Imaging in the Khmer’s Land: Cambodia Country Report

Cambodia is located in Southeast Asia on the Indochina Peninsula and borders Vietnam, Laos, Thailand and the Gulf of Thailand (Figure 1). With a total area of 69,898 square miles and population of 15,458,332, Cambodia’s population density has steadily increased since 1980. The country’s annual rate of urbanization is 2.65 %. As of 2014, 20.5% of the population lives in an urban setting. The estimated population growth rate is 1.63% (1). The capital of Cambodia is Phnom Penh, which is located in the southern part of the country. Other major cities include Battambang and Siem Reap, both of which have populations over 150,000. There are officially 24 provinces and one municipality (Phnom Penh). However, many consider Phnom Penh to be its own province. As a result, some research puts the number of Cambodian provinces at 25. The climate is tropical with two seasons: monsoon season (May to November) and dry season (December to April). Temperatures range from approximately 70 to 95°F. Cambodia’s economy largely depends on the garment industry, tourism, construction, real estate and agriculture. Cambodia gained independence from France in 1953 and was first ruled by a constitutional monarchy under King Norodom Sihanouk. After a five-year struggle starting in 1970, the Khmer Rouge captured Phnom Penh in 1975. Pol Pot, the leader of the Khmer Rouge, oversaw a brutal regime that, through executions and forced labor, was responsible for the deaths of at least 1.5 million Cambodians. The Vietnamese drove out the Khmer Rouge in 1979. After years of Vietnamese occupation, the 1991 Paris Peace Accords established a ceasefire and a democratic framework for the country. By 1993 elections established a new coalition government; yet, political instability and violence persisted throughout the 1990s. Cambodia most recently held elections in 2013, as a multiparty democracy under a constitutional monarchy. The devastation caused by the Khmer Rouge has had long-lasting negative effects on Cambodia’s political and economic systems, as well as to its infrastructure, and public health. Despite this, Cambodia has made measurable improvements. At the end of Khmer Rouge rule in 1980, life expectancy was 30 years (1). Political stabilization, economic improvement and a growing healthcare system improved the life expectancy to 63.78 years by 2015 (2). The physician density remains low, at 0.17 physicians per 1,000 people (2). As of 2012, there were eight national hospitals and three levels of referral hospitals in the public sector. Referral hospitals are categorized by three levels of Complementary Package of Activity (CPA): 1) CPA-1 hospitals do not perform surgery; 2) CPA-2 hospitals perform surgeries but with more limited specialized services; and 3) CPA-3 hospitals perform surgery with more specialized services. There are 26 CPA-3 hospitals in Cambodia (3). As of 2011 there were 2,391 doctors, 8,433 nurses and 3,748 midwives (3). There are also NGOs that run hospitals throughout Cambodia, as well as private sector health care facilities