In a two-hour long Khmer culture class our travel group recently attended, we were introduced to some traditional forms of Cambodian medicine. These treatments included Tiger Balm, the practice of Coining, and the practice of Cupping. Tiger Balm seems to be the Asian equivalent to America’s Vick’s Vapo-Rub, and comes in a liquid or balm variety. When a small (very small!) amount is placed on the temples and forehead,the essential oils become fragrant and this can relieve a variety of ailments, including headaches, nausea, etc. Tiger Balm can also be used to sooth stomach troubles and muscle aches, among other things.
Tiger Balm can be found everywhere in Cambodia– pharmacies, grocery stores, and outdoor markets, to name a few. The question begs to be asked, then– why is it that traditional, “ancient” medicinal cures are still so prevalent in today’s Cambodia?
The first reason could simply be that the traditional medicine actually works for some people. For example, today our tourguide/friend Chen, a native Cambodian, told us that while he has developed a cold this weekend, he already feels much better after he got “coined” last night– that is, a metal coin was roughly scraped over his upper chest and back area to increase circulation and aid in healing. Additionally, I have used some Tiger Balm for headaches since I’ve been here, and can say while it doesn’t completely cure the headache, the scent and sensation is often overpowering enough that you are too distracted to notice your previous ailment!
The other reason traditional medicines are used in modern-day Cambodia, however, lies in their current economic status. According to the CIA World Factbook, as of 2009, Cambodia’s GDP on Health expenditures is only 5.8%– Cambodia comes in 112th place when compared to other country’s GDPs.
So, this means that if a family member is sick, it is the family’s own responsibility to help this member– they cannot rely on healthcare, or the state for support. This fact, coupled with the fact that the average Cambodian’s per capita GDP is $2,200 annually, makes for insufficient funds for “modern”, or more aptly called, “western” medicine. Even if Cambodians had funds for western, or for that matter non-traditional medicine, according to Nationmaster.com, as of 2000 there were only 0.16 physicians per 1000 Cambodians, so access to these doctors and therefore medicines would be exceedingly difficult..
When one takes into account all of these numbers, it makes sense that the Khmer people are still widely using traditional medicine to fix ailments instead of going to doctors, where they will often charge $20/month for a medicine when a family may only have $100/month to subsist off of.
Would Cambodians be more likely to use Western medicine instead of traditional cures for things such as headaches, back aches, etc, if western medicine weren’t so expensive? At our local pharmacy in Phnom Penh, a bottle of Tiger Balm sells for 80 cents, while 20 caplets of Tylenol sells for $3. Would more access to western medicine increase their life expectancy, which is reported to be only 63 years old, according to WorldVision.org?. Cambodia will probably never get an opportunity to answer this question.
Another factor to take into account when looking into the use of traditional medicine with the Khmer people is the devastation that the Khmer Rouge left on the country. According to Culturalsurvival.org, “One of the greatest losses was people: of a population of about 7 million, 1 to 3 million are estimated to have died under Khmer Rouge rule. Many of those who perished were people with higher levels of education. Only 45 medical doctors survived, and of those, 20 left the country. Only 26 pharmacists, 28 dentists, and 728 medical students remained in Cambodia in 1979.” (). In other words, Cambodia is still healing, and a result of the Khmer Rouge could be that more “advances” in Cambodian medicine could have been halted because of the genocide.
As with most situations in Cambodia, there are no easy answers to these questions. All I can confidently say is that traditional medicine is still highly used, and poverty is extreme and common in Cambodia (31%, CIA World Factbook.). Although correlation does not equal causation, I cannot help but wonder– is traditional medicine only a crutch being used by Cambodians until a better healthcare system can be established?