What we did at the Office Today

Too Much Fun?

Just in case you thought we were only here to enjoy ourselves, we thought we should give you some info about our jobs and why they need doing. So not too many pictures and rather less frivolity in this post for once. It may seem like we are on permanent holiday, but actually we have only had 2 short breaks, one of 3 & one of 4 days in the 8 months we have been here, revolving around Khmer bank holidays - apart from the 10 days leave we used to go back to UK for Anna's lovely wedding.

No, we don't live in a hole in the road with the rats. Yes, we have made sure we have built up an essential social support network. Yes, we try to eat properly and take some time to relax. Yes, we take every opportunity to enjoy the wonderful childlike humour & good nature of the Khmer people we live & work with - they would be mortified if we did not. If we did not do these things neither of us would be able to do the jobs we do with any energy, efficiency or effect. If that counts as having too much fun, then, as a Canadian colleague of Sarah wearily said (about a particularly demotivated & dim government department in the murky bowels of the Dickensian workhouse of the Education Ministry):

''Well, you might just as well take 'em out & shoot 'em... Eh?''

We know that most of you that read our reports, & know us, 'get it' - you read between the lines, have imagination, & many have researched & read about the dreadful recent history of Cambodia & understand a bit about why it is how it is today. For anyone that doesn't, we hope the following accounts will fill in some of the gaps - photos not really required.

Sarah's Tale

We both work long days (8-5.30 or more) in and out of our offices & some of those days seem longer than others when there are power cuts. This is excluding the many evenings & weekends we have both put in. We do not lead a glamorous expat lifestyle, eat out at 'fancy' restaurants or drive airconditioned anythings. We cycle all over town & quite honestly risk life & limb every time we do so! We do not have a cleaner or cook as we are trying to live within our allowance - it is quite tiring doing all that ourselves. Even our Friday evening get together with colleagues at one of the bars usually turns into a strategic session of arranging the essential contacts & meetings which the various ministries aren't so good at.

I may have touched on this before, but we are guilty of only taking, & showing you, rather nice pictures. As I said, I don't feel I can intrude on people's lives & take pictures of families living in dug out caves in rubbish dumps, small children with lice festooning their hair weaving their way through the traffic at main junctions, begging with babies in their arms who I'm pretty sure they are not even related to; sometimes I'm not sure the babies are even breathing. Young, barefoot boys pushing their handcarts along the quiet streets late at night, scavenging the rubbish for recyclables to sell.

It is not a lot of fun basically ignoring these children, most of whom are addicted to glue or other substances, & kept that way by the people who run them. We also cannot afford to give to all the disabled and disfigured people, both physically and mentally, that live their lives out between the gutter and the mercy of the owners of whatever building they are in front of at the time.

It is not much fun cycling past the children & young adults who sit slumped up against the wall around the villa housing my office, with needles hanging out of their arms, on my way in in the morning. I wonder why they choose our bit of sidewalk - maybe they can see we are an NGO & feel somewhat safer there. Our security guard is a sweet-natured man who I don't think would kick them into the street.

I finished the Valuing Teachers report, although still have to do the final copy edit before publishing, then it goes to the printers in November. Anyone who is interested to read about the sobering state of education, let me know & I will mail you a soft copy. I presented the recommendations to various committees and groups of concerned parties and to the Minister and the Secretary of State, who received them in friendly manner that bodes well for future communications & continuing cooperative work. Frankly, the only way is up.

3 weeks ago I started my job at the Disability Action Council. There will be a lot in future blogs about the work that has & is yet to be done by this organisation - those of you with a nervous disposition... Basically it was formed at the government's request in 1997 to act as an advisory body to the government & the ministries involved (health, social affairs, education etc.) on how policies on disability should be developed, & a provider of information on monitoring & helping to implement those policies to the national branches of international & Khmer organisations concerned with disabled people. We work in the fields of education, livelihoods and rehabilitation (anything from prosthetic limbs to social rehabilitation for leprosy sufferers). To give you some idea of the scope, with one small example from each sector:

• No deaf child has ever completed their primary education in Cambodia - mind you, probably only about 40% of all enrolled children do anyway
• Disability = dire poverty
• There is a culture of unhelpful pity that is tied to Buddhism: the concept of Karma means that if one is born with a disability in this life it is because of some transgression in the last, and there is a general stigma attached to any disability, reminiscent of how I remember people's attitudes in the UK 40 years ago
• There are only about 150 physiotherapists in the whole of the country and the one spinal injuries unit (people fall out of trees quite a lot apparently & there are a distressing amount of road accidents) is due to be handed over to government control, for reasons too convoluted to address - which basically means the kiss of death.

(That's in a very small nutshell!)

I have recently been to several of our member NGOs - fantastic organisations who try to improve the prospects of adults & children who are blind, deaf, physically or learning disabled, including those children with profound disabilities. I could kick myself for forgetting the camera as it would have been very interesting for you to see how, & in what conditions, these dedicated people work, but there will be plenty of opportunities as the weeks fly by.

My main objectives as Inclusive Education Advisor are to strengthen the existing network of NGOs and to capacity build at DAC. About half of our staff are disabled themselves (polio, cerebral palsy & loss of an arm by a mine are examples), and the rest don't really have much knowledge of disabilities. They all need support with planning, proposal & report writing etc etc. They are mostly bright, young, motivated to learn & dedicated. The oldest (apart from Granny Sarah here!) is a lovely, gentle 41 year old man who graduated as a physiotherapist in 1989 & worked for 14 years at the Spinal Unit. He got a scholarship of $1.50 (one dollar and fifty cents), 10kgs of rice, a bar of soap & a spare set of clothes. He is passionate about raising the awareness of communities about the potentials of disabled people & about helping them to earn their livings and is a one man power house.

One of the problems is the perception in Cambodia of what a disability is. After the war, the many millions of landmines led to a great number of people losing limbs (if they survived) and most attention & development aid and funds naturally went to them. Now, although the number of mine victims is still a substantial 66 a year, the vast amount of disabilities are not mine related. Disabled people themselves tend to think that any policies or initiatives are not relevant for them - that they are only for mine accident survivors. Disabilities range from every sort of congenital cause to deafness & blindness, often potentially treatable or avoidable. Because there are no reliable statistics yet (due some better ones next year), it is hard to say, but there seem to be a very large number of deaf children for example.

You would be justified in asking, what on earth do I think I can do about any of this, & some may also think that there are plenty of good causes and problems back home. One thing that happened on Monday brought it home to me. We arranged a meeting between 3 speech therapists from London & some of our Phnom Penh members, the head of the school for severely disabled children, workers at the nutrition centre (an orphanage for abandoned severely disabled children who cannot eat or drink independently), & others. There are no speech therapists in Cambodia, most of our staff did not really know what they are & certainly not the range of resources they can provide. By the time we finished, we had established the role therapists could play in each of the organisations and how training might be implemented & developed a contact strategy to the ministries (in order for any development work to be effectively sustainable, it has got to be government supported, however painful & tedious the process!)

How will I know this will help any particular child? I don't, but one of the conditions that causes completely avoidable infant death, social stigma & educational exclusion is cleft palate. Now... I hope my dear brother & sister-in-law have no objection to me telling the happy story of my fabulous little nephew Cameron, now nearly 3. He was born with a cleft palate, diagnosed shortly after, and had feeding problems because of it. They were referred to a specialist, had advice on how to feed him, later he had surgery & follow ups, has seen a speech therapist & now speaks really well & will be following his big sister to school in a couple of years. Luckily, he did not need any help or advocacy from me whatsoever.

I'm very sad to say that a baby born here, unless lucky enough to be born into a family who could take him to another country for treatment, or near enough to the one children's specialist hospital, and to parents with the resources to do even that, would likely die from lack of nutrition before a cause was ever found. If he survived, he would be regarded as a victim of his fate & maybe even kept out of sight at home. He would never learn to speak & certainly would not go to school. Maybe that Monday meeting will help some babies like this in the future.

Everything we do here is drop by drop & step by step. My predecessor was instrumental in getting the policy for Education for Children with Disabilities adopted by the Ministry of Education this February - a great achievement. If I can help to get the monitoring of the implementation of that policy underway, that will be the next step. And I hope some of it will be fun!

Perry's Tale

Cambodia's population is around 14 million and growing at about 2% per year. 85% of the population is rural; 34% of the entire population live below the official national poverty level of about US$0.45 (45 US cents) per person per day (that's $2.25 for a family of five). In Cambodia, if you earn just $1 per day, you're not classified as poor. 78% live on less than $2 per day. That's eleven million people each living on less than about £1.25 per day. Cambodia ranks 131st on the UN Human Development Index. In simple terms, that means things are pretty bad in many ways, although they could still be a good deal worse: there are 46 countries in the world below Cambodia.

Infant mortality is 98 per 1,000 births. A further 43 will die before they reach the age of 5. Put together, that's one in seven. In the UK, it's one in two hundred. The maternal mortality rate is 1 for every 169 live births; in the UK it's 1 in every 125,000. Think of the implications for families of that. At the other end of the journey, life expectancy is just 58 years, compared with the UK's 79. Think about that too, those of you (like me) over 50. These figures are actually quite a bit better than ten years ago, so progress is being made in improving people's lives here, but the process of change can be painfully slow and fragile. And there's a long way to go.

33% of the population is undernourished: i.e. they simply don't get enough to eat. Malnutrition - not getting enough of the right things to eat - is an even bigger problem. Let's just give you a quote from the UN Food and Agriculture Organisation (one of the organisations I work quite closely with): "Malnutrition, especially in rural Cambodia, is widespread, particularly among children under five years and among expectant and nursing women." Malnutrition is one of the biggest direct and indirect causes of child mortality. Even of the children that survive, over one third will be stunted due to the paucity of their diet. Malnutrition continues to affect people here, especially poor people, throughout their lives. Malnutrition is often the root cause of disability.

In the West, we pretty much take it for granted that we can eat a range of food types to keep ourselves healthy. In Cambodia, up to 80% of the diet (and sometimes more) is made up of just one food: rice. Rice is very good indeed for carbohydrates but there are an awful lot of essential nutrients that it doesn't contain. Cambodians need to get their vitamins and minerals, especially iron, zinc and calcium, from other food sources. Fortunately, they have the Mekong river system and its fish. Cambodians get over 80% of their protein from fish and, for the rural poor, the figure is close to 100%. In Cambodia, fishing isn't a hobby.

But we have a problem: there's a limit to the amount of fish you can catch without critically depleting the stocks. You've probably read in the press all about this kind of thing with respect to cod stocks in the North Atlantic. In Cambodia, if we take all that we think the rivers and the sea can reasonably provide, we're left with a gap in meeting our nutritional requirements, and the gap is growing as the population grows.

Bear in mind that the picture above shows the challenges that population growth could cause in maintaining the current levels of nutrition, let alone actually improving matters for the poor. But the situation is actually potentially much worse. The Mekong is under a great deal of pressure from damming for hydroelectricity, especially in China, and is also starting to suffer from pollution. At the same time, demands for land for the growing population are leading to habitat destruction. All of this affects the ability of fish to breed.

Meanwhile, most Cambodians have no realistic alternatives to fish and the first priority for people who are hungry is to find food now. Consequently, Cambodia's harvest of wild fish has been running at the limit - and arguably above the limit - for some time now. Over-exploited stocks are at risk of collapse: if too many fish are taken, then too few are left to breed. Today, the fisheries are filling the nutrition gap but, if the catch of wild fish were to drop by just 10% per year (and some rivers have shown much more dramatic declines than that), then the situation would turn very much for the worse.

So we need to act now to increase production from other sources like aquaculture (fish farming), whilst simultaneously reducing the demands we place on the river and lake systems. My job is to help work out how to turn this:

into something like this:

These projections are ones I recently made based on the latest available data. It's the first time anyone here has really done demand forecasting as part of strategic planning and it has helped to show us where our priorities need to lie.

Without doing this, we wouldn't have known, for example, how much we need to increase the catch of fish from the rice fields (they swim in and breed when the fields flood, and they are caught as the fields drain and dry out). We knew that we could increase the catch if we dug lots of dry season refuge ponds for the fish, we just didn't know how important it was. Now we do, because we're basing our statistics on consumption, not production. I take no credit whatsoever for this particular change in data collection - that goes to the Mekong River Commission (a multinational body) and long pre-dates my arrival here - but my job was to say "what does this mean to us in terms of demand and sustainability?" and to help people to take it from there.

At the same time, I'm working to improve the understanding of how to do planning for fisheries staff across all 22 provinces of the country. This is also a first, and it's going to be a long, challenging task. I'm also helping to produce all the action plans that will go to implementing the progress we need to make. At the same time, I'm continually working to improve my knowledge and understanding of all aspects of the fisheries sector.

So that's the context my job sits in. I work with some highly talented and very capable people but there just aren't enough of them. The ravages of the past have left Cambodia short of leadership, education, management skills, training and just about any sort of infrastructure you can mention. My job is to try to help: to fill some of the gaps, and to try to help them to work out better ways of doing things.

There probably isn't very much that I do that a Cambodian couldn't do - if he wasn't already overloaded with everything else that needs to be done. And if he had got the right education, training and experience. And if he had survived the devastation and difficulties of Cambodia's recent past. Bearing in mind my own age and background, and especially how someone like me might have fared in the years from 1974 - 1979 under the Khmer Rouge, it's perhaps not surprising that I don't have as many direct counterparts as you might at first expect. The good news is that there are quite a lot of very fine people helping in the Cambodian fisheries: as consultants, as research partners, as volunteers and, last but not least, as donors.

By the way, we also now know, thanks to some excellent research, that by eating a particular type of small fish we can also significantly improve nutritional standards for the same weight of fish eaten. So our plans can not only prevent things from getting worse, they can actually start to make things much better. Now we just need to get it done.

Pressing On

So that's what the two of us do every day. It can be frustrating, annoying, infuriating, dire, hilarious, challenging and intensely rewarding: often all at the same time. But, every so often, it makes a little bit of a difference.

Our normal, lighthearted service will be restored soon. In the meantime, please don't forget the need to keep supporting VSO through our Justgiving page at www.justgiving.com/jagoteers. Our thanks go out again to all those of you who have already contributed so generously. You're helping to make a difference.