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	<title>Isabelle Roughol&#039;s portfolio &#187; Cambodia</title>
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	<link>http://portfolio.isabelleroughol.com</link>
	<description>The portfolio of young journalist and writer Isabelle Roughol</description>
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		<title>Documentary film: Beyond The Spotlight (in production)</title>
		<link>http://portfolio.isabelleroughol.com/documentary-film-beyond-the-spotlight-in-production/</link>
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		<pubDate>Thu, 04 Jun 2009 16:31:53 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Documentary film]]></category>
		<category><![CDATA[My best articles]]></category>
		<category><![CDATA[Cambodia]]></category>
		<category><![CDATA[sexual violence]]></category>

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		<description><![CDATA[I worked as an assistant producer, handling research, interviews and logistics of the next documentary film by Sundance award-winning director Kim Dong-won, which deals with sexual violence against children in Cambodia, and the social complacency and legal impunity surrounding it. I became involved in the project after my articles about a brutal double rape and [...]]]></description>
			<content:encoded><![CDATA[<p>I worked as an assistant producer, handling research, interviews and logistics of the next documentary film by Sundance award-winning director Kim Dong-won, which deals with sexual violence against children in Cambodia, and the social complacency and legal impunity surrounding it. I became involved in the project after my articles about a brutal double rape and murder attracted the attention of the producer.</p>
<p>I am no longer working on the film but it&#8217;s not yet out. More information to come when the release is announced.</p>
<p>(Photo: Children who participated in the filming, at an elementary school in Battambang, Cambodia. 3 June 2009. By Isabelle Roughol)</p>
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		<title>Fear seizes village where 2 girls were raped, murdered</title>
		<link>http://portfolio.isabelleroughol.com/fear-seizes-village-where-2-girls-were-raped-murdered/</link>
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		<pubDate>Fri, 09 Jan 2009 09:33:49 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Justice & police]]></category>
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		<description><![CDATA[9 January 2009: After the two cousins were brutally assaulted and killed, girls in the village no longer leave their home.
(Photo: The sister of Phal Sophoeun, with her brother, holds up the only picture of the slain 14-year-old. 8 January 2009. By Isabelle Roughol)
By Isabelle Roughol and Neou Vannarin
Svay Sar commune, Pursat Province – Phal [...]]]></description>
			<content:encoded><![CDATA[<p>9 January 2009: After the two cousins were brutally assaulted and killed, girls in the village no longer leave their home.</p>
<p>(Photo: The sister of Phal Sophoeun, with her brother, holds up the only picture of the slain 14-year-old. 8 January 2009. By Isabelle Roughol)</p>
<p>By Isabelle Roughol and Neou Vannarin</p>
<p>Svay Sar commune, Pursat Province – Phal Sokhoeun, 27, was careful about the safety of her 14-year-old sister, Phal Sophoeun. She did not send her to the fields or to herd the cows after school, like so many other girls in Krakor district’s Boeng Smuk village. Phal Sophoeun was a quiet, gentle fifth grader, who walked straight home from Koh Kandal Primary School to watch her infant nephew. She never strayed far from the village.</p>
<p>“I was very careful and still it happened,” Phal Sokhoeun said of the rape and murder of her little sister, whom she’d raised for the past 11 years, after their mother died and father abandoned them.</p>
<p>Phal Sophoeun had been missing since Monday afternoon, along with her cousin Nai Vinn, 11, a second grader in the same school. Friends and relatives started searching in the fields, thinking the two might have got lost on their way home. Huot Nai, 37, Nai Vinn’s father, traveled to two neighboring villages in search of the girls.</p>
<p>On Tuesday afternoon, Phal Chantha, 19, Phal Sophoeun’s brother, saw a spot of color on the forested mountain towering over the field where he was standing. He gathered a group of 10 men to investigate. About 5 km into the forest, they found the two girls hanging from the same branch of a tree, about 2 meters from the ground.</p>
<p>The cousins had been raped, beaten up and strangled to death. Both had bled from their vaginas. Nai Vinn had bruises all over her body, both legs were broken and her eyeballs had been poked in. Phal Sophoeun had a broken leg and her neck was broken in so many places that “her head could move in any direction,” Phal Sokhoeun said.</p>
<p>The girls’ bodies were cremated Wednesday. Police suspect more than one perpetrator was involved but have made no arrest.</p>
<p>“It’s difficult to identify the suspects because the house is very far from the police office and it’s isolated from the village. And when we asked the people, they seemed to know nothing about potential suspects,” said Soeun Sopheak, provincial penal police chief.</p>
<p>The investigation is also difficult because police arrived at the isolated village at nighttime Tuesday, more than 24 hours after the crime, he said. Local police will continue investigating the case, he added.</p>
<p>On the way to the girls’ neighboring homes, roads of red earth get smaller and smaller until only a narrow footpath through yards and fields leads to three houses. Here, each home has lost a daughter.</p>
<p>Three years ago, the Phans’ neighbor, Thon Than, 20, left one morning carrying fertilizer to the family farm. She was later found raped, beaten up and strangled to death. No arrest was ever made.</p>
<p>“I believe in the law. If [police] could not find out, I don’t have any idea what to do,” said Long Khun, 60, proudly displaying a framed portrait of Thon Than, the niece she raised after her parents’ death.</p>
<p>Though Thon Than was not found hung up, the cases are cruel and similar enough to send a chill through Svay Sar commune. Many parents interviewed, including in the commune town 10 km away, said they were afraid for their children and would not let them get away from the house or school.</p>
<p>In Boeng Smuk village, Un Tae, 50, won’t let his twin daughters, 20, go to the fields or tend the cows anymore. He and his three sons have taken on the women’s jobs so they can stay close to home.</p>
<p>“I might stay at home forever,” said Tay Savuth, one of the twins, who added she was terrified.</p>
<p>The village of 278 families is usually peaceful, without any gangs, and everyone here is a friend or a relative, Phal Sokhoeun said. She couldn’t think of anyone who could have raped and murdered the girls.</p>
<p>But while he doesn’t have any suspect, the village chief, Kin Ngas, 62, is looking at his constituents differently now.</p>
<p>“The crab that cuts the rice in the rice field is the crab in the rice field,” he said, suggesting the killers were locals.</p>
<p>He’s advising that children stay as close to home as possible and that women travel in groups of at least three and let their families know where they are going.</p>
<p>Contacted Thursday, Minister of Women’s Affairs Ing Kantha Phavi said she wouldn’t speak over the phone to a journalist she doesn’t know.</p>
<p>“We have a policy [to prevent violence against women]. We’ve implemented it for five years already,” she said before hanging up.</p>
<p>At press time, Ellen Minotti of Social Services of Cambodia, had not returned a call for comment. The Cambodian Women’s Crisis Center and Cambodian Social Development could not be reached for comment.</p>
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		<title>7 January 1979: The end of Khmer Rouge hell and the start of a long purgatory</title>
		<link>http://portfolio.isabelleroughol.com/7-january-1979-the-end-of-khmer-rouge-hell-and-the-start-of-a-long-purgatory/</link>
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		<pubDate>Sun, 04 Jan 2009 14:56:36 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
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		<description><![CDATA[4 January 2009: When the Vietnamese ousted the genocidal Khmer Rouge regime on 7 January 1979, they liberated the country but also settled in for a decade-long occupation. Today still, Cambodians have mixed feelings about the date, celebrated with much grandeur for its 30th anniversary.
(Photo: Visitors to the prison-turned-museum look at photos of the prisoners [...]]]></description>
			<content:encoded><![CDATA[<p>4 January 2009: <strong>When the Vietnamese ousted the genocidal Khmer Rouge regime on 7 January 1979, they liberated the country but also settled in for a decade-long occupation. Today still, Cambodians have mixed feelings about the date, celebrated with much grandeur for its 30th anniversary.</strong></p>
<p>(Photo: Visitors to the prison-turned-museum look at photos of the prisoners of the S-21 detention center. S-21 was discovered by Vietnamese troops in January 1979. About 16,000 people are estimated to have been killed there. 10 December 2008. By Isabelle Roughol)</p>
<p>By Isabelle Roughol</p>
<p>From the jungles of Kompong Cham province to the living room of a royal residence, Cambodians who could get their hands on a radio in January 1979 listened attentively for news of a military advance against the Khmer Rouge in Eastern Cambodia. Vietnamese troops with a small contingent of Cambodians—the United Front for the National Salvation of Kampuchea, mostly disaffected Khmer Rouge soldiers who had only recently fled internal purges—launched an attack on Christmas Day 1978 and were rapidly making their way through eastern Cambodia.</p>
<p>Khieu Kanharith, now Minister of Information, was in a youth brigade in Kampong Cham and in charge of listening to radio broadcasts and making daily reports to the head of the labor camp, he said. Distant broadcasters told him of the front’s creation in early December and of the troops’ advance until he himself could hear the cannons.</p>
<p>“On 7 January, the Khmer Rouge radio went silent. On the morning of 8 January, I heard from [Voice of America] that Phnom Penh fall,” he said.</p>
<p>In Phnom Penh too, foreign radio brought news of the Vietnamese advance.</p>
<p>“And it is thanks to these radio broadcasts that I am aware of the situation of our country: creation of the front of HE Heng Samrin [who led the UFNSK] and ‘liberation’ of wide swaths of the Cambodian national territory, in the South, South East, South West,” wrote Retired King Norodom Sihanouk in notes published on his Web site in December 2006.</p>
<p>“My son (the future King) N Sihamoni and I exchange in silence and with a wide smile of hope and joy the birth and expansion of the liberation front presided by HE Heng Samrin.”</p>
<p>Sihanouk did not get to see Phnom Penh’s fall as with the thunder of cannons approaching, he was put on a plane to China the previous night.</p>
<p>On Jan 7, 1979, the Vietnamese and Khmer rebel troops entered a deserted Phnom Penh without encountering much resistance. They arrived in a desolate city that had been emptied of its residents since the Khmer Rouge’s takeover on April 17, 1975. The few leaders and workers that remained in the capital under the Khmer Rouge’s reign had left hurriedly. In his book “Brother Enemy,” Nayan Chanda describes banquets meant to celebrate a Khmer Rouge victory left to rot away as the famished workers who were about to eat them were forced to evacuate.</p>
<p>Photos of the time show a ghost town with trash piled up in the streets the only sign there might have been humans there. Garbage was thrown behind roadblocks on secondary roads, according to Khieu Kanharith, who said he entered Phnom Penh about two weeks after the Khmer Rouge left it. Other streets were used as storage space, he said: plates and silverware were piled neatly in front of the current Ministry of Health on Kampuchea Krom Boulevard.</p>
<p>“And if you want to have clothes, it’s another area. If you want to have rice, it’s [the] Old Market,” Khieu Kanharith recalled.</p>
<p>“Very clean, very in order,” he added.</p>
<p>Things weren’t so orderly outside the city; thousands of former city dwellers had converged toward Phnom Penh but were kept out of the city. Vietnamese troops blocked the way and only those hired by the newly installed administration of the People’s Republic of Kampuchea could enter the capital.</p>
<p>Turn Saray, now ADHOC president and then a young father, made the perilous journey to the city with his family aboard a small boat, pausing along the way to earn their daily rice and avoid remaining pockets of Khmer Rouge. They were not allowed in the city, and outside Phnom Penh, he said, the atmosphere was that of a refugee camp, with too little food, water and medicine.</p>
<p>“I slept on the ground for a few months because there were not enough houses. My entire family slept on the ground,” he said.</p>
<p>Getting regular income was difficult, but at least, unlike under the Khmer Rouge, families were now free to be entrepreneurial to survive, he said. He earned his family’s rice by transporting people on his boat, bartering and taking a collection of odd jobs.</p>
<p>For Turn Saray, January 7 is not only the liberation of Phnom Penh; it’s the day of his personal liberation. Forced to accompany Khmer Rouge soldiers in their retreat through the forests of northern Kratie province, his family did their best to lag behind, under the pretense that the children and elderly could not follow and in the hope Vietnamese troops could catch up and liberate them. They did. Others, in the tens of thousands, were forced to accompany their captors to the Northwest, eventually landing in refugee camps along the Thai border.</p>
<p>“January 7, to me and my family, signifies a liberation, the day of liberation from the atrocity of the Khmer Rouge. But seeing many Vietnamese troops, we also had the feeling that our country would be dominated by Vietnam,” Turn Saray said, adding that nonetheless, joy overcame fear.</p>
<p>Pen Sovann, one of the founders of the front, a former prime minister in the 1980s and now an HRP member, said Cambodian rebels alone were not strong enough to topple the Khmer Rouge and needed Vietnamese help.</p>
<p>“The agreement was to establish friendships for mutual understanding, not to abuse the border, not to interfere with each other,” he said of a treaty between the PRK and Vietnam signed Feb 18, 1979.</p>
<p>“But on the contrary after the liberation, they abused the territory and they wanted this part and that part of Cambodia…. They wanted to colonize us and to control us,” he added. The Vietnamese troops remained in the country until 1989.</p>
<p>The significance of Jan 7, 1979—the symbolic date of both the fall of Cambodia’s most cruel regime and the onset of a decade of foreign occupation—remains a point of contention 30 years later.</p>
<p>Prime Minister Hun Sen, then 26, was part of the Cambodian front that ousted the Khmer Rouge, and the government, political heir of Jan 7, made the date a national holiday.</p>
<p>“January 7 was a historical day. It gave us a new birthday, and I want everyone to remember it in their hearts,” said CPP lawmaker Cheam Yeap.</p>
<p>This year, the 30<sup>th</sup> anniversary will be celebrated with a rally expected to bring 20,000 students to Olympic Stadium. That drew the ire of opposition leaders who say there is too much ambivalence about the date to make it a day of national celebration. They prefer the anniversary of the signing of the Paris Peace Accords on Oct 23, 1991, which is not a national holiday anymore.</p>
<p>“April 17 [1975] and January 7 [1979] are inextricably associated: both of them are communist Frankensteins. Celebrating January 7 without having in mind a broader historical perspective, is playing into the hands of the current Phnom Penh regime whose only raison d’etre was to ‘free’ the Cambodian people from the Khmer Rouge with communist Vietnam’s decisive but not unselfish help,” SRP President Sam Rainsy wrote in an e-mail.</p>
<p>Even 30 years after the fact, one’s position in the “liberation v invasion” debate is a quick identifier of their political alliances.</p>
<p>NRP spokesman Suth Dina once vehemently opposed the anniversary as former president of the Khmer Front Party.<strong> </strong>Now the NRP has realigned with the government, Suth Dina said he and the party would no longer oppose the national holiday.<strong></strong></p>
<p>“The overthrow of the Khmer Rouge regime and the assumption of control of Cambodia by the Vietnamese in support of their Cambodian protégés is a notably ambiguous issue,” historian Milton Osborne noted in an e-mail. “Deciding where an observer stands on that issue determines how one describes what took place, and its significance.”</p>
<p>Additional reporting by Yun Samean</p>
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		<title>Villagers say they were forced to join Cambodian army</title>
		<link>http://portfolio.isabelleroughol.com/villagers-say-they-were-forced-to-join-cambodian-army/</link>
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		<pubDate>Wed, 12 Nov 2008 15:26:46 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Breaking news]]></category>
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		<description><![CDATA[12 November 2008: The illegal recruitment process appears meant to strengthen troop presence along the disputed border with Thailand.
(Photo: A young girl holds on to her father, who has packed and is ready to join the army, at a Cambodian military base in Oddar Meanchey province. He was one of too few who volunteered; in [...]]]></description>
			<content:encoded><![CDATA[<p>12 November 2008: <strong>The illegal recruitment process appears meant to strengthen troop presence along the disputed border with Thailand.</strong></p>
<p>(Photo: A young girl holds on to her father, who has packed and is ready to join the army, at a Cambodian military base in Oddar Meanchey province. He was one of too few who volunteered; in order to reach recruitment targets, local authorities forced others to enroll.)</p>
<p>By Isabelle Roughol and Eang Mengleng</p>
<p>Kok Morn commune, Oddar Meanchey province &#8211; Villagers in Oddar Meanchey province say they are being forced to join the army to meet recruitment demands set by the military.</p>
<p>Government and RCAF officials, however, say they are in no way endorsing such a recruitment process, which appears to be illegal.</p>
<p>An Oct 17 order from RCAF Commander-in-Chief Ke Kim Yan requested local officials to find 1,100 new soldiers in the province, though it does not say whether the men should be volunteers or draftees. Failing to find enough volunteers, at least one commune — Kok Morn in Banteay Ampil district — organized a lottery to select young men to be enrolled in the army, whether they wish it or not.</p>
<p>&#8220;It is illegal as far as I know to select soldiers [this way,] but I am a lower official so I have to do or obey the order from high officials,&#8221; Kok Morn commune chief Ourn Vy said by telephone Monday.</p>
<p>The commune found 12 volunteers but had been asked in a meeting with RCAF district and provincial commanders to find a total of 35, said Ourn Vy. A lottery was organized to pick 15 young men in each of the commune&#8217;s 18 villages, and a second lottery round on Oct 31 picked 23 of those men to join the RCAF, he said in an interview at his home Sunday.</p>
<p>&#8220;They needed soldiers in my commune so I started to select them by volunteering or by drawing a lottery,&#8221; he said.</p>
<p>The 12 volunteers and 23 draftees will be sent to RCAF district headquarters for training by Jan 31, Ourn Vy said. Ke Kim Yan&#8217;s order requests two more waves of recruits to join the military by April 30 and July 31, and more lotteries are likely to be organized, Ourn Vy added.</p>
<p>The men had no choice but to participate in the lottery, and if any of the 23 selected refuse to go, they will have to be forced, said Kok Morn commune clerk Vant Soth. Though villagers were clearly unhappy, none had yet lodged an official complaint, he added in an interview at his home Saturday.</p>
<p>However, Banteay Ampil district deputy RCAF commander Ou Sareun said he did not order commune officials to organize the obligatory lottery, and that the RCAF district headquarters would simply receive new recruits as they arrive according to Ke Kim Yan&#8217;s order.</p>
<p>Provincial Deputy Governor Yim Than said authorities were only planning to form militias at present, and that there was no plan at the provincial level to recruit soldiers.</p>
<p>Minister of Information Khieu Kanharith said the government did wish to recruit soldiers but not by force and that he could not confirm or deny the forced recruitment was taking place because he had not received any complaints.</p>
<p>&#8220;We cannot force the people to be in the army,&#8221; Khieu Kanharith said by telephone Monday, adding the conscription law passed in 2006 cannot be used to recruit soldiers because the government has not yet issued a sub-decree.</p>
<p>&#8220;If they are really forced to be in the army, they can complain to human rights organizations or to the UN or to the government office or to the members of the National Assembly representing them,&#8221; he added.</p>
<p>Minister of Defense Tea Banh declined to comment on the recruitment process.</p>
<p>Villagers involved in the lottery process said they feel helpless and confused.</p>
<p>&#8220;It is not fair at all,&#8221; said Lor Sinny, a 23-year-old farmer in Sing village, who is one of the young men selected. The father of one and only son to a widowed mother, Lor Sinny said he would prefer staying home to tend to the family&#8217;s two hectares.</p>
<p>Lamenting over his poor luck in the lottery, he wondered why only a few were forced to serve.</p>
<p>&#8220;I want all the youths aged 18 to 30 years old to go because it is our country, not just my country,&#8221; he said in an interview at his home Sunday.</p>
<p>Khum Oeum, a widow and mother of a 21-year-old selectee who also does not wish to become a soldier, said her son returned from the lottery meeting with the impression that there was no way out. She said she was not aware of any possibility to appeal the decision.</p>
<p>Khum Oeum expressed particular concern because her son, who works on construction sites, is the primary breadwinner for the family</p>
<p>&#8220;He runs the family like a father to feed his brothers and sisters,&#8221; Khum Oeum said, adding her other children might have to drop out of school when their older brother leaves.</p>
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		<title>Analysis: Preah Vihear, a repeat of the &#8217;80s Thai-Lao conflict?</title>
		<link>http://portfolio.isabelleroughol.com/analysis-preah-vihear-a-repeat-of-the-80s-thai-lao-conflict/</link>
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		<pubDate>Fri, 24 Oct 2008 14:45:26 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Analysis]]></category>
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		<description><![CDATA[24 October 2008: The three-month old border dispute bears much resemblance to the conflict that pitted Thailand against the Lao PDR for a decade and left hundreds dead. 
(Photo: The Cambodian flag flies over the Preah Vihear temple, at the center of a border dispute with Thailand. 7 November 2008. By Isabelle Roughol)
By Isabelle Roughol
A [...]]]></description>
			<content:encoded><![CDATA[<p>24 October 2008: <strong>The three-month old border dispute bears much resemblance to the conflict that pitted Thailand against the Lao PDR for a decade and left hundreds dead. </strong></p>
<p>(Photo: The Cambodian flag flies over the Preah Vihear temple, at the center of a border dispute with Thailand. 7 November 2008. By Isabelle Roughol)</p>
<p>By Isabelle Roughol</p>
<p>A border left ill-defined by a century-old French treaty lead to armed clashes between Thailand and one of its neighbors, killing 1,000 people on both sides.</p>
<p>The scenario may sound eerily similar to the current standoff between Thailand and Cambodia, but the fight in question took place in the 1980s, when Thailand and Laos had their own bloody dispute over a contested piece of border territory.</p>
<p>After sporadic fighting in 1980 and again in 1984 over three border villages that both countries claimed, the Thai and Lao armies engaged in a contained battle from December 1987 to February 1988.</p>
<p>Thailand&#8217;s disagreement with Laos over the small disputed area in Laos&#8217; Xainyaburi province stemmed from different interpretations of the same early 20th century border treaties, especially the 1907 French-Siam convention that used natural watersheds to delimit the borders between the Siam kingdom and France&#8217;s Indochina. These are the same treaties that Thailand is today disputing with Cambodia over territory around Preah Vihear temple.</p>
<p>Thailand didn&#8217;t negate the 1907 treaties, but argued over which Mekong tributary actually formed the border between with Laos, wrote Ronald Bruce St John in &#8220;The Land Boundaries of Indochina,&#8221; which was published in 1998 by the International Boundaries Research Unit.</p>
<p>Corruption also played its part in the 1987 hostilities, claimed Robert Karniol, a defense analyst writing for Singapore&#8217;s Straits Times newspaper.</p>
<p>&#8220;Basically, a Thai company was harvesting timber in this area, having facilitated this by paying off both Thai and Laos army personnel. The fighting flared when the company, on Thai army advice, stopped paying the Laotians. It ended when they started paying again,&#8221; Karniol wrote in an e-mail.</p>
<p>After the fighting, and the 1,000 casualties, the border returned to a status quo with Thailand and Laos later forming a joint commission to demarcate the border, whose work is apparently nearing completion 20 years later.</p>
<p>But the short conflict was militarily significant as Laotian forces proved stronger than expected, Karniol added.</p>
<p>&#8220;[T]he fighting soon deteriorated into a stalemate as heavily favored Thai forces failed to push a dogged Laotian defense off Hill 1428,&#8221; St John wrote. &#8220;It was only after suffering combined casualties of more than 1,000 troops that Thailand and Laos agreed to a cease-fire,&#8221; he said.</p>
<p>Laotian troops were battle-hardened by years of fighting anti-communist forces and were well supplied by their Vietnamese allies, said Tim Huxley, executive director of the International Institute of Strategic Studies-Asia based in Singapore. On the other hand, Thai forces were well equipped but poorly led, as &#8220;constant politicking in Bangkok&#8221; distracted senior officers, he wrote in an e-mail.</p>
<p>The conflict ended when it had escalated to such a degree that the only way out for both sides was a full-scale war, Karniol said. Fortunately, Thailand chose to cool down the confrontation, and though the border with Lao has remained a touchy subject, tensions subsided as Thailand&#8217;s economic investment in Laos grew in the following years.</p>
<p>Similarities regarding the political and historical circumstances of the Thai-Lao clash, known as the Baan Rom Klao conflict, and the current dispute between Thailand and Cambodia are striking, but that&#8217;s where the likeness ends.</p>
<p>The Baan Rom Klao conflict unfolded in a world where East and West were still a relevant distinction. Allies of both countries, the West and Eastern bloc, played a role they are unlikely to play today if the conflict near Preah Vihear temple escalates.</p>
<p>Vietnam equipped and trained Laotian forces and also frequently clashed with Thai forces in the 1980s on the Thai-Cambodian border, following its occupation of Cambodia after the ouster of the Khmer Rouge regime in 1979, Huxley said.</p>
<p>News reports of the time recount Thailand accusing Laos of having brought in fighters from fellow communist state Cuba, though Vientiane denied it at the time.</p>
<p>&#8220;[C]ontemporary Cambodia is neither as well-armed as Vietnam was by the Soviet Union during the 1980s, and unlike Laos in the late 1980s it does not have Vietnamese support,&#8221; Huxley added.</p>
<p>Thailand, on the other hand, has enjoyed decades of military cooperation with the US.</p>
<p>But the international community appears to be steering clear of Thailand&#8217;s current dispute with Cambodia, at least as far as the public can see.</p>
<p>Foreign governments have at best expressed concern and urged for peaceful bilateral resolution though Cambodia has on several occasions threatened to take the issue to the UN, without consequences.</p>
<p>UN Secretary-General Ban Ki-moon in an Oct 15 statement after fighting killed three Cambodian soldiers at the border called for bilateral talks only.</p>
<p>In Asean, Malaysia voiced concern, but Foreign Minister Rais Yatim said Wednesday that his country would not intervene or play a mediator role in the dispute, according to Malaysian national news agency Bernama.</p>
<p>So far, Cambodia and Thailand stand alone, face to face.</p>
<p>&#8220;There might be some comparison drawn with the Baan Rom Klao conflict in the sense that a minor scuffle can threaten to escalate into a larger conflict,&#8221; Karniol said of the current Thai-Cambodia standoff.</p>
<p>&#8220;But, ultimately, cooler heads prevailed then and are likely to prevail now,&#8221; he said.</p>
<p>Qian Hai, spokesman of the Chinese Embassy in Phnom Penh, expressed a similar sentiment.</p>
<p>&#8220;They&#8217;re both our good friends [Cambodia and Thailand],&#8221; Qian Hai said by telephone Thursday.</p>
<p>&#8220;They can settle down their dispute through negotiations, we hope,&#8221; he added.</p>
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		<title>A day of hearing at Khmer Rouge trial: Duch gets pugnacious</title>
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		<pubDate>Thu, 30 Apr 2009 16:23:00 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Justice & police]]></category>
		<category><![CDATA[Cambodia]]></category>
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		<description><![CDATA[30 April 2009: The tale of one of many days of hearing at the trial of former Khmer Rouge prison chief Duch.
(Photo: S-21 in Phnom Penh, the high school turned detention center under the Khmer Rouge. 10 December 2008. By Isabelle Roughol)
By Isabelle Roughol
The contrite Kaing Guek Eav, who in the early days of trial [...]]]></description>
			<content:encoded><![CDATA[<p>30 April 2009: The tale of one of many days of hearing at the trial of former Khmer Rouge prison chief Duch.</p>
<p>(Photo: S-21 in Phnom Penh, the high school turned detention center under the Khmer Rouge. 10 December 2008. By Isabelle Roughol)</p>
<p>By Isabelle Roughol</p>
<p>The contrite Kaing Guek Eav, who in the early days of trial seemed to disappear behind his lawyer, gave way Wednesday to a more pugnacious Duch as he responded to the questions of civil party lawyers regarding the establishment of the S-21 detention center.</p>
<p>At times playfully insolent, at others visibly annoyed, Duch took issue with several questions of the civil parties, which he said had already been asked and which he chose not to answer.</p>
<p>When civil party lawyer Silke Studzinsky was surprised by his answer that he did not personally control the work of his interrogators, Duch mocked her for not knowing how military commanders delegate their duties.</p>
<p>“I think Miss Studzinsky might have not been involved in the military or other similar tasks,” he said with a smile. “As the chairman of S21, I could not be involved in all matters, that’s not possible.”</p>
<p>The exchange with Ms Studzinsky, as well as with lawyer Philippe Canonne, prompted Presiding Judge Nil Non to ask Duch to be more respectful.</p>
<p>“The Chamber would like to remind the accused to exercise proper gesture and attitude in responding to the questions by the lawyer or exercise his right to remain silent, rather than laughing, which is not viewed as appropriate,” he said.</p>
<p>Pressed by lawyer Alain Werner on the place of S-21 within the network of Khmer Rouge security centers, Duch denied that S-21 was in any way above the other prisons.</p>
<p>“Don’t regard S-21 as unique for the reason that the cadres from the central committee were killed at S-21,” he said, adding the lives of politically important prisoners were worth the same as those of ordinary people.</p>
<p>Duch detailed four categories of people who he said had authority over all security centers and sole power to decide whom to send to S-21 and when to “smash”—or kill—them: the seven zone secretaries, the central committee, the standing committee, and Son Sen.</p>
<p>“Besides these four groups, no one had the power to decide who to smash. That’s why those people should be called those most responsible for the crimes against the law of Cambodia,” he said.</p>
<p>The words “most responsible,” on which Duch insisted several times, echo the mission of the Extraordinary Chambers in the Courts of Cambodia, which is to prosecute senior leaders and those “most responsible” for the crimes of Democratic Kampuchea. The defense has argued that if Duch is to be tried, dozens more should, too.</p>
<p>Yet, Duch also made several references to his role of an influential “shepherd” over many subordinates. He taught them how to interrogate, but also how to torture, he said. Children were employed as guards as soon as they were old enough to perform the duties because they were malleable, “like a clean peace of paper that can easily be written on,” particularly peasants’ children, he said.</p>
<p>He also explained his reluctance to report on his subordinates’ misdeeds to superiors and that he was responsible for not having educated them well enough to avoid being arrested.</p>
<p>“In the communist party ranks, the subordinates had to respect their superior, and superiors had to protect their subordinates,” he said.</p>
<p>Since few under his care were affected by early purges, Duch recognized he may have received special protection from Son Sen or Brother No 2, Nuon Chea.</p>
<p>“I was regarded as a German shepherd,” he said. “That’s why they trusted me.”</p>
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		<title>Lost in translation: who&#8217;s hearing what at trilingual Khmer Rouge tribunal?</title>
		<link>http://portfolio.isabelleroughol.com/lost-in-translation-whos-hearing-what-at-trilingual-khmer-rouge-tribunal/</link>
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		<pubDate>Fri, 24 Apr 2009 15:45:22 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Analysis]]></category>
		<category><![CDATA[Justice & police]]></category>
		<category><![CDATA[Cambodia]]></category>
		<category><![CDATA[Duch]]></category>
		<category><![CDATA[international justice]]></category>
		<category><![CDATA[international living]]></category>
		<category><![CDATA[Khmer Rouge]]></category>

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		<description><![CDATA[24 April 2009: Jumbled live interpretation makes debates confusing at the court and could impact the legality of a verdict.
(Photo: Individual cells at the former S-21 detention center in Phnom Penh. 10 December 2008. By Isabelle Roughol)
By Isabelle Roughol
The poor quality of simultaneous interpretation of debates at the ECCC is a pressing issue that could [...]]]></description>
			<content:encoded><![CDATA[<p>24 April 2009: Jumbled live interpretation makes debates confusing at the court and could impact the legality of a verdict.</p>
<p>(Photo: Individual cells at the former S-21 detention center in Phnom Penh. 10 December 2008. By Isabelle Roughol)</p>
<p>By Isabelle Roughol</p>
<p>The poor quality of simultaneous interpretation of debates at the ECCC is a pressing issue that could eventually affect the legality of the court’s decisions, parties to and observers of the tribunal said Thursday.</p>
<p>Kaing Guek Eav, better known as Duch, pursued his testimony on the establishment of the S-21 detention center Thursday morning, mostly verifying facts already known to the public and historians in short and simple sentences, a request of the court so that interpreters would be able to follow.</p>
<p>“Because the translation is in a delay process, first from Khmer into English, and then from English into French, then there might be some losses,” Presiding Judge Nil Nonn told the court. “In some cases 50 percent might be lost, in other circumstances more percentage might be lost and it might interfere with the rendering of fair justice.”</p>
<p>The court adjourned at mid-day so the judges would be free to deliberate on several requests of the parties, interpretation chief among them. The judges were also scheduled to deliberate this morning so a decision on interpretation could be rendered before the start of the next phase of testimony, Nil Nonn said.</p>
<p>The Extraordinary Chambers in the Courts of Cambodia employ 40 people in the Interpreter and Translation Pool, instead of the 64 it is supposed to have, said ECCC spokeswoman Helen Jarvis.</p>
<p>“It’s been a problem, we know, for a long time of finding qualified people. We’ve had many advertisements, and it’s a reasonably well-paid position, but I am afraid the level is very high to do simultaneous translation in a court setting,” she said. The French relay translation was set up because the administration could not find competent Khmer-French interpreters, she added.</p>
<p>According to job postings on the ECCC’s website, interpreters at the court must have an advanced university level and a minimum of three years’ experience.</p>
<p>Roth Hok, deputy director of the Foreign Language Institute at the Royal University of Phnom Penh, dismissed the argument of lack of competent interpreters in Cambodia, and said the court was simply not attracting the right candidates.</p>
<p>“I think there are a host of reasons why interpreters do not want to work for the tribunal, one of which is allegations of corruption maybe, maybe because they feel they don’t know enough about the Khmer Rouge, maybe because of safety concerns. My guess,” he said, also suggesting the court might not provide enough time for training in legal and Khmer Rouge-specific issues.</p>
<p>Ms Jarvis said “considerable” time was spent on training, “whenever possible given the tremendous ongoing demands for interpretation and translation,” imposed on a department only two-thirds staffed.</p>
<p>Complaints about interpretation have surfaced in every international tribunal, all bilingual if not more, but issues at the ECCC seemed the most acute, legal observers said.</p>
<p>“The problems at the ECCC seemed to me evidently more grave than what’s happened in front of other tribunals because we have real problems of comprehension on the substance,” said Thierry Cruvellier, a journalist who has observed many international courts of justice. In Rwanda and Sierra Leone, interpretation was at time difficult but it never affected the overall understanding of testimonies and has not resulted in legal decisions being overturned.</p>
<p>Things could be different in Cambodia as international participants have had difficulties following Duch’s testimony and at least one key answer was understood differently by international and Cambodian parties.</p>
<p>On Thursday morning, defense lawyer François Roux insisted that Duch be allowed to repeat his Wednesday statement about vertical and horizontal communication lines within Democratic Kampuchea’s prison apparatus. Duch explained he only had contacts with his superiors, never with other security offices. Through the English translation, parties had heard the opposite the day before.</p>
<p>Ms Jarvis noted that because all comments are recorded in their original language and transcripts are revised and compared each day, errors are promptly caught.</p>
<p>If a discrepancy exists, the original language would prevail on paper, said Michelle Staggs, deputy director of the Asian International Justice Initiative. But in the judges’ minds when they make their decision, it will be whichever version they heard during debates, she added.</p>
<p>“It’s clearly hinging on the accused’s rights to a fair trial. At the moment, it’s not the nuances [being confusing]; it’s quite basic facts.” she said. “This could raise all sorts of issues on appeal if the defense finds that the translation was such an issue that it completely compromised the case.”</p>
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		<title>The Khmer Rouge trials begin: ambiance at the court</title>
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		<pubDate>Tue, 31 Mar 2009 15:25:08 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Features]]></category>
		<category><![CDATA[History]]></category>
		<category><![CDATA[Justice & police]]></category>
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		<description><![CDATA[31 March 2009: The day awaited for 30 years finally arrived — a former Khmer Rouge had to answer for his crimes in front of a court.
(Photo: A classroom turned torture chamber at the former S-21 Khmer Rouge detention center. 10 December 2008. By Isabelle Roughol)
By Isabelle Roughol and Prak Chanthul
The 500 seats of the [...]]]></description>
			<content:encoded><![CDATA[<p>31 March 2009: The day awaited for 30 years finally arrived — a former Khmer Rouge had to answer for his crimes in front of a court.</p>
<p>(Photo: A classroom turned torture chamber at the former S-21 Khmer Rouge detention center. 10 December 2008. By Isabelle Roughol)</p>
<p>By Isabelle Roughol and Prak Chanthul</p>
<p>The 500 seats of the tribunal’s public room were filled Monday morning as the first trial for the crimes of the Khmer Rouge regime opened in Phnom Penh. Ambassadors and other dignitaries sat in the front, with NGO workers and other foreign visitors sprinkled throughout. But the majority in the room were Cambodians of all ages, some civil parties and victims, others students visibly too young to have known Democratic Kampuchea.</p>
<p>They spoke in low voices while waiting for the judges to enter. Duch, the former chairman of the S-21 detention center, whom they came to see, sat between two guards.</p>
<p>“He’s there, in the white shirt,” said one man, pointing.</p>
<p>“He must really feel like an animal in a cage,” his neighbor said of the glass wall separating the court from the public, reminiscent of those that isolate dangerous predators in metropolitan zoos.</p>
<p>Duch scanned the audience with a peaceful gaze that didn’t betray he stands accused of crimes against humanity and at least 12,380 deaths. It was the only chance for many to get a look at the fabled man; once at the bar, he had his back to the public for the remainder of the day.</p>
<p>“The trial has been delayed for many years already,” said Dy Ratha, 62, of Phnom Penh. “I want Duch to say everything. I will be satisfied if he speaks the truth. His confession will mean that the court will have found some sort of justice for me.”</p>
<p>Duch spoke, politely answering Presiding Judge Nil Nonn’s questions about his identity, and later reading along and taking notes as his indictment was recited. His apparent lack of reaction—only a momentarily heaving chest possibly betraying emotion—irritated some.</p>
<p>“He didn’t feel any shock, but we looked at him with shock,” said Yim Ing, 45, who lost three relatives to the Khmer Rouge and traveled from Prey Veng province for the trial.</p>
<p>The 3-hour reading of Duch’s 45-page indictment bored some to the point of dozing off, but not those for whom the exposé of torture and executions was a reminder of experiences lived. In an otherwise silent courtroom, a woman cried out and held her head in her hands, refusing a neighbor’s offering to help her outside for a break. Tears welled up in the eyes of other women by her side. Dy Ratha said she chose to pray during the reading.</p>
<p>The court’s decision to adjourn at 3 pm, pushing opening statements to today, sparked a murmur of disappointment in the audience. One man cried out at the court.</p>
<p>“I’m shocked that the whole day isn’t being used,” said Amnesty International’s Cambodia researcher Brittis Edman, who explained she was concerned that victims who have made the expense of traveling here for the hearing would be frustrated. But, she added, the day remained positive.</p>
<p>“It’s more of a historical day than a disappointing day,” she said.</p>
<p>The day was not only significant for the survivors of S-21 or the relatives of those who didn’t leave the prison camp alive.</p>
<p>“To me, [Duch] represents all the Khmer Rouge,” said Oum Nuphea, who was 10 years old when the communist soldiers entered Phnom Penh. His father, a pilot and colonel in the republican army, was sent for reeducation and never returned.</p>
<p>“He didn’t go to S-21, but in camp S-X, somewhere,” said Oum Nuphea, now 44 and a pilot too. His mother also died, as well as three siblings. After 3 years and 10 months of forced labor. He said he expected explanations from Duch, maybe an apology, but that what matters to him is a guilty verdict.</p>
<p>“I’m coming back here. I am happy to turn the page,” he said. “A never-ending story is not good for people.”</p>
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		<title>Analysis: Turmoil in Bangkok heightens pressure at Cambodian border</title>
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		<pubDate>Fri, 27 Mar 2009 15:06:46 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Analysis]]></category>
		<category><![CDATA[International relations]]></category>
		<category><![CDATA[Politics]]></category>
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		<category><![CDATA[Preah Vihear]]></category>
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		<description><![CDATA[27 March 2009: The border dispute with Cambodia has for months been used in Thailand&#8217;s internal politics.
(Photo: The Preah Vihear temple, center of a border dispute between Thailand and Cambodia. 7 November 2008. By Isabelle Roughol)
By Isabelle Roughol
While officials on both sides insist that tension that rose Wednesday around the Preah Vihear temple has eased [...]]]></description>
			<content:encoded><![CDATA[<p>27 March 2009: The border dispute with Cambodia has for months been used in Thailand&#8217;s internal politics.</p>
<p>(Photo: The Preah Vihear temple, center of a border dispute between Thailand and Cambodia. 7 November 2008. By Isabelle Roughol)</p>
<p>By Isabelle Roughol</p>
<p>While officials on both sides insist that tension that rose Wednesday around the Preah Vihear temple has eased up, the incident left an impression of déjà-vu: as opposition to the government mounts in Bangkok, so does the pressure at the border.</p>
<p>The 4.6 square kilometers of disputed land near the Preah Vihear temple had been quiet for weeks when, according to Cambodian officials, about 100 fully armed Thai soldiers crossed there Wednesday afternoon and were met by Cambodian soldiers. Negotiations ensued and the Thai soldiers pulled back a few hours later.</p>
<p>Meanwhile in Bangkok on Thursday, thousands of “red shirt” opposition supporters marched to Government House aiming to oust the government of Prime Minister Abhisit Vejjajiva, and his Foreign Affairs Minister, Kasit Piromya.</p>
<p>The tables were turned late last year: with the yellow-shirted People’s Alliance for Democracy, Kasit was once of those stirring nationalistic sentiment, accusing the government of giving up the temple. Later, his appointment as the fourth foreign minister to handle the 10-month border dispute was criticized, as opponents thought he had been too cavalier in criticizing Cambodia.</p>
<p>Now, apparently unable to please either way, he stands accused of being too lenient on Cambodia, for not stopping the construction of a Cambodian road to the temple, that red-shirts say took away 250 meters of Thai territory. He withstood a censure motion in Parliament last week, but only by the narrowest margin of any government minister.</p>
<p>Cambodian officials, irritated by the slowness of negotiations, have on several occasions blamed it on the interference of Thai domestic politics. And Thai observers aren’t fooled either: an editorial in The Nation newspaper on Thursday called on the “red shirts” not to use the same methods that had been used against them.</p>
<p>“[They] should not repeat this mistake because it would not bring any good to the country, only problems and trouble,” the article read.</p>
<p>The Thai-Cambodian Joint Border Commission is scheduled to again discuss the boundary demarcation on April 6 and 7 in Phnom Penh. Such negotiations have too coincided in the past with rhetorical escalations and agitation of troops.</p>
<p>The message coming Thursday from the Thai military, through deputy spokesman Colonel Werachon Sukondhapatipak, was one of reassurance.</p>
<p>“We have a policy that we do not do anything that could be perceived as provocative,” he said by telephone from Bangkok. “We want to avoid any misunderstanding.”</p>
<p>“If this is the case, that there is a movement [of troops at Preah Vihear], then it is only a rotation. There is no order to increase troop numbers at the border,” he added.</p>
<p>Thani Thongpakdi, deputy spokesman of the Thai Foreign Affairs Ministry, said the troops had been moving within the borders of Thailand. Because the area has yet to be demarcated, both countries occasionally accuse each other of encroaching. Thani also said the reported figure of 100 soldiers was exaggerated.</p>
<p>At the temple, Preah Vihear Authority secretary-general Hang Soth said villagers had moved to the temple for fear of the Thai troops.</p>
<p>“They moved to a safe place because they were afraid an incident might occur at any time,” he said.</p>
<p>(Additional reporting by Eang Mengleng)</p>
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		<title>Diabetes a little-known but devastating killer in Cambodia</title>
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		<pubDate>Thu, 26 Mar 2009 14:42:52 +0000</pubDate>
		<dc:creator>Isabelle Roughol</dc:creator>
				<category><![CDATA[Features]]></category>
		<category><![CDATA[Science & environment]]></category>
		<category><![CDATA[Cambodia]]></category>
		<category><![CDATA[development]]></category>
		<category><![CDATA[diabetes]]></category>
		<category><![CDATA[health]]></category>
		<category><![CDATA[poverty]]></category>

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		<description><![CDATA[26 March 2009: A poor health infrastructure and little education leave many Cambodian diabetics ignorant of their disease and without the basic care that could save their lives.
(Photo: A rice seller at Phsar Thmey — Central Market — in Phnom Penh. One of the reasons for a high diabetes rate is poor Cambodians&#8217; habit of [...]]]></description>
			<content:encoded><![CDATA[<p>26 March 2009: A poor health infrastructure and little education leave many Cambodian diabetics ignorant of their disease and without the basic care that could save their lives.</p>
<p>(Photo: A rice seller at Phsar Thmey — Central Market — in Phnom Penh. One of the reasons for a high diabetes rate is poor Cambodians&#8217; habit of filling their stomach with cheap, white rice. 30 August 2009. By Isabelle Roughol)</p>
<p>By Isabelle Roughol</p>
<p>A poor, tropical country such as Cambodia is expected to have its share of health issues: malaria, malnutrition and HIV/Aids come to mind, as well as a slew of exotic parasites. But diabetes, a disease many incorrectly associate with times of plenty, is in fact a much bigger threat to this poor country, as ignored as it is devastating.</p>
<p>Even by the most conservative estimates, there are four times as many diabetics in Cambodia as people living with HIV/Aids. It could be 10 times more: few studies have been conducted, but the figure most commonly cited is 255,000 diabetics in the country in 2005. As Cambodians start feeling the effects of the world financial crisis and recede into poverty, the threat of the disease will only grow for the urban poor.</p>
<p>“People always mistakenly think that it is the disease of rich people, and that’s far from true,” said Dr Jacqueline Dicquemarre, the president of Mission Care-Development Organization, an NGO with a diabetes program in Phnom Penh. “It isn’t at all the rich’s disease. It’s everyone’s disease.”</p>
<p>About 1 in 10 urban Cambodian and 1 in 20 rural ones are diabetic, according to joint studies from the Ministry of Health, Cambodian Diabetes Association, European Center for Diabetes Studies and French drug company Servier.</p>
<p>“They have the rates of developed countries where there already were a lot of [diabetics], such as the United States, Canada, Finland. At first, it is indeed really surprising,” Dicquemarre said.</p>
<p>Diabetes is a chronic disease that causes the body to either not produce enough insulin or not use it effectively. Insulin is a hormone that controls sugar levels in the blood stream. High blood sugar levels can over time damage many of the body’s systems, especially nerves and blood vessels. Uncontrolled diabetes can lead to heart disease, strokes, blindness, kidney failure, amputations, and eventually death. The World Health Organization predicts a doubling of the number of diabetics in the world by 2030.</p>
<p>Cambodia has drawn the short straw, combining three factors that account for the high diabetes rate, Dicquemarre explained. Urbanization leads to unhealthy lifestyles, which leads to overweight, a contributing factor in diabetes. Cambodians also might be genetically more prone to diabetes because the people who survived past famines and reproduced had metabolisms that better stored calories from food; others died of starvation. People with this capacity to “store” food are thus more genetically inclined to put on weight and develop diabetes when they can eat full meals.</p>
<p>“There would have been because of that difficult past…a sort of natural selection in these populations in favor of individuals who burn less calories than others, the ‘thrifty’ ones,” Dicquemarre explained. “And when they waste less, of course, they put on weight as soon as they have more food.”</p>
<p>The third factor is purely Cambodian, or at least regional: rice. A bowl of steamed Jasmine rice has a glycemic load of 46, three times that of a can of soda, according to a list compiled by Sidney University researchers. The glycemic load index compiles the quantity and quality of carbohydrates found in any food. The higher the number, the likelier the food is to raise blood sugar levels.</p>
<p>That’s where diabetes ceases to be a rich person’s disease. As the country faces new economic hardships, low-income Cambodians are increasing the part of rice—a cheaper food—in their diet, and their blood sugar shoots up, Dicquemarre said.</p>
<p>“When eaten alone, [white rice] is almost like getting sugar in an IV,” Dicquemarre said.</p>
<p>But, argued Dr Jean-Claude Garel of Naga Clinic, a longtime physician here, rice has always been a part of the local diet and diabetes is recent.</p>
<p>“I have seen the evolution in 15 years of my practice. Diabetes, 15 years ago, wasn’t a big problem locally,” but it is fast becoming one, he said. The issue is that people are quickly changing to an urban lifestyle without any education on what it might do to their health.</p>
<p>Prevention and lifestyle education is indeed necessary and would be much cheaper than treating the many complications of diabetes, said Dr Yel Daravuth, national professional officer for Tobacco-Free Initiatives and Health Promotion at the World Health Organization.</p>
<p>HIV/Aids and diabetes have much in common: affected people can live for decades if the disease is managed through a rigorous treatment. Left uncontrolled, the diseases both lead to a slow and painful death, with the sick becoming disabled and an economic burden on their communities.</p>
<p>But while international donors have tackled HIV/Aids, which reduction is one of the Millenium Development Goals, diabetes remains ignored, said Maurits Van Pelt, director of Mopotsyo, an NGO with a peer education program for poor people with diabetes.</p>
<p>“The message is this is a public health and poverty disaster that needs to be addressed, and it gets zero attention from health policymakers,” Van Pelt said.</p>
<p>According to figures compiled by Mopotsyo, 60 percent of health sector donations to Cambodia go to communicable diseases, with HIV/Aids topping the list. Only 1 percent is devoted to non-communicable diseases. Lifestyle-related health issues, such as diabetes, obesity, tobacco and alcohol use, while deadly, get little attention, Yel Daravuth said, but added he could not confirm those figures.</p>
<p>“Not so many people die from bird flu, but a lot of money is put into it because people are concerned, people are scared of it,” he said.</p>
<p>The Ministry of Health identified the fight against non-communicable diseases as one of three goals in the government’s Health Strategic Plan 2008-2015, recognizing that lifestyle changes were likely to make NCD rates skyrocket in the next few years. Yel Daravuth said he hoped that would mean increased funding.</p>
<p>The government’s strategy is to reduce risk behaviors, improve access to treatment and better the public health sector. The plan says nothing of funding or precise methods, however. The plan’s objective is to lower, without a specific target, the diabetes prevalence rate in public hospital patients, reported at 2 percent in 2005. But since many diabetics are still undiagnosed, improving access to treatment could actually bring up the prevalence rate, at least on paper.</p>
<p>Cambodia could start addressing the issue without spending much money, Van Pelt argued. Low-cost peer education programs could teach diabetics to manage their disease, and government oversight of doctors and pharmaceutical companies could help keep the price tag low on essential drugs, he said. Without government control, drug companies lobby doctors to prescribe their most expensive drugs, and uninformed patients don’t know the difference, he said.</p>
<p>“If you have somebody living on $1 a day or $2 a day, it makes a very big difference what is on that prescription. If your medical bill is $40 a year or $300 a year, it’s going to be the different between whether you’re going to have money to eat or not,” he said.</p>
<p>“It is possibly for many Cambodians to pay for their own medicine because the medicine for diabetes can be really cheap,” he added.</p>
<p>Yel Daravuth argued drugs were expensive mostly because they must be imported.</p>
<p>In rich countries, more than half of diabetics are over 65 and have been controlling their disease for decades. They often die from something else, Dicquemarre said. Low- and middle-income countries account for 80 percent of diabetes deaths, according to the World Health Organization. There are no statistics for Cambodia, but in Micado’s diabetes program at Preah Kossamak hospital, only one in 15 patients has had diabetes for more than a decade, Dicquemarre said. Most simply can’t survive 10 years to their disease.</p>
<p>“For those who need treatment, since the patient must pay for the totality of the prescriptions here, the biggest difficulty is to have a regular treatment. It’s very dependent on economic conditions,” she said, explaining that poor patients only take their medication on days they can afford it.</p>
<p>For diabetics, blood sugar levels must be controlled all day, every day, for the rest of their life; otherwise, the treatment is useless, Dicquemarre said. If the economic crisis sends more people back into extreme poverty, it will be that many more people who don’t take their medicine, she said. She added that she was worried that a government policy to increase payment recovery in public hospitals would put one more barrier between the poor and the treatment they need.</p>
<p>The story of diabetes in Cambodia is like that of any disease. It is the story of the gap in health care access between rich and poor. In France, Dicquemarre explained, a quick laser operation can stop the bleeding of blood vessels in the eye, a common consequence of diabetes. Here, without money, trained specialists and equipment, people go blind.</p>
<p>Because the sick pay for treatment, not the state, the public cost of diabetes isn’t so much in the medical expenditures. It is an opportunity cost: hundreds of thousands of people who could be productive and instead wither away on a sick bed for years.</p>
<p>“No funding for diabetes and no policy attention is causing poverty and unnecessarily causing the disability of people,” Van Pelt said. “They could live 30 years, 40 years and die from something else.”<strong></strong></p>
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