Ratanakiri Province - Health, Education, and Development

Health, Education, and Development

Health indicators in Ratanakiri are the worst in Cambodia. Malaria, tuberculosis, intestinal parasites, cholera, diarrhea, and vaccine-preventable diseases are endemic. Ratanakiri has Cambodia's highest rates of maternal and child mortality, with 22.9% of children dying before the age of five. Ratanakiri also has the country's highest rates of severe malnutrition. Ratanakiri residents' poor health can be attributed to a variety of factors, including poverty, remoteness of villages, poor quality medical services, and language and cultural barriers that prevent Khmer Loeu from obtaining medical care. The province has one referral hospital, 10 health centers, and 17 health posts. Medical equipment and supplies are minimal, and most health facilities are staffed by nurses or midwifes, who are often poorly trained and irregularly paid.

As of 1998, Ratanakiri had 76 primary schools, one junior high school, and one high school. Education levels, particularly among Khmer Loeu, are very low. A 2002 survey of residents in six villages found that fewer than 10% of respondents had attended any primary school. Access to education is limited because of the expense of books, distance to schools, children's need to contribute to their families' livelihood, frequent absence of teachers, and instruction that is culturally inappropriate and in a language foreign to most students. Only 23.5% of Ratanakiri residents are literate (compared to 67.3% in Cambodia overall), with lower rates among those living outside Banlung District (15.7%) and among women (15.3%). Bilingual education initiatives, in which students begin instruction in native languages and gradually transition to instruction in Khmer, began in Ratanakiri in 2002 and appear to have been successful. The programs aim to make education more accessible to speakers of indigenous languages, as well as to give Khmer Loeu access to national political and economic affairs by providing Khmer language skills.

Ratanakiri is one of the least developed provinces in Cambodia. Most Ratanakiri residents (61.1%) obtain water from springs, streams, ponds, or rain; much of the remainder (32.2%) obtains water from dug wells. Only 5.5% of Ratanakiri residents obtain water from sources that are considered safe (purchased water, piped water, or tube/piped wells). Most households use kerosene lamps and other sources such as oil lamps for lighting, and few (39.5% in Banlung District and 2.1% elsewhere) have toilet facilities. Almost all households (96.2%) use firewood as the main fuel for cooking. A variety of NGOs, including Oxfam and Health Unlimited, work to improve health and living conditions in the province.