Saturday, May 31, 2014

What To Do with A Cambodian Education

My step-son is about to graduate high-school in June. He is attending one of those private schools that sprang up like mushrooms in Cambodia, although this one has been around a few years. When we enrolled him there 2 years ago (after we had researched the background and interviewed the principal) we thought he is on the way to a better education than what he would get in a public school and would pave the way for a decent college education and a good job here after that.

In fact, he has been getting a better education insofar as they offer an English language curriculum; the Khmer classes are a sort of an add-on. The main emphasis there is on that international program. He had not been doing so great at the previous school (Zaman); he simply didn’t like it there.  Well, the change didn’t help much either. He did like his school in the U. S., but mostly for its athletic program. Academics is not his thing. Let’s just say he is not the best student.

Initially we also thought that he would graduate from a school that would have an internationally recognized diploma. Fact is that though the school had applied for international accreditation it obviously did not pass muster as now they simply bestow an in-house diploma on their students. Also, the sort of funny thing about this is that their 12th grade students shrank from initially 8 down to 3, 2 Koreans and he. Most of the more affluent parents had sent their children to Australia or the U. S. for their high school diploma. After paying dearly for this quasi-education we will be left with a diploma that is recognized only by a handful of Cambodian institutions. If he were to go abroad he would have to take an additional high school year and possibly graduation there to qualify for college admission;  this apart from being able to show qualifying SAT or ACT scores, which have become the yardstick internationally to prove one’s aptitude. I am sure many parents are faced with the same dilemma. Your offspring is an average student at best and now we need to search for something that both fits their abilities and, not the least, meets with their enthusiasm. For most young people it is hard enough to choose the right studies or profession. Most people change careers at least once, some twice or even three times, and that includes me.

Aggravating this whole situation is the fact that Cambodia’s job market does not really offer many opportunities for college graduates, not to mention just high school graduates. A simple high school diploma is not worth much in the West, so one can imagine what you can with a Cambodian diploma here.  After college, only the brightest will find a decent paying job.  They may even get a scholarship abroad.

Here again we can see one of the most striking failures of the government in the past decade. It has not invested in its education system. The population growth is quite remarkable as most families still regard the number of their children as a guarantee for their support when they have retired. A huge 52 % are younger than 24; that includes 31% under 14. This is the number of children that will be  and are in  need of an education and the jobs afterwards.  An unqualified  workforce does not attract qualified investors, that is, investors that would bring more than garment processing into the country. What we have seen is an emphasis on agriculture, which in itself is an important sector for Cambodia. But huge tracts of land have been granted to foreign, mostly Vietnamese, companies for rubber plantations. This industry does not provide qualified jobs (I know about that; I own one, albeit small). Is does not create added value to the economy either. Profits are repatriated and the workforce is below minimum wage labor.

Tourism is the next largest foreign exchange earner and provides about 20% of the jobs in the country. Again, this is minimum wage labor for the most part and the workforce is mostly unskilled and needs to be trained on the job. It is very hard to find halfway skilled employees in the hotel and hospitality business. Lower and middle management is usually recruited from expatriates, e. g. Filipino. The BA in tourism is not much to speak of. Graduates hardly know anything about accounting or marketing their product abroad. But they do know Angkor history.

All this leads me to believe that my initial estimate of a generation (about 20 to 25 years) it would take Cambodia to catch up with its Western neighbor needs to be recalculated.  After all, Thailand took about 30 years to raise itself from developing country to a threshold economy. Judging from the progress this past decade Cambodia, despite having made great strides in its overall development, will take more than those 30 years to emulate their neighbors. Too much precious time is lost in this most important field – education - for the future generations.

Coming back to my step-son;  considering this situation we are hard-put to point out the right direction to him. I must admit that I personally misjudged the prospects in Cambodia for younger people. We just may have to find a way to send him abroad for studies that will give him the tools to make a decent living when he comes back, if he then comes back at all.

Thursday, May 15, 2014

Health Care - A Non-Existent Priority

I had written about some of this before under the title, “When you need a doctor”. This past week, my family and I were faced with a crisis. My step-daughter, aged 24, needed to be hospitalized in an emergency. She was suffering from abdominal pain and blood loss. She had first gone to one of those omnipresent neighborhood clinics. They gave her a drip and then just left her to her own devices. Nobody checked even further about the blood loss.  When we heard this we immediately had a friend of ours take her to the Calmette hospital emergency room. Needless to say, nobody would look at her until we had made payment for the initial exams. She was then admitted and taken to the gastro-enterology department where, you probably guessed it, she got hooked up to a drip. This is what they always do in Cambodia, whether needed or not. But they arranged for an immediate blood transfusion as the tests had shown some serious loss. If it had continued it could have led to her bleeding to death.

However, they first wanted to find a donor. When my friend told me about it I wondered how they could find someone with the same blood type so quickly. They do have a strange system in place here. Anybody can donate blood which is then exchanged at the blood bank for the badge with the right blood type. This way they ensure that the blood bank does not run out of blood. Obviously though, there aren’t enough donors. In an emergency you can hardly find a donor right away – so this is the big drawback to this system, and one is left to wonder whether they would just let the patient languish at the hospital and possibly let her/him die? We did have two donors available so never learned what they would do if we hadn’t.
They also performed a gastroscopy to determine the cause of her pain. The diagnosis wasn’t clear enough. When we talked to the doctor the next day he said he would conduct a CT scan and another gastroscopy and possibly a colonoscopy as well. It goes without saying that we needed to settle all the bills first. The room was $35 a night, exams, medication, etc., another $100. So we paid roughly $200 for two nights. The blood transfusions cost only $10, as we had provided the donors.

All planned tests and scopes would probably run to more than $500. The only thing that deterred us was that the physicians kept us waiting forever. When we showed up the next morning, no doctor was in sight. When none had showed up after an hour we just discharged our daughter ourselves. We would consult a private specialist. After all, all these procedures can be performed at a number of hospitals in Phnom Penh now.
We learned of one GI-specialist who had got his degree in France. He knew what needed to be done. Long story short, we did go to the Calmette again because they had the best anesthetic facilities. In the end, we had to cough up more than $1,000 for this treatment. This is still a downright bargain compared to the $7,000 you are charged in the U. S. as a self-paying patient, or the more than $4,000 the insurance would pay out.

What this amply demonstrates is the glaring lack of any functioning health care system in Cambodia. People who cannot afford this will be left out in the cold. One does not need to be a socialist, as the right-wing segment in America would say, to call for universal health coverage; and that is the government’s job and responsibility. There has been talk of such as system but so far only members of the armed forces get free health care. The quality of that I cannot assess but I wouldn’t be surprised if they lacked both basic knowledge and facilities. I know of one 1-star general who suffered from diabetes. They didn’t have enough insulin in stock. He had to rely on relatives to send money so he could buy it on his own. Eventually he died from complications.

The population in general cannot afford the $1000 per year or so it costs to buy some private health insurance policy. The coverage there is minimal to begin with. I say it again, from being a tolerant observer of this government I have turned into a very disenchanted bystander. They do build roads that are in serious disrepair after only a short while and schools that deliver a questionable education but one of the foremost jobs just isn’t even on the horizon.