Deep wounds fester from horror inflicted by the khmer rouge

04/18/2006
By From the Boston Globe

By Yvonne Abraham, Globe Staff

LOWELL - Chhan Touch spent the 31st anniversary of the worst day of his life in a classroom yesterday at the University of Massachusetts at Lowell, watching live video feeds of fellow Cambodians from all over the country as they calmly listed unspeakable horrors.

"I saw with my eyes, my own eyes, they arrested former soldiers and killed them," said a man in Portland, Ore. "We had two cups of rice for 15 people," said an elderly woman in Chicago.

"I have mental health problems, because I got beaten and tortured," said a woman in Lowell. "Sometimes I want to die."

"It is a very sad day," Touch said, wiping tears away.

Decades after tens of thousands of Cambodians escaped the cruelties of the Khmer Rouge, immigrants gathered in a handful of their hometowns across the United States yesterday for a videoconference designed to highlight the enormously high rates of depression and posttraumatic stress disorder that still beset Cambodians.

Those mental health problems can be accompanied by a slew of other chronic health problems, such as diabetes and hypertension.

"This is a public health emergency," said James Lavelle, director of international programs and community organizing at the Harvard Program in Refugee Trauma at Massachusetts General Hospital. "It is an epidemic of health and mental health, problems that go hand in hand."

The videoconference was organized by the National Cambodian American Health Initiative, a health advocacy organization, to connect advocates from Lowell, which has a substantial Cambodian population, with Long Beach, Calif.; Chicago; Portland, Ore.; and Danbury, Conn.

A study published last year in the Journal of the American Medical Association found that almost every Cambodian immigrant in the United States had faced trauma before they reached this country; 99 percent came close to death from starvation, and 90 percent reported having a family member or a friend murdered.

The study found that 62 percent of Cambodian immigrants suffer from posttraumatic stress disorder, and that more than half have major depression.

Community leaders said Cambodians complained of nightmares, flashbacks, and debilitating guilt. Many were loath to speak of their maladies, let alone seek professional help. Those persistent mental health problems precipitate physical illnesses, Lavelle said, and seep into younger generations, being raised by unhealthy parents in sometimes dysfunctional homes.

"We have an outbreak of hyper tension among teenagers," he said. "This is unheard of."

As Touch, 39, watched the speakers, he was thinking of April 17, 1975, when, as an 8-year-old, he stood on his balcony and saw the Khmer Rouge march into Phnom Penh, emptying the capital in hours. A huge mass of people walked out of the city. Soldiers killed those who dared to double back through the fleeing crowds to find lost daughters or uncles.

"They shot them, in the head, in the chest; I remember it vividly," he said.

When he and his family arrived at the Mekong River hours later, it was crammed with floating bodies.

"We had to drink that water," he said.

They fled to the village where Touch's father was born, to find most of his relatives murdered.

"They looked at the human race as a field of grass," Touch said of the Khmer Rouge. "The only way for a pure Utopian society is to kill all the grass. They killed everybody with an education. They killed my brother-in-law. My niece died of starvation."

The entire country became a concentration camp.

Touch learned to eat "anything that moved," he said. "Rats, snakes, sometimes raw." His sister was shot when the family was fleeing to Thailand.

When he came to the United States, he had nightmares every night for two years. Somebody was coming to stab him. He was still stuck in Cambodia and couldn't get out. He was afraid to leave the home of his foster parents, Americans who found him in a Thai refugee camp. He felt guilty that he had survived when so many people he loved had been killed.

Eventually, as his new family made him feel safer, his health improved, he said.

Touch, a nurse-practitioner in Lowell, now treats other Cambodians. His patients have no will to care for themselves, he said.

"I've never seen anybody so sick like this group, the hyper tension, the diabetes," he said. "They just stop caring for themselves, and they fall apart."

The more economically comfortable that Cambodians become in the United States, the more guilty they feel, said Vong Ros, executive director of the Cambodian Mutual Assistance Association in Lowell. That makes a coordinated national campaign to improve their mental health more vital than ever, he said.

"This is urgent," he said. "We need to come together now and ask ourselves: `How is the health of our community?' We need to use the resources that are available in this country to relieve some of the pain and suffering that people are still living."