HEALTH & WELFARE

INTERNATIONAL COOPERATIONTO SECURE THE HEALTHY LIVES OF

CAMBODIAN
MOTHERS AND
BABIESFor over two decades since the end of Cambodian civil war,
Japan has been providing support to the country in an effort to improvehealthcare for both mothers and newborn infants.
In Cambodia, childbirth isreferred to as chlong tonle, meaning“to cross the river.” The expression
compares giving birth to crossing
a large river, in that you neverknow when you might lose yourlife in the depths and fast-flowing
waters of the river. By the end ofthe Cambodian civil war, many
medical facilities had fallen into
disrepair, and many healthcare

professionals and midwives had
lost their lives. A large number of
expectant mothers in Cambodia
thus had no choice but to givebirth at home, and as the namechlong tonle implies, childbirth
was a life-threatening event forthem.
With one of the lowest maternal
and neonatal mortality rates in theworld, Japan was quick to reachJAPAN
CAMBODIA

out to Cambodia, a country thathas been rebuilding its maternaland child health system ever since
its collapse during the civil war.
Japan sent a medical adviser toCambodia’s Ministry of Healthin 1992, one year after the war
ended. And in 1997, it provided
grant aid for the construction of
the National Maternal and Child
Health Center (NMCHC) in thecapital city of Phnom Penh. The
NMCHC currently has a clinicalfunction with about 150 beds
in its obstetrics and gynecology
and neonatal departments, alongwith an administrative functionthat manages maternal and childhealth, as well as a teaching
function that provides necessary
training for midwives, doctors,and students from all over thecountry. With all these functions
Doctors learn how to use ultrasound to checkthe baby’s heart in the Neonatal Care Unit at theNMCHC. Midwives, doctors, and students
from across the country have been trained there.

combined, the NMCHC plays acentral role in maternal and childhealthcare in Cambodia today.
Japan’s support, however, is not
limited to just the constructionof the NMCHC. It started
running a technical cooperation
project in 1995, before the facility
was built, to improve hospitalmanagement, clinical services,and training in Cambodia, withthe aim of developing systemsand human resources for theNMCHC. Since then, Japan has
been continuing to provide suchsupport, while understanding
the needs of the local people.
This support has contributed toa drop in the maternal mortality
ratio in Cambodia, which was
1,020 per 100,000 live births
in 1990, falling to 437 in 2000,
and to 170 in 2014. It thereby
achieved, ahead of time, the goalof reducing maternal deaths to
250 per 100,000 live births by
the year 2015, as set out by theUnited Nations Millennium
Development Goals. Currently,
over 80% of expectant mothersin the country give birth withskilled birth attendants such as
trained midwives, and awarenessregarding giving birth in healthfacilities is growing, even in rural
areas where many babies have
hitherto been delivered at home.
Moreover, a project was
launched in Cambodia in 2016
to encourage continuum of carefor mothers and their babies.
The project provides training
about necessary care for newborn
infants, such as teaching adequate
timing of cord clamping and giving

A mother with her baby after giving birth at the NMCHC. About 7,500 babies are born each year at
this health center.

advice on initial breastfeeding
just after birth. It also provides
training about treatment methods
for premature and sick babies, aswell as follow-up care for mothers
and their children after leaving thehealth facility. The project’s chief
advisor, Dr. IWAMOTO Azusa,
talks about the importance ofthe project. “The problem about
giving birth is that we don’t know
when a normal birth will become
abnormal. That’s why continuumof care before and after birth isneeded, not just during labor.”
Dr. Iwamoto describes therelationshipbetweentheCambodian staff members who
have been working to improvematernal and child health inresponse to local needs, and theJapanese staff members who
have been helping them withtechnical support, as “colleagues
who have worked hard together.”
She continues, “We share theidea of cooperating to improve
Cambodian maternal and childhealth, rather than the idea ofsupporting or being supported.

We are working together on
projects so that mothers andtheir babies can live a better life
together.” The strong bond thathas been built across borders inhope of a healthy life for mothersand children will no doubt
continue to bridge the river for
many years to come. Top: Built in 1997, the NMCHC has been affectionately
nicknamed “the Japan Hospital” by locals.
Bottom: Dr. IWAMOTO Azusa (front row, right) with
Cambodian doctors of the Neonatal Care Unit at theNMCHC.