19 Dec 2014

Chained in cells: the plight of some of Cambodia's mentally ill

The people of Cambodia have suffered like few others, but according to Father Kevin Conroy there are only 15 beds for psychiatric patients in the entire country.

When I asked Father Kevin Conroy to describe himself, he chuckled, then followed with: “I am an optimist, yep, an optimist.” When you consider how the Cleveland, Ohio native spends his time, a large quantity of the stuff is probably the only way to get through the day.

Father Conroy is one of just a few clinical psychologists in Cambodia, a troubled nation of 15 million souls. He arrived in 2006, as a member of a US Catholic charity called Marynoll and soon discovered that in terms of mental health services, he was just about it.

As problems go, that’s a major one because the people of Cambodia have suffered like few others. Not only is it one of the poorest countries in the world but it is still grappling with the legacy of the Khmer Rouge. A regime led by fanatics, it murdered some two million people and set about destroying all vestiges of civilisation in an attempt to create a “self-sufficient” and “classless” society. Schools, libraries and hospitals were razed and the people who staffed them were eliminated. Thirty years later, Cambodia is still trying to recover.

Progress is slow. According to Father Conroy, there are only 15 beds for psychiatric patients in the entire country and the government devotes just 0.02% of its budget on mental health services. In terms of cash, that’s about $300,000 – but health workers reckon very little of it actually makes it to patients. “Where is it, where is this money?” says an exasperated Bunna Phoeun, who helps the American psychologist organise a mobile health service. “It’s not enough for 15 million people. There are so many people who have problems.”

We got the chance to see what Bunna was talking about after spending three days on the road with him, Father Conroy and a small team of health workers and volunteers. They conducted a series of clinics in rural communities and visited homes where family members had been chained up or incarcerated in dark, home-made cells and you can see more in our film. “Every time we go somewhere, we find more people like this,” says Bunna.

Still, team members are never judgmental. “It’s not easy,” Father Conroy said when I asked him why one family, called the Chanthuns, had chained up their son Donnie to the wall. “They don’t know what else to do, it’s more helplessness really. They are afraid he will run away or somebody else will hurt him.”

Donnie, who is 22, has suffered from seizures since he was a little boy and the health workers think he may have epilepsy. Although they have limited funds, they have promised to provide medication, counselling and little bit of money to get Donnie to hospital for a more thorough examination.

For Donnie’s tear streaked mother, the offer of assistance comes as a blessed relief. “I need help. I can’t go anywhere, I always think of him wherever I go.” I asked her what Donnie was like. “He is a quiet boy, he likes to sleep in his hammock, he just likes to watch people and he wants to be happy. The traditional doctors haven’t helped at all.”

Yet that is how most Cambodians try to treat mental illnesses. Traditional healers draw on a wide variety of techniques, remedies and potions to rid their patients of their ailments – including mental health problems – and it’s something Bunna, a trained psychologist, knows plenty about because his uncle happens to be a traditional healer. “They think that ghosts have infected the patient, or evil has got into the body, or causing something wrong.”

While such culturally ingrained thinking represents a challenge to the mobile health team, Bunna says there is not much they can do about it. “I have told (my uncle) to be careful when treating mental health patients but I don’t stop him because I can’t. It would be bad to do that.”

As for Father Kevin and the rest of the team, they hope to expand their service, sending out a health team in their rickety looking van every single weekend in the upcoming year. Nonetheless, the American priest is a realist. “I doubt this country will ever have enough trained people on hand to help treat mental health problems,” he said, “but we will do our best.”

Follow @c4sparks on Twitter