GLOBAL HEALTH PERSPECTIVES
CULTURE & HEALTH
Cambodia
Culture and Health
Common Cultural Practices
Cultural Tips for Travelers
Gender Norms
In Cambodian culture, the role of women aligns with ancient Khmer beliefs in which the apsara, or goddess, was believed to be the ideal woman and an example of how women should behave. Women are expected to obey their elders and to remain gentle, soft-spoken, and never complain. Unfortunately, this continues to be a problem, as many women do not complain of pain or illness and do not seek medical treatment. Women do not speak freely with men and are expected to take care of the home and children. Interestingly, women usually handle the finances of the family and are primarily responsible for educating children about moral, social, and cultural issues. Men usually work in order to provide income; they are also expected to be involved in the community and religion. Overall, men do not experience as much pressure to conform as women. In Cambodian culture, it is believed that any offense committed by a man can be corrected; however, a woman would be ruined and lose the respect of her family and community (Wetzel, 2008).
Culture is “a set of rules or standards shared by members of a society, which when acted upon by the members, produce behavior that falls within a range of variation the members consider proper and acceptable” (Skolnik, 2016, p. 146). Culture affects health in many ways, including an individual's beliefs about illness and the degree to which medical services are used for treatment.
In Cambodia, if Western medicine is available, it will typically only be utilized if all traditional remedies have failed. This is due to the high cost of Western medical services, the lack of health care facilities and professionals, and the fact that most drugs are available over-the-counter at a lower cost. Furthermore, Cambodians have traditionally treated illness through self-care, herbal remedies, hot-cold balance, and other rituals. When using Western medicine, Cambodians expect to be given a medication that will cure their illness almost instantly, and they often stop taking medications, such as antibiotics, if they feel that they are no longer experiencing symptoms. Cambodians believe that if there are no symptoms, there is no illness. Some Cambodians who seek treatment from Western medicine believe that the prescribed medications are for Westerners and are too strong for them, so they will self-adjust the dosage (Cambodian-Australian Welfare Council [CAWC], 2010).
Cambodians will often seek Khru Khmer, traditional healers, to use herbs and magic to cure illness. Conditions that they are called on to heal range from broken bones to mental illness. Many Cambodians believe that illness is a result from an evil deed performed in a past life, or bad karma. They also believe that spirit possession, spells, and neglect of rituals can cause illness (Wetzel, 2008; CAWC, 2010). Most Khru Khmer learn their craft from family and each other; interestingly, however, the Cambodian government opened the National Center of Traditional Medicine, which allows individuals to train as traditional healers (CAWC, 2010).
Amulets: In Cambodia, young children can often be seen wearing amulets and beads on strings; they are usually worn on the neck, wrist or waist. These amulets are believed to protect the child from harm, both physically and spiritually. Unfortunately, it has been found that many of the amulets and beads placed on the string are made of lead, which has led to heavy metal toxicity in the individual. At high doses, lead poisoning can be fatal; it can also cause other symptoms, such as neurologic changes, developmental delays, and kidney damage (Wetzel, 2008; CDC, 2014).
Rice wine: Rice wine is a locally brewed drink in Cambodia that is believed to have medicinal properties. It is typically infused with herbs, tree bark, or animal parts. Brewers have recently started adding insecticides and other deadly chemicals to the drink due to a demand for higher alcohol content. The drink is inexpensive, so it has widespread use; this has affected the greater population’s health negatively, as the additives have caused blindness, death, and other illness (Wetzel, 2008).
Smoking: Smoking is infused in the Cambodian culture, though it is typically more of a masculine activity, as 69% of men and only 10% of women smoke (Wetzel, 2008). Traditionally, cigarettes and cigars have been given as gifts and offerings. Sometimes, smoking is even used to keep insects away from an individual. Unfortunately, this cultural practice is harmful to health, as it can cause lung and heart disease, and stroke.
Sor Sai Kjey: For one to three months, during the postpartum period called Sor Sai Kjey, the woman must stay on a bed under which a charcoal fire continues to burn. Cambodians believe that the woman has lost a lot of energy while giving birth, so the fire will help to restore her energy (CAWC, 2010). She does not bathe during this time and consumes only hot water, wine, tea, fish, and pork. The lack of hygiene during this time leaves the woman susceptible to infection, and the lack of variety in nutrition can cause metabolic disturbances. During the first three days of this period, other women breastfeed her baby and continue to care for the child for the rest of the duration; unfortunately, this practice can hinder establishing a bond between the mother and child (Wetzel, 2008).
(Source: https://ssl.c.photoshelter.com/img-get/I0000c54QgHxeTUA/s/850/850/020maternity-cambodia.jpg)
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The traditional greeting in Cambodia is a Sampeah, which is palms pressed together in front of the chest and a slight bow. This is usually accompanied by the words “Chumreap Suor” to say hello. The lower the bow and the higher the hands are held, though they should never go above the nose, the more respect is being shown. It is considered rude to not return the gesture when greeting a Cambodian (Waitemata District Health Board, 2015).
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To show respect, address men with Lok, or mister, and Lok Srey, or missus, followed by the individual’s given name.
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Cambodians consider it bad luck to offer too many compliments or praise to a child who is not wearing a protective amulet (Waitemata District Health Board, 2015).
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When sitting, do not point your feet toward any other person or image of Buddha, as this is viewed as impolite (CAWC, 2010). Similarly, it is considered rude to step over an individual’s feet or legs when they are lying flat. Feet are believed to be the lowest valued body part (Wetzel, 2008).
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As most Cambodians practice Buddhism, they follow the belief that the head is the most sacred part of the body. As such, never touch another person’s head (CAWC, 2010).
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Refrain from touching during interactions with Cambodians, as they are not accustomed to this, especially touching from the opposite sex (Wetzel, 2008).
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Do not sit or stand at a level that is more elevated than an elder, as this is considered disrespectful (CAWC, 2010). Furthermore, it is considered impolite to hold eye contact with an elder or anyone else who is considered a superior (Wetzel, 2008).
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Never raise your voice or embarrass an individual in public; this is considered impolite and a sign of a negative personality (CAWC, 2010).
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Most often, you will see men wearing trousers, shirts, and sweaters; women wear a blouse and skirt, or sampot. Both males and females often wear a traditional checkered scarf, or krama, that is used for many purposes, including a turban, towel, or shawl (CAWC, 2010).
(Source: https://i0.wp.com/181.224.157.53/~bhoomisc/wp-content/uploads/cambodian-clothing-sampot.jpg)
(Source: LUSH Cosmetics North America. (2015, March 7). Stand with the women of Cambodia [Video file]. Retrieved from https://www.youtube.com/watch?v=pO49oaLD1IM)