NGOs, International Aid, and Mental Health in Cambodia
Gordon, Natalie Ann
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Research shows that there are enduringly high rates of trauma in Cambodia from the Khmer Rouge genocide and current daily stressors including poverty and a corrupt government. Additionally, Cambodia is a highly aid dependent country. There is strong international involvement not only in providing aid to the government, but also in giving grants to local NGOs. Despite this heavy international aid, mental health services in Cambodia are insufficient to address the need. Cambodia is party to the International Convention on Economic, Social, and Cultural Rights, meaning that Cambodia is legally obligated to ensure the right to the highest attainable standard of health which includes mental health. Because Cambodia faces resource and infrastructure limitations, the international community is legally obligated to assist Cambodia’s efforts in ensuring the right to health, under the same convention. The fact that these services are not being provided shows that both parties are failing in their obligation to the right to health. The purpose of this thesis is to examine why this mental health gap is not being addressed by international or local actors. To gather data, interviews of local NGOs were conducted in Cambodia, along with observations of meetings with international and local actors, and on-the-ground volunteering experience with a local Cambodian NGO. Some document analysis was also conducted to gather data about how these entities present their programs and goals. The findings from these different sources of data were recorded and triangulated to find common themes and conclusions. This research revealed five main conclusions about why mental health is not being addressed. First, there is poor collaboration between international donors and local NGOs, as well as poor participation with the recipient communities. Second, there is a tension between high government corruption and a need for better regulation of the NGO sector. Third, local NGOs have little autonomy in their programmatic priority setting. The international community has more money and power to set the health agenda in Cambodia. Fourth, there is a disconnect between the Western dominated international understanding of trauma and healing and the culturally embedded Cambodian understanding of trauma and healing. Finally, there are significant funding and infrastructure shortcomings that limit the ability of local NGOs to function effectively. All of these conclusions negatively affect aspects of the right to the highest attainable standard of health and have important implications for research and policy.