Cambodians are a superstitious lot.
They generally believe in ghosts, spirits, fortune tellers, karma, traditional (harmful) remedies & practices, dream prophesy, a magic log for predicting lottery numbers to name just a few. It is easy to mistakenly think that these superstitions are only really limited to rural, uneducated people but the truth is that I haven't met many Cambodians that aren't significantly superstitious.
There also seems to a general lack of skepticism, unless its regarding something a foreigner says, which results in people readily believing propaganda, gossip & rumour. With the recent flooding this rainy season the conspiracy theory circulating was that the government had caused the floods by letting Thailand open flood gates, whilst protecting themselves in Phnom Penh. Support for this theory was that only the northern provinces were flooded & the southern capitol was not. Phnom Penh was in fact knee deep in water but when I tried to explain this, I have friends who live there & post regularly on Facebook, my counter argument was immediately dismissed. Reason & evidence are not very powerful tools when used in a debate here, as they might well be elsewhere in the world.
Doctors here will have coining when they get a headache. My assistant's father believes that a certain sort of moth gives you TB. My land lady 'disappeared' half of scabby dog's puppies because 6 is an 'unlucky' number & 3 is 'lucky'. My khmer teacher believes I have had a love spell cast in me - not as a metaphor but as a real-life spell that requires numerous ceremonies to break it. A friend's baby will grow up 'retarded' because she didn't wear a hat.
My friend was in a foul mood in work this week. Turns out a fortune teller had told him he would lose a limb in an accident this year so he must urgently do a ceremony which will cost $30. When I suggested that he save his money & not do the ceremony so he can feed his family for a week I was met with scorn. So I asked him did the fortune teller ever tell him good things - not often he admitted but he didn't believe the good things anyway, just the bad. Better to spend money to prevent an accident than have to pay expensive medical fees was his reasoning.
He also believes in ghosts & along with 14 million other people here. One nurse I used to work with was one of the few Cambodians I've met who actually doesn't believe in spirits. His mother became ill soon after her mother died & was convinced that she had been possessed by the spirit of her mother. He asked my advice about how he could manage what sounded to me to be anxiety & a normal grief response. Even though he didn't believe in ghosts or share his mother's 'traditional' beliefs, I suggested he should do as his mother wanted, which was to go to the Pagoda & be exorcised by a monk. He was skeptical but did it & it worked.
Beyond understand the culture of a country & the health belief systems imbedded in it you would think none of this should effect me very much but this superstition & associated lack of critical thinking extends to health workers, which means they don't believe a word I say. I am not mocking Cambodians for being so superstitious rather highlighting it as one of the many barriers to effective capacity building here.
I asked R when he was head nurse & J was a VSO volunteer in his hospital did he disregard her advice & ideas the same as the staff we currently work with do. Turns out not, which is why he has been working with J for 5 years. He may be superstitious but he is also open minded & adaptable.
So did you accept everything J told you? - I probed.
Of course not! - he snapped (he has the limb loss thing hanging over him remember) - I would listen, think about it, see if it made sense & if she could prove she was right & her way was better I would do - he explained to me.
100% of the time?
No maybe 95% of the time.
And the other 5% - why didn't you follow that advice?
Not because I didn't believe the evidence - he assured me - but because it was difficult to do in the current situation like doing 15 minutely vital signs on an emergency patient for example.
I conceded that in the UK we had an automated machine that would monitor a patient in resus & then the nurse could retrospectively fill in the observation from the machine's memory if they were too busy giving drugs, taking bloods etc. at the time.
So what do me & J do that you find odd or strange? - I was curious to know.
Silence.
What do we believe that you don't understand? - I persisted
Nothing - he eventually shrugged.
Now this answer could be due to one of two reasons;
1) J & I are devoid of any cultural opposing beliefs or behaviours (very unlikely)
or
2) R is too self absorbed to even consider any one other than himself......
Realistically I know I can't change superstition here but I can try to understand it so as to work better within the healthcare system to help improve it; working with open minded, if some what superstitious, health workers such as R.
They generally believe in ghosts, spirits, fortune tellers, karma, traditional (harmful) remedies & practices, dream prophesy, a magic log for predicting lottery numbers to name just a few. It is easy to mistakenly think that these superstitions are only really limited to rural, uneducated people but the truth is that I haven't met many Cambodians that aren't significantly superstitious.
There also seems to a general lack of skepticism, unless its regarding something a foreigner says, which results in people readily believing propaganda, gossip & rumour. With the recent flooding this rainy season the conspiracy theory circulating was that the government had caused the floods by letting Thailand open flood gates, whilst protecting themselves in Phnom Penh. Support for this theory was that only the northern provinces were flooded & the southern capitol was not. Phnom Penh was in fact knee deep in water but when I tried to explain this, I have friends who live there & post regularly on Facebook, my counter argument was immediately dismissed. Reason & evidence are not very powerful tools when used in a debate here, as they might well be elsewhere in the world.
Doctors here will have coining when they get a headache. My assistant's father believes that a certain sort of moth gives you TB. My land lady 'disappeared' half of scabby dog's puppies because 6 is an 'unlucky' number & 3 is 'lucky'. My khmer teacher believes I have had a love spell cast in me - not as a metaphor but as a real-life spell that requires numerous ceremonies to break it. A friend's baby will grow up 'retarded' because she didn't wear a hat.
My friend was in a foul mood in work this week. Turns out a fortune teller had told him he would lose a limb in an accident this year so he must urgently do a ceremony which will cost $30. When I suggested that he save his money & not do the ceremony so he can feed his family for a week I was met with scorn. So I asked him did the fortune teller ever tell him good things - not often he admitted but he didn't believe the good things anyway, just the bad. Better to spend money to prevent an accident than have to pay expensive medical fees was his reasoning.
He also believes in ghosts & along with 14 million other people here. One nurse I used to work with was one of the few Cambodians I've met who actually doesn't believe in spirits. His mother became ill soon after her mother died & was convinced that she had been possessed by the spirit of her mother. He asked my advice about how he could manage what sounded to me to be anxiety & a normal grief response. Even though he didn't believe in ghosts or share his mother's 'traditional' beliefs, I suggested he should do as his mother wanted, which was to go to the Pagoda & be exorcised by a monk. He was skeptical but did it & it worked.
Beyond understand the culture of a country & the health belief systems imbedded in it you would think none of this should effect me very much but this superstition & associated lack of critical thinking extends to health workers, which means they don't believe a word I say. I am not mocking Cambodians for being so superstitious rather highlighting it as one of the many barriers to effective capacity building here.
I asked R when he was head nurse & J was a VSO volunteer in his hospital did he disregard her advice & ideas the same as the staff we currently work with do. Turns out not, which is why he has been working with J for 5 years. He may be superstitious but he is also open minded & adaptable.
So did you accept everything J told you? - I probed.
Of course not! - he snapped (he has the limb loss thing hanging over him remember) - I would listen, think about it, see if it made sense & if she could prove she was right & her way was better I would do - he explained to me.
100% of the time?
No maybe 95% of the time.
And the other 5% - why didn't you follow that advice?
Not because I didn't believe the evidence - he assured me - but because it was difficult to do in the current situation like doing 15 minutely vital signs on an emergency patient for example.
I conceded that in the UK we had an automated machine that would monitor a patient in resus & then the nurse could retrospectively fill in the observation from the machine's memory if they were too busy giving drugs, taking bloods etc. at the time.
So what do me & J do that you find odd or strange? - I was curious to know.
Silence.
What do we believe that you don't understand? - I persisted
Nothing - he eventually shrugged.
Now this answer could be due to one of two reasons;
1) J & I are devoid of any cultural opposing beliefs or behaviours (very unlikely)
or
2) R is too self absorbed to even consider any one other than himself......
Realistically I know I can't change superstition here but I can try to understand it so as to work better within the healthcare system to help improve it; working with open minded, if some what superstitious, health workers such as R.
But as Stevie Wonder would sing - "When you believe in things that you don't understand.Then you suffer. Superstition ain't the way"
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