PREAH VIHEAR WAITING HOUSE PROJECT 2007

In 2007 CRY received a proposal from the Provincial Health Department of Preah Vihear, requesting support for a purpose-build Waiting House in the ground of a referral hospital. The CRY team visited Preah Vihear and decided to go ahead with the build. The building of the Waiting House was completed in 2008. The grand opening was held in September 2008 and was attended by Marcia Hammond, the CRY Representative / Asia, Martyn and Gaynor Dunsford, the CRY founders, the Provincial Governor, all the local dignitaries and local women.

Preah Vihear is a large northern province of Cambodia. Its capital is Phnom Treng  Meanchey. The province itself is named after the temple of Prasat Preah Vihear, one of the historical sights in this province. Much of the province is extremely remote and strongly forested. Unfortunately large logging companies have reduced the natural landscape by carving huge tracts of pristine tropical hardwoods. Preah Vihear is one of the least populated provinces in the Kingdom of Cambodia. This tranquil site is popular for its Preah Vihear temple, located on the border between Thailand and Cambodia. The province has one of the worst infrastructures in the country with no proper major roads in existence. Getting around the province is not that easy if you're used to proper roads and the usual transportation possibilities, as there are only few collection vehicles or some money-hunting motor drivers to take you where you would like to go. In Preah Vihear you will find three of the most impressive architectural legacies from the Angkorian era: the mountain temple of Prasat Preah Vihear; the 10th-century capital of Koh Ker; and the mighty Preak Khan.

Geography

Preah Vihear province is 13,800 km². It boarders with Thailand in the north; Laos in the East with Stung Treng; with province of Odder Meanchey and Siem Reap in the west, and the province of Kampong Thom to the South. The province is blessed with endless natural treasure: its acres of dense, hilly forests and scrub green vegetation. 

Demography

The population in Preah Vihear province is quite homogenous socially, culturally, and economically. Almost 70% of people are poor and about 50% are illiterate. Farming and agriculture is the main source of income for this poor population. Almost every families here cultivate rice as their main crop, together with some additional work such as the making of palm wine, raising domestic animals such as pigs and chickens, and hunting.

0.7% of the population is involved in business and about 5% form the military, police and civil servants. In recent years, many people have migrated from different provinces to live in this province, which contributes to an increase of the population in this area. Apart from Khmer nationals, there are four ethnic minority groups namely Kouy, Phnong, Thom Phoun, and Charay in this province. They can speak both languages: Khmer and their own language. In term of religion, most of Khmer people follow Buddhism.

The Khmer people have a strong belief in the supernatural and spiritual, particularly in remote areas. In time of health problems they would refer to the village elder or village doctor looking for a cure rather than seeking the help of medical professionals in the health centres or the referral hospital. This in turn contributes to maternal and infant mortality rates.

Climate and Population

Cambodia has a tropical climate, which is warm and humid. In the monsoon season, rain comes down in abundance and causes other difficulties such as road blocks which makes it difficult to travel to the other part of the country from Preah Vihear.
The average temperature is about 27 degrees Celsius; the minimum temperature is about 16 degrees. December and January are the coolest months, whereas the hottest is April.

General information about the provincial climate:

There are 145,045 people in Preah Vihear province (National Survey, 2006). There are 4 levels of local authority: made up of 7 districts, 49 communes, and 210 villages in the province.

Health Centres

"In 2006 and 2007, almost half (20/44) of patients were brought to the provincial referral hospital from health centers by hospital ambulances. The cases referred to the hospital were post-term pregnancies, pregnant women and postpartum mothers who had complications and were impossible to deliver at the health center level. Some of them died in hospital because they were referred to the hospital too late, with central placenta praevia or partial placenta praevia, postpartum hemorrhage, prolonged labor etc for instance. 
These problems might have been solved if we had provided medical intervention right away. On the other hand, we consider that maternal death is a tragedy not only for the women but also for their families and community as well. Beyond the grief of loosing a loved one, there are also social and economic consequences. After the mother’s death, it is often observed that their children become malnourished and stop attending school, especially girls. The family also faces many problems. Mothers are very important in each family; they contribute to the family income and work hard for the well-being of the entire family. In particular, they feed the children and ensure their education. Maternity Waiting Houses will bridge the gap and will facilitate care for mothers who are in need of urgent care. The women will come to stay in the Waiting House for the last few weeks of their pregnancy and a few days after delivery, particularly those who have risky signs or symptoms. On the other hand, it is for those who do not have any dangerous signs or symptoms but they do not feel comfortable staying at their home in far-out villages for the delivery. During the period of stay in the Waiting House, health provisions are easy to provide and urgent care is at hand. Moreover, the women receive health education, anti-natal care, safe delivery, and postnatal care while staying in the Waiting House. In addition, the maternity Waiting House is a suitable place for pregnant women, particularly for those who live far away from hospital and they do not have relatives who live near to a hospital. 
We believe that if we have a Waiting House for pregnant women in the hospital, the maternal and infant mortality, and the morbidity rate will definitely reduce. Research in other countries shows that maternal deaths drop in areas where maternity Waiting Houses are located, particularly in Eastern Nigeria, they helped reduce maternal mortality in hospitals from 10 to less than 1/1000 deliveries and the stillbirth rate from 116 to 20/1000" (HM, 2007).

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