Wat Svay Thom, Siem Reap, Cambodia
ADMINISTRATOR SAMANTHA POWER: Good afternoon, everyone. Thank you for coming. Thanks also to our partners from the Cambodian government who have joined us here today.
This is my fourth trip to Cambodia, but it is my first trip to Cambodia as USAID Administrator. But, maybe more significant than that, it is the first trip to Cambodia ever by the USAID Administrator, despite decades of investments that USAID has made in economic development, health development, food security, and the like. So, I feel really personally privileged to be back in a country that I find incredibly beautiful, filled with such warm and hospitable people who have welcomed me many times over the years. To now get to come back as USAID Administrator, it's a great privilege.
I had the chance to tour a tuberculosis screening clinic here at the Svay Thom Pagoda. Over the past five years, USAID’s Community Mobilization Initiatives to End TB, which we have called COMMIT, has helped Cambodia make remarkable progress preventing, detecting, and treating tuberculosis. And, I got to see this screening effort, at least in one of them, up close.
In the past 20 years, Cambodia has cut the rate of tuberculosis in this country by almost half, and the country is no longer on the World Health Organization's list of the 30 highest TB Burden Countries. That is genuine progress. But, of course, the fight against TB is not over. An estimated 54,000 Cambodians contract TB still every year, and about a third of TB cases go undetected.
So, to help Cambodia meet its goal of ending TB in this country by 2030, I am pleased today to announce a new five year initiative, which we will call COMMIT II, the second phase of our investment here. We will start with an initial $4 million investment for the first year of the program, with additional funding to come.
I want to stress that this is one of the largest local direct awards that USAID has ever given to a local Cambodian organization. We think it's extremely important to invest directly in Cambodian organizations that are doing the work out in their communities to advance the health and the interests of the Cambodian people.
Through this program, COMMIT II, we will work directly with local communities to improve TB screening, diagnosis, and TB preventive therapy. We will focus especially on identifying and treating the cases that are currently going undetected. And, we know that getting at these undetected cases is the key to preventing the spread of this terrible disease.
Our work together, that of USAID with the Cambodian people, that of USAID with the Cambodian health ministry, is really just one example of the productive health partnership that has developed over the last decades. And it is also, I think, reflective of what is a deepening partnership between the United States and Cambodia, and between the American people and the Cambodian people.
I'd like to say a word about malaria as well. Over the past decade, the U.S. has invested $87 million to support Cambodia's efforts to eliminate malaria. These efforts, led by the Cambodian people, have been a stunning success, with Cambodia registering zero malaria deaths since 2017 and now on track to completely eliminate malaria as soon as next year.
We have also supported Cambodia's efforts to make childbirth safer for mothers and for infants. Since 2005, Cambodia has reduced maternal deaths by 67 percent, infant deaths by 71 percent, and deaths of children under five by 81 percent.
The United States and the American people also stood with the Cambodian people during the COVID-19 pandemic, delivering 3.3 million vaccines and providing $16 million in other support.
We are really gratified now that Cambodia has become a new partner in the U.S. Global Health Security Strategy, which aims at making sure that Cambodia has the infrastructure to have the surveillance capacity in communities, the lab equipment and testing equipment that it needs in order to prevent, detect, and respond to future health threats.
Now we are supporting Cambodia taking on another urgent health threat, and this is one that – while I know the press has covered TB in the past, has covered the incredible progress made against malaria – this may be a harm and a form of illness that even the press has not yet given significant coverage to. And, this issue is lead poisoning, and specifically the lead poisoning of children.
Lead poisoning slows a child's brain development. It harms their bodies, and it can even kill children. Lead poisoning affects an estimated six million children here in Cambodia. That's over 70 percent of all kids in this country.
Taking on this global menace of lead poisoning is extremely important to USAID. It is an urgent priority for the United States government as a whole, and Cambodia has already made itself a really important partner in this effort. Cambodia was one of just 26 founding member countries in a brand new Partnership for a Lead-Free Future that we just launched in September at the UN General Assembly. And, we are really thankful to the Cambodian Health Ministry and to the government for stepping forward and being a leader in raising its hand and committing itself to eliminating lead poisoning for children here in Cambodia.
Lead poisoning, unlike a lot of other diseases, is really hard to detect. It is tough to know also what the source of lead poisoning is. Is it spices? Is it paint? Is it the recycling of batteries that is causing lead poisoning?
Today, which as it happens, is part of international Lead Poisoning Prevention Week, I am pleased to announce that USAID will support Cambodia's first-ever national survey to evaluate the levels of lead and other heavy metals in the blood levels of children and pregnant women. We will also look together at the level of lead in products in Cambodian stores. And, we will together work to understand how prevalent lead is in the environment. To be clear, understanding where lead poisoning is coming from here in Cambodia is absolutely critical to preventing it going forward.
USAID will also work together with the Royal Government of Cambodia and with UNICEF to take steps to mitigate lead exposure by raising awareness and developing policies and regulations that will prevent future exposure. Together, I am confident that just as we have on malaria and TB and just as we did on COVID-19, together we will make progress against this invisible threat.
USAID stands ready to support the doctors, the teachers, the parents, the government officials and the citizens who want to rid their communities of lead poisoning once and for all. This partnership matters a great deal to the United States. We see how far it can go, and we are very satisfied with the progress that we have seen in the health sector, and eager to learn from it, to see how we can propel progress in other sectors as well.
And with that, I am happy to take your questions. Thank you.
QUESTION: My name is Chamna. I am from Cambodianess, a news outlet based in Siem Reap and Phnom Penh, ma’am. So, ma’am, my first question is that you know, as the first USAID Administrator to Cambodia, visited Cambodia for two days, can you give us, like, a brief activity that you have done and also you will do tomorrow?
And, the second question is that, why do you choose Siem Reap, one of the cultural provinces of Cambodia, to visit, ma'am? And, also the third question, I was informed that you will visit Prime Minister Hun Manet tomorrow. So, what do you hope to communicate with the Prime Minister, ma'am?
ADMINISTRATOR POWER: That's a lot of questions. So, let me start with why did I come to Siem Reap. This is my third trip to Siem Reap. Once a person has come to Siem Reap once, they always insist on coming back. And, any tourist who has come if they haven't come back, it is only because it is so far away. But, for me, when I knew I was coming to Cambodia, I've had such beautiful connections with the people of this town in my previous visits, such rich conversations. And again, the privilege for me is now to come as USAID Administrator and to actually see the work that we have been doing as the United States, as the American people, with the Cambodian people in communities, you know, in a manner that is not only advancing the U.S.-Cambodian partnership, but touching real lives. And so, just as the Cambodian people have touched me over the years, I felt I had to come back.
And in terms of the content of the visit – my visit follows on, of course, the visit of Secretary [Lloyd] Austin, our Secretary of Defense. We believe really strongly in the United States in what we call the three Ds – diplomacy, defense, and development – because the three Ds reflect the needs, in a way, of all individuals, which is to be physically secure, to be free, to express oneself, and to live as one chooses and as one, and to raise children in a manner where you can imagine them fulfilling their dreams.
And then, of course, to develop economically. And we think that, you know, an enhanced security partnership of the kind that Secretary Austin discussed with more exchanges and more familiarity between us, more diplomatic engagement, and these really significant development investments will hopefully support those incredible Cambodians who are doing work to build a brighter Cambodia for the next generation. And, of course, young people are at the heart of Cambodia's economic progress, and will be at the heart of its progress in strengthening its institutions, its governance, the rule of law, et cetera.
My visit will include, yes, a meeting with Prime Minister. I'm very much looking forward to that. I already had the chance in January of this year to meet with the Prime Minister in Davos when he attended, and I attended, the World Economic Forum. But, of course, now we have had a chance, over many more months, to work on shared challenges like strengthening global health security; to initiate new partnerships like the new partnership to combat lead poisoning. And, I look forward to talking about what more can be done, recognizing that we all want to see Cambodia's economy continue to grow. He has been very specific, of course, about Cambodia – wanting Cambodia to become an upper middle-income country by 2030. We, as USAID, want to understand how we can be catalytic in supporting certain sectors, and so hearing directly from him about his priorities now deeper into his tenure as Prime Minister will be very important.
And, of course, we recognize as well that non-governmental organizations, community-based organizations, civil society organizations, that those organizations who are in the community have such an important role to play as well in delivering services like we saw being delivered, in screening tuberculosis, or in educating the community, but also in rooting out corruption and exposing those forces that get in the way of Cambodia's economy reaching its full potential, and above all, the Cambodian people benefiting as much as they should from all that Cambodia offers and all that young people are investing in that economy. So, I will see the Prime Minister.
I will, of course, later today – I can't come to Siem Reap without seeing some of Angkor Wat. I will engage with individuals outside of government who are looking at, you know, what more can be done, again, to strengthen freedom and governance and the rule of law in this country. And, you know, I'm really looking forward to learning. On every trip, I learned so much, and Cambodia has changed really so much since my last visit to this country, which was back in 2012. Even just driving around, I can see so many of the changes. But again, my privilege is to be here as USAID Administrator and to talk to our incredible team about what more we can do to accelerate the progress in support of Cambodian leaders, inside and outside ministries.
QUESTION: Okay, ma'am. Also, my second question has two parts, of course. Now, you're touring the TB, you know, let's say, progress. How to eliminate them, how to make the system better. So, what are the development[s] that you see so far back then, back there, when you tour the, you know, the mechanism, and also, what are the challenges that still remain? That, you know, when you talk to the expert, they say, there are many challenges out there that needs to be done. That is the first part of the question.
And, the second part of the question can be cultural, again, because I see doctors, I see, you know, organization experts, but, at the same time, they are working on health. But, they are not in the clinic. They are not in the hospital. They are in a pagoda, which is a sanctuary for Cambodia, so Buddhism for hundreds of years. So, when you see, you know, expert, modern, expert, modern equipment coming together with old people in the sanctuary of Cambodian religion, how do you make of the situation?
ADMINISTRATOR POWER: Well, and this is really important, I think, to stress what is so significant about what Cambodians are doing here, is that they are coming to the people. They are bringing the equipment to diagnose whether TB is present in a person to a more central location than the people would otherwise be able to access. So, normally, this very sophisticated X-ray equipment, and the computers that process the X-rays to diagnose whether somebody is likely to have TB, these individuals would have to go very, very far [to access].
And, what USAID, in partnership with the Cambodian Ministry of Health and with this non-governmental organization that has been at the forefront, what we have done together is come up with activities that are designed to move the diagnosis and, ultimately, the treatment closer to the people. And, that is what you saw here, is a large group of individuals who were told that if you come to this place at this time, you won't have to drive miles and miles in order to get the X-rays. And so, everyone here either had some symptom of TB, or had someone in their family who had some symptom. So, in their mind, they were worried, “Maybe, would I?” but maybe they weren't worried enough to drive so far. Maybe they couldn't afford a bus fare, or, you know, they didn't have a motorbike in order to be able to make it that far.
And so, among the people who are here, I’m sure, are people whose TB cases would have gone undetected if we had relied on the old way of doing things. And so, this is really a partnership that looks at the data, sees that a third of TB cases in Cambodia go undetected, and so we have to fix that. If Cambodia is to reach its goal of getting rid of TB by 2030, that is going to require detecting all the cases of TB so that TB then isn't spread in communities. And, mobile clinics, mobile health workers, mobile screening is going to be a big part of that solution.
And, you know, I think that when one seeks out meeting places, gathering places, one looks and here again, we as the United States and as USAID, we defer entirely to the Cambodian Ministry of Health about where best to situate these mobile screening, this equipment. We may invest the resources to purchase this equipment, but fundamentally, when it comes to respecting Cambodian culture, we are the guests of the Cambodian people. We are the guests of the Cambodian Government, and we take their lead and follow their guidance about how best to, again, meet people where they are likely to feel comfortable traveling to and sitting for some time as they go through the different stages of diagnosis, you know, starting, of course, with with the X-ray. But then, if they are deemed, if it is deemed possible that they have TB, going further, and then even waiting for a couple hours to get the formal diagnosis, then the counseling that is going to come. That is a long afternoon. It's a lot to ask of particularly elderly people, who are among those who gathered. And so to do so in a manner that is culturally sensitive, but that also allows the individuals who come the comfort of not being out in the blazing sun for the entire day. I'm assuming that is why this location was chosen.
QUESTION: Okay, so my final question is not related to TB or but it's more like related to your, let's say, journalism career. So, in Cambodia right now, a lot of young people are interested in journalism, if not you know the media subject. And also, you said that you were a former journalist working in many countries and zones, and now you are a diplomat, so it's like a career transition. So, just a message for young people in Cambodia, how does journalism help shape, you know, a person's career in the future? I mean, after they do journalism, of course.
ADMINISTRATOR POWER: I think journalism is an incredibly important form of civic participation. All of you are bringing to your communities news and facts and often vital information that citizens need to learn. For example, when journalists cover a local happening like this in Siem Reap that there was a gathering where people were able to get TB screening and diagnosis right here, somebody reads that or they see that on the news, and then they think to themselves, “Oh, I haven't been feeling that well. Maybe I will go and find a screening facility. Or I will ask someone if they know when next this kind of gathering is going to happen, this kind of screening, mobile screening is going to be available.” That's an example of the kind of good that a journalist can do for their community.
Obviously, they're also in countries where corruption has been an issue. Journalism can be extremely important in also helping law enforcement know where corruption is happening so that it can be rooted out. The Cambodian government really wants to continue to grow the economy. All of us would like to see more American investment in Cambodia. Journalists have a really vital role to play in shining a spotlight on the kinds of things that might need to change in order for that investment to come at a faster clip than it has up to this point.
So, you know, I look back on my journalism career, and I feel grateful that I had that chance to be a journalist. I feel grateful to have made some small contribution, I hope, through my journalism. But, the other thing that young people should know as they think about their careers is, if you're a curious person, journalism is incredible. Look at you. You've asked that's your sixth question. You're clearly a very, very curious person. But, journalism is incredible because you just get to go around and ask questions, any question that comes into your mind. You can actually earn a living asking questions and learning. And so, you get to perform something that hopefully helps your community grow and progress, while also yourself satisfying the kinds of questions that you've had maybe since you were a small child. So, I think it's a great career.
The more that Cambodia can strengthen its checks and balances, where it has more and more independent institutions, that will give investors confidence. And journalists, over time, will become more and more independent, and will be a very important source of sunlight on all the developments in Cambodia, helping it progress into a more stable and prosperous society.