Soun Neang is a firm believer in the traditional practice of kors kha-yal to cure illnesses.
As a farmer during the Khmer Rouge regime, Soun Neang, now 63, witnessed a young woman in her early 20s fall to the ground, unconscious from exhaustion while harvesting fruits and vegetables.
For 10 days, a group of old women in the labor camp repeatedly performed kors kha-yal, or coining, on the unconscious woman, using a metal spoon to continuously scrape her skin. Finally, on the 10th day, she was revived.
“The girl could have died if she wasn’t coined by those old ladies,” Soun Neang said. “I believe in kors kha-yal because it works and I saw it work with my very own eyes.”
Kors kha-yal is a common practice that many Cambodians believe can “scrape bad wind” to the surface of the skin to restore the body to health. It involves rubbing the skin vigorously with a thin metal coin, producing angry red marks and purple bruises.
Though it is commonly practiced by traditional healers, Western-trained physicians say there is a scientific basis for the efficacy of the age old practice.
Kors kha-yal causes the brain to release endorphins, a chemical that has a pain-relieving effect, said Dr Reid Schaftell of Phnom Penh’s American Medical Center.
The continual scraping action thus “promotes a feeling of well being,” Schaftell said. Coining also elicits a very basic physiological response: It increases blood circulation, helping to reduce fever and relieve headaches and muscle pain.
“The increased blood flow to the surface cools down the circulatory system,” Schaftell said. “It works like a car radiator.”
The patient’s psychological belief in kors kha-yal also plays a large part in his or her recovery.
“In order to be cured, you have to have your belief and strength, both mentally and physiologically,” said public health physician Dr Mengly Quach. “The doctor alone cannot be the only cure. He can only do so much.”
Many of the coining practitioners, who often offer their services at local markets, aren’t aware of the scientific rationale for kors kha-yal, said Dr Gavin Scott of the Tropical and Travelers Medical Services.
“The majority of Cambodians who do things like coining don’t know why it works,” Scott said. “They just do it.”
Having traveled throughout Cambodia for over a decade and witnessed farmers in small villages perform coining on many occasions, Scott agreed that kors kha-yal works.
But, while coining may be a cheap way of treating a cold, fever, headache or stomach pain, some illnesses require professional treatment.
“It’s no substitute for seeing a real doctor,” Scott said.
At the center, Schaftell observed that many of his patients only resort to seeking doctors when coining fails to cure them of their ailments. Often, he said, lack of money prevents people from seeking professional medical treatment earlier.
Schaftell said some patients should avoid coining altogether.
“I don’t recommend it to someone who has delicate skin, especially babies,” he said. “Patients can get ugly keloid [scars] from coining if the skin is broken.”
Still, he said: “Coining is part of the Khmer culture and there’s nothing wrong with that.”
A mother of four, Vuthy Chea, said everyone in her family has experienced kors kha-yal. The
52-year-old soda vendor said she can’t afford to have her family see a Western doctor, like Scott, whose office is just around the corner from her house.
“All of my children must [receive] kors kha-yal either from me or from my oldest daughter when they become sick,” she said.
Her youngest daughter, Srey Kouch, 16, was coined last week for fever and has now recovered.
“I woke up feeling not well and had no energy to cycle to school,” said Srey Kouch, a student at Sisowath High School.
“My mother started to work on my back and front,” she said. “Afterward, I slept and rested until dinner.”
Srey Kouch said that the pain was unbearable during the coining session. “I bite my lips and tighten my fists when it hurts,” she said. “But I must be strong and hang on until my mother finishes so that I feel well again.”