Sources of Health Education in Kampong Chhnang
There were eight different sources mentioned when I asked where they received their health education or mosquito-borne disease awareness: radio, books, elders, village health volunteer, health clinic, IRD, village meeting and their children. Most women cited that they received their health education from two to three sources. Thirty-seven mentioned the village meeting as a source of health education and thirty-five said this was the best form of health education they received. Thirty-four mentioned that both the radio and health clinic were forms of health education. However, only five said that these were the best form of education. While six mentioned that the village health volunteers, health clinic and IRD staff are the best form they all shared the same reason for declaring these sources the best. All women unanimously said that the village meeting was the best form of health education because they could ask questions and exchange ideas during the meeting. Those who said that the health clinic, the village health volunteer and IRD staff members were the best form of education mentioned how they could ask questions directly. Person-to-person communication is key in disseminating information in Cambodia.
Toll the Village Bells
The village defines life for rural farmers in Kampong Chhnang, Cambodia. Typically, 70 to 100 people occupy a village. Entire families can live their whole lives in one village. Men will grow up in one village and move to their wives’ village after marriage. Villages in rural Cambodia are like small towns in America—everyone knows each other. This insulating aspect of Cambodia villages influences the effectiveness of spreading information and educating the community.
When I would go out to the villages to perform interviews, the village chief would meet me and take me to each household, knowing exactly where to go and the families I was interviewing. While I accompanied International Relief and Development (IRD) staff on community-based teaching programs and health evaluations, the village chief or village health volunteer was always available to take staff to where they needed to go. In most cases, IRD was familiar with the village and would go to one mother’s house and wait a few minutes as the rest showed up because they had heard IRD was there. The communities I encountered during my two months in Cambodia were very interconnected and relied on internal support in many cases. Villagers farm together, that is, they help harvest each other’s fields and others watch their children while they are out in the field.
Monthly or bi-monthly village meetings disseminate information. The village chief will call out to the village via a loudspeaker and encourage people to attend, hinting at what will be discussed. IRD often conducted village meetings in Kampong Chhnang Province to teach mother/child health to mothers and husbands. When I observed these meetings I estimated about 20-25 adults and 13 children in attendance. IRD also set up a drama show with local students who would visit several villages acting out their play.
IRD utilizes village meetings because that is how community members receive their information and are more inclined to attend them. Bessette (2006), in collaboration with the International Development Research Center, writes that meetings are relatively easy to set up; a non-governmental organization (NGO) simply has to arrange it with the village chief. He also notes that the success of these village meetings is not dependent on level of interest or logistics, but rather success is dependent upon the quality and implementation of information. This suggests that even if a meeting is different from what a villager might want to hear, it can still impact their understanding and opinion on a certain issue if it is engaging.
Village meetings are crucial in spreading health education because Cambodian villagers rely on direct interpersonal communication for their information needs (Bessette 2006). Although women mentioned hearing about malaria and dengue prevention on the radio, they always emphasized how they preferred village meetings and that this method was the most useful form of health education for them. At meetings they can ask questions and exchange ideas with the meeting coordinators and with fellow villagers. Radio and TV is used primarily for entertainment and, occasionally, news. Written forms of disseminating information are seldom used because literacy levels remain very low in rural villages. Bessette (2006) highlights this issue by stating that illustrated handouts can be used but are constrained in the amount of information they can convey. The meaning is also lost with text present. A rainy climate also poses problems for posting leaflets on information boards.
Cambodia’s culture of close-knit and interconnected villages allows for the easy spread of information on a community level, but can limit comprehensive coverage of those informed if some villagers do not attend or are socially separate from the rest of village. One of the women I interviewed admitted that she rarely went to village meetings and her husband was always in the field and could not attend them either. Her level of health education was low and she knew little about mosquito-borne diseases and prevention. If some villagers do not attend village meetings, how then does health education reach them?
Mee et al (2003) found that friends or neighbors are the main source of information about news and other events both in the village and beyond because they live close together. I also witnessed groups of villagers hanging out on the road or at a house, talking and sharing recent news. In this case, NGOs would have to trust that if certain villagers do not attend several community meetings then their neighbors or friends would inform them of what transpired. Yet this second-hand information is not often comprehensive. Also, because the village chief organizes village meetings, his level of commitment may affect how well a village meeting is run. Mee et al (2003) state, “Several sources reported that the commitment of the Village Chief varies between villages, with one villager stating that their Chief was too busy to help”.
The spread of information and health education in Cambodia is largely dependent upon village meetings and overall village cooperation. This raises the question of what can be done when that source of information is incompetent or insufficient in delivering information. Mee et al also noted that villagers tend to distrust information from village outsiders. However, villagers view NGO workers, monks and health center staff as reliable sources of information. Fortunately in that sense, NGOs would not have to bridge that particular trust gap. The fact that villagers respect the advice of monks indicates that Cambodia has a religious institution that NGOs can use to reach different areas of villages and perhaps, impact the opinions of the villagers on a different level.
While there are gaps that can be found by using village meetings as the primary source of information dissemination, they are the most reliable and accessible source for most villagers. The structure of Cambodian villages allows for health issues and concerns to be addressed as a community. This support system aids humanitarian efforts by involving a community as a whole and allowing villagers to be responsible for the welfare of their neighbor. Why then is Cambodia still struggling with levels of poor health in rural villages? Is it a matter of the villages, the government or NGO involvement?
 Bessette, Guy. 2006. “People, Land, and Water: Participatory Development Communication for Natural Resource Management”. London: Earthscan.
 Mee, A., Haylor, G., Vincent, S., & Savage, W. (2003). Information access survey: Cambodia. Accessed via aquaticcommons.org.