Mentally ill in Southeast Asian nation shackled and caged
Kong Chhoeung, 53, has been chained to his bed of bamboo slats for 13 years in the Treng Troyeng village of Cambodia. Gaunt and weak with a haunted face, he is shackled at the left ankle and never gets to walk because the chain is too short. 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 age 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 looks after both of her chained brothers and survives by selling food in the market. She earns about 50 cents a day. The 58-year-old woman is at her wit’s end.
“I feel angry about this situation, which has allowed people to suffer for so long without proper care,” says Father Kevin Conroy, a diocesan priest from Cleveland, Ohio, who has served as a Maryknoll priest associate in Cambodia for the last 10 years. “Local Catholic priests often tell me about mentally ill people in their parishes whom they are unable to help. I feel in my heart that these are the poorest of the poor.”
Mental illness is a widespread and undertreated health issue in this poor Southeast Asian country 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 were murdered in what is known as the Killing Fields in the late 1970s. With everything from infrastructure to the educational system destroyed during this period, mental health has not been considered a priority. The government spends a mere 0.02 percent of its total budget on mental health.
Father Conroy’s Mental Health Team is helping to fill this void. “The Maryknoll Mental Health Team grew out of my years teaching at Phnom Penh University in the master’s program for clinical psychology,” he says. “The students got together and we decided to start a project that would help the mentally ill and educate others in the community. It seems we have no shortage of young Cambodians who want to serve the mentally ill.”
The 61-year-old priest has a background in mental health and social work, and served in mission in El Salvador during times of violent upheaval from 1989 to 1995. He went on to earn a master’s degree and then a doctorate in clinical counseling before coming to Cambodia with the priest associates program, which invites U.S. diocesan priests to serve for a time with Maryknoll to answer the call of overseas mission.
One of Father Conroy’s former students, bright-eyed 27-year-old Be Bunnary, has been working with the Maryknoll Mental Health Team for three years and makes frequent visits to the rural areas. “People do not understand what mental health is,” Be Bunnary says. “We educate the communities so they understand. When we hear about a person with mental illness, we visit their home, conduct interviews and hold counseling sessions. Then if necessary we take the patient to get treatment at the hospital.”
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. Team members will often take patients there in their own vehicles. 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. Still, the hope is that they will one day be freed. 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. Father Conroy says the Maryknoll program needs its own treatment and rehabilitation center where patients could stay and receive ongoing care.
The Maryknoll program stresses the importance of involving not only the families of the sick but also the entire community. “When we first come into a village, the people say they have no hope,” Father Conroy says. “But when we come back a couple of times to visit that person, the whole village seems to get better, their spirits rise and the feeling of hopelessness is dispelled. Often when the mentally sick person’s condition improves and they start to work and become productive, the economy of the village improves.” So 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. “But now more and more cases are being revealed as we take interest. Village leaders are getting involved and looking for a solution. This is new. People were in darkness before, but now they are beginning to see the light as they understand the problems of mental health.”
Learn more about Father Kevin Conroy
Sean Sprague, a freelance photographer and writer based in Wales, U.K., is a frequent contributor to Maryknoll.