Chained-up in Cambodia

Kong Chhoeung, 53, has been chained to his bed of bamboo slats for 13 years in Treng Troyeng — a village in Cambodia. Gaunt and weak, he is shackled at the left ankle; the chain is too short for him to walk.

He goes to the toilet by crouching on the ground next to where he lies. His older sister, Kong Mom, cleans up his mess, brings him food and is his only caregiver.

When he was about 40, Chhoeung showed signs of mental illness and grew violent. He started attacking his family and sexually assaulting girls who passed by the homestead. Then he tried to burn the house down.

In a country almost devoid of mental health services outside main cities, Kong Mom’s only recourse was to chain up her brother at home, for his safety and the safety of those around him.

Worse yet, Chhoeung’s younger brother, 38-year-old Kong Tha, also became mentally ill, and he too has been chained up for the last year a few yards away, out of the sight of his elder brother. Kong Mom, a food seller, looks after both of her chained brothers.

"I feel angry about this situation," says Father Kevin Conroy, a Maryknoll priest associate who has been working in Cambodia for 10 years. "Local Catholic priests often tell me about mentally ill people in their parishes whom they are unable to help … these are the poorest of the poor."

Mental illness is a widespread and under treated in this Southeast Asian nation that is still recovering from the trauma of the Khmer Rouge government’s reign of terror under leader Pol Pot. 

At least 2 million people died as a result of the regime’s hyper Maoist policies. Recovery has been slow thanks to the following civil war, international ostracization under communism and current corruption.

Mental health has not been a priority. Today, the government spends a mere 0.02 percent of its total budget on it.

"The Maryknoll Mental Health Team grew out of my years teaching at Phnom Penh University in the Master's program for clinical psychology," says Father Conroy. "The students got together and we decided to start a project that would help the mentally ill and educate others in the community."

The 61-year-old priest has a background in mental health and social work. He served in mission in El Salvador during times of violent upheaval from 1989 to 1995 and went on to earn a Master’s degree and then a doctorate in clinical counseling before coming to Cambodia.

 

Father Kevin Conroy, visits a person who has been mentally ill for five years and has been chained due to his aggressive behavior. (Photo supplied by Maryknoll Magazine)

One of Father Conroy’s former students, 27 year-old Be Bunnary, has been working with his Maryknoll Mental Health Team for three years. "[Rural] people do not understand what mental health is," she says.

"When we hear about a person with mental illness, we visit their home, conduct interviews and hold counseling sessions," she continues. "If necessary we take them for hospital treatment."

Many Cambodians view the mentally ill as being possessed by evil spirits, Be says. "They would have cold water poured over them, get beaten with sticks or sometimes burned with fire to expel the bad spirits," she says. "None of this works. They often get injured and become even more sick and depressed."

The Maryknoll team encourages families and patients to seek treatment at hospitals that have a psychiatric department, as not all of them do. Little by little they are achieving results, but the problem is a protracted one.

Patients usually return home to be chained up again, albeit in a calmer, sedated state. A lucky few go on from the hospital to receive care from the Missionaries of Charity who have a residential rehabilitation center for such cases in the capital, Phnom Penh.

The Maryknoll program stresses the importance of involving not only the families of the sick but the entire community. "When we come back a couple of times to visit [a sick] person, the whole village seems to get better, their spirits rise and the feeling of hopelessness is dispelled," Father Conroy said.

Father Conroy involves village leaders and parish workers in basic training to understand and deal with mental illness.

"Before, people would not talk about mental health problems due to the shame and stigma attached," says Leng Hong, a parish worker in Kampong Speu who received such training. "[People now] understand the problems of mental health."

This is an edited version of the article that also appeared in maryknollmagazine.org.