Cambodia is a country that recently attained the lower middle-class income status following the consistent economic growth in the country. Although the nation has made significant strides in alleviating poverty, it has remained a common challenge for most of the indwellers in the rural areas. As such, the people in the countryside have been unable to acquire enough income to ensure access to quality medical care. Notably, the maternal health has improved significantly being a fundamental aspect of the millennium development goals. The mortality rate has diminished in the last couple of years, but challenges related to public service delivery and quality medical care are still rampant and need to be addressed. Notably, integration of western culture in health care provision would introduce inequalities as suggested by Iemmi, Gibson, Blanchet, (2015)
Cambodia lies between Vietnam and Thailand and has borrowed most of its cultural practices from Laos and Vietnam. The religious practices esteemed by the Cambodians include that of Buddhism and Hinduism which was borrowed mostly from the Asians and Indians. Moreover, the people of Cambodia have developed a unique tradition from syncretism. From historical times, the inhabitants have been trained and nurtured to respect their culture. The tourists who visit this country see the practice propagated on every phase of life and across different age groups. Chumreap Suor is a form of greeting that has remained prevalent, and despite the economic growth, it remains an essential aspect of the culture of the people. This greeting involves pressing the palms together below the chest with a slight bow. However, when the Cambodians want to express a high level of respect or reverence maybe to visitors or government officials, the hands are held higher, and the bow is lower. Notably, men have changed and the use of this greeting is reducing among them. Nonetheless, most women maintain the greeting and unless a foreigner offers a handshake, most of them prefer using the Chumreap Suor. Moreover, in the Cambodia culture, dances have been a central part of the culture for over a millennium. The most common form of dance is known as Apsara which is performed by mostly women in the royal court (Burridge and Frumberg, 2010). In fact, most foreigners feel like their visit is incomplete if they have not attended one of the traditional dances concerts in the land.
The social justice in Cambodia is below the desired level. The level of crime rate is higher with even young people being involved extensively in criminal activities. Sometimes foreigners and tourists have been victims of burglary and armed robbery (Jackie Ong and Smith, 2014). Despite the government efforts to reclaim the illegal weapons and explosives held by criminals, criminals continue to have access to such weapons at the detrimental of national security. Notably, there is a high possibility that the low-income levels would have played a significant role in increasing crime activities. The crime correction centers need to be improved so as to be of greater benefit to the criminals. Overcrowding and corruption are common vices in the Cambodian prisoners making the life of the poor more miserable. Additionally, cases are there of people who have been imprisoned because of minor offenses. In fact, the possibility of serving long sentences for minor offenses is common. As such, the penalty that does not commensurate the offense can make the criminals worse as they want to do their worst so that their penalty will be equal to their crime once they are arrested. Such a situation compromises the well-being and security of both foreigners and inhabitants.
In Cambodia, social injustices are prevalent in workplaces because of inadequate legal structures and adherence to set laws. The low levels of income and challenges like unemployment make individuals vulnerable and gullible. Poverty pushes people to work in workplaces that do not meet the minimum workplace safety requirements. Further, most employees in this category are paid low wages, with a lot of work and long working hours beyond the recommended ones by the human rights. Inadequate safety in workplaces has claimed lives of people, and others are continuing to work in those environments putting their lives at risk of injury or death. Unequal income distribution remains an issue that required to be addressed and changed. Notably, although there have been attempts by union members to have collective bargaining agreements, they have not been very fruitful. Surprisingly, the economic growth may record as growing and improve, but the drivers and beneficiaries of such change are a small proportion of the population. Platon, (2015), suggests that social injustices like racism and gender discrimination jeopardize the ability of a nation to make economic growth as steadily as it should in the absence of social injustices.
The ministry of health in Cambodia has the responsibility of providing health care to the citizens. The goals and objectives of the department aim at providing access to quality medical care across the population at an affordable rate. Such quality health care would include high quality of life with better wellbeing to enable the people to make an economic difference in their lives while they are healthy. The equitable aspect of the health care aims at ensuring representation of all the population with the exclusion of even the poor ones. The strategic plan focuses on critical dimensions of health care provision like maternal health, newborn, reproductive, non-communicable and communicable diseases. The medical service delivery aims at adopting individualistic and standardized health care that would promote equality as highlighted by Kapalla, Krapfenbauer, Mozaffari, and Costigliola, (2016). The strategic framework aims at eliminating financial and other barriers to quality health care. In the removal of these obstacles, the health care coverage will be extended, and the networks expanded as WHO would require ensuring access to medical care even to people living in remote places in the countryside.
The service delivery model incorporates both the public and the private sector. The public sector has more affordable rates to the Cambodians and most utilized model of health care delivery. In fact, the private sector usually does not provide the complimentary packages or the minimum packages but only offer a few limited services by the NGOs and international bodies from time to time. The private sector accounts for about 26% of total health service delivery and is normally reserved for the wealthy citizens. People in Cambodia prefer the private sector for curative services while the public sector for preventive services like TB or HIV/AIDS testing Harrison, (2015). The minimum packages are provided by health centers that extend to the rural areas as well. These health centers offer first aid services, normal delivery, initial consultations, maternal and child care health, immunization, health education and referrals as noted by Andreeva and Unger, (2014). Although the network of health centers has extended throughout the country, its effectiveness is limited as each health center is supposed to meet the needs of between 10,000-20,000 patients (Naor and Bernardes, 2016). Unfortunately of these over 1000 health centers, by 2012 only about 50 % had the capacity of providing the minimum package. Various constraints limit the quality of health care service. The primary challenges include inadequate number of staff coupled with inadequate facilities and equipment like required drugs by different patients. Additionally, operational guideline requirements are wanting, limiting the capacity of the available person to offer quality health care. Apart from the health centers, there are referral hospitals in Cambodia that provide more sophisticated medical services that cannot be provided at the health center level. This district, national and provincial hospitals provide services related caesarean sections, major surgeries, ICU, blood transfusion and also obstetric services.
The quality and safety of healthcare sector need a transformation if every citizen is to access health care. Significant disparities exist between geographical regions and different social groups across the country. The affluent can obtain the best health care and those living in semi-urban and urban areas. However, the poor farmers in the countryside may not access health care whenever they need it. As such there is need to train and deploy more personnel throughout the country with policy makers being more focused on quality delivery of services Van de Poel, Flores and Van Doorslaer, (2014). The management has been giving close attention to the sector by investing financially in it as noted by Ir, Horemans, Souk, and Van Damme, (2010). In fact, the last four to five years, the budget allocation to the health sector has doubled. Moreover, the government is helping the poor deal with the health risking through the creation of the Health Equity Funds in all health centers (WHO, 2016). Aspects of social security and health insurances that are affordable are matters that policymakers are implementing in the nation to increase health coverage.
A westernized state like the United States that would like to impose its culture in Cambodia would present various outcomes in the health sector and other areas of life. Trying to impose the culture of the USA in this quite conservative community would result in resistance to change. The people will sense a threat to the loss of the essence of who they are and opt to retain what they have held on for a long time. Further, the western country imposing the cultural change may not understand the value these people place on their particular way of life. As such lack of that understanding would limit the ability to influence the Cambodians positively. For any change to be sustainable, there is need to understand the reasons why people value certain aspects of their livelihood. From that point, the westernized country can integrate change. The culture of the western nations can assist in helping people deal with global challenges like trauma as suggested by Chung, (2001). Notably, when the country imposing change does it tactfully through involving the people, it is possible for the Cambodians to lose their culture especially if they realize such change will result in a positive outcome like poverty alleviation. Alternatively, integration of a western culture would lead to internal communication conflict because of the multicultural set up as noted by Ravazzani, (2016). The two cultures will be conflicting, and some individuals within the society would be unwilling to change. Economically speaking, integration of the western culture would strengthen the relationship with Cambodia, open the country to globalization and chances are there will be strong trade relationships as highlighted by Pongratz-Chander, (2014). Andreeva and Unger, (2014)
Andreeva, V. A., & Unger, J. B. (2014). Host society acculturation and health practices and outcomes in the United States: Public health policy and research implications worldwide. Journal of public health policy, 35(3), 278-291.
Burridge, S., & Frumberg, F. (Eds.). (2010). Beyond the apsara: Celebrating dance in Cambodia (Vol. 1). Routledge India.
Chung, R. C. Y. (2001). Psychosocial adjustment of Cambodian refugee women: Implications for mental health counseling. Journal of Mental Health Counseling, 23(2), 115.
Harrison, M. (2015). A Global Perspective: Reframing the History of Health, Medicine, and Disease. Bulletin of the History of Medicine, 89(4), 639.
Jackie Ong, L. T., & Smith, R. A. (2014). Perception and reality of managing sustainable c...
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