Despite the warmth of the morning sun, the mood among the group of villagers

seated on a blue tarpaulin under a milk tree is subdued, even morose. The women,

mostly widows, are here to discuss their past at a newly established self-help

group. It is Sim Keo's turn to talk.

Group therapy sessions encourage TPO program participants to talk about their past problems.

The tears roll across her wrinkled

cheeks as she describes the traumas of her life under the Pol Pot regime. Those

who think that two decades is a long time should come here - the terrible

memories are as fresh as ever, seared deep in their minds.

"So numerous

were the nightmares which happened to me," she sobs. "You know, my children died

of starvation and their bodies buried like those of cats." It takes several

minutes before she is composed enough to explain further.

After her

husband was murdered, accused of being a capitalist, Keo was sent to a new

cooperative two days walk away. Her abiding memory is her children's tears of

hunger - there was no food on the journey. On arrival she went directly to the

kitchen, but the cook refused her rice.

"You know what I did?" she asks,

wiping the tears from her cheeks with her krama. "I just cried with them and

looked at their hungry faces with so much pity. I never thought that my life

would turn out like that."

As the wife of an accused intellectual, Keo

was put to work in fields far from her children. Overworked and undernourished,

she collapsed frequently. Her children were even worse off: lack of food made

them sicken. Their bodies swelled, and four of the five died. 

Memories of her starved children being buried like animals during the Pol Pot years are etched deep into the soul of Sim Keo.

When she

heard the news she ran to find them, but Angkar - the organization - refused to

let her touch her children. They were, she says, buried like animals. To this

day her head aches with the memories.

Chhay Marideth is a counsellor at

an NGO called the Trans-cultural Psychosocial Organization (TPO) which runs the

self-help program. She says the group discussions are tremendously important for

coping with past traumas. The civil war and the daily struggle to survive meant

people had no opportunity to discuss their experiences. Bringing them together,

she says, helps the healing process.

"It is like an abscess," she says.

"If we do not open it, it will become even more painful."

Kann Kall,

managing director of TPO, says that talking about their problems allows others

with similar issues to suggest solutions.

"When they express their

emotions their feelings improve," he says. "This is good

therapy."

Although many are unable to cry at home in front of their

children, crying in the group is common.

"This kind of intervention is

like an arrow which can kill three birds at the same time," he said. "One, it

improves their mental health, two it reduces the problems involved in taking

care of a family member, and three the family can then generate more

income."

He gives an example: one of his clients, profoundly disturbed by

her experiences under the KR, would scream at anyone passing her house. After

her husband died she became an alcoholic and ended up with no friends.

Initially, says Kall, she refused to join the group, but changed her mind after

hearing one of the members talking about their troubles.

She explained

that after her husband died she thought her neighbors wanted her land and house.

Dwelling on that made her extremely depressed and she began to see her neighbors

as her enemies. Taking part in the group helped her depression: she stopped

drinking, attended the pagoda and improved her income.

Nom is another

participant. She initially found her experiences to painful to

discuss.

"If I tried to talk about the past the emotional shock would

prove too strong. I would find it hard to breathe properly," she says. "I miss

my lovely son and my husband to this day."

Her husband was a journalist

during the Lon Nol regime, but she lost him and her son in the space of only ten

days. Some days she was unable to sleep, and the times she could sleep were

choked with bad dreams.

"If my husband were still alive, he might be

working as you are," she told this reporter.

The loss of her loved ones

drove her often times to think of suicide, but she has decided that is not an

option.

One month later the Post went back to visit the two women.

"After talking with the group my feelings improve, but only for a short

while," Nom says, chewing on tobacco. "It still comes back. I need more

help."

Sim Keo is slicing a fish which her grandchildren have caught in

the ricefield. She says she would like more meetings to discuss the experiences

of the past.

"I feel better now," she says. "It has been in my mind for

20 years, and in all that time I hadn't told anyone."

 

WHO's regional strategy

Thirty-seven western Pacific countries adopted a regional strategy for mental

health during the last session of the World Health Organization (WHO) regional

meeting.

Minister of Health Dr Hong Sun Huot said the strategy should be

culture-specific and take into account the country's

situation.

"Cambodia's people only recently finished a civil war," he

said. "It left many people with mental illness problems. The country does need

to make mental health a priority, but we just don't have the money to run it

[well]. It will require support from governments, NGOs and the

communities."

Dr Shigeru Omi, regional director for WHO, said that

promoting mental health was as important as promoting physical

health.

The objective of the strategy is two-fold. First, to decrease the

burden of mental illness and disability, and second to improve mental health in

the region. Among the new policies and legislation will be a guarantee of

adequate facilities to help people with mental health disorders.

Dr Sun

Huot said human resources needed to develop, which would require outside help.

Cambodia has no psychiatric hospital and only three outpatient clinics. The

plan, he said, was not to build more hospitals, rather to create small units in

existing hospitals that could treat mental health problems.

"We need

[WHO] to help us develop human resources and provide education for psychiatrists

and nurses in the community," he said.

Bill Pigott from WHO Cambodia said

that the country would receive advice, resource materials and guidelines on how

to build a mental health system. The working group, comprised of NGOs and

government, would help.

"It is a good example of people working together

to do something on mental health," said Pigott. "The work [will help]

development of policy and a plan of action for mental health. It provides a

framework."