How Cambodia is coping with the COVID-19 crisis remains a grey area in the nascent research on the pandemic in Asia. While South Korea and Taiwan have been held up as models, dictating the strategies to be taken in response to the epidemic, in Cambodia there has been until very recently a certain disregard of the health risk to the benefit of economic and political concerns. The country suffered from an early infection, with a first confirmed case on January 27, 2020. However, official data published over three months later on May 7 reported no deaths linked to COVID-19 and only 122 confirmed infections for a population of approximately 16 million. At the time of writing, 26 days passed since the last positive case was reported on April 11. In other circumstances, this low prevalence would qualify COVID-19 as an epiphenomenon. A series of measures aiming to contain the epidemic have nevertheless been put in place, such as restricting gatherings and travel, and closing schools and some businesses, but these remain unequally implemented, monitored and controlled. The crisis affecting Cambodia lies mainly in the impact on the country’s economy.
The textile industry was greatly affected by the floundering global economy. A break in the production capacity for raw textile materials in China induced supply problems, and resulted in many businesses closing in Cambodia. At the other end of the chain, the vertiginous drop in orders for finished products from Western Europe and the USA, where the economies have ground to a halt, has aggravated the situation for the some 800,000 workers concerned (Pierson 2020). With no supplies coming in and no orders going out, the whole industry is threatened with collapse and thousands of people are facing unemployment.[i] Another crucial sector in Cambodian economic life, tourism, came to a sudden stop in January 2020, further shaking the national economy.[ii] Finally, the mass withdrawal of Chinese investors, diverted by the crisis in their own country, has also plunged Cambodia into an uncertain future. In response to the situation, the government recently announced the release of USD 800 million for the first six months in order to limit the impact of the economic crisis (Vicheika 2020).
The damage to the economy and the persistent threat of the epidemic itself partly explain the central role assigned to COVID-19 in the discourses and practices of the country’s authorities. But to fully understand the extent of this crisis, we must take an interest in its political appropriations. The virus is being used as a pretext to mobilize international funds, to consolidate the country’s diplomatic relations and to impose the Cambodian leaders’ domination within the national political perimeter. COVID-19 has become a multi-faceted alibi, encroaching into such diverse domains as medicine, society, politics and the economy, and thus blurring the boundaries between them. As this preliminary paper will show, Cambodia is a telling example in the study of the sociopolitical appropriation of issues initially considered to be health-related.
COVID-19 as a financial resource
A pandemic always poses biological, social and economic problems, but Cambodia has not yet experienced the torments of a full-blown COVID-19 health crisis. The economic fallout in this country is thus playing out in the shadow of this alarming threat. Cambodia has a weak, badly equipped health system that lacks specialized practitioners, and the occurrence of a wide-reaching national epidemic would indeed be a terrifying catastrophe. It is thus a question of anticipating the outbreak. However, there are no ready-to-use methods in pandemic preparedness (Elbe 2018), and the financial boon resulting from forward planning for the catastrophe could sway the governing authorities in directions that diverge from the true needs of a public health response. Indeed, a hypothetical health crisis in Cambodia in the future represents a very tangible financial resource in the present. Since the start of the “epidemic”, millions of dollars have flooded the country.
The World Health Organization immediately intervened and made its position known in the fight against COVID-19. The German government, USAID, H-EQIP and UNICEF are among those who responded quickly to ensure the procurement of ambulances and medical equipment for Cambodia, as well as to develop national diagnostic capacities and implement an e-learning program once the schools had closed. The Bill Gates Foundation and the Chan Zuckerberg Initiative, the charitable arm of Facebook’s founder, worked together to provide means to local researchers to sequence the COVID-19 genome. By the start of April, the World Bank had loaned USD 20 million to build and equip specialized centers, recruit new staff, buy medical equipment and medicines, and strengthen the diagnostic capacities of the twenty-five provincial hospitals. It was followed by the Asian Development Bank, then by Japan, which also contributed USD 20 million. India and France just provided aid to a provincial hospital and the Pasteur Institute, respectively. These donations are sizeable considering that the spread of the epidemic in the country is still very low, several months after the first case was declared, although recent warnings from the World Health Organization estimate that Cambodia could be in an ‘early stage’ of the epidemic.
However, to date, the implementation of the actions cited above has been very low key. Excepting the introduction of some testing in the capital, the quarantining of textile workers who left their workplaces for the Khmer New Year, the follow up of returning migrants, a series of training courses for health personnel and the repeated governmental announcements about COVID-19 on social media, the health landscape remains virtually unchanged. A number of people, journalists and laymen alike, have questioned whether this windfall is being used effectively, in a country sadly known for high levels of corruption.[iii] Perhaps seeking to silence critics, Prime Minister Hun Sen allocated his own salary for seven months from April 2020 onwards to a newly established Anti COVID-19 Committee. This was a surprising move from the country’s strongman,[iv] who was then repeatedly downplaying the risks associated with COVID-19, even threatening to ‘kick out’ journalists and officials wearing face masks.[v] Since the prime minister himself is the head of the Committee, which gathered more than USD 10 million in the first few weeks, these actions have not in fact silenced anybody, quite on the contrary.
Many ministers and State agents have however followed his lead and given up their salaries too. Private donations of this type have abounded, including from the Chinese billionaire Jack Ma and the Vietnamese Business Club in Cambodia. The Cambodian government also allocated a budget of USD 30 million in early March and, as mentioned above, has since received aid from various international agencies. The fact that the Cambodian government has so far provided little accounting for the usage of these funds raises some thorny questions, as yet unanswered.
COVID-19 as a diplomatic medium
There are no official documents presenting how much aid has been received from China, Cambodia’s largest economic partner and leading benefactor. One of my contacts in the Ministry of Health confirmed that China has granted ‘colossal’ financial aid, but he also went on to mention the ‘technical’ aid provided by this country. A seven-member team of Chinese experts did indeed travel to Cambodia in late March to help implement an appropriate health policy and educate local personnel about hospital admissions, sample testing, triage and treatment. This indicates a profound and radical change in the health landscape, as China rapidly becomes a global center for expertise on the subject of COVID-19. This relocation of the sites of expertise, formerly located in the all-powerful West, is particularly remarkable (Gaudillière 2020). Italy, Laos, Russia and Serbia have also been assisted by teams of Chinese medical experts in a package of health interventions, which, as a whole, feed China’s medical diplomacy. China is using the worldwide COVID-19 crisis to reposition itself, not without controversy (Pantucci 2020), from an authoritarian regime that incubated the pandemic to a responsible international stakeholder and provider of global goods at a moment of crisis.
When the Chinese specialists stepped onto the tarmac of Pochentong airport in Phnom Penh, equipped with provisions of ventilators, masks and other medical equipment, it was also the occasion to celebrate the relationship between the two countries. The arrival of the Chinese team was broadcast live on local TV channels, including the state-run National Television of Cambodia (TVK), the official Facebook page of the Cambodian Prime Minister, and leading online news providers. The team was cordially greeted by Cambodian Health Minister Mam Bun Heng and the Chinese Ambassador to Cambodia. The group posed for a photo showing welcoming banners that read: “a friend in need is a friend indeed”, “Lancang-Mekong has a single origin, China and Cambodia have only one heart”. More recently, on April 20, an expert team from a Chinese hospital who fought against COVID-19 on the frontline in the hardest-hit Hubei Province shared first-hand clinical treatment experience, and epidemic prevention and control measures, with their Cambodian counterparts via a video conference gathering over 150 medical staff from both countries. The COVID-19 crisis has helped Cambodia to consolidate its relations with China. The leaders have made substantial efforts to ensure that the perception of this relation between the two countries penetrates into the deepest layers of the Cambodian society, as shown by the creation of a popular Karaoke song about COVID-19 in which explicit thanks are given for help from “our Chinese brother”.
Since the epidemic was declared in Wuhan in December 2019, Cambodia has been using COVID-19 to further its diplomatic relations. Prime Minister Hun Sen stressed his country’s unwavering support for a stricken China. He initially maintained air links with China and gave permission for more than 3,000 Chinese people to land in Cambodia directly from the center of the epidemic, before Wuhan was quarantined on January 23.[vi] Hun Sen publicly downplayed the risks associated with the virus and refused to repatriate Cambodians living in Wuhan. He addressed these expatriates directly, insisting they should stay in China, “as friends would do to support each other through a difficult period”. In fact, the Prime Minister actually decided to visit his ‘fellow citizens’ himself to provide some moral support. Hun Sen travelled to Beijing and fulfilled his diplomatic mission, but was not able to visit Wuhan, by then under quarantine.
The Prime Minister then achieved a diplomatic masterstroke in agreeing to allow the Westerdam ship to dock in the port city of Sihanoukville on the February 13. Previously, six other countries in the region had refused entry to this US-flagged cruise ship for biosecurity reasons (they were Japan, Taiwan, South Korea, Guam, Philippines and Thailand). Cambodia distinguished itself by letting the 2,257 passengers disembark and was highly praised by the World Health Organization for this act, which it saw as an “example of international solidarity”.[vii] However, Cambodia’s actions in the Westerdam affair were not aimed at combatting propagation of the virus. Hun Sen remained skeptical of the threat posed, and personally welcomed the passengers, wearing no face mask, bearing armfuls of flowers and traditional scarves. Over two thousand passengers thus entered the country, including several positive cases that were detected only later. This act allowed the Prime Minister to re-establish relations with the United States, which had previously criticized the Cambodian government for unjustly imprisoning the main leader of the opposition party in 2018. The Westerdam episode also aimed to detract media attention in the very week that the European Union was retracting various trade preferences from Cambodia because of the governmental malpractices aimed at eliminating all forms of political opposition.[viii] A new arena is thus opening up, providing a platform for the country’s political ambitions, both in terms of international relations and internal politics. Let us now turn to the latter.
Political autocracy in the time of COVID-19
The political domination of Cambodia’s leaders is particularly visible in their hunt for ‘fake news’ about the epidemic and the government’s response to it. This campaign, which predates the current situation, was institutionalized during the COVID-19 crisis by the ministry for information with the creation of the Fake News Monitoring Committee on March 11, 2020. This body’s official mission is to combat Facebook and other website pages that could harm national security, spread fear among the population or incite social disorder. Indeed, the government has ordered the arrest of over forty people since the end of January, some of whom are now in prison for supposedly inciting disorder or tarnishing the reputation of leading politicians.[ix] But the accused are often activists or members of political camps opposed to Hun Sen’s Cambodian People’s Party (CPP). They are convicted for posting opinions on social media, such as announcing that a family member has been infected, or criticizing the government’s actions to fight the epidemic. Such attacks on freedom of expression are unfortunately common practice in this country. For instance, during the 2018 national election, all radio and press bodies that did not toe the line and support Hun Sen’s vision were closed. The COVID-19 crisis makes such conduct aiming to sideline opponents and silence the population more visible. It accentuates the traits and shortcomings of a country trapped under an autocratic regime.
The picture sadly continues to get bleaker. One of the leaders of the Cambodian League for the Promotion and Defense of Human Rights (LICADHO) publicly denounced these wrongful arrests on Radio Free Asia, and then found himself also threatened with imprisonment. During a press conference held at the National Assembly on March 30, Prime Minister Hun Sen sent out a clear message: “I call you by name, Mr. Am Sam Ath of LICADHO. You should be careful of your comments during this situation. Although Cambodia has yet to be placed under a state of emergency, I can still arrest you since you support those offenders, which can be considered as part of your complicity in committing illegal offenses in Cambodia. (…) Such support for the expression of ideas aimed at discrimination and stoking fears (…) deserves my public warning” (Radio Free Asia 2020). Since then, Hun Sen has been working towards passing state of emergency legislation. This man is thus preparing for a dangerous omnipotence, further subverting a country known as a ‘hybrid democracy’ (Cohen 2019, Un 2005).
In pushing for a state of emergency, the Prime Minister adhered to article 22 of the constitution, which stipulates that such a state is possible when the nation is battling a public health emergency related to the emergence of a new disease. Using the new COVID-19 epidemic as a pretext, Hun Sen orchestrated a unanimous vote to pass the state of emergency law through the national assembly on April 9, then through the senate on April 17.[x] The law is due to be adopted in the next few days, once it has approval from the King. The Prime Minister’s government will thus hold total power to monitor and control the media, telecommunications and the internet, as well as to prohibit the diffusion of information likely to instill fear or provoke social chaos. Anyone attempting to counteract the functioning of the state of emergency or compromise national security faces a maximum prison sentence of 10 years. Yet, the recent history of this country is sadly marked by fabricated false allegations of treason or incitement to chaos. It is reasonable to assume that the political oppression of opponents to the regime will reach a fearsome climax in the coming weeks, further endangering already fragile human rights and freedoms.
Laurent Pordié is a Senior Researcher in the Anthropology of Science and Medicine with the CNRS in Paris, and a member of the Research Unit Medicine, Science, Health and Society (Cermes3). His current work explores drugs distribution networks, pharmaceutical regulation and heterodox practices of diagnosis and drug combination in Cambodia. He is the editor of the book series “Social Studies in Asian Medicine” with Amsterdam University Press.
[i] The textile industry generates about 40% of Cambodia’s economic output and 80% of its exports (Pierson 2020).
[ii] The tourism industry made up 32.4% of the Gross Domestic Product in 2017 (OECD 2018).
[iii] In 2019, Cambodia was ranked as the most corrupt country in Southeast Asia and one of the world’s infamous leaders (Transparency International 2020).
[iv] Hun Sen is the sitting head of government since 1985, which makes him one of the longest serving leaders in the world. On this powerful and controversial person, see Strangio (2014).
[v] Hun Sen changed his take on protective behavior about a month later, on April 21. In a Facebook post, the Prime Minister appealed to all citizens to carry facemasks and sanitizers when travelling, to wear facemasks everywhere and wash hands before and after touching anything in a public place.
[vi] When the government banned the entry of travelers on March 17, this did not apply to China, only to the United States, France, Germany, Spain, and Italy.
[vii] This episode is all the more significant since it occurred at the same time as another ship, the Diamond Princess, was anchored off the Japanese coast with 712 confirmed cases of Covid-19 aboard.
[viii] “The European Commission has decided to withdraw part of the tariff preferences granted to Cambodia under the European Union’s Everything But Arms’ (EBA) trade scheme due to the serious and systematic violations of the human rights principles enshrined in the International Covenant on Civil and Political Rights” (European Commission, 2020). Standing in stark contrast with these accusations, the European Union ordered a transfer of USD 66.7 million to Cambodia on April 20 to help restore the economy during and after the Covid-19 period.
[ix] Counterfeits of hygiene and medicinal products are now also subject to increased controls. The flexible nature of state-directed pharmaceutical regulation and the unofficial economy prevalent in the country (Quet et al., 2018) have facilitated a flourishing illicit market. On-line pharmaceutical sales were rapidly prohibited and suspect products destroyed in the markets during police raids that were deliberately mediatized. [x] For a non-official translation of the draft law, see Agence Kampuchea Presse (2020).
Agence Kampuchea Presse (2020). Full Text of Approved State of Emergency Draft Law, Agence Kampuchea Presse, April 10. https://akp.gov.kh/post/detail/29564
Cohen, H. J. (2019). “Unconditional aid and ‘hybrid democracy’: The case of Cambodia.” Asian Journal of Public Affairs 11(2): http://dx.doi.org/10.18003/ajpa.20194
Elbe, S. (2018). Pandemics, pills, and politics: Governing global health security. Baltimore: Johns Hopkins University Press.
European Commission (2020). Trade/Human Rights: Commission decides to partially withdraw Cambodia’s preferential access to the EU market. Press Release, February 12. https://ec.europa.eu/commission/presscorner/detail/en/ip_20_229
Gaudillière, J.-P. (2020). “La fin du grand partage? A propos du COVID-19, des réponses à l’épidémie et de la santé globale.” AOC, April 3.
OCDE (2018). Economic Outlook for Southeast Asia, China and India 2019: Towards Smart Urban Transportation. Paris: Éditions OCDE, http://www.oecd.org/dev/asia-pacific/saeo-2019-Cambodia.pdf
Pantucci, R. (2020). “How China’s coronavirus medical diplomacy is failing to win over the world.” South China Morning Post, April 4. Pierson, D. (2020). “New clothes pile up at Cambodian factories. Coronavirus forces U.S. brands to cancel orders.” Los Angeles Times, April 15.
Quet, M., L. Pordié, A. Bochaton, S. Chantavanich, N. Kiatying-Angsulee, M. Lamy, P. Vungsiriphisal (2018). “Regulation Multiple. Pharmaceutical Trajectories and Modes of Control in the ASEAN.” Science, Technology and Society 23(3): 1-19.
Radio Free Asia (2020). COVID-19 Cases Rise Across Southeast Asia as Governments Step Up Damage Control. Radio Free Asia, April 3 https://www.rfa.org/english/news/laos/searoundup-03302020200244.html
Strangio, S. (2014). Hun Sen’s Cambodia. New Haven: Yale University Press. Transparency International (2020). Corruption Perception Index 2019, https://www.transparency.org/cpi2019
Un, K. (2005). “Patronage politics and hybrid democracy: Political change in Cambodia, 1993-2003.” Asian Perspective 29(2): 203-230.
Vicheika, K. (2020). “Cambodian government allocates up to $2 billion for economic fallout from coronavirus.” VOA Cambodia, March 10.
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