A harrowing but fascinating & enlightening visit to a UNESCO memory of the world site: The Khmer Rouge S-21 interrogation centre

Before reading this you need to know that it may be upsetting. That isn’t deliberate. It isn’t gratuitous. It isn’t intended. But I think it is impossible to not be moved by learning about what happened in the Khmer Rouge S21 interrogation centre & prison.

The site is a former high school which was used as the Security Prison 21 (S-21) by the Khmer Rouge from 1975 to 1979. 

We’re talking about something occurring during my lifetime. S-21 was one of at least 150 execution centres in Cambodia during those four terrible years at at least 12000 but possibly up to 20000 prisoners were killed in S21 alone.

The Khmer Rouge adapted high school to become a prison by converting classrooms to torture chambers & tiny prison cells.

Prisoners were provided with a munitions box in which to defaecate and a plastic bottle in which to urinate. Any spillage is on the floor resulted in beatings or electrocution.

Prisoners were showered by hose pipes – sometimes once every three months – and spent their time shackled to iron bars and each other in the larger chambers.

The people who were brought here – children, women and men – were repeatedly tortured and coerced into providing false confessions to “crimes” they never committed, after which they were murdered.

Medical experiments were carried out in the prison by Khmer Rouge doctors who had received four months of training – including blood draining until death and removal of organs without anaesthetic.

Physical torture, mental torture, neglect, disease, dehumanisation and outright degrading treatment occurred, it would seem, every day.

Only 7 people are known to have survived S21 and when the prison was discovered during the liberation in 1979, the final 12 prisoners who had been murdered there – and left behind – were given a proper funeral in the grounds of the compound.

This is a place of great sadness but it is preserved very carefully, very factually and very respectfully.

I believe it is important, when working in a different country from home to try and learn more about the history of the communities and the society in which they are now placed. It is only by trying to learn about this that I think it is possible to even try to understand about why people living in communities today do, or have to do, the things we see.

I’ve had the privilege over the last week to be able to speak privately to an academic lawyer working in the Khmer Rouge Tribunal:

http://www.eccc.gov.kh/en

That tribunal – properly constituted in accordance with law – is still hearing cases now of people from the Khmer Rouge who are accused of genocide and other crimes against people. What is absolutely right is that they have the right to full legal representation and to defend themselves. Their cases are handled in accordance with accepted legislation with international and Cambodian legal experts involved.

To do otherwise would be no better than the lack of human rights in S21 interrogation centre itself.

This centre is now a very calm and peaceful place.

As we finished the visit there was an old man sitting on a chair, asleep in the shade.

He was one of the seven survivors of S21. 

He deserves to sleep there, or wherever he wants to, for as long as he wants to.

Hello, my name is Andrew… in Khmer

It has been great to meet the Youth Volunteers at the Board Meeting today.

Andrew

Young people who have been teaching me Khmer as well as talking about their experiences here at the centre – what works well and what they would like to see changed.

We had a lot of laughs as I mis-pronounced my name MANY times but I can now count to THREE (four and five are a bit of a struggle at the moment), say “Hello, my name is Andrew”, say I am a Doctor, say “Thank you”… and also tell a joke (thankfully it is only two words in Khmer!).

The value of co-designing services with children and young people cannot be underestimated. I’ve seen here in Cambodia that the Youth Volunteers often have things said to them that the children and young people may be shy about telling the teachers and this can be incredibly beneficial to ensure that some of the more difficult issues facing children and young people are found out about and tackled.

Back in the UK there are many great examples of children and young people taking a leading role in policy development. Have a look at these for a few examples:

NHS England Youth Forum

http://www.byc.org.uk

Becoming a Member

 

4509 children and young people supported Jan-Apr 2016

Over the last four months, 4509 children and young people and 2219 families have been provided with support from M’Lop Tapang.

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  • 2231 children and young people from 1497 families have been supported by the Outreach Team
  • 882 children and young people are in the Back to School programme
  • Each month 309 children have been provided services by the mobile library
  • There have been 222 hotline calls
  • There are now 1017 ChildSafe members

 

From a medical point of view:

  • 8893 treatments for children and 436 treatments for adults have been provided in the Medical Clinic
  • 379 treatments have been provided through outreach visits

 

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We are currently in the process of writing up, for scientific publication, the results of research undertaken with vulnerable street-living, street-working and street-associated children and young people. Watch this space as the results will, I believe, really advance the worldwide understanding of the issues faced by vulnerable children and young people. The partnership with Salford University and The Pennine Acute Hospitals NHS Trust is crucial in helping us to move this important piece of work forwards before moving on to further academic evaluation of outcomes of the above work.

One of the new partnerships being formed here is a three year project focused on re-integration and job employment activities for children and young people incarcerated in the local prison.

There are about 286 children and young people in the prison and optimisation of their health both prior to and after release will be crucial to maximise the success of this project.

286 children and young people in prison with a problem with their water supply.

286 children and young people, in one town, who will require a huge amount of support to re-integrate them into society.

The child protection issues here are prevalent in every part of the town and it is through the recognition of the interaction between health, education, social care, vocational opportunities and justice that the best opportunities will be available to optimise the future for these children and young people.

Remembering the seven steps to better protection of the health and wellbeing of children and young people is crucial to continue to improve the lives of the people who are the present, and the future, of our global society:

1.Improve education

2.Increase employment

3.Tackle poverty

4.Decrease neglect

5.Recognise YOUR role as a community leader

6.Empower children and young people

7.Develop ChildSafe communities with children and young people at their hearts

 

Snake bites!

It’s been a day of teaching today.

The day started with a 0600am wake up and we were in the M’Lop Tapang centre before 0800am. This morning we delivered four hours of training on first aid and recognition of the seriously ill or injured patient.

We expected ten people in the group but 30 arrived which made for a lively interactive session!

We don’t teach CPR here – it isn’t right to potentially resuscitate a child to the point where an intensive care admission might be required when there is no such unit here – but that doesn’t stop us from teaching important skills to recognise and respond to serious illness or injury.

After a working lunch at the Holy Cow, I spent the afternoon talking to the outreach, education and social-work teams about the recognition of child abuse cases and the seven steps to greater protection of children and young people that I’ve learned from my work visiting different professional groups around the world.


After teaching I went straight into a videoconference discussing global health and immigration.

The team here are really pleased to have received a grant from the BMA information fund providing much-needed educational resources. I’ll try and get a photo of the books tomorrow to demonstrate why we need to build a new library here in the near future!


The first half of my meeting didn’t end until after the centre here had closed but one of the staff kindly dropped me off in the 4×4 so I’d be in time for the second half of the meeting before doing some more work on which patients might need a referral up to Siem Reap – a twelve hour bus journey away.

It’s been proper bi-directional learning today. I’ve learned loads about treating medical emergencies in resource-poor settings and have been able to pass on knowledge and skills to hopefully further develop the skills of the super multidisciplinary team here.

That bi-directional learning brings me back to snakes. I’m none too fond of our slithering neighbours. I say neighbours as they are, apparently, all over the community here.

Ravy – the amazing Nurse Practitioner here – has been teaching us about snake bites today. Something I didn’t know much about but I’m glad I learned.

Apparently the snake sometimes come to visit clinic! I only hope I’m at an outreach clinic if they do! 🐍

::gulp::

Good night!

Lead poisoning

I’ve seen some incredibly anaemic children in clinic today. One child was in urgent need of a blood transfusion. The local referral hospital has run out of blood. When that happens they need to ring around anyone they know might have the same blood group to see if they can donate.

There are lots of children here who have anaemia from many different sources:

  • Dietary – lots of children exist on little more than white rice
  • Haemoglobinopathies
  • Poisoning

For sure, there are more causes as well but the number of children here with lead poisoning far exceeds the number I’ve ever seen in the UK. Not difficulty really given the number is, as far as I recall, zero.


After clinic today we came down to a coastal village – a village where there are no toilets and limited electricity – where there are a large number of children with lead poisoning.

It’s a fishing village and the nets that are made in the village are weighted down with lead.


We’ve been learning about the challenges faced by the local community here. SicKids’ trustee Den Carter has been capturing our work this week – he’s an expert at sensitive image and video capture and over the coming months we’ll be able to talk about the amazing success stories we’ve seen this week. Success stories that I hope will encourage people back in the UK to get involved in the work of SicKids. Watch this space!
I’ll leave you with the following thought…


That photo was taken from the fishing community village. The village with no toilets. The village where there are large numbers of children with lead poisoning. The village where the mobile school goes each week to deliver education to the children, and the mobile medical team provides outreach clinics.

In the back of the photo you can see a golden beach. That beach is a private beach belonging to a Five Star hotel. People from all around the world come to visit. I wonder, when the guests are lying on their sunloungers, if they realise the stark juxtaposition of their privileged lifestyle as compared to the poverty a mere metre or two away.

I hope they venture out of their comfort bubble and make sure that some of their dollars go to the community who really need them.

Tomorrow, its first aid training in the morning and I’m giving some human rights lectures in the afternoon before preparing for the arrival of the other Board Members on Friday.

Good night! 🌜

Outreach medical support at Otres Beach

It rained today. When I say rain I really mean RAIN. Like proper rain. In buckets from the clouds above.

That’s problematic if you have to undertake your clinic on the ground but also the reason a waterproof tarpaulin comes in very handy.


Dozens of people appeared when we arrived this morning and gently jostled for first place to see our medical team under the trees. As the rain got heavier we hopped into the back of the vehicle to shelter from the increasingly heavier drops (I mean pints really) falling from the sky… and when it got too humid in the boot we were back outside in the open air to see the children who needed medical attention.

We’ve seen children with a whole range of conditions today – from things that could be treated under the trees, both surgical and medical, to those that needed to come back to the health centre with us in the car.

But in amongst all of the children was a remarkable woman. The matriarch of the community – at 86 years of age. Her husband died 30 years ago and she has lived all through the Khmer-Rouge times. I can’t even begin to imagine the things she has seen.

She very quietly sat beside me for the whole of the clinic – with a calming influence over the group that was forming. 

And when clinic was over she showed us into her house beside the road and offered us lunch.

The thing about all of the Cambodian people I’ve met on outreach is how generous they are.

Sometimes it really is those who have the least that give the most.

ChildSafe: the potential to improve the protection of children and young people in the UK

I first became aware of the ChildSafe movement when I was awarded a Fellowship by the Winston Churchill Memorial Trust in the United Kingdom. The international travel associated with this Fellowship, for life, allowed me to visit the USA, Singapore, Malaysia and Cambodia to write a report, Living on a Railway Line, aimed at turning the tide of child abuse and exploitation in the UK and overseas.

 

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It was whilst in Cambodia that I gained first-hand experience of the ChildSafe movement. I have personally seen how ChildSafe protects communities in which it is operational and also how, I believe, it could be transformational if implemented in the UK. This initiative is both inspiring and original in its nature, objectives, resource management and results. It highlights very clearly to me that tourism can be, and is, a strategic tool to help ensure protection of human rights in countries through sustainable social development.

 

ChildSafe informs communities about risks that their children and young people are facing and how to be actively involved in their protection including:

 

  • Training vulnerable communities on how they can protect their children and young people from specific risks and to prevent them from involvement in these and being a visible scheme within the whole community.

 

  • Providing training for travel, hotel, transport and food businesses (all of which have been found to be relevant in UK child sexual exploitation investigations) to allow their staff to immediately recognise and protect children and young people at risk of abuse.

 

  • Identifying and training key people in communities who want to volunteer their help in protecting children and young people. These are trained, certified and continuously monitored whilst being ChildSafe members.

 

  • Informing travellers on the most effective ways to protect and support children and young people and to be respectful of the communities that they interact with. This model, which I have seen work so successfully overseas, is very easily adaptable to an intra-country UK setting.

 

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We have repeatedly seen the difficulties that have been faced protecting children and young people around the world, which have become publicly apparent through recent investigations, and ChildSafe offers a real alternative to a traditional delivery model. It overcomes some of the issues that children and young people have come up against when trying, and failing, to access agency systems. It works particularly well with communities and groups that have been considered, in the past, to be “hard to reach” when, in reality, the difficulty is that the agencies have not been able to, or not known how to, reach them effectively. The scheme is aimed at better protecting children and young people from all forms of abuse. Recognising child protection as a key public health priority and using ChildSafe as a vehicle to give more strategic direction to the protection of children and young people gives a renewed focus on the importance of protecting and promoting the health and wellbeing of children and young people throughout the regions where it operates.

 

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I have seen the creativity and authenticity of the scheme demonstrated in a very visible and public way in Cambodia and I know that the work the ChildSafe organisers have done to promote the concepts with international travellers before they enter at-risk areas will be a superb contribution to the protection of children and young people living in those regions. In focussing, currently, on the special needs of countries that are, to some extent, still in a development phase, ChildSafe is a perfect example of how Target 8B of the United Nations Millennium Development Goals is being implemented in reality.

 

It is clear to me that the principles underpinning ChildSafe are highly inspirational which have already made a significant impact in the areas where the scheme is functioning, but which are competitive and sustainable enough to be replicated throughout the tourism sector at local, national, regional and international levels. Looking specifically at the Global Code of Ethics for Tourism, ChildSafe promotes tourisms contribution to mutual understanding and respect between people and societies and, in particular, the international human rights aspects of tourism and the protection of children and young people. In promoting those human rights and, in particular, the individual rights of vulnerable groups, ChildSafe shows how tourism can be a vehicle for individual and collective fulfillment.

 

In setting out so clearly how the exploitation of human beings, in any form, conflicts with the fundamental aims of tourism, ChildSafe is a model example of how tourism can be used to improve human rights in societies throughout the world.

 

In making transparent that under no circumstances should “sex tourism” be promoted, encouraged or tolerated, ChildSafe underlines the obligations of all stakeholders in the development of tourism.

 

In implementing the principles of the Global Code of Ethics for Tourism, and in particular the protection of human rights, ChildSafe demonstrably stimulates knowledge creation amongst travellers and communities, disseminates good practice throughout societies and in different countries, and is having transformational, inspirational effects in communities where some of the most vulnerable children and young people live, and work, in the world.

 

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My first hand knowledge of how ChildSafe operates, the effects it has on the sustainable protection of the communities where it is placed and the significant impact it has had on the tourism sector, which is replicable world-wide, makes, I believe, the ChildSafe scheme an ideal candidate sustainable rolling-out to other communities throughout the world.

 

In the UK, ChildSafe could offer us something different, something not reliant on statutory services and something that would empower communities to better protect the children and young people living within them.

 

The question is, which organisations are forward-thinking enough to recognise the benefits that a UK trial of ChildSafe could have…?