Four case
studies in Banan and Bavel District
A report for
The Asia Foundation and Catholic Relief Services
By
Center for
Advanced Study:
Hean Sokhom,
Ph.D.
Ngoun
Sokunthea, BA
Chan Kanha, BA
Judith Zweers,
MA
December 1999
Democratic processes of participation and the growth................................................................ 1
of Civil society................................................................................................................................................................. 1
Table of Contents...................................................................................................................................................... 2
Introduction................................................................................................................................................................. 3
Background...................................................................................................................................................................... 3
Methodology..................................................................................................................................................................... 4
1. The VHC-model.......................................................................................................................................................... 6
1.1 How do villagers perceive the VHC?.................................................................................................................... 6
1.2 Key persons in VHC.................................................................................................................................................. 9
1.3 Ownership of VHC.................................................................................................................................................. 11
1.4 Conclusion............................................................................................................................................................... 12
2. The CMCF/CR Model.............................................................................................................................................. 15
2.1 Findings in Kdong and Prey Sangha................................................................................................................. 15
2.2 Conclusion............................................................................................................................................................... 16
3. Key persons and indigenous
forms of cooperation.................................................................. 17
3.1 Kdong........................................................................................................................................................................ 17
3.2 Kampong Sromor.................................................................................................................................................... 18
3.3 Prey Toteung I......................................................................................................................................................... 19
3.4 Prey Sangha............................................................................................................................................................. 20
3.5 Conclusion............................................................................................................................................................... 21
4. Problems and needs.......................................................................................................................................... 22
5. General Conclusions and
Recommendations................................................................................. 23
5.1 VHC model............................................................................................................................................................... 23
5.2 CMCF-model........................................................................................................................................................... 23
5.3 Problems and Needs............................................................................................................................................... 24
5.4 The need for further research................................................................................................................................ 26
The central focus of this study is the growth of civil society through democratic processes of participation in activities aimed at the development or betterment of society in Banan and Bavel Districts in Battambang province. The Asia Foundation (TAF) and Catholic Relief Services (CRS) are both concerned with strengthening civil society processes at the grass roots level and want to explore areas of potential collaboration.
The first step was a research project in two districts of
The
research was meant to gain more insight into those processes by asking the
following questions:
- Have people in the project areas of Bavel and Banan Districts begun to understand and internalize the participatory processes involved in the Village Health Committees (VHCs) and Co-Management, Co-Financing (CMCF) committees, or are they simply carrying out what is expected of them by donors?
- What are the factors which explain why VHCs and CMCFs have been successful in meeting their objectives?
- What are some of the difficulties that have been encountered along the way?
- Have VHC and CMCF activities remained largely focused on specific health concerns or have they had a broader impact in other areas?
- Have VHC and CMCF structures had an impact on the building of a esense of communityf (addressing issues and making decisions as a community and not just as a collection of individuals or families)?
- To what extent have the Management or Governance mechanisms or processes introduced through the VHCs taken hold in the project areas?
- What is the impact of such mechanisms or processes on the development of civil society in the target communities? How can this further be enhanced?
- What are the priority issues or concerns of people in the target areas that might benefit from citizen-administered participatory and/or democratic processes?
- What are the best approaches to deal with such priority issues and concerns?
- Are there particular sensitivities that one should take into account in addressing these issues and concerns?
Two weeks of research
were too short to cover all points.
However, we were able to do more than we might have expected because of
the facilities provided to our team by CRS-Battambang.
CRS
and TAF emphasized not having any preconceived views on the outcome of the
research, trusting that the people who will be contacted through this research
know best what the most important issues, needs, and concerns are for their
communities. This report therefore
reflects the perceptions of the people who are directly involved in the above
mentioned structures (i.e. as members) themselves, or take an important part in
the participatory and democratic processes initiated by CRS.
The
Terms of Reference asked for a qualitative exploration of the attitudes,
perceptions, and aspirations and needs voiced by grass roots civil society
actors in the districts where CRS is working.
The views of our informants could only be brought to light by careful,
unstructured interviewing. This
methodology rules out precise findings in terms of percentages or numbers; we
are not able to answer questions about the prevalence of certain issues, or the
frequencies of certain feelings in the communities.
Another
aspect of qualitative research is that our findings are based on perceptions,
which are inherently partial. In a
village, for example, a VHC may carry out many more activities than any
particular villager sees or can remember.
The aim of this research was not to evaluate the program or assess the
impact of any specific CRS intervention, nor provide a comprehensive account of
VHC functioning. Our aim was to explore
the democratic dynamics that CRS had tapped at the village level.
In
this report we utilize some Khmer concepts to emphasize that they are not
easily translatable into English. One of
the Khmer concepts frequently used in this report is Angkaa (NGO). We found that
many informants speak of Angkaa as a
more or less abstract entity, as something from outside they cannot really
grasp. They often donft perceive NGOs
as basically different from one another.
In this report we will frequently use the word Angkaa instead of NGO or CRS to stress its somewhat vague and
abstract meaning.
We
also frequently use the term Chah tum:
respected key people in the village of 40 to 50 years or older. The villagers themselves frequently used this
term. They describe Chah tum as kind
people who think of the common interests, who have experience and often have
good, 'ripe' ideas. People trust them,
and often turn to them for advice, especially when issues of conflict or money
are involved. These elders are able to
call villagers to contribute money or labor for a common goal. According to the villagers, women can also be
Chah tum; during our research however
we only met male Chah tum.
Given
the very limited time for the research (eleven days for field trips) we decided
to focus on four villages: Kdong and Kampong Sromor in Banan District and Prey
Sangha and Prey Toteung I in Bavel District.
We spent two to two and a half days in each village, which is too short
a time to really be able to uncover all the issues, problems and
sensitivities. On average we were able
to conduct 22 interviews per village.[1] We talked to four to seven VHC-members in
each village. In Kdong and Prey Sangha
we interviewed one of the two Community Representatives (both women) and in all
villages, except Kampong Sromor, we interviewed the village chief. In each village we conducted on average 15
interviews with villagers, of which about three were ekey personsf.
Approximately 65% of our interviewees were women. We chose our informants on a purposive basis,
not randomly. We sought out informative interviewees. Some interviews took a long time and covered
different topics; others were shorter and were more focused on one particular
issue, depending on the circumstances.
We did not ask everybody the same set of questions, but chose to cover
specific topics in each interview in order to be able to go more in depth. However, we made sure that in one village all
topics were sufficiently covered, i.e. the VHC, the CMCF, key persons and
indigenous forms of cooperation, and
main problems and needs. We spent as
much time on a topic as was needed to get an understanding. During our meal breaks, the researchers from
our two teams met to discuss the results in order to decide how to
proceed. We always started by
interviewing the VHC-members, CR and village chief (if present), after which we
interviewed villagers and respected key people (as indicated by VHC-members,
village chief, and other villagers). We
made sure that we covered all parts of the village. We introduced ourselves to the villagers as
independent researchers who wanted to learn from the villagers about their
village life. We tried to make clear
that we were neither part of, nor linked to an Angkaa providing materials.
When asking our informants about the VHCs (often starting with very
indirect questions) we pretended not to know anything about these committees
and encouraged them to explain to us everything they knew. This report presents the main issues that
came up during our interviews.
Beside the four villages mentioned above, we also visited Knach Romeas in Bavel District for one day, because elections for a newly set up VHC were held only five days before. We were hoping to gain more insight into the perceptions of the people about the identification process of candidates and the actual election process.
CRS-field
staff in all villages we visited had announced our arrival beforehand. In almost every village the VHC-members and
the village chief were waiting to be interviewed. Although we preferred to speak with people
separately (to prevent one person taking over the whole interview and to
encourage people to speak about their real feelings), this was seldom possible. It would have been very impolite to send
people away who had arranged their schedule in such a way as to be able to
speak with us and sometimes had been waiting for a long time for us. In Knach Romeas for example, where we
initially were not planning to talk with VHC-members at all, our arrival was
announced on the wrong day and the whole VHC-committee had been waiting for us
on that day. We felt we had to spend
time with them, and so there was only one afternoon left to interview
villagers. However, we also realize that
we would not have been able to talk to the VHC-members and CRs in the other
villages if our arrival were not announced.
We really appreciate the efforts CRS made to facilitate the
interviewing.
The
village chief often was present during the interviews with VHC-members. In some cases the village chief also joined
interviews with villagers, or VHC-members would follow us to whisper answers to
our informant. These are unavoidable
difficulties in conducting research for a very brief time in a village.
The Village Health Committees (VHC) that were the point of departure for our research were set up by CRS-Battambang from 1996 onwards in 29 villages in Banan and Bavel District, Battambang. An important factor is that the community elects the members of the VHCs through a system of secret ballots. Village Health Volunteers and TBAs (Traditional Birth Attendants)– if present – automatically become members. Key people in the community together with CRS staff identify candidates for elections. For every male candidate there have to be two female candidates; however, the villagers are free to elect whomever they want. The final results of the elections therefore, do not necessarily reflect the gender composition among the candidates. Nevertheless approximately 51% of all elected members in the 29 villages is female.
CRS staff trains the committee members on issues such as
health education and proposal writing.
The members provide health education to the villagers, refer patients to
the
The main reason for looking at the VHC was to find out to what extent it operates in a participatory way and how it enhances democratic processes of opinion sharing and decision making. We first tried to find out what people actually know and think about the VHC, its meetings and other activities in which the participation of villagers is needed.
We
found that the villagers in general do not seem to think in terms of a formal
VHC committee structure. Especially in
Kampong Sromor and Kdong the VHC as such was little known, but people were able
to mention the names of one or two persons in their village who are ein charge
of healthf. However, most villagers knew well about
meetings in which the construction of wells and latrines was discussed; some of
them spoke of the ewell and latrine committeef. The construction of wells and latrines was
often not linked to a VHC, especially in Kdong and Kampong Sromor. The most common finding in those two villages
was that informants feel confused by the large number of committees and
meetings in their village. Apparently,
there are so many committees and so many Angkaa,
that they donft know anymore what is what and who belongs to what. Currently, there are six NGOs working in
Kdong with a total of six committees: a VDC, a VHC, a credit-committee, a
fertilizerbank-committee, a ricebank-committee and a loan-without-interest
committee. In Kampong Sromor four NGO
are present with in total five committees: the VDC, the VHC, a credit/savings
committee, a dry season rice committee and a cow bank committee.
In
Prey Sangha and Prey Toteung I people were mostly aware of the existence of a
VHC, although it was more difficult for them to tell us about the aims of the
committee. Although people in both
villages knew the VHC, it still seemed a somewhat vague entity to them.
In
all villages our informants mentioned activities which had been initiated by
other committees than the VHC. We got
the impression that all village committees seem to have blended together for
the villagers. People spoke in terms of
meetings rather than in terms of committees.
We found that members of the VHC are often also involved in other
committees and this clearly contributed to a blending effect. Sometimes the village meetings of other
committees also distributed information about health. In Kampong Sromor the most active VHC-members
are involved in the VDC and/or in other committees as well. In order to work more efficiently, they
decided to hold just one general committee meeting in which the activities of
the different committees and different Angkaa
are discussed at the same time. Accordingly the CRS supported VHC becomes
merged with similar efforts that use a participatory approach to village
development issues.
Since participation of villagers in VHC-activities mainly takes place through big village meetings, we decided to focus more on those meetings than on the VHC as a committee. The first village meeting conducted after the establishment of a VHC is an especially important one. In this meeting the villagers are asked to brainstorm about their most basic health-related problems, the main causes and possible solutions. In this meeting the VHC also consults the villagers about the first priorities to be set. Although in many villages this meeting must have taken place more than three years ago, we found several people who could still remember it. Our informants who reported usually attending the meetings, said that their main reason to go was ecuriosityf and avoiding the risk of enot getting anythingf.
It is possible that the VHC and CRS-field staff have set their priorities already before this meeting takes place, and more or less eguidef the villagers towards the same conclusions. Accounts from a CRS-fieldworker and a few VHC-members suggest that this takes place. The fact that villages all come up with the same priorities (health education, wells and latrines), i.e. what CRS has to offer, reinforces this impression. However, we found one example of the opposite: villagers setting a totally different priority. In Kdong people decided to give priority to building a road to the village pond in order to avoid skin diseases. CRS accepted this and instead of providing culverts for latrines and wells, they provided laterite. This is a good example of autonomy of villagers, not just following the proposals of a donor, but being able to advance their own agenda, and of the donors responsiveness to expressed needs. We feel that this first meeting made a considerable impression on villagers and is a good example of how democratic processes of participation can take place.
The next question was to find out what actually happens at the village meetings: do villagers really participate by raising questions and concerns, by sharing problems and ideas, or are they basically listening to what the VHC-members have to say and accept their proposals?
The accounts from the villagers differ from each other, so it is not easy to get a good overall picture. Some villagers reported lively discussions, whereas others in the same village reported speeches by the village chief and Angkaa (showing the material they can provide) and a quiet audience that just follows: gwhen Angkaa asks us whether we want something, we just say eyesf.h Many people reported being too afraid to speak out. Some people seem to be afraid mainly because they are not used to speak in front of a big audience; others think that the presence of the village chief and Angkaa are the main constraining factors. Nevertheless, all informants told us about the attempts of the village chief and Angkaa to urge people to participate in the meeting by encouraging them to speak.
We
think it may need some time for villagers to get used to the idea that their
contribution is really appreciated.
After all, Cambodia has a recent history of an authoritarian, very
hierarchically structured society. Two
informants told us that the meetings remind people of the meetings in the time
of Pol Pot. gHowever, when they see
concrete results, they understand that these meetings are differenth,
according to one informant. According to
another informant this experience from the past is still a major obstacle for
people to participate in meetings: meetings are eofficialf and are often
perceived as ean order from the topf.
The fact that the term Angkaa
is the same term used for Pol Potfs government may influence the sentiment
voiced here. More than half of our
informants seldom attended meetings.
Besides
the meetings, people are supposed to participate in certain project activities
as well.
Those village projects are basically building latrines and digging wells (except the road building in Kdong). CRS provides material and explains how to proceed; the villagers have to contribute labor and organize it themselves. One well can serve 10 – 15 families and the cooperation of all families is needed to build it. The family on whose land the well will be constructed organizes it. The other families have to contribute labor or money.
We
found several cases in which the cooperation seemed to work very well. After its construction the families really
considered the well as etheirf well. However,
we also found other perceptions of well ownership. To the villagers it does not
always seem to be clear whether it belongs to the families who built it, to the
eauthoritiesf, or to the community as a whole. In one case several families refused to
cooperate in construction, but wanted to use the well when it was
finished. This caused a conflict between
the families that did cooperate and the families that did not, and the
non-cooperative families were refused access to the well. In another case the families using the well
didnft consider it to be their well, but the well of the family on whose land
it was built. We are however not sure
that this was a well constructed through VHC mediation. In another case villagers did not use the
well because it was located too far away from their homes. Another problem mentioned was the maintenance
of the well. Some families accused others of not cleaning the well, after which
it became unusable.
Considering the accounts of several villagers and VHC-members we have the impression that sensitive decisions such as the location of the wells may not always be taken in the large meetings. According to the perception of our informants it is the village chief who takes those decisions together with Angkaa.
For
the building of latrines we found no cooperation between families. Each family is supposed to build its own
latrine, and if it lacks the force to do so, no one will help.
We
have the feeling from the comments of our informants that activities of the VHCs
in general tend to decline over time. In the beginning the committee is quite
active, involving villagers through many village meetings, but after a few
years it reduces its activity. In two
villages people complained that the activities had stopped (Kdong and Prey
Toteung I) and in Kampong Sromor people felt that the activities in general
(all committees) were reduced. Kdong and
Prey Toteung I seem to be divided in two parts: people of one part accused the
VHC-members of only building latrines and wells for their own (and village
chieffs) relatives in the other part of the village, after which the
activities seemed to have stopped. In
both villages people reported not having seen any activity/meeting in the last
year.
A
certain decrease in activities over time was confirmed by VHC-members in
different villages: they reported not having enough time to spend for
VHC-activities. A VHC-member in Kdong
told us that the last village meeting took place one year ago. There were no such complaints in Prey Sangha.
In Cambodian society each village traditionally has certain generally recognized, highly esteemed and respected key persons who play an important role in generating ideas for cooperation, and mobilizing villagers to take up certain tasks for the betterment of the village. CRS recognizes the importance of such key people in the community by involving them in the selection process of candidates for the VHC. By doing so, it seems to us that CRS is one of the few international donor organizations applying such a strategy.
Before
elections for VHC-members takes place, a list of candidates is prepared. CRS first asks the village chief to identify
candidates (of whom 2/3 should be women, then other key persons in the village,
as well as villagers, are asked to recommend people. If the potential candidates accept, a final
list is prepared from which the villagers (at least 50% of the households have
to be present) can elect candidates through a system of secret ballots.
Although certain respected key people in the community are asked their advice and recommendations, the village chief seems to play an important role in drawing up the list of candidates for elections, at least in the perception of the people. Almost all our informants, whether VHC-member or not, emphasized the designation of certain people by the village chief. Most VHC-members told us that this was their main reason for becoming a candidate. Listening to the words of one VHC-chief, it seemed to us that it had been difficult for him to refuse because it was the village chief who had pointed him out.
One
informant felt that all members are people whom are somehow related to the
village chief/local authorities. We have
no further evidence for this. However,
it is noteworthy that several other informants mention that the village chief
is not automatically a respected person in every village. In some villages people criticized the
village chief for being selfish, gaining money at the cost of the community, and
nepotism. This is not to say that the
village chief is always a selfish person: in some villages he may indeed be
generally considered as a helpful and trustworthy person. It is likely that the village chief selects
candidates who he thinks are capable of carrying out the VHC tasks.
We
asked the members of the VHCs about the most important reason for becoming
VHC-member. Almost all mentioned reasons
such as: Plew Loak (working for the
betterment of the village), good reputation, a good name for the village as a
whole vis-a-vis other villages, setting a good example for the next generation,
and Plew Thoa (gaining merit for next
life). Underlying all those reasons,
there are of course also other ambitions.
Several informants expressed the hope of finding a job in the future
with an NGO or at the district hospital.
Or, as one informant said: gI hope that one day Angkaa will see meh.
The
VHC-members were all very positive about the VHC and its health activities.
They perceive the VHC as an important improvement to the health situation in
their village. All members told us they want to continue their VHC activities
for a long time.
However,
a big issue in almost all villages was the fact that the VHC-members do not
receive any other salary or incentive than an allowance for following training
courses. Except for Prey Sangha, all
VHC-members complained about not getting any salary or gift for their
work. Not all villagers believe that the
committee members work for free. They
often talk about ethe people who work for Angkaaf. The villagers who are aware that no pay is
involved, assured us that it affects their work: it demoralizes them, and makes
them less and less active over time.
Many villagers added that the committee members only work when Angkaa comes to the village.
Many
elected members were already active in the past: some were echief of womenf
in the communist time; others were just helpful in common works in the village,
such as building a road, a dike, etc.
They are often also involved in other committees, such as the VDC,
credit committee, etc, as we noted above.
Most villagers consider the VHC-members as good, kind and helpful
persons. Some informants added that the
VHC-members are talkative and gare able to speak with Angkaah.
We
found only a few examples of Chah tum
in the VHC. Interestingly enough, the
village chief of Prey Sangha only wanted young people in the VHC: older people
were excluded from membership. According
to one Chah tum, the main reason
behind this is the faster understanding of young people: they can work faster
and have a higher education than the elders.
At the same time he feels that the young often lack a feeling of
responsibility. Although the Chah tum in this village can not be
member of the VHC, they are always invited to attend the meetings and are
considered as important advisors to the VHC.
Still, it seems an arbitrary exclusion of one particular group in
society by the village chief.
Villagers do not seem to look at the VHC-members with different eyes now they are working in the VHC. In general, they are considered as helpful, but not as people they would turn to for help if they have a (health-related) problem. We did not have enough time to get a firm impression on whether the VHC-members gain in prestige or esteem in society. Several women VHC members reported feeling better able to express themselves. One woman told us that she is proud of her membership and the knowledge she gained through the training: she gained confidence in speaking out.
In
Prey Toteung I new elections were held because some members had dropped
out. The main reasons mentioned, were:
too many illiterate people in the committee, not willing to work without a
salary, or husbands who donft want their wife to work for free. Once an informant told us another reason:
husbands who donft want their wife to work for roat (government/authority).
In Kdong one informant stated that working for a committee does change
the character in some cases. Before
becoming a committee member, they are good people: honest, hard working and
helpful. But after some young members
become committee members, they take advantage from working in the
committee. He stressed that was is not
the case for the VHC, because there is no money involved.
Besides
Kdong, Kampong Sromor, Prey Sangha and Prey Toteung I, the research team also
visited Knach Romeas in Bavel district for just one day. The main reason for visiting this village was
the fact that elections were held just five days before.
Due
to circumstances (see Introduction) we only could spend half a day (3 hours)
talking to some villagers, not all of whom participated in the elections. We feel this is too limited really to be able
to comment on the identification process and the elections, as the villagers
perceived them. Only two informants were
able to comment on the identification process and the elections. According to them, the elections were conducted
in a fair and secret way. They were
positive about the elections and had the feeling that the right people were
chosen. They told us that this way of
selecting people for a certain task was entirely new to them, and that they
could imagine using it also for other occasions, such as for the commune
council.
One
of the main ideas underlying the VHC is that it belongs to the people, to the
villagers. We asked the villagers how
they look at the VHC: to whom does it belong and for whom is it working? In
case our informants didnft know the VHC, we asked them about the ownership of
committees in general, or focused more particularly on the meetings, asking
villagers by whom they are organized.
In
Kdong and Kampong Sromor all informants told us that Angkaa and the village chief organize the health and wells/latrine
meetings. One woman in Kdong, who could
still remember the VHC-elections, spoke in terms of electing grepresentatives
for CRSh. Another woman in the same
village thought that the chief of the gwell and latrine committeeh is working
for Angkaa. In Prey Sangha and Prey Toteung I most people
believed that the VHC belongs to Angkaa. Only two informants (in Prey Sangha and Knach
Romeas) stated that the VHC belongs to the villagers. One should realize however that the notion of
ownership in question here is a Western (development) concept, which may have a
different meaning to our informants. It would require further research to find
out how this concept is really understood.
It
is not surprising that many people connect the meetings/VHC to the village
chief. The village chief is heavily
involved in any VHC-activity. Although
he is not an official member of the VHC, he is officially an advisor to the
committee. The moment CRS comes for the
first time to the village, the Village chief is contacted. He is the first (and according to many
villagers also the most important person) to select candidates. He calls the
villagers to a meeting (often through the help of meekroms). He is present at the village meetings and seems to play
an important role by delivering speeches.
In Kampong Sromor the village meetings are often held in the house of
the village chief or a village policeman.
Angkaa representatives are often
present in the meetings and play an important role. According to the people, Angkaa shows its projects (latrines/wells) and shows the material
it can provide. Many villagers feel
there are only activities when Angkaa
comes to the village.[2]
Some people say about the VHC members that gwhen Angkaa comes, they workh.
When
we asked the villagers in Kdong and Kampong Sromor to tell us about the whole
process - from organizing the meeting until the meeting itself - they only
talked about the village chief and Angkaa. When we asked them whether there were also
villagers or a committee involved in the organization of a meeting, they said
that villagers from a committee were present and participated but they did not
know whether they were involved in organizing it. In some villages the CRS field staff seemed
to play a very important role in urging villagers personally to participate in
activities.
Only
in Prey Sangha we found a few people who considered the VHC as their
committee. However, when we asked them
why, they explained that Angkaa told
them so. Some villagers would consider
the members as working for the villagers (although one said they are working
for the authorities), but couldnft answer the question whether the VHC belongs
to the villagers, Angkaa or the
authorities.
Our
VHC-informants in all villages were positive about the future of the VHC, but
at the same time made it very clear that they need the continuing support of
CRS, and preferably a salary or other incentive. The villagers in Kdong, Kampong Sromor and
Prey Toteung I were also very clear about the future. Viewing the overall
reduction in activities over time, they saw little or no future for the
committee, unless Angkaa stays
heavily involved. In case Angkaa would withdraw, they saw no
future at all. Because, as one informant
told us: gOur people are not strong in contacting (other) Angkaa for supporth. The
biggest fear seems to be that there will be no NGOs to provide material, and
without material there will be no concrete activities anymore.
One
informant in Kdong was more confident about the sustainability of the VHC. He compared it with other committees in his
village (a rice bank and a credit scheme) that seem to work well and are able
to continue without support from outside.
In Prey Sangha people in general seemed to be more self confident and
proud of their own capabilities than in the other three villages. Almost all our informants expressed their
confidence in the VHC and were quite sure it would continue its activities even
if Angkaa would withdraw. According to one informant: gFirst we should
do things ourselves and then we can ask Angkaa
to help provide the material.h However, he also added that the VHC-members
need more training. Prey Sangha is
different from the other villages because of its Kampuchea Krom roots and its
relatively well developed civil society (see page 20-21).
We found two examples in which the VHC might have had a broader impact in the community. In Kdong one VHC-member said he used his training on proposal writing from CRS to write a proposal to ea generous womanf in the United States to build a school. We heard many different stories about who actually got the idea and wrote the proposal, not supporting the first (VHC-) account. Nevertheless, it clearly shows that someone got the idea and took the initiative to contact other donors. In Prey Toteung I the chief of the VHC stated that she initiated the idea to create different associations in her village and that the VHC had served as an example. Considering the fact that the husband of the VHC-chief was involved in the initiative of setting up the associations, we have good reason to believe that the VHC may have served as a catalyst for the reestablishment of traditional self-help village associations.
When looking at the VHCs, we can basically distinguish three levels of participation: the participation of the members of the VHC; the participation of villagers in the meetings; and the participation of villagers in the concrete project activities.
Considering
the good results of the health programs of CRS and the accounts of the
VHC-members themselves, we conclude that the members of the committee are
important contributors to the improvement of the health situation in their village. They seem to be participating well in the
program, although their activities tend to reduce in time and seem to be linked
more or less to the arrival of CRS in the village. The motivation of the members is a point of
concern. We will return to this issue
later.
One of the roles of the VHC-members (amongst many others) is to be an intermediary between the villagers and the CRS, and to make sure that the projects decided upon in the meetings by the villagers are really carried out. The villagers elect the members of the committee through fair and secret elections, and in general it seems that the right people were chosen to take up the job. The VHC-members consult the people through village meetings where they can voice their concerns, their needs and their ideas.
The participation of the villagers in general mainly takes place through those meetings. There are basically two different kind of meetings: the first meeting in which priorities are discussed, and the meetings following thereafter.
In the first general village meeting people are asked to brainstorm about the most basic health problems in the villages, about the causes and possible solutions. The villagers take the opportunity to speak out about problems and solutions in a fairly democratic way. The example of the road building in Kdong is the best evidence that - at least in this village – the meeting was taking place in a participatory and democratic way and that CRS was really willing to respond to the wishes of the meeting by providing laterite instead of culverts. In several villages people were still able to recall this meeting, although it must have taken place several years ago. This is quite remarkable when considering the number of village meetings (of all committees) that take place in a village in general.
The third level of participation is the participation of villagers in carrying out specific projects: mainly digging wells and in the case of Kdong also the construction of a road. There were cases in which good cooperation was reported and places where this was not the case. However, we have got enough evidence that a small group of families can take up a common task and perceive the outcome as common property. Nevertheless, conflicts around scarce goods are always likely to arise. Therefore, we think the process could benefit from the development of a conflict resolution or mediation agency or mechanism that could deal with such disputes.
The
cases where the well digging did not have good results seemed to be connected
to the decision of the place where to build it and who would take care of
it. A logical place/space for deciding
upon those issues, would be the village meetings following the first one
mentioned above.
This brings us to our next point: to what extent can we speak of the village meetings following the first meeting in which the priorities are set, as places where people can and will speak out and are really heard? The introduction of formal democratic processes such as fair and secret elections and majority vote are the first stage. Consolidating democracy in daily practice is a second one.
The
research findings showed that one of the main reasons for villagers to attend
the meetings, was the hope of getting something out of it for themselves (or
being afraid of losing a chance when not going). The meetings are important places where
potentially limited and strategic goods are distributed and where decisions may
be taken about their allocation. We have
some indications to believe that the decision about whom is going to receive a
well first and where this well will be located (potentially very strategically
and politically sensitive questions) may not always be taken in the meetings by
the villagers themselves. According to
some informants this decision was made by the VHC and the 'higher levelf. We do not know to what extent such important
decisions are taken in the meetings, since the perception of people may be
different from reality. However, we think this should be a major
point of concern. Our sense is that
villagers are well able to distinguish between the form of democracy
(elections, majority vote) and its substance (participation in decision making
on all levels about the allocation of strategic resources). The enthusiasm of people for village meetings
would be a reflection of their perception that a sufficient degree of decision
making power were really available in these meetings.
However,
we are aware of the fact that shared decision making is not only a matter of giving
the possibilities, but also one of taking the opportunities offered. Here an important constraining factor is the
presence of the village chief in the meeting (and in general the influence of
the village chief in the whole of VHC activities). We should not forget that the village chief
is an appointed official, representing an authoritarian communist system. One of the aims of enhancing democratic and
participatory processes is to try to break into the all encompassing power of
the local authorities and give the people a chance to have a say in the
developments that affect the future of their village and that affect their
personal lives. We are very much aware
of the sensitivity of this subject and will come back to this later on.
Another
constraining factor is the role of Angkaa
as perceived by the villagers. If
meetings are perceived as a major Angkaa-device
to get things done, the meetings may not develop into places where real and
free sharing of opinions can take place, and where the villagers will feel free
to make decision of their own.
Activities seem to take place especially when CRS comes to the village;
this can partly be explained by the fact that CRS brings material which makes
it possible to start concrete activities such as digging wells or building
latrines. However, a lack of motivation
from the part of the VHC-members may, to a certain extent, play a role as well.
The meetings often seem to be a place where the village chief and the CRS-field
staff play the most important, or perhaps the most visible, roles. Few villagers could remember the roles of
VHC-members in those meetings.
Many of the above
mentioned findings were the same for all villages. The main difference we found is that the
villagers in Prey Toteung I and Prey Sangha mostly know about the existence of
a VHC. Prey Sangha was different from
the other three villages in that the villagers seemed to be more confident
about the future of the VHC.
It
is still a bit too early to be able to speak of a recognizably positive impact
of women taking active part in committees.
However, it is likely that it will be positive in the long run. One important factor to take into account is
that we have the impression that meetings in general (not only health related)
are for at least 50% attended by women, one of the most important reasons being
that men are often working outside the village during the time meetings are
held.
gThe
linkage of communities to health services is one of the key principles of
Community-Based Primary Health Careh, according to the Implementation Guide
CRS/CBPHC, and this linkage must be gsustainable and responsive to the health
needs of the communityh (Implementation Guide CRS/CBPHC, p. 145).
In order to achieve such a linkage between the village level and the
commune level, CRS set up Co management / Co-financing committees (CMCF). The purposes of the committees are, amongst
others: to facilitate the flow of information from the community to the Health
Center and vice versa, and to create a system for community gownersh of the
Health Center to participate in management and financing of the Health Center
(Implementation Guide CRS/CBPHC, p.
146). The committees consist of
two Community Representatives (CR) from each village served by the Health
Center (one man, one woman) and two Health Center staff. The villagers elect the CRs. Although the CMCFs were established only from
1998 onwards, the Health Centers show a dramatic increase in numbers of
patients.
We
talked to the Community Representatives (CR) in Kdong and Prey Sangha (Kampong
Sromor and Prey Toteung I do not have CRfs yet; we were for a too short time
in Knach Romeas to have a look at the functioning of the CR in that village).
In
Kdong we talked to the female CR. She explained us that the male CR stopped his
activities as a CR because of lack of time and money. The CR in Kdong does not have any medical
background. According to her, the
villagers mainly elected her in 1998 gbecause I always showed up in the
meetings.h She told us that her main duties are to visit sick people and tell
them to go to the Health Center. But she
added that when she is busy, she has no time and stops this activity. In the CMCF-meetings, the health center staff
mainly wants to get information from her, such as the diseases in the village,
how many people go to private practitioners, whether the fees are suitable,
etc.
She did not attend the meetings the last two months, because she was ill. However, during the interview she repeatedly stressed the fact that she has to pay for her own transportation to the Health Center and that she does not always have enough money to go. This suggests that the reason of her absence may not have been illness, and may occur more often in the future.
The
CR had only vaguely heard of the VHC: there was no relation between her and the
VHC.
The
vice-chief of the VHC knew the CRs, but another member of the VHC had never
heard of them. There is obviously a lack
of coordination between the two, which could easily be remedied.
When
asking the villagers, we found out that almost no one knows about CRs. Even after an explanation from our side, most
villagers assured us that Kdong does not have such representatives. Even the niece of the CR we interviewed –
living almost next to the CR – assured us that she was not involved any such
activity. All our informants, except
one, told us they go to the private practitioner when ill. One informant told us that a man and a woman
in the village can help people go to the Health Center by asking the Health
Center to waive any fees. There probably
is some vague understanding of the idea of a CR, without specific knowledge of
who serves in this capacity.
The
situation in Prey Sangha was different.
In this village we also interviewed only the female CR. She has a medical background as Village
Health Activist in the past and was trained by CRS as TBA. Besides, she works as a private
practitioner. She is also a member of
the VHC. She described her role as
follows: informing the Health center about diseases in the village and
informing the villagers about vaccination programs, medicine, and fees and
services at the Health Center. She told
us her activities included going house-by-house, gathering people in small
groups, or usingVHC-meetings to inform people.
Most
villagers know the woman who is CR, but apparently more as a private
practitioner and someone gwho works at the Health Center and can give injections
and vaccinationsh, than as a key informant who informs people about policies
and fees at the Health Center. Only one
of our informants could remember ever having received information about fees,
but mentioned someone else as the informant than the two CRs.
We must admit having a problem in drawing any conclusions about the CMCF. Our findings suggest that the activity of the CRs is not well known, at least in Kdong. But the dramatic rise in patients at the Health Centers indicates that somehow information is reaching villagers. Obviously, the CMCF somehow managed to overcome the natural mistrust of the villagers regarding Health Centers. It was beyond the reach of this study to approach this part of the research in another way (i.e. a tracer-study of people who visited the Health Centers in the past few months). However, we think it is worthwhile to try to get a deeper insight into the dynamics in play here.
When
talking about participation it is most important to try to get an understanding
of and insight into Cambodian culture and society. What are the occasions in which Cambodians
get together to cooperate, how do they mobilize resources and how do indigenous
forms of cooperation appeal to the villagers? Are they willing to work for the
common benefit of the community, and are there things we can learn from it when
entering a village with the aim of setting up a program based on participation
and cooperation?
We
tried to find the indigenous forms of cooperation in the four villages, as well
as the main key persons behind those activities. We found quite some diversity among the four
villages with regard to both the number and activity of key persons in the
communities and the level of cooperation among villagers, whether in a more or
less organized form or not.
We
will discuss both issues (key persons and indigenous forms of cooperation)
together for each village because they are closely linked to one another.
The
research team found the lowest level of cooperation in Kdong village. Many villagers talked about the past with a
slightly nostalgic feeling: we often heard the names of two important key
persons in the past, especially the former commune chief who used to live in
the village and was a great initiator of many projects. He was considered as a real leader who called
villagers to a meeting to discuss his plans and ask for contributions in kind,
labor or money. He was able to make the
projects (such as building a road) attractive to such an extent that men, women
and children, and even people from nearby villages would join to help. All villagers talked about the past as the
time of the real leaders, whereas nowadays the village seems to lack such key
persons. One informant stated that this
kind of cooperation doesnft happen anymore without the involvement of Angkaa: gAngkaa has to create the idea.h
When
we asked villagers whom they consider as key people in their community, most of
them replied that there are no key people, other than the village chief. Further asking sometimes elicited one or two
names, but those names would seldom be the same for different informants. Sometimes Chah
tum were mentioned, but they only seemed to be called upon in case of
conflicts. Mistrust among people was
mentioned several times as the main problem preventing cooperation. When we
asked the people whom they would turn to for help if they had a problem, the
answer would be that gwe solve our own problemsh, mainly within the own
family and sometimes with the help of a neighbor. Only in case of conflicts people would turn
to the village chief and Chah tum.
We
found no other forms of cooperation without an NGO involved, than individual
contributions to a family organizing a death ceremony. Not even occasionally for constructing a
house, or helping with someonefs harvest.
Kdong
does not have a pagoda: villagers go to the nearby pagoda in Phnom Sampeu. That pagoda has a Wat-committee, but this
committee seems to be involved only in the building of the pagoda. The village chief is the key person for
collecting money from villagers for development projects organized by NGOs.
The
situation in Kampong Sromor was not very different from that in Kdong, although
there was a little more conformity in key persons pointed out by villagers than
in Kdong. The most respected persons are
the acaa and some Chah tum. They are known for leading villagers to join
religious ceremonies at the Pagoda in Choe Tiel (Kampong Sromor does not have a
pagoda either). They are sometimes also
involved in raising money from the villagers for building a road or other village
projects. But as in Kdong, the people in
Kampong Sromor told us they would basically solve their problems within the own
family: gwe can help ourselvesh, was the much-heard adage. Only in case of conflicts, the village chief
would be called upon, as well as Chah tum
playing part in conflict resolution basically as witnesses.
Some
informants complained that the Chah tum
in the past used to be more active in the village, but nowadays mainly worked
for the development of the Wat. Our
informants recognized that the Chah tum,
as in the past, are still the ones with ideas and initiatives, but they are
gslowh. They do not have the energy
and the materials that the Angkaa
has.
The acaa in Kampong Sromor blames foreign organizations for changing the tradition of mutual help, such as exchange of labor or draft animals. He claims that since efood for workf programs were started in this village, it has become more difficult to ask peoplefs contributions without paying them (either in food or money). He admits that poverty also plays an important role: people are too busy trying to earn a living. Nevertheless, he tries to urge people to contribute money for community activities, especially for road building. Although the main reason given is bon craen, gaining merit for next life, it mainly leads to the betterment of the community. He is afraid that people will forget about the importance of bon craen. Another informant, chief of VDC, complains that people are more and more often only thinking about themselves. He especially blames the rich who are often less willing to contribute than the poor. Two villagers see the main reason behind the decline of exchange of labor rather in the fact that each family has less farming land than in the past. People can do everything by themselves now and donft need the help of others anymore.
Probably
there are more factors playing a part in the slow disappearance of mutual help.
Other
villagers praise Angkaa. In the
recent past nobody had the idea of joining forces to get things done for the
betterment of the community, mainly because people were too poor to spend time
for anything else than earning a living.
But since Angkaa came, people
feel they themselves can do things for the village.
The
village chief sometimes raises money or other contributions from
villagers. However, most villagers
admitted that they prefer to give money to monks or the acaa, especially when it is used for religious purposes. The main
reason they give is trust in monks and acaa
and gaining merit. Monks and acaa are occasionally involved in
raising money for village construction works as well, especially roads. Once the VDC and village chief were not able
to complete the construction of a road.
The acaa turned to the abbot
and the Wat-committee in Choe Tiel. With the help of two monks and a
loudspeaker they were able to collect money needed.
As
in Kdong, we found no indigenous forms of cooperation or association, other
than ceremonies organized by the acaa
for religious purposes.