On the southern, industrial fringes of Phnom Penh, six heavily pregnant women spill out of a tuk-tuk and waddle across a pitted, dusty road.
Streaming through the gates of the Cambodian Children’s Fund (CCF) – an NGO providing education, accommodation and healthcare to over 1,200 children in one of the city’s poorest districts, Steung Meanchey – the women wait patiently in line to have recent ultrasounds examined.
Established in 2004 by ex-Hollywood movie mogul turned third world altruist, Scott Neeson, CCF launched its Maternal Care Program in 2009, and the labours have yielded impressive results.
Face slightly weathered but warm, with a toothy grin and mop of tawny, sun-bleached hair, 53-year-old Adelaide native Neeson scaled the career ladder swiftly – from humble beginnings hanging posters at a country theatre, he soon moved on to film distribution in Sydney and in 1993 hightailed it to Los Angeles, eventually nabbing the plum role of President of 20th Century Fox International.
During his tenure he oversaw the releases of blockbusters such as Titanic, Braveheart, Independence Day, X-Men and the Star Wars prequel trilogy.
In 2003, a respite from the Beverly Hills soirees and Marina Del Ray yachts took the form of a visit to Cambodia’s temples and Neeson soon found himself knee deep in Phnom Penh’s waste, with hundreds of languid, scrawny kids fishing about for anything of value.
Less than five years ago, Steung Meanchey was home to the capital’s municipal rubbish dump, a gargantuan, six-hectare spread of rotting plastic.
Hundreds of the country’s poorest would try to eke out an existence at the site, scooping up anything of worth.
The tip was shifted even further outside the city’s edges in 2009, close to the Killing Fields, but the community it served remains, the area is still laced with poverty, debt and desperation.
An alarmed Neeson pulled two children from the dump and for $40 had them enrolled in school – a year later he had sold his home, resigned from his job, leased a building and hired his first Khmer staff member.
“This area is one of the poorest in Cambodia,” he muses, “nearly all of these people are carrying huge, huge debts, with the majority from medical costs – most of them have migrated here from the provinces to try and find some kind of work,” he says.
CCF’s latest project, the Maternal Care Program, has now assisted 408 women through their pregnancies, delivering 354 healthy babies. Of the 408, 54 are still yet to give birth, meaning that so far, every single child born and their mothers have survived.
The program targets Steung Meanchey’s most vulnerable – to join, pregnant women must be either living in poverty, have a history of poor health or come from a domestic violence situation.
There are three nurses at the clinic who check ultrasounds, conduct regular health assessments, make home visits, and supply drinking water, rice and vitamins to the women’s families for the entire nine months.
“We also provide an ID card, registering all their details and expected delivery dates, and we send them to hospitals for regular urine and blood tests and doctor check-ups. If there are any problems, we scale up the care and give them priority treatment, and the women deliver their babies at nearby hospitals without having to pay a thing,” says Son Thoen, a maternal care supervisor and nurse at CCF.
Neeson is no stranger to the media, but his pride in the project is palpable, gesturing wildly and speaking in elongated bursts.
He scoops up four-year-old, grinning Sokly, whose perilous birth sparked the Maternal Care Program.
“I remember I had a call from her father in the wee hours of the morning – I have no idea how he got my number – but he was stuck outside a major hospital with no money to get in, and his wife was bleeding profusely.
“It cost me $15 once I arrived to get her in, however it was a breech birth so we paid a further $40 for the operation to get Sokly out. If I hadn’t answered my phone that night, both mother and baby wouldn’t have survived.”
Earlier in our visit, Neeson leads us about two kilometres south from the CCF site to a tatty, makeshift hut flanking the former tip’s periphery.
“There was a complete lack of hygiene and some of these women were literally giving birth on the rubbish dump or on grimy floors like these,” he says.
“There’s still such a long way to go for Cambodia’s health system – it lacks everything from the bricks and mortar to build hospitals to the training of doctors and nurses. There are some great facilities for children but adults have very limited options.”
Cambodia’s maternal and child health has seen vast improvements over the last decade, and it’s come at the ideal time – 80 per cent of the country’s population is under 33, acccording to AusAid research, with most women in this age group currently in their child-bearing years.
Maternal mortality has fallen form 472 deaths per 100,000 live births in 2005 to 206 deaths in 2010, exceeding the country’s millennium development goal of reducing that number to 250 deaths by 2015.
Meanwhile, infant mortality has decreased from 66 deaths per 1000 live births in 2005 to 45 in 2010.
Between 2006 and 2010, the number of supervised births increased from 44 per cent to 71 per cent.
Since 2007, most of the $65 million of funding injected by AusAid has directly targeted child and maternal health and healthcare for the very poor. However Megan Anderson, AusAid counsellor for development and cooperation, said that although maternal and child health had made great strides in Cambodia, often the poorest 10 per cent of the population are the hardest to reach.
Anderson says a hurdle that remains is convincing people to access public health services.
“Maybe they had a bad experience, or had no experience with western medicine, maybe they are in very remote areas - they may not know about these kind of schemes. But we are trying to get the system national,” she says.
“We’ve made huge, huge gains though. Nine hundred women and their babies now live every year. Few other countries have been able to bring numbers down so substantially.”