Living With Pollution

You Eat It. You Breathe It. You Live in it.

Pollution wafts through the air we breathe, the food we eat, the water we drink, the people we love.

It kills and sickens Cambodians every day.

We know what it is, we know how to stop it, and still countless Cambodians die from it each year. Countless, because it’s often invisible, microscopic, and nearly impossible to link, for certain, to individual deaths.

Pollution, in the broadest sense of the word—that which makes our environment unclean or impure—lurks as a fatal danger in Cambodia more than land mines or AIDS.

Perhaps even more dangerous, people often don’t recognize pollution as such. In Cambodia, it’s not bad air or toxic waste that threatens us.

In fact, Cambodia has far less of those pollutants than many other Asian countries because industry hasn’t yet flourished here. “The air in Cambodia has not been subjected to the pollution that is tremendous in other Asian countries,” says Georg Petersen, the country representative for the World Health Organization. “There is no industrial waste really to talk about.”

He lived in Manila with its traffic-choked streets and heavy industry for five years and says there is a world of difference between the air here and there.

Solid waste is a big problem throughout the region. Garbage collection services have been nationalized, privatized and nationalized again by governments who don’t always make it a priority.

Cambodia, in line with other Asian cities,  also has problems with an infrastructure that is unable to handle the waste produced by its growing population.

The economy can also make a bad situation worse. In the beginning of December, 3,000 tons of waste contaminated with mercury arrived in Sihanoukville from Taiwan. The WHO is still looking into how dangerous the waste may or may not be. Petersen believes the waste may have arrived in a condition safe for disposal but that scavengers opening the containers and breaking the blocks of waste into pieces may have destabilised it.

Beyond the smog and toxins, the health and science worlds also view pollution as the raw sewage and flood waters entering our rivers, the spoiled meats and vegetables sold in markets, the garbage on the street that draws flies and rats, the stagnant roadside puddles that breed dengue mosquitoes.

And everything else that makes our environment “unclean or impure.”

Unlike land mines—which killed and injured 2,486 Cambodians in one year at last count—or HIV—which infects 140,000 Cambodians right now—pollution’s toll on life is hard to quantify, though no less staggering.

Every year, 13,000 Cambodians die of TB. Pollution is a factor.

Every year, every child under 5 suffers up to seven respiratory infections. Pollution is a major factor.

Every year, diarrheal diseases kill Cambodian kids more than any other ailment. Pollution is the leading factor.

And 80 percent of Cambodia’s pollution comes from us, individually, rather than industry.

Waste from our bodies and homes ultimately swims in the city’s water supplies, untreated. It floats in the air after sun and wind convert it to dust. It drifts in the Tonle Sap where children wade and fishermen fish. It soils the vegetables for sale in the market.

And Phnom Penh—surrounded by three rivers, numerous lakes and endless rice paddies—falls particularly vulnerable to the perils of polluted water.

“There is a curious irony that is so blatantly evident that at times we miss it: That we are the source of so many of our dilemmas,” says Joel Vanderburg, project management officer of the World Health Organization. “Pollution is the classic example of this.”

And with it ride the viruses and bacteria that cause itchy eyes, skin rashes, food poisoning, cholera, tuberculosis, dysentery, pulmonary diseases, diarrheal illnesses, typhoid fever, acute respiratory ailments and literally hundreds of other sicknesses.

Although doctors can rarely draw conclusive links, experts agree on an indisputable tie between our health and our environment.

“The environment is the biggest factor in health,” says Dr Phoeng Chhy Leang, who treats children at the Municipal Hospital adjacent to the Sihanouk Hospital Center of Hope.

The trouble starts at home and spreads from there. “These environment problems are very important because we try to be clean among our family members, but we cannot separate ourselves from outside the family,” he says. “We cannot separate ourselves from the environment.”

If one person is sick in a clean place, the illness likely won’t spread. “But if you live in a society without sanitation, it is easy for disease to spread,” Dr Phoeng Chhy Leang says.

And sanitation—flush toilets, water and sewage-treatment plants, clean water supplies—Cambodia has precious little of. Furthermore, many Cambodians don’t understand the science of health and sanitation. They don’t know that germs cause disease. They often attribute illness to evil spirits or bad karma.

“They don’t know,” says Dr Kaing Sor of Preah Bath Norodom Sihanouk Hospital, commonly known as the Russian Hospital. “The patients don’t know about dirt, feces.”

His hospital tries to teach cause and effect. “We tell them to keep their houses clean, to try to keep sick people away from other people. We try to tell them to be healthy because they lose money if they’re sick. They can’t work if they’re sick. They understand that, but of course we still have sick people.” There are 114 in his hospital on this particular December day.

“We have a lot of work to turn around the thinking of the population. They have many old ideas. It’s hard to get them to think of scientific thoughts.”


A Public Problem

Scientifically speaking, sanitation is the answer. More than any other cure or remedy, Vanderburg says, the biggest improvement in public health “is to give them clean water and a place to dispose their waste.”

But, like almost every problem in Cambodia, pollution is tied to mo­ney shortfalls, politics, lack of education, corruption, government instability and always the presence of some other problem that demands more immediate attention.

What’s left is a circle of hurdles and a few ominous statistics.

For starters, hard numbers and studies in Cambodia rarely exist. “There haven’t been a lot of good epidemiological studies here on the sources of diseases,” Vanderburg says.

Just 31 percent of Cambodians have access to safe water sources; 15 percent have access to sanitary disposal.

The Environment Ministry and the European Commission started a lab to study water quality. Just as it has gotten up and running, the EC funding is scheduled to end in less than a week.

Phnom Penh water still flows from river to home through the original, colonial-era French system that continually breaks down, leaks and pollutes the water through cast-iron pipes.

Water going in the other direction—sewage—is never treated. Waste-water flows directly from sink and toilet to street drains to the Tonle Sap, Mekong and Bassac rivers or a number of overfilled sewage ponds around town.

The Western world faced the same problem a century ago. “The conditions in Phnom Penh appear very similar to the conditions in [the US] and western Europe during the last quarter of the 19th century,” says Al Zanoni, a US civil engineer and professor at Marquette University in the state of Wisconsin. “By the start of the 20th century, conditions became so intolerable around major cities that it became necessary to ‘intercept’ these storm sewers and direct the total waste flow to central treatment plants.”

Almost 15 percent of Phnom Penh families have no toilets.

Open sewers (and none other) run through Tuol Kok and the area around the Khmero-Russian Hospital, and directly into the city’s surrounding ponds and rivers.

Furthermore, the city grows 5 percent to 6 percent a year, compounding the problems.

According to a 1998 UN Population Fund report, Phnom Penh generates between 400 to 700 tons of garbage a day, depending on the study. But PSBK, the company that recently took over the city’s dump and garbage trucks, complains that only 60 percent of clients pay their collection fees, and only 40 percent of garbage left for collection is bagged for the workers. The rest soaks up the rain and blows in the wind.

A recent PSBK report noted a critical problem in the company’s line of work: People tend “to anarchically throw garbage.”

That trash, swept and loaded onto 40 PSBK trucks by some 692 employees, heads straight to Stung Mean­chey, the city’s only landfill. It’s a spot—completely open, surrounded by homes, ponds and rice paddies—where rubbish is dumped and razed and picked apart by some 200 families who survive on selling salvageables they find in the refuse.

“A garbage dump, in and of itself just because it has a bad smell, doesn’t necessarily have to be a health problem,” explains WHO’s Vanderburg. But if that trash attracts rodents (it does) and if it leaches into the ground and water (it does), the dump turns threatening.

And the rain, when it comes, churns all those numbers and percentages like an oversized martini shaker, intoxicating the entire city with a well-polluted brew.


The Canal

Thirty-eight-year-old Bun Pheng sells grilled bananas from a small roadside stand that sits across a wooden bridge from her home of eight years. Beneath that bridge bubbles a black mix of raw sewage, water, garbage and “everything from the residents of Phnom Penh.”

The open sewer meanders through her neighborhood and dozens of others in Tuol Kok. Residents recall the same dark sludge, lined by riverbanks of trash, 10 or more years ago. They’ve all heard the talk of cleaning it up, but answer in unanimity: “I’ve never seen it.”

Indeed, Mom Sandap, chief of the Phnom Penh Municipal planning office, rattles off a litany of reasons clean-up plans have thus far failed. They selected a US company for the job. The company’s technician left and his replacement had to “re-study” the Tuol Kok situation. And then the July 1997 fighting got in the way. These things all take time, he says.

Meanwhile, another rainy season has dumped its load inside the wooden homes lining the canal. “When the rain falls down, it floods. In less than half an hour, it’s on the street and into the house,” Bun Pheng says while sliding bananas onto a stick.

She motions to her mid-calf, where she says the water reaches sometimes. “We have to bring everything into the house to put on the bed. After the rain, we wash the house.”

She heads inside—two dark rooms with blue walls. A green moldy smudge near the door, about two-thirds of a meter high, shows where the water comes and goes.

“I don’t have money, so we have to stay here,” she says. It’s the only area she can afford. “I don’t have a man in the house. We were separated.”

Her youngest child came down with dengue. She says mosquitoes breed in the water.

“No one likes to live like this. Everyone would like to live in a good house.” But there’s no money to buy a new house.  She makes a few thousand riel a day.

Down a block, the same black water flows steadily through the neighborhood. Cans, plastic bags, fruit peels—the detritus of everyday urban life—line the banks and bob in the water.

Twenty-four-year-old Sok Chantheoun sits outside on a slat platform with his 76-year-old father and a few other relatives. The family has lived here since 1979. “We have lived here a long time, and we’re used to it. We don’t feel anything about it. It is normal,” Sok Chantheoun says.

Down the road and across the street, Kim Tech, 25, and his mother Em Siem, 50, sit outside their white-tiled home. They, too, suffer the sewage floods.

“The smell is bad, and also it’s a source of disease,” Kim Tech says. The government sprays for mosquitoes here, but still, people get sick. “Especially the little kids always have a problem.”

He wears a long-sleeved pink-and-gray dress shirt over new blue jeans, drives a 250-cc Honda Shadow and admittedly sports greater wealth than his neighbors across the street. Regardless, the swamps still invade life on his side.

He’s lived here 10 years. “It’s the same. It never changes….Every year when the rainy season comes, the floods start here….The people here want to have a proper system, but we know the government is facing a political crisis and doesn’t have time to pay attention to the problem.

“Here in Phnom Penh, compared to other places, this is the worst place.” He says he cannot compare his living conditions to those in other countries. He recites a Khmer phrase to explain that if a person is “here,” he or she cannot simultaneously be “there.” It is impossible to know.

He does know this: “If we see the sky looks like rain, we are afraid.”


Early Morning With Garbage

It’s 5:32 am. The big, white French truck with a whirling yellow light approaches its first stop at the park between streets 106 and 108. Three men and a woman work silently, diligently, repeatedly heaving then refilling three baskets of refuse: grass clippings, a pizza box, plastic bags, soap boxes.

Bare hands and flip flops are the work crew’s standard attire.

The day’s light rises slowly under a faint rain. Dust billows from the back of the truck. The sweepers had hit the streets at 4 am, preparing for this next task.

The truck creeps up a quarter of a block with the workers in tow on the streetside. In this pile: a pillow, a windshield, tree branches, a section of concrete pipe.

A worker tosses the shattered windshield into the truck cavity. Meanwhile, the mighty mechanical arm sifts and pushes, sifts and pushes, crunching and mauling the rubbish, then shoving it deep into its maw.

The driver, Lan, crumples a cigarette pack and tosses it out the window, onto the ground. He hops out, looks around, looks at the pack, picks it up and throws it into the rear of the truck.

Lan, 40, has driven a garbage truck for 13 years. He makes about $50 a month. He sits in the cab and listens to the radio while the others work on the ground. When they’re through, he drives ahead a few meters, then waits again. He keeps the engine running.

Forty-year-old Ya is hard to talk to because she works swiftly and doesn’t stop moving. She has four kids, 10-17 years old, who study at the Stung Meanchey dump school. Her husband is dead. She makes 3,300 riel a day.

“I like this work. Why? Why? Because I need to make money.” Then she runs off to her coworkers and repeats the conversation, exactly.

This batch: Shirts, a burned mat, an incense can, cockroaches scuttling between their feet. Up a block: a flower perfume box and a Vietnamese 10,000 dong note.

Ret, a 42-year-old in a blue shirt with an alligator on the left breast, promptly picks up the money and shoves it in his pocket. He’s nearly doubled his daily wage.

Next stop: a broken pot, the type used for boiling herbal syphilis remedies; a pile of shells; a dirty syringe; an empty penicillin bottle; a pineapple head; Halog medicated facial cream; a fish spine; a page from a Vietnamese newspaper wrapped around a pile of excrement; a used maxi pad.

At 6:48, Mo Vanna, 42, unveils. Up until now, he’s hid his face behind a cap and a krama. He shovels steadily; not much time for talk. Occasionally, he covers his mouth with a surgical mask.

A kid runs up to the workers and throws a black plastic bag to Ny’s feet. Ny wears a silk shirt with a wild pattern in yellow, pink and blue. He tells the kid to throw the bag onto the truck, and the child disobeys and runs off.

Phsar Chas yields charcoal and a pile of snail shells. Mo Vanna buys bananas and a bag of food from the market.

The crew starts work on the pile just west of the river at 7:10. More dirty needles. The guys pick up three Mild Seven packs. Collect 20, they say, and they get a free shirt. The last basket’s contents fall into the truck at 7:39.

“We work in the rain. The rain stinks,” Ya says.

Asked about hazards, Ya says she’s never stepped on a needle. “But,” she says, pointing to her index finger, “twice I pricked myself a few months ago.” Then she turns her head toward the ground and shovels some more. The truck lumbers on until it fills up and heads for the  dump.

There, each new load draws flocks of human scavengers, pouncing on freshly overturned piles of filth.

Among them is Kut Vundy, 17. He’s not working too hard this morning and, dressed in a white windbreaker, looks fresher than his colleagues.

He has worked at the dump for two years and studies at a nearby school. He has parents, but “They don’t work. They are old,” he says. “I work here because I earn money…I don’t like it. It smells. I get sick, I get headaches and stomach aches.”

Kut Vundy studies English, tries hard to practice it here and now, but knows very little. He doesn’t want to stay at the dump. “I want to be a teacher,” he says.


Sick Wards

Zanoni, his metier in water sanitation, warns of the many health risks from polluted water. “There are literally hundreds of water-borne diseases,” he says. He teaches his students about “the big seven:” typhoid fever, bacillary dysentery, cholera, amoebic dysentery, giardiasis, cryptosporidiosis and infectious hepatitis.

Though rare in the West, these diseases daunt the developing world.

Som Sokhoeuthy, 33, lives with her husband and two kids in Tuol Kok, surrounded by garbage and a polluted pond where she says flies and mosquitoes breed. She runs a small karaoke and drink shop.

Today the 33-year-old mother sits on a bed at the National Pediatric Hospital with So Samnang, 10, who has intestinal problems and his 2-year-old sister, So Sreipec, asleep in the throes of dengue. The boy only eats porridge. His stomach can’t tolerate other foods.

“Near the house, it’s like a pool with water,” Som Sokhoeuthy describes their home. “People throw garbage in there.” She doesn’t know what to do because people build houses near the pool. “The pool is too deep.” It would cost a lot to fill it up.

The garbage is everyone’s problem, everyone’s responsibility. She throws garbage in there, too, she says. Her neighborhood doesn’t really have a designated pick-up spot, so people throw where they always have.

“The Phnom Penh Municipality should take action,” she says. “For the people, it’s impossible.” No one there has enough money.

The Teaching

Sanitation is not something humans know instinctively, health experts say; we must learn it.

“The household environment is a dangerous environment,” says Jamie Meiklejohn, a project officer with Unicef, which has helped Cambodians build more than 12,000 latrines.

“If you consider that 9 million people are defecating on the land or near the rivers, I’d say that’s a large pollution problem,” he says.

But people don’t understand the potential harm, he says. “I think for most people it’s habit. Not having sanitation facilities, they go where they need to go. But that’s in the absence of understanding that defecating wherever can be dangerous.”

At any given time, he says, about 50 percent of Cambodian kids have diarrhea.

But, he says, education makes progress, although it’s not quick or simple.

Dr Phoeng Chhy Leang of the Municipal Hospital talks of varying reactions to his lessons on sanitation. “The people understand about it already a little bit,” he says. “It depends on the family. Some families teach kids, but other parents don’t take care much. So the children also do not take care….We need to remind them, to educate them.”

Perhaps people don’t instinctively understand because they can’t see the connections. “It’s not necessarily anything you directly see or make an association with,” says WHO’s Vanderburg. “I think people are probably very aware when they don’t have good water—up to a point.”

According to a Unicef report, aid workers who conducted a sanitation study in Pursat province in 1992 found among villagers “a near-total lack of awareness of the relationship between human waste disposal and excreta-related diseases.” Those same workers reported difficulty in motivating people to build latrines. Other aid workers cite similar findings nationwide.

An Overseas Development Administration study in Battambang touched on a key difference between Western and Cambodian thoughts on sanitation. When researchers tried to discuss cleanliness with Cambodians: “it became apparent that these concepts were closely associated with tidiness, order and beauty, rather than the germ theory or concepts of invisible contamination of pollution. There are several Khmer words used to translate the word dirty. Most seem to relate in some way to the concept of disorder or matter out of place.”

So the education must dig deep, changing age-old beliefs with scientific ones. That doesn’t happen overnight.

WHO’s Vanderburg has worked around the globe and found that people appreciate the chance to live clean lives. But they often don’t associate the causes and effects of disease.

“That’s where superstitions arise.” People blame demons or magic or gods for their ails. “What it says is that people do have a certain logic because they’re looking for a cause. I don’t think I’ve ever heard of a situation where people didn’t try to find a cause for illness. That cause might not be correct.”

“If people have the option for clean water, they certainly will vote for clean water….Given the options, most animals, including human beings, will choose to do things most hygienically.”

But more often than not, people can’t change their lives. “My suspicions are…there’s just nothing they can do,” Vanderburg says. “Their first concern is having something to eat and a place out of the rain….We know how to prevent these things. With water pollution and communicable disease transmission, we know how to prevent that.”

It just takes money.

And in a happenstance world of illness, accident and death, money isn’t such a daunting dilemma.

“If you look out the window directly at the moment, you might not be optimistic,” Vanderburg says. But look again.

In fact, he says, Cambodia can set an example for the rest of the world. Without heavy industry, the air remains relatively clean and toxic waste hasn’t regularly surfaced here.

But Cambodia, like many developing countries, has the potential, as discovered recently by a Taiwanese plastics company that shipped its waste to Sihanoukville, for becoming a dumping ground for industrialized nations, although that possibility is just speculation, says WHO’s Petersen.

“There’s an opportunity in a sense to try to maintain [en­vironmental standards] as factories come in, as more vehicles come in,” says Vanderberg. Even as things at times look desperate, there are examples of improvements taking place.”


Lessons Learned

Forty-nine-year-old Peng Thon sits on his bed in Preah Bath Norodom Sihanouk Hospital’s tuberculosis ward. He’s been here a few months but, now, after a strict treatment regimen, his TB is finally in remission.

He sits at the edge of his slat bed, bony arms poking out from under a white tank top, a red-and-white krama draped over his shoulder.

He lives on the outskirts of southern Phnom Penh, across the Monivong Bridge. “My village is not too clean. It’s regularly flooded….There are five people in my village in the same state I’m in.” Three others went to the hospital but didn’t follow through with their TB treatments. They died. “I can now see why they died. They neglected their TB treatment. They tried to drink wine, to pray to God. For a while, I thought God could save me.” He now knows the strong hand of science involved in his disease.

What is pollution? He talks about what it is not; about living in a clean place where the people around him aren’t sick; about a beautiful home and beautiful water on beautiful land.

“That is a clean life. That is good health.”

(Additional reporting by Kimsan Chantara)


A Look at
The Facts…

Cambodia’s pollution problem is tied to a never-ending circle of politics, opinions, statistics, unfortunate realities and a lack of funds. Take a look:

By Jerry Redfern

The Cambodia Daily

Behind a plain set of wood doors on the first floor at the Environment Ministry in a room brimming with bottles, burners and beakers, a small and growing group of technicians measures the excrement in Cambodia’s water.

Started in 1995 and run for the moment on European Commission funds, the Ministry of the En­vironment’s Water Quality Control Laboratory bakes, boils, grows and chemically alters water samples from across the country, quantifying what many believe is a water supply succumbing to a growing population.

The lab drew its first sample Dec 18, 1997, from a spot noted in the lab’s official or­ange ledger as “paper factory.” Since then, it has tested Cambodia’s water 405 times at sites nationwide. Lab workers test the water’s pH, conductivity, mass, chemical pollution and some 15 other parameters.

Heng Nareth, deputy director of pollution control, closely follows the lab’s work from his second-floor office. “Right now I have great worries about waste­water from households discharged directly to [the Tonle Sap] river,” he said. He studies a computer-generated map of Phnom Penh that hangs behind a desk in the laboratory that precisely plots the location of test sample sites and sewage ponds across the city. He reaches up to touch it.

“Right now, I have great worries about this half because it discharges straight into the river,” he says as he sweeps his arm across the right side of the map, an area that in­cludes everything in Phnom Penh east of Monivong Boulevard. The wastewater causes “some problems,” he says. “We have found many, many bacteria in the river.” The ones they have found are those that breed in feces.

The city’s tap water comes from wells in the Tonle Sap, the Me­kong and various spots ar­ound town. In view of that, what does Heng Nareth drink? “Nor­mally, I drink the tap water. But I boil it.”

Is bottled water then a safer bet? Heng Nareth be­comes uncomfortable. He opens the ledger to a page with the lab results of nearly 20 types of bottled water. Columns that should show zeros, don’t.

He quickly shuts the ledger and says, “Fifty percent do not comply” to World Health Org­anization standards. He says the lab was only doing “informal testing,” and that, “Right now our department focuses only on the effluent.”

Heng Nareth traces the effluent problem to a growing population and the city’s antiquated sewer system. It is clogged and can no longer handle the waste dumped into it.

Also, the h Meanchey dump.  s   It’s a livelihood, in a city where 11 percent to 19 percent of the people live in poverty.  s  About 13.5 percent of Phnom Penh’s population lives in squatter settlements, and twice that many live in, “overcrowded and unhealthy conditions.”  s  A 1995 profile on the Bassac squatter camp found 5,000 families there. Within six months, 20 children had died of preventable diseases.  s  Phnom Penh grows at least 5 percent a year, compounding the problems.  s  According to a 1998 UNFPA report, “Population growth has outpaced adequate housing, livelihoods, roads, transport, water, sanitation, waste disposal and health services.”  s  The report continues: “Many of those who migrate to urban areas are actually moving into worse conditions in terms of their overall quality of life…”  s  Only 60 percent of Phnom Penh households have piped water.   s  Just 31 percent of Cambodians have access to safe water; 15 percent have access to sanitary disposal.  s  Only half of Phnom Penh households are connected to the citywide drainage system.  s  All Phnom Penh homes should have septic tanks; only 23 percent do.  s  Wastewater flows directly from sink and toilet to street drains to the Tonle Sap, Mekong and Bassac rivers.  s  In Phnom Penh, 14.9 percent of residents have no toilet.  s  Nationwide, 62 percent of families have no access to toilets.  s  A 1992 study in Pursat found that 78 percent of people defecate on the ground; 3.8 percent dig a hole then cover it.  s  Thirty-seven percent of Pursat villagers said they defecate near riverbanks; 14 percent use pond areas.   s  In Pursat, 83.8 percent of schools have no latrines.  s  Experts agree: Many people don’t understand the hazards of human excrement.  s  Fifty-four per­cent of respondents to a 1994 Concern survey boil water daily; 17 percent do so occasionally; 29 percent never do.   s  The report asserts: “The use of water without boiling almost certainly correlates with the prevalence of disease in the area: fever, diarrhea, cough, vomiting, eye infections and skin diseases.”  s  A Battambang study determined that people’s rainwater jars are too heavy to clean regularly.   s  The same study found that people use the same jars for scooping and drinking water; the jars have no handles, so their fingers touch the water.  s  Of 1,000 newborns in Cambodia today, according to a 1996 Unicef report, 200 will have access to safe water coming from piped systems or wells; 800 will use contaminated water coming from unprotected wells or springs, rivers or ponds; 840 will have no access to sanitary facilities.  s  The same report states that diarrheal diseases result from ignorance, poor environmental sanitation, lack of personal hygiene, inadequate water supply and unsafe excreta disposal.”  s  The same report links malnutrition to lack of health services, inadequate water supplies, poor food hygiene or child care.  s  A 1996 socio-economic survey found that 49.3 percent of Cambodian kids under 5 weigh less than they should for their age; 56.1 percent are shorter than they should be for their age; 12.2 percent weigh less than they should for their height.  s  The Unicef report states: “The amount of food a person consumes obviously has a direct bearing on their health, and ultimately, their chances for survival.”  s  Cambodia’s infant mortality rate at 108 per 1,000 live births is the worst in East and Southeast Asia, along with Laos.  s  As many as 65,000 Cambodian kids under 5 die each year.  s  Cambodia’s maternal mortality rate of 473 per 100,000 live births, is among the highest in East Asia.  s  The Unicef report states: “A Cambodian child is more likely to die before the age of one year than a child in any other country in East Asia and the Pacific Region.”  s  But a 1997 UNDP Cambodia Human Development Report states that it’s difficult to draw statistical comparisons because Cambodia has no regular census.  s  The first census in more than 30 years was taken this year by Land Rover and elephant.  s  Furthermore, the Unicef report states, research in Cambodia was limited before the war years. “This means that there is very little documented information about family and community life and the ways in which people traditionally coped in times of difficulty.”  s  The report­ continues: “A direct link between poor environmental conditions and poor health is difficult to draw in the absence of adequate quantifiable data and research.”   s  This makes work difficult for health officials and aid organizations seeking money to solve Cambodia’s problems.  s  And Cambodia desperately needs money.  s  As well as government support.  s  The government spends just 6 percent of its budget on health and 10.3 percent on education.  s  A new draft budget would boost those numbers, but it awaits National Assembly approval.  s  Likewise, Cambodia’s draft environmental law waits ; it has waited through a toppled government, an election, a government-less period, and the start of a new government.  s  Regardless, health and sanitation experts say most of Cambodia’s environmental attention—and money—goes toward the “green sector”—saving trees, wildlife and biological diversity.  s  Those same experts say the “brown sector”—sanitation, water treatment, pollution control—suffers.  s  The health and social sectors need more money.  s  In 1993, then-Prince Norodom Sihanouk signed the Declaration of the World Summit for Children; Goal four calls for universal access to safe drinking water by the year 2000.  s  On Sept 22, 1992, Cambodia joined more than 150 other countries in accepting the Convention on the Rights of the Child. It mandates compliance with World Summit goals.  s  Further­more, the Child Con­vention guarantees: “The right of every child to a standard of living adequate for the child’s physical, mental, spiritual and moral development.”  s  The convention’s Article 24, 2c, stipulates that member states must combat disease and malnutrition, “taking into consideration the dangers and risks of environmental pollution.”  s  It also requires nations to “ensure that all segments of society” are educated about health, nutrition, hygiene and environmental sanitation.”  s  With similar goals in mind, a 1992 WHO report recommends: educating about littering and defecating in public, and the health risks in eating vegetables grown in sewage lagoons; prohibiting children from swimming in lagoons and posting warning signs about the hazards.  s  The report also recommends adequate garbage containers citywide; enough vehicles and people to collect the city’s garbage; laws to enforce garbage collection.  s  A 1994 survey found that garbage was never collected from 68 percent of Phnom Penh’s squatter areas.  s  The 1994 study found that 38 percent of squatters dumped their garbage on the ground; 25 percent burned it; 15 percent dumped it in water and 12 percent put it in a bin for collection.  s  That was many moons and garbage companies ago, before PSBK took over this year.   s  Still, PSBK Director Sieng Pich says people could do more to help the collectors by bagging their garbage in plastic and putting it in designated pick-up spots.  s  “Our people have low education, so they don’t understand,” Sieng Pich said.  s  Even so, PSBK reported collecting 332,194 cubic meters in their first nine months of operation.  s  And as the adage goes, “One person’s trash is another one’s treasure.”  s

Sometimes, it’s the only way to make a living.  s


alf-dozen sewage settling ponds in Phnom Penh are full. The ponds (where people also bathe, fish and grow vegetables) should work as simple natural filters: polluted wa­ter flows in, gar­bage settles out, clean water flows on. But the ponds are clogged with up to 4 meters of sludge, some dating to the colonial era. This causes sewage to run into surrounding neighborhoods.

But there are plans to rebuild the sewer system with help from a Japanese grant, Heng Nareth says. He hopes to begin work next year.

Problems keep arising, though. The settling ponds hold sludge contaminated with hazardous waste, so it can’t easily be treated and sold as fertilizer—the original plan. Two systems are needed: one to carry and treat hazardous effluent; another to carry away rainwater, which in­creases sewer loads ten-fold in rainy months. Meanwhile, people keep moving to the city.

Heng Nareth and the lab also face a more serious threat. Their EC funding runs out at the end of the year. “If we want to improve the water quality,” he says, “we cannot say that ‘This is no good’ without analyzing.”

“I call for another donor to help us.”




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