For the last month I’ve been working on updating a handbook on rehabilitation services for people with disability in Cambodia. In essence, the book is intended to be a comprehensive guide by province and district of all of the organizations that are providing assistance or services to people with disability across the country. We intend to publish it in English (for the NGOs) and Khmer (for the government, and more importantly, the people in the villages for whom it is designed) online as well as in hard copy for general distribution.
Jesuit Refugee Service (JRS) and the Cambodia Campaign to Ban Landmines (CCBL) started this project over two years ago, but the nature of work, of organizations and of government in Cambodia means that nothing is permanent, and every year the book must be updated (our plan this year to publish online and take submissions as services change is meant to remedy this). My job has been to track down all of these people and organizations and offices across the country, get the contact information and address for each, and a line or two about their work. Easy, right?
It turns out I have encountered more than a few challenges in this project, and came to realize that they are not project-specific challenges at all. In fact, I’ve had similar experiences working in the same sector in other countries. But they say something important about the reality of the development sector and the expectations that Westerners have in the developing world. Here are my thoughts:
1. Assumptions about “efficiency”
Over the course of this project, sometimes it has felt like I’ve been working from scratch. Phone numbers are no longer in service, the language barrier has been a monstrous difficulty, emails are rarely returned, and websites – when they’re listed at all – either no longer exist, are in poor condition with little actual information, or are for international NGOs and never list contacts or addresses.
The deadline for our book was yesterday. By mid-afternoon it was going well: the end was in sight. I was into the final edits and formatting. I’ve spent the last month meeting different organizations, talking to directors, and learning about the incredibly complicated and at times mind-boggling levels of government hierarchy from commune to district to province to the top national officials. I’ve updated tables and tables of mine clearance data so we can illustrate which parts of the country have increased their demining activities, and analyzed them next to tables of casualty data – how many people have been injured or killed by ERW over the last few years, organized by district. I’ve visited people in villages and discussed disability rights awareness. I’ve been invited to rehabilitation centres where wheelchairs are built and an old woman was trying out her prosthetic leg for the first time, and a tiny blind boy was running his fingers over braille and raised images, and a mother with a small child with cerebral palsy was discovering how strong she was. It’s been a lot of travel time, and it was exhausting, but it was worth it.
Which is why it was ironic that the moment that almost broke me was when I discovered, a few hours before our deadline, that we were missing the addresses and contact information for three of the 11 provincial rehabilitation centres (PRCs) in the country. Including one in Siem Reap, where I live and we are based. No problem, I thought, we just happen to have about 14 community liaisons at the centre currently attending a meeting for our Survivor Network Project. I tracked down the two men from here in Siem Reap and asked for the address of the local PRC. They looked at me blankly. They looked at each other blankly. They conferred. They called over another guy. I turned to my coworker who is doing much of the translation for the book and asked him what was going on.
“They don’t know, I think,” he said matter-of-factly.
“Okay. Well. Do you know the address? Or the phone number?” I asked him.
He paused. “No, I don’t think so,” he replied.
This is ridiculous, I thought. We’re literally 15 minutes away from this centre, half the people here have been there, this is precisely the sector they work in, and no one has a phone number or an address? I would spend the next 2 hours tracking down a variety of people, phone numbers, addresses, only to discover again and again that they were incorrect. It was driving me crazy. At the end of the day, we found the business card of someone who used to work for Handicap International (HI, the organization that has provided the operating costs for the Siem Reap PRC in the past) that had the address printed on it. No contact name or phone number, but at least people could find the damn place.
I am hardly the first person to realize that addresses don’t work the same way in the developing world (especially Cambodia) as they do in North America. And I’m hardly the first person to be exasperated by it. In Cambodia, you are more likely to list an address as “Across from the Old Market” or “200m away from the river” than to use a house number or street number. And that is actually fine, because it works really well for the most part, and obviously I’m in no position to challenge it. It’s frustrating though, to then be working in a format where we’ve set ourselves up for this challenge. Maybe instead of having all these address listings we should have had direction listings? After all, if this book is intended for people needing to access services, I want to make sure they know how to get there.
2. Assumptions about “doing it better”
Which brings me to my second point. The biggest difficulty I have with the development sector is that it is, in fact, the “help sector” and this has a serious implication when it comes to who is being helped and why and to what end. When we started this disability book, I realized I didn’t know what the definition for disability was, legally, in Cambodia. In turns out, I still don’t. One day over the phone my supervisor and I hashed out our own definition for the purposes of the book, taking into account which organizations we intended to include, and how broad the demographic was that we were appealing to.
I almost wrote this blog on the idea of “inclusivity” in the development sector, but realized I didn’t have anywhere near the time or space to properly deconstruct this idea. But inclusivity permeates everything in Cambodia, because such a huge portion of the population lives with some form of disability. This is due, in part, to the massive legacy of war in Cambodia, as well as the nature of healthcare and the impact of malnutrition in the country, the consequence of poverty, and finally the reality of rural life here, which is physically strenuous, exhausting, and often remote.
The point is: it was incredible to me that no one had done this before. I assumed in a country where literally hundreds of NGOs are on the ground someone would have created some sort of directory on services. And technically, there has been, here and there: the Catholic Church did one years ago, and HI put together listings of general development NGOs in Battambang and Kampong Cham. Apparently UNICEF did one on child protection (this doesn’t surprise me, I’ve worked with UNICEF before in child protection and have been impressed with their ability to organize local partners). But it seems impossible to actually get my hands on a copy of any of these, and they are all either too broad, or woefully outdated.
But to what end is it our responsibility to put this book together? I naively assumed the government would have a list of the 11 PRCs with their contact info on a website somewhere. Or a list of NGOs working in their country neatly organized by theme (disability! Children! Agriculture!). But apparently they don’t. So it does give me some satisfaction that our book will be able to contribute to this.
This raises the question though: who is responsible for which services? Sustainability is something that is often talked about by expats working in the developing sector in Cambodia, and everyone seems endlessly frustrated by the lack of it. For example, each of the 11 PRCs across the country have historically been operated by a collaboration of the government and one of four internationally respected NGOs – ICRC, Veterans International, HI, and the Cambodia Trust. In the last year, HI finally felt it was time to withdraw its operational assistance from two of the centres it has supported for the last 20 years. Responsibility of the centre was completely turned over to the government. Almost immediately, the quality of services decreased drastically. It’s only one example of a hundred similar cases. It raises serious concern for long-term sustainability of projects, and the responsibility of the international community to decide whether to remain working in a place or to leave. And that’s a big problem for the “help” sector. Over the course of my academic career, and my previous work in development, I have mercilessly criticized the theoretical issues I have with development, with the lines you can draw to imperialism, with all kinds of Western guilt and responsibility to the developing world. But here I am, after all, and I do think what we’re doing is important, and will be a tangible contribution to people in need. It’s just frustrating when you feel like no one else whose responsibility it should be really gives a shit sometimes.
3. Assumptions about “being here first”
When you have hundreds of NGOs working in one small country, there is going to be duplication of projects. Everyone wants access to the same little pools of money that seem to evaporate faster every day. I remember sitting in a child protection meeting with UNICEF in eastern Sri Lanka three years ago, where local organizations presented updates on their current projects. Two different NGOs each seemed to be building a well in the same small village, where only one well was required. I remember distinctly our regional UNICEF child protection manager exploding when both organizations refused to put a stop to their project and let the other have it. It was a huge waste of money, time, and energy, when there were hundreds of other child protection issues that could have been addressed successfully by either organization.
While putting together our book on disability services, we came across a lot of organizations that appear to be doing the same work. Sometimes, this makes sense – there are a lot of children with vision or hearing impairments in Cambodia, so it stands to reason that there are a number of specialized schools and programmes catering to them. The broader difficulty was when I actually managed to track down an organization that claimed to be working in a certain area with a certain group, but in reality they did not have an office or a representative there. And then they would refuse to admit it. I understand that this might happen if I was a possible donor, but one would imagine that because the purpose of the book is to provide local people with a guide to services in their area, the organizations supposedly providing the services would be honest about their activity. Unfortunately this is not the case. Which is why my supervisor wisely only includes organizations in our book when she can find a person who has actually received positive and tangible services from them.
Putting together this book on disability services has taught me a lot about the nature of “the help sector” in Cambodia. And though it can be frustrating, in the end, we still produced something that I think will be a real service to the people in villages who need it. In addition, the majority of organizations and levels of government I met were enthusiastic about something like this finally being compiled. And I have learned more about disability in Cambodia than I ever thought I would be able to.
These thoughts are not intended to read as a rant about development (though, rereading it, yeah, parts of it kind of sound that way). Rather, I wanted to be able to deconstruct my ideas and assumptions about the work that I’m doing here by noting throughout my criticism that yes, I am conscious of my position and my perspective. I know where I come from, and I know that among the major theoretical criticisms of development is that it reinforces self/other binaries. And unfortunately I see that, all the time. I know. But I’m also still here. And I want to understand how to overcome these things (can they be overcome?). And I also want to keep doing what I’m doing (I think). Because there is a lot that needs to be done in Cambodia – and with a little cooperation between NGOs and government, I believe it can be. But it requires some serious long-term thought and motivation. And I don’t know where one acquires those things.