Krouch Sopheak has never visited a modern doctor. In his 38 years, he’s cured all his aches and pains with the help of his uncle, a travelling healer from Banteay Meanchey province.

“Traditional healers deal with all kinds of minor maladies,” Sopheak says, sitting next to a burlap bag filled with herbs, roots and bark in a shop in O’Russei Market.

He’s come to Phnom Penh to buy herbs for his uncle, who is preparing a tonic for a woman with severe menstrual cramps.

Sopheak’s uncle, 55-year-old Hok Heng, is just one of Cambodia’s many kru Khmer, traditional healers who combine herbal remedies with rituals to cure patients with ailments ranging from a minor infection to the curse of an evil spirit.

In a country where modern doctors are often poorly trained and health clinics under-regulated, many people choose to place faith in these natural prescriptions.

As Cambodia develops economically, traditional healing techniques co-exist with modern medicine, and often serve as a last resort for those seeking treatment. And there seems to be little risk of losing the tradition: Even young urbanites are choosing to train in the healing arts.

Choosing a doctor

Most Cambodians switch between modern doctors and traditional healers quite fluidly, says Ian Baird, an associate professor at the University of Wisconsin-Madison who researches traditional healing practices in Southeast Asia.

“Whether they are richer or poorer or urban or rural, they are very flexible,” he explains. “They think there are a number of things that might cause the illness, so they might start off by going to the doctor and the pharmacy, and if after a while they don’t get better then they begin to think maybe it’s a spirit and they go to a spirit doctor.”

People often trust the medicine from traditional healers more than pharmaceuticals because it is considered more natural, says Ryun Patterson, author of Vanishing Act: A Glimpse into Cambodia’s World of Magic. Likewise, fortune tellers and spirit mediums substitute modern psychology treatment with their services.

The personalised treatment provided by a kru Khmer is an additional perk, Baird says. Patients – especially those who are poor – often view hospitals or health clinics as crowded, unfriendly places where they are ignored for hours. So they choose to seek out the services of a more traditional, and often, more local healer.

“It’s likely the traditional healers are people from the same societies [as their patients], they often don’t ask for money up front; there is a very different approach that is appealing to a lot of people,” Baird says.

Still, he adds that the majority of patients visiting traditional healers seek solutions for long-term illnesses like arthritis and back pain, not serious maladies or those that require urgent care.

“We’ve had a few people come here seeking cures for cancer, but we don’t know what to prescribe for that so we don’t give them anything,” says Kong Siv Cheng, a 28-year-old who works in an herb shop with her husband, who is training to be a kru Khmer.

Magic for major illness

Not every kru Khmer shies away from treating serious illness. In Phnom Penh, Buddhist monk Southern Serow says the majority of his patients visit him when they have problems modern doctors can’t fix.

Serow has treated patients with herbs and rituals for a decade, and says that thousands of patients flock to his pagoda each year seeking treatment. “I can cure everything except HIV,” Serow says.

When a patient arrives in Serow’s pagoda, the monk’s first job is to provide a diagnosis. He dips an incense stick into a jar of powder made from wild boar fat, coconut oil, python fat and bee pollen, and asks the patient to lick it from the stick.

“If the taste is sweet then the ailment is purely physical. If it’s sour, then the patient has a spiritual problem,” Serow explains. “Worst of all is if it’s spicy. A spicy flavour means the patient is beyond saving and will definitely die.”

Patients usually stay in the pagoda for a week to a month. While there, they are sprinkled twice a day with holy water. Often they are prescribed a potion to drink. “If I use only herbs and remedies, then the treatment takes longer. And if I use only blessings, it will also take too long,” he said. “Using the two together works best.”

About 90 percent of the people who visit the pagoda have been cursed by an evil spirit, says Serow, who claims that he can bring people back from the brink of death by having them drink his holy water.

Serow prescribes different medications depending on the patient’s ailment. The concoction for treating evil spirits has four tree-based ingredients, all of which are ground into a fine powder stored in plastic jars on Serow’s shelf. He also has a powder made from 10 ingredients that can cure cancer, he says.

And potions and powders aren’t the only method of treatment. Sometimes, Serow will write a prayer on a betel leaf in Pali, a script used in early Buddhism, and have the patient eat it. Occasionally he taps people with respiratory problems on the chest with a carved piece of blessed wood.

“People come to me and give me complete control of their bodies,” he says. “They accept the service and know that if they die, then it’s their fate.”

But most of the patients under his care don’t fall ill again, he says, showing off a binder filled with photographs of cured individuals.

After a patient’s departure, the monk gives them a katha, an amulet to wear around their waist for protection, or a spirit cloth known as a yuan to hang in their house. Like many kru Khmer, Serow also moonlights as a fortune teller.

On the top floor of Serow’s pagoda, current patients sit in their pyjamas, rubbing salve on their faces, guzzling herbal tonics from plastic bottles, and lounging.

Rain Sop, a teacher from Prey Veng, says she first visited a medical doctor when her headaches started six years ago. She travelled to Vietnam, where medical facilities are considered superior to Cambodia’s, to get a scan.

Nothing could cure her headaches, which grew more severe last year. But after staying in Serow’s pagoda for six days her symptoms were starting to subside, she says.

“I think I’ll soon recover completely,” Sop adds.

Another patient, an elderly woman named Sar Ean, shows reporters a rash around her abdomen. She’s been in the pagoda for one month and nine days and her rash is beginning to disappear, she says.

A trip to the market

On the edge of O’Russei Market, a handful of storefronts peddle herbs and tonics. The miniature bazaar is testament to Cambodia’s flourishing herbalism trade. Each shop has its own kru Khmer who mixes remedies, while assistants know which herbs to prescribe for which illness.

Lingchu, an earthy red mushroom, is believed to cure ulcers and irritable bowel syndrome. Small seashells mixed with lemon are used to clean the urinary tract and prevent infections. Tepru, a dark red tree bark, is boiled with water or rice wine to treat constipation. Moringa tree seeds are chewed or ground into a powder to treat high blood pressure. (Some say they also prevent cancer.)

“Sometimes 10 or more herbs will go into a tonic. The most common ailments people seek remedies for are stomach problems and symptoms that occur after childbirth,” says healer Ma Oun as she wraps small jars of medicinal oil in plastic to stock on the shelf.

As if on cue, a woman appears seeking herbs for someone who has just given birth. Oun and her daughter begin rummaging through the bags. “Once you boil the herbs, you have to drink them the same day,” she instructs.

Two of Oun’s children, her 33-year-old son and 30-year-old daughter, are studying to be kru Khmer. Only her youngest daughter opted for modern medical school. “This will be my sister’s store,” Oun’s youngest said with a shrug. “I want to do something different.”

A professional practise?

Traditionally, Cambodia’s kru Khmer learned from an older mentor. Oun, who has been practising healing arts for 30 years, said she never received a formal education. But for her children the situation has changed.

Many of the country’s latest generation of kru Khmer have passed through the National Centre for Traditional Medicine (NCTM), which began offering five-month training courses in 2009, with the initial support of the Nippon Foundation. Graduates receive accreditation from the Ministry of Health.

On its website, Nippon, a Japanese non-profit that aims to promote social innovation, extols the virtues of traditional medicine, calling it “a unique and valuable resource”.

The NCTM was the first step toward preserving traditional medicine in Cambodia, as well as ensuring proper treatment in remote provinces.

With Nippon funding, the school trained about 345 healers, but the money dried up in 2013. The school restarted its courses this past June with the help of donations from healers around the country. There are currently 42 students enrolled, each paying around $240 for the course.

The average student is about 25 years old, according to Moeung Vannarom, the school’s director. During the course, students learn about medicinal plants, botany and basic medicine. But for Vannarom, getting practitioners licensed is as important as standardised education for the tradition’s survival.

“Training is just one factor to maintain the practice,” he said. The industry also needs regulations to guarantee high-quality services and a minimum standard of care.

Although the techniques may seem strange to those accustomed to modern medicine, Patterson says their efficacy shouldn’t be underestimated.

“It’s a function of belief,” he says. “Studies show this stuff is very real and has very effective results.”