In the past, the problems of political instability and internal genocides had an adverse impact on the healthcare system in Cambodia. For instance, after the fall of the Khmer Rouge regime, the United Nations sponsored a national election that supported the non-governmental organization to help in rebuilding the country. Despite the continuous economic growth, there is an unequal distribution of health facilities between the urban and rural areas. As such, inequalities in health care continue to be an issue between diverse socioeconomic backgrounds. The number of children suffering from malnutrition and acute respiratory infections is higher in rural areas than in urban areas. Besides, the dual burden of disease continues to be a threat due to the increase in mortality rates from non-communicable and infectious disease. Also, malnutrition remains to be a major problem for childrens health in Cambodia. In addition, there are emerging burdens from high blood pressure, cancer and heart diseases affecting public health. This literature review will discuss ethical issues in global health care service in Cambodia and speculate on the outcome of integration with a westernized countrys culture.
In the recent years, there is an increased research on the ethical issues on global health care service to address the common health problems in Cambodia. Infectious diseases, tuberculosis, malaria, dengue fever, and chronic diseases increase the mortality rate in the country (Bigdeli et al., 2016). Thus, ethical issues play a significant role in global health research in developing countries. Medical and scientific research have become cross-national and cross-cultural to help solve ethical issues affecting health care delivery (Israel, 2013). Cambodia believes that suffering is inevitable hence making them not to seek health care. Culture and social injustice can be a barrier to westernized health care because of lack of familiarity with Western diagnostic techniques. Despite the health problems, Cambodia uses the American health care system. Ethical issues such as culture and social justice make the Cambodia not to seek health care.
Culture can be a barrier to the provision of patient care for people from diverse backgrounds in the society. Understanding ethical issues in the clinical setting are important in developing health service delivery that responds to the cultural and social contexts of racial and ethnic minorities. For instance, culture affects perceptions of health such as the causes of diseases, experiences of pain and illness. Cambodia as a country is made up of a range of subgroups and personal differences. With seemingly endless variations, culture brings a different set of symptoms to the clinical setting. Especially in Cambodia, culture influences the meanings the society impacts on various diseases. This cultural diversity helps to shape the interaction with health providers through diagnosis and treatment (Neelakantan, 2013). Healthcare in Cambodia is embedded in traditional methods of healing which emphasizes on herbs. In global health, public health care in Cambodia is affected by social issues such as poverty, political instability and racism.
The Cambodian culture is a combination of different indigenous folk traditions of the Indians and French. The introduction of western medical practices was rejected by indigenous practitioners who believed in sorcery and exorcism to expel the evil spirits from the patient. Thus the Buddhist monks were responsible for the provision of medical services through the use of senses rather than Western therapy. A majority of diseases were attributed to humoral imbalances or supernatural causes. Cambodian belief spirits cause diseases by entering in patient's body through food. As such, black magic practitioners can prevent the spirit from causing harm (Gilbert, 2007). Additionally, they believe the natural sources of diseases are the wind, water, earth and fire which impair body functioning. Treating the diseases require performance of rituals to deal with the spirits and pay homage to the good spirits and herbal medicines.
Culture causes most of the ethical issues in the global healthcare delivery. The cultural relevance of patient education has a profound impact on how they respond to information provided by health practitioners. The Cambodian belief that culture is important for patient compliance they take medications which they have an underlying understanding of how medicines and the body work. There are several important cultural beliefs for Cambodians that nurses should be aware of to offer a culturally diverse medical care. In Cambodia, family members should avoid conflict and confrontation with healthcare providers to maintain harmony. Cambodian patients try to avoid disagreement with the health recommendations due to respect for authority. However, they may not follow treatment recommendations because of their culture.
Cambodian health care beliefs differ from the traditional American culture because of each ethnic group believes, in its perspectives and values of diseases. The differences in cultures have often created a barrier to medical care due to diverse backgrounds. Cultural differences have affected Cambodian peoples attitudes toward medical care and managing of illness (Gilbert, 2007). Patients and their families incorporate their cultural beliefs to the concepts of health and diseases with expectations of treatment to conform to their traditional expectations. Also, patients roles are influenced by specific values and beliefs.
Lastly, culture plays a significant role in assessing a persons health. When providers understand the patients practice of cultural norms, they build rapport for effective communication. The solving of ethical issues in Cambodia requires developing of efforts to reduce health disparities through addressing the physiological and psychological health of individuals and families. Also, healthcare providers should make connections with the community to determine the prevailing conditions. Provision of equitable and efficient health care requires providers to understand that not all patients are affected by culture-specific beliefs.
Social Justice is a human concept that provides the dream of equality and balance, but it often fails. Cambodia has a high rate of social injustices such as abuse of unionists, human trafficking, and unsolved political murder. Despite the authorities struggle to collect weapons and explosives, criminals have always found accessibility. Mostly the foreign residents and visitors are always the victims of armed robberies and burglaries. There are many cases of injustices occurring in Cambodia making people feel vulnerable and powerless in the society. Most of the violence witnessed in the country is because of lack of trust to the judicial system. The continuation of violence indicates the absence of a functioning and efficient justice system (DiazpedregaI, Destremau, & Criel, 2014). The people are forced to seek retribution for themselves in the face of injustice practices. Cambodians continue to feel isolated from the human rights without the substantive rule of law.
Social injustices continue to be an ethical issue in Cambodia due to lack of effective legal frameworks. As such, the country needs to uproot the causes of crime, eliminate the culture of impunity and address the weaknesses of the judicial system to build a sustainable legal institution. The sticky web, mostly causes the disconnection of Cambodians of justice and entangles the country's political history (Grundy, Hoban, & Allender, 2014). The state does not want to be responsible for the genocide because there are more complex reasons why criminals remain uninvestigated.
According to the Cambodian people, personal healing is dependent on shared mourning and sense memory that is preserved as part of human consciousness. The wake of massive trauma is approached from individual, national, international and societal perspective. From the unique viewpoint, healing process requires reestablishment equality of value and power to restore self-esteem and dignity while societal healing involves relieving stigmatization from the society. According to Cambodia government health issues requires restoring the country's ability to provide and maintain equality under the judicial service system (Peltzer, Pengpid, Puckpinyo, Yi, & Vu Anh, 2016). The global health aims at reducing impunity through the commitment of the international community in providing justice.
Additionally, social injustice continues to be evident in human trafficking and child labor. People continue to provide forced labor in Cambodia without the provision of basic safety and healthcare. The horrific workplace disasters have claimed hundreds of lives in the country (Stansell, 2005). Informal workers are the most vulnerable to low wages, inadequate dispute resolution procedures, log working hours and lack of basic labor rights to safeguard their well being. Uneducated workers do multiple jobs which are barely enough to support their families and have minimal social protection. In most of Cambodia, there is a growing concern of tackling these ethical issues to meet national development goals.
Cambodia needs to improve the standards of occupational safety and health to prevent workplace accidents. The progress towards the formation of a social justice system is essential to solving ethical issues and their effect on the country. Effective strategies such as strengthening freedom of association and supporting equal distribution of resources are important in the economic growth and development. Cambodia's rapid growth can reduce inequality and support peoples aspirations for a healthy lifestyle. The country's economic dynamism will enhance social progress if the right policies are implemented to improve human rights. Measuring the economic growth of the country should be based on the availability of decent jobs and the well-being of the population.
Public Health and Model of Healthcare Delivery in Cambodia
Lack of sanitation facilities and unsafe drinking water are the common causes of infectious diseases such as typhoid and diarrhea in Cambodia. However, with the growth and development of the economy, there are significant improvements in the sanitary conditions since the 1990s. According to the World Health Organization (2010), 65% of households in Cambodia were able to receive safe drinking water. The ministry of health in Cambodia has played a significant role in improving the sanitary conditions (Davies et al., 2014). For instance, in 1990 after Cambodia gained political stability, the humanitarian and health aid organization was welcomed enhance public health. Currently, the ministry of health has centralized the public health to facilitate faster decision making in response to health problems. Government health facilities have been provided for the treatment of low health patients. However, such government services are not available in the rural healthcare centers. Thus the non-governmental organizations provide health care to the rural set up in Cambodia.
Outcomes of Integrating a Westernized Culture with Cambodia Culture
The integration of Cambodia culture and the United States health care system is critical in addressing patient health literacy. Cultural barriers offer a challenge to an adequate provision of care for the Cambodian people living in the United States. Over the past years, the US healthcare providers have begun to address the importance of integrating culture in improving patient care (Albert et al., 2015). The cultural beliefs and values of Cambodian people affect their interpretation of healthcare messages. According to the American Nursing Associatio...
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