Many people in the developing countries live in places that lack adequate health care services. The Nippon Foundation has been providing support for the creation of medical services in Asia that make full use of traditional medicinal remedies, which have been handed down from generation to generation and are a cheap and viable alternative to Western medicine. In Cambodia, “Kru Khmer” practitioners, with their extensive knowledge of medicinal plants, are now being looked to as the key to a better standard of community health care in the future.
Safeguarders of health
After the end of World War II, Cambodia, Laos, and Vietnam gained their independence after a prolonged period of colonial rule. However, the countries subsequently became embroiled in the Cold-War conflict and prey to the intrusive actions of neighboring countries, leading to internal divisions and immeasurable suffering by the people. The scene in Cambodia was particularly brutal. In 1975 the Pol Pot regime seized control of the government and systematically began killing the people it perceived as its opposition. In 1978, Vietnam invaded Cambodia and drove the Khmer Rouge into hiding, setting the stage for a decade of fighting among rival factions. It was not until 1991 that the hostilities ended. Pol Pot’s vision of an agrarian utopia had led him to execute millions of people, including doctors, teachers, lawyers, and students, and when order was finally restored, there were no professionals to assume positions of responsibility in politics, medicine, and education, severely hampering the rebuilding effort.
With doctors in short supply, the job of diagnosing and treating disease fell to traditional healers known as “Kru Khmer” (literally, “Khmer teachers”). The Kru Khmer had practiced medicine in rural areas since the start of the Khmer empire in the ninth century, passing down knowledge of healing techniques and local plants from generation to generation. However, the expertise of individual healers was confined to the locale in which they practiced because of the lack of specialized training in these healing techniques on the national level.
After the period of internal strife came to a close, modern Western medical techniques were introduced into Cambodia. However, most people, especially those living in rural areas, opted for traditional remedies, especially those using medicinal plants. In April 2009, the Cambodian Ministry of Health established the National School of Traditional Medicine to consolidate the system of traditional medicine and contribute to an improvement of the country’s health care services as a whole. The Nippon Foundation, which has long provided support for programs that make use of traditional medicine in Cambodia, provided full-fledged support for the school’s opening and the Kru Khmer who enrolled at the school.
Cambodia’s first national association of Kru Khmer
In the first year, all 50 places for the National School of Traditional Medicine’s six-month course, which covered medicinal plants as well as anatomy and other disciplines of contemporary and Western medicine, were immediately filled. The students, all professional Kru Khmer, ranged in age from their twenties to their sixties. The following academic year (April 1, 2010 to March 31, 2011), the course for experienced practitioners became the advanced course, and an intermediate course lasting 10 months was created. In the four years from 2009 to 2013, about 350 people graduated from the school. Graduates of the class of 2011 established the country’s first national organization of Kru Khmer, called the Cambodian Traditional Healers Association, or CaTHA, which launched various activities to enhance new medical services using traditional medical remedies and herbs. The organization has played a major role in the creation of a network of traditional healers in Cambodia—one of the school’s founding objectives.
Prom Tem, a Kru Khmer from the village of Chumkiri in the southern part of Cambodia, was in the second graduating class. After graduation, he returned to his village and resumed his work in a clinic there. He says he got so much out of the program that he encouraged his eldest son, who will take over his practice in the future, to attend the program as well.
“Because I specialize in bonesetting, I’m good at treating fractures and injuries,” Prom tem said. “Thanks to what I learned at the school, I was able to dispense medications for other illnesses. The number of medications I keep on hand rose from four to ten, and my patients are more satisfied, too. Many of the people in the school’s advanced class have a wealth of experience, and we got to know each other well enough to give each other advice about treatments for disorders we’re familiar with. Naturally, we’re still in touch with each other today.”
Bang Menghok, who was part of the first graduating class and at 23 years old was the youngest in the group, says that the exchanges he had with other students was a good experience for him. Bang currently works in the secretariat of CaTHA.
“Though my career as a Kru Khmer was short, my mother came from a Kru Khmer family and I grew up seeing them work. Before the start of school, my mother told me, ‘Learn the methods of others, but be sure to keep ours a secret.’ When classes began, the older students shared their knowledge with us, while I, being younger, showed them how to use a computer. We helped each other and became friends in the process. Initially, my dream was to use the knowledge of medicines I’d acquired to set up a successful business in the capital, Phnom Penh, but my encounter with the other students made me decide to do something to make the lives of Cambodians better.”
Tadanori Takada, who has worked in the CaTHA’s secretariat since the organization’s founding, talks about his hopes for the role of Kru Khmer in the future.
“In Cambodia, traditional medicine plays an important role in people’s lives. Statistically, about 80 percent have used traditional medicine. Cambodians are treated with Western medications at hospitals in emergency cases, but they rely on traditional healers to deal with chronic problems, common colds, stomachaches, and other minor conditions. A farmer bit by a snake or an insect while working in the fields, for example, would normally see a traditional healer. The Kru Khmer are the ideal people to serve as the primary health providers in the community under the system of healthcare in place in Cambodia today. In this regard, CaTHA will likely play an increasingly important role in the future.”
A hands-on program to teach elementary schoolchildren about medicinal plants
An initiative by Ouch Thorn, who was in the 2010 class and is now the head of a rural village in a port town of Kampot Province in southern Cambodia, is being viewed with interest by other Kru Khmer. The project involves growing local medicinal plants in a garden created for this purpose at an elementary school. Ouch Thorn teaches the children and their parents about these plants and how they are used.
“After graduating and returning back to my village, the number of patients visiting my clinic rose. I guess the official ‘seal of approval’ carries weight. As I made my rounds as the village head or helped out in the fields, people come to me with questions about their health. Though my main job as a Kru Khmer is to dispense medication and advise people which medicinal plants can be used to relieve symptoms, I realized that in addition to dispensing medication and advising people, Kru Khmer have a role to play in improving local health and hygiene through education and other means.”
The classes on medicinal plants at the elementary school are taught by Ouch Thorn. On the day of this interview, the school received a number of rare medicinal plants from the Ministry of Health’s National Center for Traditional Medicine that are not found around Kampot Province, and Ouch Thorn carefully explained their properties and uses to the children. The donation was made possible with funding from the Nippon Foundation. Everybody seemed to have enjoyed the lesson, and the children enthusiastically recounted what they had learned:
“I love medicinal plants. They smell good, too.”
“We learned that the leaves of the guava are good for stomachaches.”
“At home, we always use herbal remedies because of their efficacy.”
Health as a springboard to peace
After working as an acupuncturist and moxibustion practitioner in Japan, Tadanori Takada moved overseas to offer treatments there. In the course of his work, he came into contact with Cambodian traditional medicine and began to help out with some of the initiatives. Describing his experiences at CaTHA, Takada says, “I was born in Nagasaki, so I have strong feelings about peace. I would like the people of Cambodia, who experienced the brutal civil war and have suffered as a result of the landmines planted, to finally know peace. Ensuring good health for people throughout Cambodia with medicinal plants and traditional medicine is, I believe, the first step toward this. Changing Cambodia from a land of landmines into a land of medicine is our guiding vision. When I see the smiles of the children at the school’s medicinal garden, I feel the great potential of traditional medicine. In Japan, I learned the techniques of traditional medicine. Here in Cambodia, I will do all I can to put this knowledge to work for others.”
The graduates of the National School of Traditional Medicine are active in locations throughout the country. It is hoped that their activities will influence the stance of the Cambodian government and be a sustainable part of the country’s health-care policies.
Photographs by Hisayoshi Osawa