Cambodia’s reputation for a hardworking, intense lifestyle means women have to take particular care with their health

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RICK VALENZUELA

A woman restocks a display of promotional condoms during last year’s Water Festival in Phnom Penh.

Doctor Laura Watson is a general health practitioner with a postgraduate degree in obstetrics and gynaecology.

She is the resident women's health specialist at Phnom Penh's International SOS medical clinic, and what follows is some basic health advice for women living in Cambodia.

Family planning and contraception

Condoms and the pill are the most common methods of contraception preferred by both expatriate and Cambodian clients at International SOS, and use of the ubiqtuous OK pill and condom, which is available at most pharmacies, is widespread.

However more long-term methods such as IUDs, injectables and sterilisation are also available in Cambodia.

Watson says many of her wealthier clients don't trust the OK pill and condom because it is so cheap.

But the pills and condoms are heavily subsidised and quality-controlled by Population Services International, a global health NGO, who target the OK brand at poor women.

According to Watson the OK pill is the same as a very popular pill called Microgynan, currently prescribed to 70 percent of women in the UK.

It is also popular in the US, Australia and other developed nations because it is well-tolerated by most women.

Watson says many Cambodian clients misuse condoms and the pill, so family planning counselling and clear instructions are a priority.

Cambodians and expatriates clients are also regularly concerned about weight gain and loss when taking the pill, but Watson assures users that this fear is not founded in scientific fact.

"There is some evidence that the pill stimulates appetite, but there are absolutely no findings that it makes you fat," she said.

Never taking a holiday, not looking after yourself properly, drinking too much, smoking too much – this kind of burnout behaviour we see a lot of.

OK condoms retail for 500 riels for a packet of three while the OK pill is just $2 for a year's supply.

Dr Laura Watson. PHOTO SUPPLIED

Regular check-ups

Pap smears and breast examinations are available in Cambodia, and Watson advises regular breast self-examination and Pap smears for all women aged over 25, or three years after initial sexual intercourse.

Women who have never had sex or are over 65 do not need to have a Pap smear.

Watson advises having a Pap smear every two to three years, although there is debate over this, with different countries offering alternative advice.

Older women need to think about dealing with menopause, vigilant breast examination and keeping their bones healthy.

Pregnancy

Along with contraception use and regular breast self-examination, Watson's strongest advice for women living in Cambodia is not to have children too late.

"Fertility is a big issue for women here. There are a lot of career women in Cambodia and they get over 35 but haven't found the right time or the right partner and always assumed they can have families," she said.

"I see a lot of women having fertility problems, and I think it's very difficult for the individual and the relationship to go through fertility treatments."

Watson says she counsels a lot of women who have trouble meeting the right partner in Cambodia, after focusing on their careers and moving around a lot, and the anecdotal "man drought" in Cambodia is a big concern for many women.

"I think there's never a right time to have a child and if you've found someone you want to have a baby with - go for it," she said.

Watson also says if you can afford it to have your baby overseas, the closest options for modern health care being Singapore or Bangkok.

She says there are no international standard neo-natal intensive care facilities in Cambodia, and while most women are low-risk, if there is an emergency during the birth, such as respiratory problems, there are no adequate facilities in Cambodia.

Mental health

Watson says she wonders whether a lot of "Type  A" personalities are drawn to Cambodia, loosely meaning highly ambitious, workaholic, competitive people.

"A lot of people who have struggled to fit in at home are attracted to Cambodia because there are a lot of people who are different here. And there are also a lot of people who are running away from problems and end up in Cambodia - people with drug problems, alcohol problems and mental health problems," she said.

"It's the kind of intensive living that people often do here. Working seven days a week, never taking a holiday, not looking after yourself properly, drinking too much, smoking too much - this kind of burnout behaviour we see a lot of."

Watson says generally women are more accepting of mental health issues than men, and the idea that physical symptoms may the product of mental stress.

She says a lot of her work involves talking to people about structuring their coping mechanisms and discussing holistic lifestyle changes that may help deal with the problem.