A publication of the Asian Development Bank No. 1    June 2008
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Health care and education are less accessible to poor women, and they are frequent victims of domestic violence and HIV/AIDS passed on by their husbands
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Voices of the Poor

“My mother asked me, ‘What is the use of your going to school, if we don’t have anything to eat and life is so difficult?’”


LIVING WITH WORRY Up to 80% of the people in villages around the Tonle Sap—a source of livelihood for subsistence farming and fishing—live in poverty
Photo by Eric Sales

What is poverty? It is a woman who watches her son die from dengue fever because she cannot afford the $1.20 it would cost for a taxi ride to a nearby hospital. It is the man who continues to illegally log a forest because he needs the money from the small amount of wood he can haul away. It is a woman whose husband migrates to sell his labor across the border, then comes home and gives her HIV/AIDS. It is the child who cannot go to school.

These are images from Cambodia reported in a study conducted by the Cambodia Development Resource Institute (CDRI) in collaboration with the country’s National Institute of Statistics. The study, titled We Are Living with Worry All the Time: A Participatory Poverty Assessment of the Tonle Sap, was financed from the Poverty Reduction Cooperation Fund (PRCF), managed by the Asian Development Bank. The PRCF is financed by the UK Department for International Development. Poor people in 24 villages of the Tonle Sap, the largest freshwater lake in Southeast Asia, were interviewed about their lives as a way of integrating real people’s experience into development strategies.

Long a source of livelihood for subsistence farming and fishing, the area is of special concern to policy makers in Cambodia because it contributes directly or indirectly to the livelihood of about 15% of Cambodia’s people. Yet poverty rates in the Tonle Sap Basin can be as high as 80%.

For CDRI, Cambodia’s premier development research agency, the study grew out of ongoing work on rural poverty. According to the institute’s executive director, Larry Strange, it was a chance to transmit the real voices of people. “I believe in the power of institutional storytelling,” Strange said. “We have many interesting stories to tell.”

Heartbreaking Reality

The words from the report describing the reality of life are sobering. “Villagers drink contaminated water which causes women to fall sick with leucorrhoea [vaginal discharge] and uterus problems,” said a section on access to water, based on a discussion with villagers. “Male villagers are usually sick with diarrhea, stomachaches, and typhoid.”

And when people fall sick, most health care is unreliable, far away, and expensive, the report says. “We have to bring along money to show the nurse or doctor so that they will give us medical treatment; otherwise, they will not take care of us,” said one woman quoted in the study.

The real human consequences of this are recounted in the quotes sprinkled throughout the text, sometime in heartbreakingly plain language:

“Her son died of dengue fever because she had no money to send him for treatment at the hospital,” a woman said of her neighbor. “At that time her husband didn’t live with them… He was away from home… She didn’t take her son to the hospital until he was seriously ill, and then she took him to her parents-in-law’s house to borrow money from them. Unfortunately they did not lend her anything and then she left her son with the parents-in-law for 2 nights. Her son became worse and worse, so she rushed to get him two injections from the private healer. The healer told her that her son was seriously sick and had to be sent to the state hospital. However, she had no money to pay for the taxi to take her to the state hospital in Thmar Kaul and she took her son back home; soon after, he died.” The taxi would have cost her 5,000 riels—just $1.20.

Development initiatives have improved living conditions for many poor families, but the law of unintended consequences also remains at work in Cambodia. Something that may seem like a good idea in a planning ministry does not always work out so well on the ground.

In one such instance, it must have seemed that giving a boat to a village was a good idea, but it turned out to be inappropriate for the resource level of the area. Nonetheless, the villagers have their boat, which, judging from this interview, they cannot use: “We received a motorboat from the health department,” explained a member of the commune council from a Po Treay village. “It has a very big motor and uses a lot of fuel. We can’t afford to pay for the fuel and we don’t know how to drive it, so it’s of no use to us. People who are ill don’t want to use the boat since they cannot afford it. We have asked that the boat be changed, but the health department said that they could not do that and that it was our responsibility to take care of the boat.”


Source: UNDP Human Development Report 2007/08

Tenuous Existence

What comes through in these stories over and over is the matter-of-fact tone. There seems little alarm in the statements, just a frank assessment of their life conditions. And sometimes it takes very little to give rise to a note of satisfaction. “Sitting in my house (3 meters by 4 meters) we can see the sky. At night, I enjoy watching the stars,” explained a widow of her simple living conditions. “Many households just live inside old abandoned train carriages.”

It is a tenuous existence and things can go wrong very quickly. “If my gill net is stolen, I have no food to eat because the gill net is the only thing that I depend on for my livelihood,” said a widow in Kampong Thkoul village. Yet she lost two nets in a single fishing season in 2005. After the first net was stolen, she had to save up for 3–4 months before she could buy a new one, which was then also stolen. The thieves were never caught.

Things are sometimes made worse by the gulf that can exist between local officials and the poor.

“After the poor sold their land, they did not use their money wisely, but spent all of it. Now they have no land,” said a district governor in Siem Reap. “They cannot grow rice and vegetables and they cannot raise animals.”

“We are poor and we have nothing to depend on except land, so when we face any difficult problem, such as health concerns, we might sell land as the only way to survive,” explained a landless villager in Kompong Cham. “Actually we don’t want to do that, but we have no choice.”

“My husband had a serious case of malaria in 1990, and we were short of food, so I had to mortgage our ricefield to get (about $60 worth) of gold. I had no money to get my land back, and 3 years later I lost it to the creditor,” said a landless woman in Siem Reap.

For women, the report notes, life is frequently much harder than for men. Health care and education are less accessible to poor women, and they are frequent victims of domestic violence and HIV/AIDS passed on by their husbands. “Violence against women, including domestic violence, marital rape, and rape, was raised as an issue in all of the villages studied,” the report noted.

Chilling Stories

The statistics and the stories are chilling. Domestic violence occurs in four out of five families in the village, said a group of women in Kouk Trach village. It is common in poor households and in families where the men gamble and drink, the women said. “When the drunken husbands reach home, they complain a lot, and then beat their wives and children,” they said. “Those who gamble sell their properties while others incur loans to pay their gambling debts. Their wives try to pay what their husbands owe so that their family will not be put to shame.”

Women who suffer rape and abuse have little or no legal redress or social support. “Most cases of rape have been easily judged,” said one villager. “The offenders just agree to marry the victims and then the case is ended.” Not surprisingly, such marriages often end in divorce.

Given the levels of poverty and despair, coupled with changing social mores—especially for men—the study says that men seek out alcohol and drugs to relieve stress and that this, again, comes back to haunt the women. “Violence happens when my husband gets drunk and jealous of me,” reported a woman in Plov Loung village. “He always insults [me] and shouts at [me].” Sometimes he forces her to have sex with him. If she refuses, he accuses her of having an affair, she said.

The authors intend the study to inform policy making at many levels and to be part of an ongoing dialogue within the government about how best to address many interlocking issues. A series of workshops is being held with key stakeholders to discuss the findings. “The view that emerges from the villages,” the report stated in a section on governance, “is that many of the poor and the destitute… often appear to be beyond the reach of public policy. This observation poses serious challenges for the government and its development partners in delivering effective poverty reduction outcomes.”

Cycle of Despair


BEYOND REACH The poor and destitute in the Tonle Sap area often appear to be beyond the reach of public policy
Photo by AFP

The stories are both poignant and sad. In one case a villager reported that a physical assault by local thugs went unreported because the victim did not have the village clerk’s filing fee of about $1.20. In another case, villagers reported to police that illegal “electrofishing” was going on in the lake and harming their catch. The police confiscated the equipment of the criminals but that did not stop the fishing. “Afterwards (the police) sold the electrofishing gear to get money to line their own pockets,” one of the villagers explained. Such small abuses dot the landscape of poverty and create a sense that the government is remote and inaccessible.

Even those with a measure of authority, such as local commune councils, sometimes report that they feel powerless. “We are the local authority, village and commune, (and we) have prohibited villagers from cutting down the forest,” said a commune council member from Kampong Thom. “But… the people who cut down the trees are powerful and high-ranking. Some villagers sell their labor to those people, while others log the forests for sale (of wood) and for house construction. We do not take action because we have no power to arrest those powerful people.”

In instance after instance, the people of the Tonle Sap themselves say they have little access to education, health care is a major issue, and that infrastructure, while improving, is not reaching the village level in appropriate ways. To claw their way out of poverty, villagers report sending their sons and daughters to work for less than $2 a day in neighboring Thailand or for half that much inside Cambodia. There is little opportunity here, the report says, and the government, donors, and NGOs need to be mindful of the voices of the poor.

The fear is that this cycle of despair will continue in the Tonle Sap Basin, even as the urban and tourism-based economy grows. “The study shows that the implementation and enforcement of public policies are often undermined by the fact that local officials are routinely confronted with conflicting policy objectives, inadequate information, scarce resources, ambiguous authority, and a sometimes uncooperative citizenry.”

The challenge for policy makers and other stakeholders in the Tonle Sap region, the report concludes, is to design and strengthen strategies that are ecologically sustainable, pro-poor, and conducive to social and economic development.

One way to start is by listening to these voices.