WHO declares 2020 the global year of the nurse and midwife

Bree Turner Cambodia, Stories

2020 is designated by the World Health Organisation as the first ever global Year of the Nurse and Midwife​. To mark this, we wanted to share Lim’s story, where she talks about the major differences in the quality of services provided by some private clinics in Cambodia, compared to MSI.

A Battambang native, 39-year-old Lim Raneth, has been working at Marie Stopes Cambodia since 2009. Prior to joining us, Raneth began performing abortion at private clinics where they didn’t require a license or certificate to be a provider. She said: “When I was working at the clinic, very few people there had any degree. They only learned from each other.”

Due to “loose policies”, she witnessed many cases of abortion complications, including abrasion and even fatalities. “The clinic was still operating only because the owner of the clinic was able to resolve the issues privately. Although I never encountered any of the cases personally, I heard about one woman who died due to uterine perforation during the abortion procedure.”

She adds: “Not only was the procedure in those back-alley clinics dangerous, but it was costly as well – women who wanted an abortion were charged by the number of weeks they were pregnant.”

Raneth’s perspective shifted after she joined Marie Stopes Cambodia in 2009

“I feel like I have helped many women since working at Marie Stopes Cambodia – we have saved their lives. Everyone here is skilled.”

She adds: “Without Marie Stopes, women will have to risk unsafe abortion that might even result in deaths. I have worked at Marie Stopes Cambodia and I have worked elsewhere – I notice the difference. We have experience and skills”

Working at the Marie Stopes Battambang Centre, Raneth and her team receive an average of 20 – 40 clients a day. Most of the clients are in their 20s, and they visit the center to receive gynecology services. Out of all the clients that she has seen, one client stood out in her mind:

“I remember one client. She was 52 and she got pregnant. Her youngest child was 17 years old. Her husband had been using withdrawal for 17 years, so he thought he was an expert at that. One day, she got pregnant. Her husband accused her of cheating on him. He threatened to kill her because he was enraged. He said he was an expert at withdrawal, so how could she get pregnant? When they arrived at our clinic, we consulted them both together. We said, ‘Are you sure that you always pull out in time?’ He said hesitantly, ‘Not all the time.’ I said this is the reason that caused the pregnancy because his wife is still menstruating. He thought about it and agreed. The client ended up choosing to have an abortion because she felt she was too old to bear another child.”

“Having seen so many cases of women risking their lives because they don’t want to be pregnant cemented my passion for being a midwife”​

Despite the wider access to abortion services, there are still many people who are unaware or lack information about the services, so they resort to using unsafe and traditional methods. “Some women don’t come to clinics because they think they’re unable to afford it. One of the methods that they choose is to drink strong rice wine with crushed peppercorn and garlic as the concoction would increase body heat and cause stomach pain”, she says.

“I think my job is very important because without us, the women would have to go elsewhere and it can be dangerous for them. If we don’t help them, there will be even more problems.”

“The key to reducing unintended pregnancy is to expand access and knowledge about contraception”

Raneth has seen positive changes when it comes to women’s behaviours. “More people are informed about contraception in Battambang and they’re opting for it. However, there are still some people who are deterred from the idea as they still hold on to the misconceptions that using contraception would make them lose weight or make them develop cysts or even cancer.”

She adds: “Those who come to get contraceptive services at the clinic tend to be those who are married and have children. Very few women who have never had children come to get contraception. This might be due to the stigma that is placed upon women when it comes to premarital sex.”

“If I’m scared and I’m afraid of being sinful, then everyone is sinful. If we’re afraid of being sinful, then we don’t get to help people. If we don’t help the women, they would go elsewhere and they would risk their lives, so we’re saving their lives. It’s not sinful.”