Why We Do What We Do: Restoring Freedom in Cambodia

Family Amputee

UPmovement began with a simple vision – to restore the freedom of human mobility to over one million amputees worldwide. Niche topic? You guessed it. To date we haven’t been able to find many other Social Enterprises that are focused on the same social cause.

Being so specific has led to a number of questions from our community. The most common being:
- “Why are you working with Prosthetic Limbs?”
- “Sounds like a great cause, but I know nothing about it”
- “How do we know what you’re saying you do actually creates a positive impact?”
- “Why Cambodia?”

Therefore, for our first blog post, we want to give a general overview of our Social Cause – Prosthetic Limbs in Cambodia. Here, we'll explain the current situation, why it’s an important social cause, and what we’re doing about it.

Farmer Amputee

Cambodia at a glance

After decades of civil wars and political unrest, Cambodia has begun to emerge from its ruins, becoming one of the fastest growing economies in the developing world with an average growth rate of 7.6%. There are however lingering effects of its history, most prevalent being an amputee crisis. During the civil wars, an estimated 6 million landmines and other explosives were laid across the country. Most of these locations were never recorded and as a result, more than 60,000 Cambodians have lost one or more limbs from stepping on these landmines ever since. Many more have lost their lives in the process. 

Combine this with an increase in amputations from diabetes, other diseases and a steadily increasing amount of road accidents, this gives Cambodia the unfortunate label of having the most amputees in proportion to its population.

 Farmer Amputee

Effect of amputations on livelihoods

Being an amputee in Cambodia has a significant effect on one’s quality of life in forms of economic deprivation and employment difficulties. There is also a lead-on effect of the livelihoods of their immediate families and wider communities.

Let’s begin with some basic facts. Cambodia has a population of 15.29 million (2019 census). 78% of the population live in rural areas. There are upwards of 60,000 amputees with 85.23% of these living rurally. 95% of these amputees do not have access to proper prosthetic rehabilitation and care in their local community because it simply doesn’t exist. Many of them must travel to the capital (Phnom Penh) to receive any sort of treatment. As many rural communities do not have their own transportation, it can sometimes take days to travel to the capital city.

Rural communities are still largely agrarian, meaning that most families are farmers and make their money selling the crops that they can farm on their own properties or on local land. For coastal towns, many adults fish to make a living.

The basic activities and movements that encompass farming become near impossible when one has a mobility disability or worse when one has an amputated leg. Individuals with an amputation therefore cannot contribute to the farming efforts of their families and greater community. Instead, many amputees end up on the streets either begging or selling small artefacts that they have either made or found. Many female amputees may result to sex work to make a living. 

The health and wealth of Cambodians is slowly increasing, yet amputees are getting left behind. The average income for a Cambodian in 2019 was $4080USD/year ($12/day), however 57% of Cambodian amputees sits just below the poverty line, at $2/day. This has detrimental effects on the individual, the immediate family and the greater community. With less income being generated, these communities are finding it significantly harder to increase their wealth and improve the overall quality of life.

Regardless if an amputee can travel to a nearby city to receive treatment, Prosthetic limbs are expensive, and it's not a one-time payment. In developing countries, Prosthetic limbs cost anywhere between $250-$1,875USD depending on materials, country and supplier. On average, each patient needs a replacement foot every 3-5 years and can easily transition through 15-25 different limbs in their lifetime. This timeframe is significantly shorter in children, where growth requires a whole new limb on average every 6 months. This is not a sustainable option, let alone an option at all for many.  

Cultural insensitivity

There’s also a cultural aspect to take into account. Individuals without limbs are shunned in their communities. In Cambodia, people who have lost their legs or arms "signify the end of one’s life". You are "not important anymore". The Khmer term for people with disabilities (jon pikar) means you are paralysed and cannot do anything. Amputees have found that their “neighbours and friends stop talking to them” and in even some instances, family members “kick them out of the house when they try and enter”. This would have a detrimental toll on the mental health of amputees. 

What we are doing

This is the social cause that we exist to serve. Amputees in our target countries face significant headwinds in providing for their families and greater communities. Their average income reduces and the economic output is depleted.

UPmovement exists to help provide free prosthetic rehabilitation and care to amputees in rural and urban Cambodia. We work with NGO’s already on the ground to deliver these services. We’ve partnered with A Leg To Stand On (ALTSO), who make their own modular prosthetic limbs legs + feet for $250 (USD), and are provided to amputees for free. 

Through our sale of colourful socks, we help support the building of these prosthetic limbs and the services given to amputees so that they can improve their quality of life which in turn will help improve the overall economic output of Cambodia.

Restoring Freedom, One Sock at a Time. 

 Child Amputee

References: 

Development, O., 2019. Population And Censuses. [online] Open Development Cambodia (ODC). Available at: <https://opendevelopmentcambodia.net/topics/population-and-censuses/#ref-76394-2> [Accessed 15 September 2020].

Laferrier, J. Z., Groff, A., Hale, S., & Sprunger, N. A. (2018). A Review of Commonly Used Prosthetic Feet for Developing Countries: A Call for Research and Development. Journal of Novel Physiotherapies8, 380.

Lau, J., 2018. What Life Is Like For Amputees In Cambodia. [online] The Mighty. Available at: <https://themighty.com/2018/05/life-after-amputation-from-land-mines-in-cambodia/> [Accessed 15 September 2020].

Mousavi, B., Soroush, M. R., Masoumi, M., Khateri, S., Modirian, E., Shokoohi, H. & Rassafiani, M. (2015). Epidemiological study of child casualties of landmines and unexploded ordnances: a national study from Iran. Prehospital and disaster medicine30(5), 472-477.

Tebbutt, E., Brodmann, R., Borg, J., MacLachlan, M., Khasnabis, C., & Horvath, R. (2016). Assistive products and the Sustainable Development Goals (SDGs). Globalization And Health, 12(1), 79- 79.