For weeks prior to the Khmer Rouge’s capture of Phnom Penh on April 17, 1975, explosives peppered the city, inflation rose and the population struggled. “Everybody was tired of the war,” said Song Tan, then a 26-year-old medical intern at the capital’s Calmette Hospital. “No wonder when the Khmer Rouge entered, the people were so happy.”
Tan is a paediatrician based in Long Beach, California – home to a large number of Cambodians – and president of the Cambodian Health Professionals Association of America (CHPAA), a non-profit organisation founded in 1998 to encourage Cambodians to enter the medical profession in the US. Originally from Takeo province in southern Cambodia, he was later educated at the Lycée Sisowath in Phnom Penh and studied medicine at Phnom Penh University.
You can imaging how many people were sick at that time. [We had] to bury the corpese ourselves
During Tan’s internship at Calmette in 1974 and 1975, Phnom Penh’s population swelled and hospitals were bloated with bombing victims, amid a violent civil war between Khmer Rouge soldiers and forces loyal to Lon Nol’s republican government, which led Cambodia between 1970 and 1975. “My medical school was hit many times,” he said. “My home also was hit one time. A lot of my family members were injured – four died.”
Tan was on call on the night of April 16, 1975. “Being a good student, a good intern, I came to work,” he said. Many residents were initially elated by the Khmer Rouge’s victory the next day, but confusion ensued as cadres ordered people to leave the city.
Tan said he witnessed civilians, including patients at Calmette, evacuated in the April heat. “People operated [on] the night before had to leave, with IV drips,” he said. “I [saw] people leaving their parents behind because they [could not] carry them.”
“I was not able to go home and my parents [were] evacuated by themselves – I was separated from them, from that time on,” Tan added.
Tan said he and other staff were permitted to remain at Calmette for almost three weeks, to treat Khmer Rouge soldiers with battle injuries and diseases such as cholera. On May 7, he was sent with others to an area called District 42 in eastern Kratie province, where he remained almost until the end of the regime.
As soldiers demanded their biographies along the way, Tan said the medical staff began to obscure their backgrounds. “The more uneducated, the better,” he said, adding that later in the regime even people with high school educations were deemed suspect.
Tan described the period as almost “prehistoric” in its lack of proper schools and hospitals, where patients often grew sicker from the treatment than the illness. Healthcare was largely rudimentary, with untrained staff relying heavily on traditional medicine.
Tan said he was forced to work at a dam construction site and narrowly escaped being killed in late 1977, when his name was omitted from a list of people – which included some of his colleagues and their families – to be transferred to another village and who were later executed. Tan was forced to marry a woman from his area, but they separated after the regime fell and are no longer in contact.
After Vietnamese troops defeated the Khmer Rouge in January 1979, Tan returned to Phnom Penh – a shadow of a city after years of relative desertion – and helped to coordinate Calmette between March and November that year. Tan said hospital staff worked “like hell”, using supplies from Vietnam to treat people for starvation and diseases like tuberculosis. “You imagine how many people were sick at that time,” he said. “[We had] to bury the corpses ourselves.”
Though there was more food and greater freedom after Khmer Rouge rule ended, Tan said many people left Cambodia because of uncertainty and instability. After claiming that he was from Battambang, Tan travelled with a group to the northwestern province in November 1979, from where he went to Banteay Meanchey province and crossed the Thai-Cambodian border. He resided and volunteered in several refugee camps along the border for just over a year – including the massive Khao I Dang – before migrating to the US in 1980. Tan eventually qualified as a doctor in the States, though he said many others were unable to prove their credentials.
Tan said that some Cambodians who lived through the Khmer Rouge period experience trauma symptoms, and that post-traumatic stress disorder (PTSD) was fairly well documented among refugee populations in the US. “The effect is still not completely gone,” he added.
The impact of the Khmer Rouge era on the mental health of Cambodia’s population was considered in a 2011 book entitled Cambodia’s Hidden Scars: Trauma Psychology in the Wake of the Khmer Rouge. Government assistance for mental health treatment is limited in Cambodia, though a few local NGOs offer services.
In 2011 the CHPAA expanded its role and now raises funds to conduct annual medical missions to Cambodia. The association concluded its third trip in March this year, during which 170 medical professionals – doctors, dentists and surgeons – treated thousands of people in Takeo province. A fourth mission is planned for January 2014.
Tan said that although Cambodia’s health sector has modernised, it is still behind in skills and equipment. “It’s getting better every year – I see the difference,” he said. “But I feel like there’s still a lot of need everywhere.”