The future of post-conflict countries depends upon how governments and their people confront, reconcile, and move forward from their past. Survivors are the key stakeholders in this process, not only because they are the teachers and storytellers about this past, but also because they are the barometer for their nation’s development and achievement of a better future.
Cambodia in the late 1960s and early 1970s was consumed by the Vietnam War and between 1970 and 1975, Cambodia was torn apart by internal conflict, foreign intervention, and ultimately the destruction of society. In April 1975, Khmer Rouge forces captured the entirety of the country and for the next four years, the Cambodian people suffered indescribable horrors including genocide, crimes against humanity and unimaginable human rights violations. Following the collapse of this regime, the Cambodian people continued to be plagued by internal conflict, which was accentuated by international isolation that perpetuated, if not aggravated, the instability, famine, and the most horrendous human conditions. All told, Cambodians suffered through nearly four decades of war, genocide, and inhumanity.
It is believed that approximately 7 million Cambodians survived the Vietnam War period, and approximately 2 million Cambodians died during the genocidal Khmer Rouge regime. This means that approximately 5 million Cambodians survived both.
There are well-established statistics demonstrating a higher prevalence of trauma-related mental health disorders in post-conflict societies. Although research in this area continues to be challenging, surveys of Cambodian survivors suggest there are many types of mental health disorders and trauma-related health conditions that continue to this day. For more than two decades, the Documentation Center of Cambodia (DC-Cam) has been working with the survivors of the Khmer Rouge regime to develop a better understanding of survivor needs, interests, and perspectives. To this end, DC-Cam conducted its own limited survey.
As of August 2022, DC-Cam has collected information from over 31,000 Khmer Rouge survivors, with the research and analysis of this work compiled into a booklet titled “Information on the Healthcare for Khmer Rouge Survivors.” DC-Cam’s findings indicate that among the physical and mental health conditions reported by survivors, hypertension, gastrointestinal disorders, malaria, mental illness, and heart disease, were, in this order, the priority health concerns and debilitating conditions for survivors. Further, of the survivors surveyed, 87 percent reported still having disturbing memories of the Khmer Rouge period, and 25 percent of respondents reported still suffering nightmares about this era, even though these experiences occurred more than 40 years ago.
If there is a lesson to be taken from the Cambodian survivors’ struggle with physical and mental health, it is that the trauma of this period continues to manifest even decades later – not only in the health of survivors, but also the multiple generations born long after peace came to Cambodia. Trauma can ripple through familial and societal relationships, affecting children and grandchildren and broader family and community networks. Pathological behaviors like domestic violence and substance abuse are linked to trauma-related mental health disorders. Further, mental anguish and suffering from trauma and loss or feelings of shame, guilt, or anger can impact even institutions, including those that are seemingly well removed from a survivor’s family and local village.
Without question, the consequences of violent conflict, atrocities, and inhumanity cannot be neatly confined to any category of individual or collective well-being. Post-conflict societies are consumed by the cascading effects of these violent periods that influence all societal and governmental institutions.
Even today, Cambodia continues to grapple with the scourge of landmines and unexploded ordinance from its past. According to the Cambodian Mine Action and Victim Assistance Authority, almost 65,000 people were casualties of landmines or explosive ordinance between January 1979 and July 2021. This number includes almost 20,000 deaths. While the number of injuries and deaths caused by landmines and explosive ordinance has fallen over the years, as recently as 2020, there were 65 casualties to these buried explosives.
In addition to the more observable examples of the impact of Cambodia’s violent history on individuals and communities, there are more subtle consequences that pervade Cambodia’s socio-political development and national identity. For example, DC-Cam has observed notable examples of how trauma from the Cambodian genocide influences identity, individual and collective relationships, the raising of children, work, schools, and even belief systems. But these observations are just surface level.
At a deeper level, there are numerous accounts about how the trauma from this era influences broader conceptions of society, ethics, and governance. How youth perceive public service; whether survivors trust public or private health services; how public and private health services relate to their patients; and how laws and customs are interpreted, enforced, and complied with – questions like these can reveal deep-seated, unconscious biases that are influenced by, if not originate from, individual and collective survivor experiences that have become multigenerational in their impact.
Going further, even Cambodia’s socio-political climate and culture of governance continue to be colored by the experiences of this era. What are the people’s responsibilities to their government, and how should government civil servants perceive their responsibilities to their people? These questions and so many more are not only affected by the experiences of this era; indeed, the last 40 years of Cambodia’s history significantly shapes how the Cambodian people imagine their individual, collective, and national future.
DC-Cam is nonetheless encouraged by the Pentagonal Strategy of the new Cambodian government. DC-Cam sees this strategy as not only targeting the critical needs discussed above, but also as aligning with DC-Cam’s investments in, and advocacy for, the Cambodian people. The Cambodian people are the preeminent variable in the strategy and work toward realizing a better future for the Cambodian nation. The Cambodian people must occupy the top of the Pentagonal Strategy, which they do, and this decision is so important for ensuring the people are not left behind in Cambodia’s modernization plans.
Cambodia must modernize its institutions if it is to mature into a developed nation, but modernization cannot be a zero-sum game in which the Cambodian people are sacrificed at the altar of technological, economic, or industrial growth. In fact, Cambodia’s future depends upon the prioritization of the poorest and most marginalized of people.
Even though Cambodia’s history spans centuries, Cambodia has become defined by its 20th century past. There is no greater way for a country to break from its past and redefine its future than by caring for the people that lived in this past.
The survivors of Cambodia’s violent past are Cambodia’s Greatest Generation. How we care for this generation of the 20th century will be the proof of Cambodia’s commitment to its vision for the 21st century.