K ANDAL - Yem Lay lifts her left hand to her face, rattling the metal chain that

has attached her for the past two years to a wooden post at her village

home.

Cambodia has no long-term hospital beds for mental patients, so the

very people who love Yem Lay the most - her six children and husband - are

forced to restrain and care for their schizophrenic wife and mother as best they

can.

Many other families are in the same position.

Hugging her

knees to her chest, her mouth curled in a shy smile, tiny Yem Lay, 44, almost

looks like a child.

But her hands are gnarled and permanently clenched

into fists. Her bony frame reveals recent refusals to eat. A faint perfume of

urine floats above her wooden bed.

The thin chain that attaches her to a

world she no longer recognizes is wrapped around her wrist and nailed tightly to

a post that holds up a broken back roof. She previously had a leather thong but

that she broke too easily.

Today is peaceful. There is no sign of the

fighting, the swearing and beatings that have echoed for years through the

two-room house. This morning, things are under control.

"She doesn't

recognise me. She says I am not her daughter," says 16-year-old Mang Malis,

reaching out to brush a wisp of hair from her mother's ear.

"If you were

my daughter, I would build a big house for you," whispers Lay. Malis smiles. She

knows that will never happen.

Malis, the second-eldest, left school

after the third grade to look after her mother and her younger siblings. She

says she will never get married "because my mother is ill and poor. I will stay

to look after her forever."

Lay's family used to have land for planting

rice. They tended cows. Her husband drove a cyclo in Phnom Penh, while Lay sold

cigarettes and other small items at the roadside near Komong Toul village in

Kandal Steng.

Her mental illness has reduced them to poverty. Her

husband, But Mang, has sold off nearly everything they own to pay for

traditional healers and conventional medicines - none of which have cured her of

the voices in her head, or brought back the memory which would allow her to

recognise her six daughters, aged five to 23.

With no state mental

facilities, and like many other families in the same position, Lay's family has

no recourse but to keep her at home.

The problems started about ten

years ago. Malis remembers her mother laughing a lot, dancing at strange

moments.

Seven years ago, after the particularly difficult birth of her

fifth child, Lay became seriously ill.

"She had a fever and she couldn't

speak... After one month she felt better, but she was always angry at her

husband," says her sister-in-law But Mik.

The family tried taking her to

a hospital, but after four days of cursing and hitting out at medical staff, the

doctor made them take her home.

"She tried to find several Khmer Kruu

(traditional healers). Sometimes she felt better, sometimes not," says Mik.

Then, for a while, she believed she was a Khmer Kruu, insisting she had cured

herself.

"Every day she went out to pull out the newly-planted rice. She

dismantled the house. She beat the children, saying 'You are not my children,

I'll beat you until you die,'" says Mik. The family tried to keep her in the

house, but often, she would escape.

"Finally, she cracked the head of a

neighbor child. The neighbor told the authorities. We decided we had to keep her

in the house and tie her."

The chain is about one metre long. Lay can

neither walk to the centre of the room, nor out to the garden behind the house.

She sits all day, mumbling words no one understands, sometimes asking who all

the children are around her.

Things are not always this peaceful. "When

she swears at anybody, it's very clear," says Malis, explaining the younger

children often leave the house to get away from her cursing.

"When she

gets angry, she stands up and pushes on the roof and says to her husband: 'You

are a bad man. A bad man.' And she throws her food away," says Mik.

A

foreign doctor came to see Lay once. He diagnosed schizophrenia. She was given

medicine, but it tasted bad and made her dizzy. She refused to take it.

Lay's family is now getting some support from local health care workers,

trained by NGO Medecine de L'Espoir International.

"They are working

with the kids... trying to relieve their frustration and tension," says director

Mychelle Balthazard. The children are getting some financial support from a

local NGO that normally works with street kids.

Balthazard says they

plan to take Lay into Phnom Penh, to visit the psychiatric department of

Sihanouk Hospital.

And the family is trying to find a different method

of restraining their mother. The chain hurts her wrist, but an earlier, leather

rope was easily broken.

Lay's oldest daughter has married and moved away.

Malis says she hopes her younger sisters can all finish school, so they can get

jobs and help support their mother.

Her family's devotion is Lay's best

chance at improvement, says Balthazard.

"An advantage of the Khmer

society is that there is often more family support than in Western countries.

Because there is no hospitalisation, the family is more involved."