Common Healthcare Interventions / Behaviors

1. Multiple Interventions:

   Cambodians often seek health through multiple routes at the same time. It is thus crucial for HCPs to ask about other interventions they are currently using or have used recently, including:

   1. traditional or Chinese herbs/bark;
   2. spiritual interventions (spirit strings, incantations,etc);
   3. local health center;
   4. local referral hospital;
   5. local private clinic;
   6. other NGO hospitals/clinics.

2. Traditional Healers:

   Unlabeled herbs and barks are often used; the MOH has produced a manual on herbs available, many of which are effective. Patients, however, usually do not know what they’re using.

3. Cupping ( )& Coining (“Koh Kchol”):

   Cupping and coining are commonly sought for pain relief, using hyperemia and perhaps pain distraction to provide relief. The human touch and social experience of the encounter also has value.

4. Spiritual Interventions and the Temple:

   Spirit strings, charms (eg, tiger’s tooth), being prayed over with “holy water”, etc are commonly sought interventions at the local temple. The local temple grounds (wat) is the generally the center of most communities and may be where people go when they are dying.

5. Single-Packet Multi-drugs (“Psom Tnam”):

   Cambodians often go to the local pharmacy, state a complaint (“I have a headache”), and receive a single packet of mixed drugs, such as on tablet of amoxicillin, one paracetamol (acetaminophen), one prednisone, one multivitamin, and one iron.

6. Avoiding foods (“Dtom Ahaa”):

   Patients often want to know what foods to avoid for their illness. This often relates to hold/cold thinking.

7. Hot/Cold Approaches:

   Less educated Cambodians in particular think of disease in terms of hot/cold dichotomy. Diarrhea is hot, so use of hot foods such as mangos and small bananas are to be avoided. Often hot and cold are related to what causes heartburn and what does not.

8. Pharmacy Care:

   What westerners consider to be “prescription-only” medications are readily available at most pharmacies. Pharmacies typically sell medicines in blister packs, and patients purchase for daily use, rather than “in bulk” – thus, prices are higher.

9. Western-style Doctor Care:

   Cambodians generally seek western-style care, but often expect this to be aggressive, with testing and prescription of multiple drugs at once. IV medications and fluids are seen as the best treatment.