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Healing a nation’s trauma without mental hospitals

Cambodians experienced a massive traumatic event, defined by the Diagnostic and Statistical Manual for of Mental Disorders as “a direct or indirect exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence”.

Theresia Citraningtyas (The Jakarta Post)
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Phnom Penh
Sat, December 21, 2019

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Healing a nation’s trauma without mental hospitals Cambodians experienced a massive traumatic event, defined by the Diagnostic and Statistical Manual for of Mental Disorders as “a direct or indirect exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence”. (Shutterstock/Marekuliasz)

C

ambodia, a country with a population of 14.7 million people, only has 64 psychiatrists and no mental hospitals. At Khmer-Soviet Friendship Hospital, patients line up for antidepressants that are no longer used in Indonesia and a small dose of first-generation antipsychotics.

Fifteen psychiatrists, including Prof. Yim Sobotra, head of mental health and substance abuse, treat 800 to 1,000 psychiatric outpatients every day and six emergency inpatients for up to two weeks.

At Siem Reap Provincial Referral Hospital, Prof. Uy Chan Thol, the hospital’s deputy director and a psychiatrist with one year of cardiology training, admits psychiatric emergencies in the intensive care unit.

In 1975 to 1979, when the Khmer Rouge still ruled the country, Cambodia’s only two psychiatrists at that time perished along with their mental hospitals and hundreds of patients. A real-life Thanos, Pol Pot annihilated half of the population, especially the most educated.

It was only in 1998 that Cambodia had its first 10 new psychiatrists, trained in Oslo University with funding from the International Organization for Migration. They included Prof. Kim Souvan, now the deputy director of the Department of Hospital Services at Cambodia’s Health Ministry.

Cambodians experienced a massive traumatic event, defined by the Diagnostic and Statistical Manual for of Mental Disorders as “a direct or indirect exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence”.

This can cause intrusions of unwanted memories, heightened arousal (manifested from being easily startled to aggression), depressive thoughts or feelings and the tendency to try to avoid any reminders.

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