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A ‘living symbol of resilience’

The medicine cabinet at Ka Sunbaunat’s clinic
The medicine cabinet at Ka Sunbaunat’s clinic Eli Meixler

A ‘living symbol of resilience’

As a child, Dr Ka Sunbaunat noticed that his parents – who had been exposed to fighting between French, Japanese and Thai forces during World War II – sometimes behaved oddly. His mother often talked in paranoid whispers. And his father, a teacher and generally a calm and pleasant man, lashed out in anger in times of stress.

The desire to understand his parents’ mental health problems put Sunbaunat on the road to becoming a psychiatrist. Later, seeing the damage wrought on the nation by the Khmer Rouge drove him to devote his life to creating a mental health care system in Cambodia.

This coming week, at the 16th Congress of the World Psychiatric Association in Madrid, he will receive the Geneva Prize for Human Rights in Psychiatry, which comes with an award of $21,427.

“[Sunbaunat] is now regarded as the father of Cambodian psychiatry and, from his work with the mentally ill, as a ‘living symbol of resilience’,” reads a statement from the foundation.

There were two psychiatrists practising in Cambodia before 1975, but both were killed by the Khmer Rouge and the only psychiatric hospital was closed. Today, there are more than 46 locally trained psychiatrists and a number public and private psychiatric clinics.

That’s still grossly inadequate for a country of about 15 million people, where an estimated 27 per cent show symptoms of acute anxiety, 16.7 per cent suffer from depression and 2.7 per cent have post traumatic stress disorder.

On average, Organisation for Economic Co-operation and Development countries have about 154 psychiatrists per one million of population, while Cambodia has three psychiatrists for every million.

But the fact there are any at all is largely thanks to Sunbaunat.

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After the end of the Khmer Rouge’s reign, Sunbaunat – who was a third-year medical student before the fall of Phnom Penh – took it upon himself to repair the psychological damage inflicted during the years of conflict.

“I thought at that time a lot of Cambodian people were suffering from psychiatric problems, and I wanted to develop psychiatry in Cambodia,” he said. “But there was no one to teach psychiatry, because all the doctors had been killed.

“I proposed to the minister of health in 1983, after I graduated, to find a scholarship to study psychiatry overseas. He told me it was not possible, because at that time Cambodia was under the international isolation. We just had connections with communist countries, where psychiatry was very rudimentary.”

For nearly 10 years, he lobbied the government to turn its attention to the mental wellbeing of the population.

Finally, in 1992, the Ministry of Health created a sub-committee on mental health, headed by Sunbaunat, which – thanks to some funds from the Norwegian government – led to the creation of the country’s first psychiatry program at the University of Health Sciences. In 1994, Sunbaunat helped manage Cambodia’s first three-year-old course in specialist psychiatric medicine, in which he was also a student.

Sunbaunat retired from his government and academic positions last year but still operates a private practice in his home.

These days, his patients include foreigners, middle-class Cambodians and the poor, who he gives free treatment. He doesn’t treat any senior political figures or tycoons. “They go to doctors overseas,” he said.

Some of his regular patients are former Khmer Rouge cadres who struggle with mental anguish over their actions.  

Looking to the future, he said he worries that the development of the mental health system is getting “sleepy” and that the sector suffers from a lack of coordination. The government does not make mental health a priority, he added.

“They say no one dies from mental health and people die from HIV. But how many people die in traffic accidents because of alcohol or substance abuse? How many people commit suicide?”

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