In contrast to the solid economic foundation in Cambodia, the political framework was unstable. The government faced erratic government policies and was and was ruled by unpredictable leadership. In 1863, some of the struggles ended when France took over and created its protectorate. Cambodia regained its independence in 1953 from France, while Prince Norodom Sihanouk continued to rule the country as an autocracy until 1970. He was eventually overthrown in 1970 by his prime minister, General Lon Nol and a military government was established. As a reaction to the military rule of Lon Nol, the Khmer Rouge (Red or Communist Cambodians), which were a small group of revolutionaries, waged a war with the army until 1975.

Cambodia is located in southeastern Asia where it borders Thailand, Laos, and Vietnam. In addition, Cambodia is a worldwide export business that exports items such as rice, cotton, and rubber. The Cambodian official language is Khmer, which is the oldest language with written record of any Southeast Asian language in stone inscriptions dating back to the seventh century. The language contains 66 consonant symbols, 35 vowel symbols, 33 superscripts, and 33 subscripts. For that, Khmer is a very hard and complex written language. Historically, Cambodia was conquered by France. At that time, only the elite people were offered a higher education with the French. Only the poor or rural people used the Khmer language. After 1979 and the end of Pol Pot’s rule, Khmer language became used in schools and public literature. Although, the Khmer language is an official language, illiteracy of percentage is high. In rural places, people have problems learning how to read or write Khmer. There are only a few schools in rural areas, and many rural people can’t pay tuition, books, and other resource fee‘s. Elders mainly continue to only speak Khmer while school age children have adapted themselves more to speaking the English language. Many of the younger children have lost their Khmer language, never having learned it at home.

Listed below are the five points taken from the section on reproduction that our group has selected:

Even though family planning is uncommon in Cambodia, some Cambodian women in the US will use birth control such as Depo-provera injections or birth control pills, but seldom condoms.
Cambodian women shy away from prenatal care in the states because they require frequent physical exams. Although, after understanding the importance of these types of exams more and more are beginning to participate.
Cambodian women believe that drinking homemade rice wine, herbal medicines, coconut water, or beer will ensure babies health; while, showering at night and drinking milk will cause their baby to have a heavier birth weight which is believed to result in a difficult delivery.
Some Cambodian women will avoid sexual intercourse for six months to a year in order to give their body time to heal after the delivery of their baby. Cambodian women who grew up in the US are falling away from traditional Cambodian remedies given by their mothers even though they insist.

The first clinical topic we have chosen to present is on postpartum traditions of the Cambodian women. Cambodian women call the postpartum period Sor Sai Karchey or literally "soft/weak tendon". Many Cambodian women practice a number of traditions during this time and it is considered to be a period where the woman in in fragile health. Traditional birth attendants are known in Cambodia for providing most of their services to Cambodian women who are poor, as the services they provide are inexpensive and locally available. At present time, traditional birth attendants deliver the majority of Cambodia's babies. Most of them are older women who have learned the trade by being self taught, from a relative, or while under the Pol Pot regime. Some NGO's offer training to the birth attendants for instruction on hygiene, and education about referrals to health centers for high-risk deliveries to try to reduce the high mortality rates.
Cambodian's believe that a woman's body becomes cold after giving birth. They take steps to heat the body and prevent cooling. A woman is permitted to take a warm sponge bath, but not to shower for a few days to a week after she delivers. They believe it is important to keep the body covered from head to toe. Cold ice water is deemed unhealthy post delivery in the hospital. Cambodian's perform rituals as well to prevent "Tos" which is similar to postpartum depression. Tos is described as more physical and can be benign. If a woman isn't able to or simply does not follow the rituals, such as refraining from heavy lifting or having sexual intercourse, it is believed she will experience tos as a result. 'Roasting' is when the mother lies on a bed with her baby above a fire. Roasting starts immediately after birth and takes normally a week to complete. Not only does it heat the body, but it is believed to prevent illnesses after the postpartum period.

The second clinical topic presents information on the Cambodian perspectives on Asthma. Between July 20 and August 25, 1994, a questionare was developed for the Cambodian people to obtain information about the knowledge of their culture and asthma. People reported that asthma was not worsened by not eating, colder temperatures, weather changes, or emotions. One woman reported her children get asthma when they play too much and are very active, get a fever, smell the pet dog next door, or from changes in weather. None of those interviewed reported a link between asthma and smoking. In the refugee camp and urban areas of Cambodia, asthma is treated with IV medications and oxygen. Until before coming to this country, many Cambodian's may have never have seen an inhaler. In Cambodia, asthma is recognized as a disease. One patient referred to the wheezing associated with asthma as a cat's cry. One woman with asthma stated it was difficult to live with the disease because it was hard to explain, it did not show, and one with asthma does not appear to be sick.
The Cambodian people are unaware of what causes asthma. Some suggested it was inherited, as two small children and a father all had asthma. Another woman believes that asthma is not communicable. One interpreter became confused about the difference between inflammation and infection. She stated interpreters sometimes use the terms interchangeably, most often using infection in the place of inflammation. Asthma was distinguished from illnesses with cough such as tuberculosis and pneumonia. More stigma was associated with tuberculosis which was perceived as a very serious illness with symptoms that include a green, productive cough which is severe at night. It was recognized as being a communicable disease. Most Cambodian's felt asthma was not curable, yet, one woman believed moving residences could cure the disease. People did not report using home remedies except for herbal teas, but all had experience with traditional and western medicines. The traditional Cambodian healer is known as the /krou k'mai/. This healer provides treatments to those with asthma including things such as drinking animal blood, eating toads, and certain insects. A wife of a patient said she had even heard of drinking blood from a black dog with wine to treat asthma. There are no such healers of these types in the US. One woman did report hearing of a healer in California who performs moxibustion. She even had seen a Chinese specialist and has tried herbal medicine which was very expensive. Children are not permitted to use herbs because of the strength.