide hands. He consents to lie down on his back, on one end of a long wooden table. I move to the end of the table and sit facing the top of his head.
I ask Mr. Chanthon, our CPI liason to the Cambodia Volunteers for Community Development, to tell him I am going to pick up his head and proceed to do so.
�Relax your head,� I say. Mr. Kam, a little hesitantly, does so. We begin. I know at once, the compensatory patterns he has formed to adjust for the missing left leg and the oddly, medially rotated right foot and leg that must carry his medium sized frame.
Mr. Kam�s neck is thick with congestion and feels quite rotated to his right upper cervicals, base of the skull and spreading up into the right side of his head. I follow the weight of his head which leads me toward a right side bend, ear to shoulder. I know this is a neural pathway to his shoulders and left amputated leg. We work slowly, at the pace his central nervous system is able to tolerate work. His body�s soft, connective tissue is the guide. Stored within the fascia layers are his physical and emotional experiences, the map to unwind what has happened. He tells me that he has daily headaches.
Soon his head volunteers back bending (extension). I invite him to move back, dropping his head into my hands out in space, to allow extension. This is a way the brain begins to unwind and tonify the capabilities of the spinal cord and associated neural ganglia. The real work begins, that of neural connections.
Mr. Kam�s body responds readily. His neck congestion starts to break up, the hypertensive tissue starts to unwind. His eyes close and he rotates his his face right to deepen the release. I acknowledge the information flow to his left arm by lifting it.
Mr.Chanthon translates again for us. I tell Phan that he may feel different sensations and to move his attention toward them. We will go into and through these tense, strained places, the working edge, and feel them release.
�For me,� I tell him, �it is like driving a car. I know the roadways, the map, and simply help his body stay the course for self-healing�.
We all laugh, his body guides. He is the healer.

The Group Reaches Cambodia

Clear Path Co-Founder Imbert Matthee is leading a group of CPI supporters across Vietnam, Cambodia and Thailand. He has filed this report.

The short, energetic and somewhat nervous man with the boyish grin points to a field where his uncle was caught fishing by the Khmer Rouge. They sent him to the jungle near the Thai border and within a few months, he was executed.

Everyone in Cambodia has a story that marks a memory from 30 years of torturous civil war.

This is the story of Savorn Singha, 38, born in Bovel district, Battambang Province when the first fighting started and still shell-shocked by the trauma he shares with the rest of his country. His story is an introduction to the part of Cambodia where Clear Path International and its Cambodian partner hope to start their next project in support of landmine accident survivors.

Battambang Province and in particular the districts that straddle the Thai border have the country�s highest landmine accident rates. The day before our group arrived in the Bovel commune close to the new project site, a landmine exploded behind the community building. While our partner organization, Cambodia Volunteers for Community Development were here in April to survey landmine survivors about their interest in learning new skills to boost their income, two accidents happened back to back.
An explosion goes off at least once a week. Here�s why.
The trouble started in the 1960s. Savorn�s home village called Kauk is a good example of how communities got caught, then remained suspended in the crossfire, resulting in the thousands of landmines and pieces of unexploded ordnance that contaminate their environment to this day.
Kauk was strategically located on the Mongkol Borei River that runs somewhat parallel to the Thai border about 90 kilometers inland. At first, it was the White Khmer who set up a base in the land between the river and the border. That was the year Savorn was born: 1967. Supported by Thailand, the White Khmer fought the regime of King Sihanouk. The rebels would cross the river, capture Kauk until they were chased by Sihanouk�s troops.
The pattern would repeat itself for years. After 1970, it was the Khmer Rouge that fought the U.S.-backed government of General Lon Nol. From 1975 to 1979, the village suffered under the murderous Khmer Rouge regime until its troops were pushed back behind the river by invading Vietnamese troops.
Every week, the shells and rockets would fly overhead across the river. Khmer Rouge troops would cross the river, encircle the village, occupy it and reckon with anyone suspected of supporting the other side until the other side would launch a counter attack and beat them back across the water.
The conquering government troops would subject the villagers to the same treatment. Savorn says 20 people in his community of 120 families were killed by Khmer Rouge or government troops. School was constantly interrupted. Troops from both sides helped themselves to the village�s meager crop of rice.
�We were like a nail between the hammer and the plank,� he says, explaining that both his parents died in their fifties from �war trauma.�
The fighting across the river lasted for nearly two decades until it finally stopped in 1996. By then, Savorn had fled to Thailand, where he finished high school in one of the refugee camps and took an engineering course.
He came to Cambodia in 1992, though not to Kauk, and went to work for a village economic development project supported by the United Nations High Commission on Refugees, Oxfam and the Australian Embassy. Now, he is a program manager for Village Focus International, which is helping CVCD and CPI to put together the new project in western Battambang Province.
The two organizations hope to build a destination agricultural and vocational skills training center for disabled landmine accident survivors and members of their families. It would serve beneficiaries in three districts, including Bovel, where Savorn is from.
The meaning of Bovel in Khmer aptly describes its experience since the late 1960s. The word stands for �twirling water in the lake.�
Savorn, who has helped set up and run a similar facility in Pursat, says his personal history and his village�s experience make him very passionate about the project.
�I have seen the suffering of the disabled people in my village,� he says.
One of his hometown neighbors lost an arm and an eye in an explosion. Another lost both legs. In his village, six people were killed and seven injured by landmine accidents, plowing, cutting bamboo, hunting. Two were blinded.
�I can share my experience (in development),� Savorn says. �They need my help.�

Le Thuy, Quang Binh Province, Vietnam

Authored by CPI Co-founder Imbert Matthee.

When I was here in August, workmen were just starting to dig a foundation. Now, the new Le Thuy community-based physical rehabilitation training center has been completed. With the guidance of the center�s physical therapy nurse, several dozen disabled children use its equipment eagerly.

In one room, they pump the rowing machine and walk the thread mill. In the other, a teacher shows them how to exercise with weights. They are strengthening their muscles and, in some cases, relearning how to use their bodies.

Funded by Clear Path International and the East Meets West Foundation, the training center is the only of its kind in Quang Binh Province. It�s fully integrated with the school for disabled children on the same grounds.
Only two months in operation, center director Hu says, the training center is already showing results: �Some children only knew how to crawl. Now they stand and touch the wall.�
The center serves 19 out of the 28 communes in Le Thuy District, which has a total population of 145,000. About 70 children attend five classes a day � four academic and one dedicated to physical therapy. Twenty children live in the center�s dorm.
The staff was trained by specialists from the Vietnam Cuba Friendship Hospital in Dong Hoi, the provincial capital. The children�s parents go through an initial two-day training course so they can continue the exercise regime at home. Some parents attend their children�s training classes when they can, Hu says.
Former CPI country director Hugh Hosman worked with East Meets West to set up the center. EMW paid for the construction. Clear Path paid for the equipment and the training.
The center is a good example of our capacity-building goal for mine-affected communities in the former Demilitarized Zone. Le Thuy District has 691 disabled children, 300 of whom are mobility-impaired. Forty-two children from the district are scheduled to receive surgery at the Vietnam-Cuba Friendship Hospital, after which they will come to the training center for rehabilitation.
It�s already a great community resource and could well become a model for similar centers in the DMZ area, where these kinds of facilities are still sorely lacking at the local level.