Chhim Sotheara, executive director of the Transcultural Psychosocial Organisation (TPO), said the reason he has chosen to work on psychological matters in the community for almost 30 years is because he cannot bear to see patients excluded from their families and communities. His dedication to his work was responsible for his recent win of “Asia’s Nobel Prize”.
In late August, the Raymon Magsaysay foundation announced the awarding of the 64th Raymon Magsaysay Award – called the Nobel Prize of Asia by some – to Sotheara.
Sotheara said that receiving the award made him extremely happy. He also said it had come as a shock because he had no inkling he might be named.
“We knew nothing about it. I did not know I had been nominated – or who nominated me. The announcement came totally out of the blue. I was actually unsure if I should believe I had won, because I thought it may be an elaborate scam. They told me not to tell anyone, so that made me even more suspicious,” he said.
What convinced him that the award was genuine was when the foundation presented the evidence of two years of research and interviews. They had interviewed some of his staff and various people working in the healthcare field to find out what they knew about him, and about the TPO.
He said that the highly educated doctors often preferred to work in large hospitals in cities, but he was focused on working where he felt he could do the most good – in the community.
“To treat people suffering from psychological issues requires the participation of families and communities. Therefore my decision to work in the community with the TPO was significant, and obviously that resonated with the judges,” he said.
Another factor in his award was his extensive work with the Khmer Rouge Tribunal. Originally a victim of a Khmer Rouge himself, he studied medicine and then returned to help fellow victims.
He placed a great deal of importance on his studies of “baksbat” which literally means ‘broken courage’ or trauma, a syndrome seen in Cambodia that is similar to post-traumatic stress disorder, and was able to adapt his western medical training to a Cambodian cultural context.
“I think there are a lot of people who would be working abroad for a high salary if they had my qualifications. I think that my decision to return to Cambodia may have also influenced the awards,” he added.
He explained that psychological problems are increasing in almost every country. Cambodia has many mental health issues, but specialised healthcare services are still inadequate.
“Mental health problems have not decreased – I believe they are on the rise. As we all know, the Covid-19 pandemic has placed additional strain on many people. This is not unique to Cambodia of course, but this is where I work. Covid-19 has affected almost everyone psychologically, in one way or another,” he said.
He added that people’s awareness of mental health remains low, but is significantly higher than it was when he began working in the field more than 20 years ago. Most people are unafraid to say they are not feeling well need help. He had noticed this especially among young people who would often help their parents to seek treatment.
He said that most people would experience mental health issues in their lifetimes and hiding them generally only made them worse.
The TPO provides mental health services to about 10,000 people per year. This means that by the time the organisation celebrated its 20th anniversary in 2017, it had likely treated or offered counseling to more than 200,000 patients.
As a young man, he never wanted to be a medical doctor. In fact, he had dreamt of becoming an architect, with visions of building skyscrapers and making Phnom Penh look like New York or Tokyo. The Khmer Rouge era changed his path. When the murderous Pol Pot regime was finally deposed, there were just 40 medical doctors alive in the Kingdom, and they were suffering from the same physical and psychological damage as the general population.
It was in the years after the regime that his mother told him she wanted him to become a doctor. She reasoned that there was no effective medical treatment available at that time, so if he trained, he could at least look after the family if they fell ill.
He recounted that he the family faced many challenges after the Khmer Rouge, with his single mother raising two children, he and his brother. His older sister died during the Khmer Rouge regime, while his father passed a year earlier.
“With no access to a doctor at all, we had a terrible time whenever anyone fell sick,” he said.
He pursued his medical degree at the University of Health Sciences from 1986 to 1992. In 1992-93, he worked as a dispensary translator for UNTAC, and treated people in Preah Vihear province. It was there that he met a large number of patients who were suffering from mental health issues that they did not know how to treat.
From 1993 to 1994, he worked as a surgeon at Kampong Chhnang Provincial Hospital, where he encountered women who had developed dementia after giving birth and observed a disproportionately high number of attempted suicides.
These observations started a drive to understand mental health and set him on his current path. From 1994 to 1998, he studied psychology, following his degree with a master’s degree from the University of New South Wales in Australia. He returned to the Kingdom, where he worked at the Khmer-Soviet Friendship Hospital from 2000 to 2002.
While working in Phnom Penh hospital, he conducted research in various provinces. He once met with a patient at the hospital who had been traveling since 2am to try to seek treatment.
“I felt enormous sympathy for her as she had travelled five hours to access healthcare. At that time there were very few doctors. She had to spend an entire day to see a doctor, get medicine and return home. That’s what changed my thinking. I realised that psychological treatment needs to be available in the community,” he said.
When TPO announced that it was recruiting a new director, Sotheara applied. Once he had passed their entrance exam, he resigned from his government role. He worked at TPO until 2008, when he began to resource his PhD dissertation at Monash University in Melbourne, Australia. One he had successfully defended his dissertation – on Baksbat (broken courage) – in 2014, he returned to TPO.
He has remained there ever since.