Restoring the Joy of Motherhood

Generations of women in Cambodia have come to fear death during childbirth. An alarming number die or lose a child every year due to inadequate healthcare, poor nutrition, and a lack of proper education. Samaritan’s Purse is delivering hope to mothers in remote Cambodia through life-saving healthcare and the message of eternal salvation in Jesus Christ.

 
Sophie outside of her home in Choeng village.

Contractions started at 3 a.m. Sophie’s husband, her parents, and traditional birth attendants gathered at her house for the delivery. By 12 p.m., no progress. The attendants insisted that the baby wasn’t ready yet.

Things began to look eerily similar to the previous year.

In 2012, Sophie was pregnant with her first child. When it was time to give birth, she labored for many long hours at home before anyone recognized danger signs. Finally, the decision was made to take her to the nearest health center—about two hours away. But by the time they arrived, it was too late.

Sophie had lost her baby.

Now in 2013, Sophie was attempting to give birth for the second time. While she continued to labor, Samaritan’s Purse staff arrived in the village to distribute supplementary food to malnourished children. We had been working with the mothers there to help improve nutrition and provide parenting training. Then we heard about Sophie.

Our staff rushed her down pot-holed, red-dirt roads to the closest health center about 15 miles away.

I felt so tired and had no more strength.

During the painful journey, Sophie feared the worst.

When she arrived, three doctors attended to her. They gave her an injection and an IV, and they fervently tried to save her child. Three times they attempted to pull the baby out. One doctor pulled so hard he fell down, and the baby finally came.

Silence.

“I felt so tired and had no more strength.”

Sophie sat on a large wooden platform outside of her home in Choeng village, surrounded by a handful of friends and neighbors. She said having them there made it easier to talk about the tragedy. Samaritan’s Purse staff listened intently as the 22-year-old told her heartbreaking tale of losing two children in the past two years, her voice quivering. Behind her, a mother nursed a newborn.

 

A Pioneering Work

 
The Maternal Child Health program is opening up opportunities for staff and churches to serve and interact with communities.

Samaritan’s Purse started a Maternal and Child Health program in Cambodia’s remote Kratie province in 2013 to help women like Sophie. The goal is to reduce the mortality of mothers and their young children by improving obstetric care, teaching essential nutrition practices, and increasing access to quality healthcare.

The health of mothers and children in the Kratie province is among the worst in Cambodia. A pregnant woman here is 10 times more likely to die in childbirth than in the United States. Infants in their first month of life have the highest mortality rate in the country. One out of every 12 children doesn’t make it to the fifth birthday.

“Our goal is to work where the people are suffering the most, where they’re hurting the most, and where the needs are the greatest,” said Patrick Seger, Cambodia Country Director. “There are needs throughout Cambodia, but when you come to the northeast part of the country over in Kratie, you see the needs are so much greater than in some of the other provinces.”

Tharanga Diyunugala is the health program manager in Cambodia. When he traveled to Kratie and met the suffering mothers and children—and didn’t see any other organizations helping in the area—he knew it was a place that Samaritan’s Purse should be.

Thousands of people in this country, where the population is only 1 percent Christian, can hear about our Savior

“The road conditions are poor, villages are far apart, the population density is low, access is difficult because half the year it’s flooded and the rest of the year it’s dusty,” he said. “I think we, as believers, pioneering the work of God in this area, should be able to overcome those challenges. So if no one is going, we should be going there.”

Field staff invested time in 20 remote communities, building relationships with thousands of mothers, fathers, grandparents, village chiefs, and health care staff. We screened 986 children, and provided supplementary food for those who were malnourished. Already, 70 percent of them have recovered.

We staged instructional dramas and held Gospel-centered teachings about health, hygiene, and parenting. We trained 255 volunteers to spread the messages within their communities. We told people about Jesus Christ, prayed with them, and watched the Gospel transform lives.

We thought we would work with about 30 villages once the project was complete, but we found the need to be much greater. This year we have committed to 22 additional villages. We are training another 240 volunteers and screening 1,300 more children. We are holding safe motherhood classes focused on pregnancy and newborn care, and we are building maternal wards at the health centers so that women like Sophie will have a place to stay before and after giving birth.

A foundational aspect of our work involves equipping Cambodian church leaders to reach out to their communities.

The local church has very limited resources and knowledge about how to help, counsel, and educate people related to health and other social issues. We offer trainings on topics such as basic community health, nutrition, childcare, and parenting, followed by an orientation on how to use these skills for effective evangelism. Forty local pastors have been mobilized thus far through the program.

The Maternal and Child Health program has the potential to expand into dozens more villages throughout the overlooked, remote Kratie province and others like it. Mothers who thought they were forgotten can gain support to have safe pregnancies and raise healthy children. Little boys and girls who haven’t been nurtured or fed nutritious foods can receive loving care to grow strong.

And thousands of people in this country, where the population is only 1 percent Christian, can hear about our Savior, who said, “Come to Me all you who labor and are heavy laden, and I will give you rest” (Matthew 11:28).

LISTEN NOW: Carol Nowlin, program development officer, shares about how the Maternal Child Health program helps the church.

A Lost Generation

 

Cambodia suffered massive loss of life in the Khmer Rouge genocide in the late 1970s. The ruthless dictator, Pol Pot, imposed a radical, agrarian communist society, forcing people to relocate to rural areas, wiping out the infrastructure, and mercilessly killing anyone perceived as a threat—especially the educated.

An estimated 2 million people lost their lives under the brutal Khmer Rouge regime. Nearly an entire generation disappeared, and most of the knowledge that passes down from parents to children, from educators to students, from medical professionals to patients, was buried with the slain.

This tragedy crippled the role of motherhood. Displaced young women were left without mothers to teach them how to take care of their children. Health professionals and educators weren’t alive to give them care and instruction.

Survivors did the best that they could. But a deficiency of information combined with a survival-mode mentality still persists today, especially in remote, poverty-stricken areas like Kratie.

Pregnant women don’t take care of themselves. Mothers no longer nurture their children. People lack the knowledge to cook basic, healthy meals. Malnutrition is an unfamiliar concept, as many women reason that they were also skinny and sickly as children, so it must be normal.

LISTEN NOW: Bunren Van, Maternal Child Health project manager, explains how the Khmer Rouge damaged families.

“We don’t want that to pass down to the next generation too,” Tharanga said. “Since Khmer Rouge time, education has been very poor, health has been very poor, particularly in this area. If you don’t do anything now, 20 years down the road it will be the same. We want to change that.”

Through the Maternal and Child Health program, change starts with mothers and their young children. They are not just the most vulnerable; they also have the power to foster a new, healthy generation. About 12-15 percent of the children are under 5 years old, and they represent the future.

Tuol Sleng Genocide Museum has over 6,000 photographs that were taken of Khmer Rouge victims before they died.

After the genocide, the Cambodian people had to begin again from scratch. But today, these women have an opportunity to give their children a better start. We want them to understand the importance of child nutrition, to learn about pre- and post-natal care, and to deliver their babies safely at the health centers.

And when we teach them what their mothers didn’t have the chance to hear in a pre-natal visit or their grandmothers couldn’t share while cooking around a fire, new traditions can begin. In the name of Christ, Who promises new life to all who turn to Him, we can help give back to people who had so much taken away.

“We are, in a way, restoring something that Cambodia lost,” Tharanga said.

 

A New Hope

 

Twelve-year-old Seva fills glass soda bottles with gasoline in front of her house in Dong village. The family sells them for $1.25 per liter, along with other “fuel station” snacks.

Her mother, Savet, started a cassava farm by herself and works hard to help look after her family.

“I feel the same as other women in the world, the mothers,” she said. “For the women who try to take care of their children, they feel that it’s not easy. They feel that it’s very difficult.”

Like many women in her village, Savet used to feed her children one meal per day of whatever she could find—usually rice. A heavy workload and lack of nutrition education limited Savet’s ability to provide proper food and care. This took a toll on the children, especially little Vicheko. The youngest of Seva’s three brothers, the 4-year-old suffered from frequent illness.

Right now my son looks healthy, and he is never sick or feverish like before the program.

“He was so skinny, and I didn’t know why,” Savet said. “When Samaritan’s Purse came and measured, I realized my child was malnourished.”

Savet joined our nutrition training and learned simple ways to add essential foods like vegetables and proteins in meals. Now she cooks healthier dishes and has already seen a change in Vicheko.

“Right now my son looks healthy, and he is never sick or feverish like before the program,” Savet said.

An alarming number of mothers and children endure illness and even lose their lives every year in rural Cambodia due to poor health. Proper nutrition in the first few years of a child’s life is crucial for long-term development, but the women do not know the cause-and-effect. No one has ever told them. One bowl of rice per day was their normal. But a new normal is taking root.

Solida Lim is a Samaritan’s Purse health and nutrition officer. As a Cambodian, she understands the challenges these women face.

“Compared to other countries, I think that Cambodian women do not have a high education, and when they get married they have many children and don’t have a chance to make a better life,” Solida said.

Working directly with mothers in the villages, Solida sees firsthand how simple changes can make life-saving differences.

“Before, they don’t know the children are malnourished,” she said. “Then after we screen, we teach them how to take care of them—especially hygiene and also how to improve cooking and mealtime for their children. Now, their children are becoming better and better.”

As our staff works daily with mothers and children in Kratie’s villages, women are offering us their trust, following our trainings, and seeing vitality return to their families. Mothers like Savet are creating new, healthy habits for their families, and daughters like Seva are watching and learning.

“I really want this project to spread to other villages and other people,” Savet said. “I want the people in each village to grow healthy.”

 

A Joyous Future

“I felt afraid.”
– Sophie, when she discovered she was pregnant

“I felt not happy, but like, I felt afraid.”
– Mab, 23, 6 months pregnant with first child

“Mixed feeling – afraid and happy together.”
– Naroth, 17, 6 months pregnant with first child

“I felt very happy and also I felt afraid because it’s my first time.”
– Khoeun, 27, pregnant with first child

“I feel worried in case something goes wrong, if a bad thing happens.”
– Voeun, 24, 6 months pregnant with third child

“I just felt worried and concerned about my baby,
wondering if it will be OK or not.”

– Sophal, mother of children who are 5, 4, 2, and 1½ months

 

Too many Cambodian women have come to expect difficulty and death during childbirth. Carol Noulin, program development officer, is troubled by the stark contrast between her experience giving birth to two children in the U.S. and pregnancy in rural Cambodia.

Women are learning how to care for themselves and their families, children are growing healthier, and soon, mothers will have a place to stay when delivering babies.

“When I had my babies in the United States, you know there can be complications or that sometimes people lose their babies, but that’s uncommon. So it’s a very joyful, very expectant time,” she said. “When I came to Cambodia and started talking to women and hearing their stories, I learned that there’s a lot of fear. Women ask for prayer a lot. They say, ‘I’m worried about my baby. I’m worried about myself.’ So, it’s sad because it should be an expectant time. We shouldn’t have to fear that right in the midst of giving life, death would happen instead.”

Sadly, this fear becomes a reality for many women in rural villages. Instead of giving birth at health centers, they rely on traditional birth attendants or even deliver alone in the forest. When complications arise, they are too far away to receive skilled care in time. However, the women can’t go to the health center before they begin labor because there’s not a place for them to stay.

But that’s changing. Samaritan’s Purse is building maternal wards at the health centers for these women.

The maternal wards will include a delivery room, a kitchen, and a room for women to stay before and after giving birth. While the women are there, our staff and church partners will provide health trainings and share the Gospel.

Wards are currently under construction at two health centers in the Kratie province, including the one nearest Choeng village. With enough support, we have the capacity to build up to 15 throughout Kratie and other remote areas of Cambodia.

Carol believes that women’s fears will fade as more lives are saved.

“The maternal wards that we’re building here in Cambodia are one of the things I’m most excited about because I can see that they are so badly needed,” she said. “They need a place where they can come ahead of time so that problems are caught early and they can survive childbirth and their child can as well. It’s a really simple, low-cost way of saving lives, and I’m really excited that our Maternal and Child Health program is helping women in this way.”

Another woman who is eager to spread the word about the maternal wards is Voeun Chem, a mother and grandmother. Last year when Samaritan’s Purse asked for volunteers to help promote good health for women in Choeng village, Voeun signed up.

She lives just down the road from Sophie and also knows the pain of losing children. Voeun had a son who lived for a month, two children who lived for three months, and another son who passed away when he was 12. Her eldest daughter, Phoeun, 33, experienced a miscarriage at three months, another one at seven months, and had a baby girl who died at birth.

“It’s hard for the mothers. We worry about our grandkids and about our daughters because something very often happens to the women who are delivering babies,” Voeun said.

Phoeun and her mother, Voeun, a Samaritan’s Purse village health volunteer.

But mixed in with the sorrow, her voice carries a sense of optimism. Voeun is about to welcome two new grandchildren into her family. Phoeun is seven months pregnant, and her other daughter, Sam Oeun, 25, is eight months along with her first child.

Both of her daughters plan to give birth at the health center, and as a volunteer, Voeun helps other pregnant women in Choeng village understand the benefits of delivering there as well. With a personality much bigger than her petite frame, Voeun exudes passion about her role.

“Sometimes I walk house to house to encourage the pregnant women to access the health center, especially to deliver the baby at the health center, not at home,” she said.

Hope is rising in Choeng village. Women are learning how to care for themselves and their families, children are growing healthier, and soon, mothers will have a place to stay when delivering babies.

Sophie sits outside her house in the hot sun with friends and neighbors. She has attended Samaritan’s Purse training sessions, and knows there soon will be a maternal ward near her village.

Next time, she believes, the tears will be joyful.

LISTEN NOW: Hear Sophie explain her future plans for giving birth.

In March 2014, Samaritan’s Purse launched a 10-day fundraising campaign for our maternal and child health program in this country. Through an outpouring of generosity, our $300,000 goal was exceeded by 22 percent. With your help, we can help even more women and children in rural Cambodia.

 
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Cambodia - Maternal and Child Health Your gift can help Samaritan’s Purse reduce the mortality rates of women and their young children by improving obstetric care, teaching essential nutrition practices, and increasing access to quality healthcare. The physical relief we provide in the Name of Jesus Christ mobilizes our local church partners and earns them a hearing for the Gospel.

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