Reflections on a Learning Tour of Cambodia with CARE

At an integrated health center in Siem Reap

At an integrated health center in Siem Reap

Between November 21-26, a delegation of international influencers and policy makers participated in a Learning Tour in Cambodia hosted by the humanitarian antipoverty organization CARE. The delegation included three U.S. Members of Congress (Rep Kay Granger R-TX; Rep Ander Crenshaw R-FL; and Rep Mike Quigley D-IL); two Members of Parliament from Australia; representatives from the media, nonprofits and private industry; and AU’s executive in residence, Anita McBride.  McBride participated as a representative of the academic sector and as a former member of the George W. Bush administration, which established and implemented innovative U.S. foreign aid programs, including the President’s Emergency Plan for AIDS Relief (PEPFAR), the Millennium Challenge Corporation (MCC), and the President’s Malaria Initiative (PMI).

Driving home the importance and impact of CARE’s work

As a global organization whose mission is to eradicate poverty, CARE operates in 90 countries, implementing health, education and development programs. CARE focuses much of its work on women’s health and education, based on findings that educating women and improving their health is one of the most effective ways of empowering communities and improving people’s standard of living in the developing world. Part of CARE’s overall strategy is to maintain close ties to societal influencers– policymakers, educators, and communicators, who, it is hoped, will be most effective in spreading the word that investments in foreign aid are having a lasting impact. Through a grant from the The Gates Foundation, CARE’s Learning Tours play a vital role in its communication strategy by taking these influencers “off the beaten path” and into direct contact with people on the ground who are benefiting from these investments. Another objective of the tours is to demonstrate that the workload is being shared between various governments—including that of the focus country—private industry, and non-governmental organizations.

Cambodia is considered a success story and therefore an ideal destination for CARE’s latest Learning Tour. CARE began operating in Cambodia in 1973, providing emergency relief and preparedness, health, education and development assistance. Since then, the country has made progress, with its government devoting significant resources to women’s health and maternal and infant care and HIV/AIDS prevention in particular. The Cambodian government is still dependent on foreign aid, however, with 30 to 40 percent of budget coming from donor funds.

On its Cambodian Learning Tour, the CARE delegation spent time in both the capital city of Phnom Penh and in Siem Reap, a city in the northwestern part of the country near the ancient Buddhist holy site of Angkor Wat. The tour started in Phnom Penh, where the group received a briefing by local technical experts, representatives of CARE and USAID, the Centers for Disease Control (CDC) and the US Embassy, and by Cambodia’s  Minister of Women’s Affairs, before moving on to site visits.

Empowerment and self-determination

Touring a Levi Strauss Touring a Levi Strauss garment factory with David Ray, CARE's Vice President for Advocacy

Touring a Levi Strauss garment factory with David Ray, CARE’s Vice President for Advocacy

One of the first stops was to the Levi Strauss factory in Phnom Penh, where the company operates a health education program for its workers. According to McBride, the company’s “strategic business model involves improving the health and working conditions of its employees as well as providing fair wages and good working conditions.” McBride found the health education program particularly encouraging. She said, “Here are women working very hard in the garment industry to provide for their families and improve their lives, but their employer is also providing them an opportunity to learn about another important aspect of their life, and that’s their health and their decisions about having families.” She went on to say, “Our delegation was impressed by this model workplace program that provides an environment where they can lead this discussion amongst themselves with a facilitator and in a safe space.”

Another site the group visited was a Village Savings and Loan Association (VSLA) program in Sre Ambel. The VSLA program is a community-based and community-led microfinance initiative in which members set policy and determine where and how much money will be loaned. One benefit of these VSLAs is that they help make financial knowledge and decision making power available to women (McBride first visited a VSLA program in 2010 on a CARE Learning Tour to Sierra Leone).  VSLAs now operate in 60 countries and reach more than 9 million people.

At a Village Savings and Loan Association meeting with Rep. Kay Granger (R-TX) and Musimbi Kanyoro, CARE Board Member and President and CEO of the Global Fund for WomenGranger (R-TX) and Musimbi Kanyoro, President and CEO of the Global Fund for Women

At a Village Savings and Loan Association meeting with Rep. Kay Granger (R-TX) and Musimbi Kanyoro, CARE Board Member and President and CEO of the Global Fund for Women

The delegation next flew to Siem Reap for visits to a women’s health clinic and an integrated health center. At the women’s health clinic, McBride was impressed not just by the coordination of the medical care the patients received, but also by the safe environment the clinic provided and its approach to empowering women with the education needed to make the various maternal and child health decisions that affect their lives. She said, “What I liked about the session we attended with a young woman we met at the clinic was that she took this information she had learned and was able to have a conversation with her husband about the spacing of their children. It was a family decision that they were making together.”

The integrated health center the group visited for mothers, infants, and young children, was one of the many Centers around the country that is now providing a coordinated “continuum of care,” from prenatal and maternal care to health visits throughout the first few years of a child’s life. Once again, McBride was encouraged by the emotional support patients received in a safe and healthier environment where entire families could be together around the clock while waiting for the birth of a baby. “There were generations – mother, grandmother, aunts, cousins, nieces, sisters and young children, who were waiting for the mother to have her baby and be able to recover and be monitored before going home,” McBride said. This welcoming environment is important, not just to the practitioners and patients but to the entire family. McBride explained, “The Cambodian government has placed an emphasis on increasing the number of women who give birth in clinics rather than at home. Through an aggressive awareness campaign and through the partnership with agencies like CARE and USAID, currently, approximately 60 percent of Cambodian women now give birth in a health center.”

With the mother, sister and child of a new mother who delivered her newborn at an integrated health center in Siem Reap.

With the mother, sister and child of a new mother who delivered her baby at an integrated health center in Siem Reap.

“We are lifted up when others are lifted.”

In addition to meeting with the US Embassy, USAID and CDC representatives working in Cambodia, the delegation also encountered other Americans in Cambodia, including Peace Corps volunteers and Fulbright scholars, one of whom was Erin Moriarty Harrelson, a PhD candidate at American University conducting anthropological research among the growing deaf community in Cambodia. Moriarty Harrelson, who is herself deaf, is working under a joint Fulbright-National Geographic “digital storytelling fellowship” and is learning how to use video, text, maps, and other visual format to document  lives of the deaf community in Cambodia.

As a longtime advocate of effective, well-monitored U.S. foreign aid and global investments, McBride believes that U.S. leadership coupled with greater cooperation between governments, private entities and NGOs, is  essential to achieving sustainable development. “What we saw in Cambodia is a good example of how aid recipients want to be partners in their development and good stewards of the development assistance. We saw programs that demonstrate how our investments are improving lives and how we are having a greater impact by collaborating more effectively with US agencies on the ground and through multi-sector partnerships.”

That revelation, McBride said, is one of the important outcomes of the Learning Tours. “Sharing that message will help build greater awareness amongst Americans who have a distorted view of the amount of U.S. foreign aid (it makes up less than one percent of the U.S. budget) and  who question whether it’s effective or valuable to our interests.” She is optimistic about the prospects for ongoing U.S. foreign aid, but emphasized the importance of educating the public about its benefits.  “Americans are compassionate and generous and are uplifted when we see others’  lives lifted up, but it’s also important we make the connection between improved health outcomes, increased economic empowerment and  greater global stability and security.”

–by Lisa Moscatiello