My friend returned home to Cambodia a few months ago. For three years he experienced severe abuse at the hands of employers in a rich nation paying an extremely low wage, providing slum living conditions and treating my intelligent, kind, funny and impressive friend as though he was a lesser human than themselves. That’s the price you pay for being poor – all other characteristics become invisible. He tolerated the experience until he finally had to break his plans and his contract to save his own sanity. I was going to share a picture of the shack he lived in but he asked me not to, explaining his request with “bad times”.
Good times are upon him though, reunited with his wife and young children, and recently he has been running a few errands. This week he delivered food to the family whose 3yo had drowned the day before I dropped in to visit in January 2017. He reports: “The family were very happy when they saw everything I brought there. I bought everything near her house and the neighbor also very very happy“.
This shack sits perilously on the edge of a riverbank in the shadow of a hill. During rainy season the river rises towards the bamboo slat floorboards with increasing velocity. Atop the hill is an expensive resort promoted as a social enterprise in order to attract donor money. In reality this luxury resort operates as a private business, employing impoverished rural youth on unlivable wages with unlivable work conditions under a management team who pay themselves handsomely via oblivious European donors.
Meanwhile the visit to Cambodian Health Professionals Association of America has led to various interventions. One example of the mini van of people who traveled out of Phnom Penh, something that some of them had never previously experienced, to access care otherwise unavailable to them, is the young boy in the below photograph, seen being tested for a specialised shoe. I don’t know this boy but looking at his condition I suspect he has developmental dysplasia of the hip (DDH). This condition occurs in about 1 of every 1,000 births and can develop during the first few months of life. Babies who are born with, or who develop DDH can be treated and parents can be informed of ways to prevent it from occurring, such as safe wrapping techniques for unrestrictive positioning of the hip.
Australian families have free and universal access to Child Health services whose job is to promote the health of our children. Health promotion tips relating to prevention of DDH is one of the topics parents are informed about. Hip dysplasia is screened for at birth and then at repeated visits in the child’s early years. Where it is detected, treatment is available and free. As literate English speakers we have access to multitudes of resources on the topic, such as safe wrapping information via Red Nose or the International Hip Dysplasia Institute, and support and resources via Healthy Hips Australia.
Prevention and treatment however, require a level of health literacy and access to health services which most of the world’s very poor do not have. Anyone from a wealthy country who travels to a poor country is likely to notice many more disabled people than we are used to seeing at home because of our in-built privileges. This combination of reasons, along with the higher rate of risk factors seen in many disadvantaged populations, is why.