Thursday, June 4, 2009

Degrees of separation

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Quantity not quality is the watchword of the education debate to date. There are jobs out there but few young people qualified in the right disciplines to fill them and turn the economy around.

Pace makers: CEO of CIDC Information Technology Mike Gaertner

CamCambodia is on the road to achieving its 2015 Education for All target, but access to education is no longer the main issue for the country. The focus has shifted to its quality, not quantity.

In Education for All, a 2008 Unesco report, the country was listed as one of 63 to have mostly achieved universal primary school enrolment (93% male to 90.7% female) with more than 3m children at school across the country in 2007-08.

However, it was also listed among the worst-performing countries with regard to literacy and was recently ranked 121st in the world in an ICT (information and telecommunication technology) development index report by the Geneva-based International Telecommunication Union.

“The government has made great strides in providing education for all,” says Sandra D’Amico, managing director for HR Inc Cambodia, a human resources consultancy. “The challenge, though, is not only access to education, but the quality of education and type and level of training. Graduates require more practical skills for the job market.”

According to Professor Jean-Jacques Paul, economics and management project manager at the Royal University of Law and Economics (Rule), weak government policy compounded by a shortage of funds is at the core of the skills-shortage crisis.

Luu Meng, the Cambodian Hotel Association president, says there is a chronic shortage of qualified trainers and teachers, which the Ministry of Education, Youth and Sports (MoEYS) acknowledges. “We have to improve, but the number of scholars and facilities is limited,” says Roth Sokha, head of the department of higher education.

Meanwhile, companies are rising to the challenge and supplementing the lack of skills training in the education system. Meng says he spends more than 10% of his annual budget on training his staff. “In the hotel industry, this figure is usually as low as 3%-4%.”

Paul Guymon, the regional research director for IndoChina Research, says his company spends thousands of dollars a year on training. “In other parts of the world, universities take students further.” However, this system works as long as companies have the capacity to train their staff. “Some employers fail to understand the need for staff development and training,” says Meng.

While teaching and training standards are key challenges to address, for D’Amico another part of the problem is the lack of job information, career guidance and advice about what is on offer. “Youth, job seekers and education institutions are not making informed decisions based on market needs. There is a lack of understanding, coordination and information flow between industry (demand side) and the labour market supply (job seekers and education providers).”

A survey conducted by the International Labour Organisation (ILO) and the Cambodian Federation of Employers and Business Associations (Camfeba) in 2008 found that 70% of young people rely primarily on the advice of their parents when deciding what to do after high school. Students leave university with unrealistic expectations of the job market, D’Amico points out.

“There are currently jobs for civil engineers, electricians, architects and technicians,” says Ung Vannthoeun, vice-rector of Norton University, “butmost students study business, and economics. Now that sector is oversupplied while others are undersupplied. They choose courses based on public perception of the related industry, not job opportunities.”

Many students feel that after studying for a BA or MA they should be made a manager, have an air-conditioned office and a reputable salary, says Meng.

But Sophea Mar, social sector officer for Asian Development Bank, views that “because quality of education at all levels is low, companies opt to recruit graduates with BAs and MAs to ensure basic skills”.

In 2007, a mere 200 students graduated in engineering as opposed to 4,700 in business, says Paul. “Students don’t know the demands of the market because there are no surveys.” That’s because various institutions and government bodies are working on specific statistics, so there is no comprehensive national survey on the labour market. Until this information has been gathered, it is up to the private sector to inform education institutions of the needs of potential employers. “The ILO is skilled in assisting partners in collecting data, but real success will depend on the close association between industry and teachers,” Sukti Dasgupta, senior specialist on employment polices for ILO-Bangkok sub-regional office, says. There is also a problem with limited access to education, worries Sophea: “Management institutes are everywhere, but where are the engineering institutes? How can students consider studying for a science degree if they have never seen the inside of a lab?” However, strides are being made to redress this imbalance. The second Unesco regional science and

technology camp organised with MoEYS aimed to give Cambodian children hands-on experimentation in a laboratory in an attempt to raise their interest in scientific and technical skills. A three-day National Educational Congress, held in March, discussed reform strategies while at the start of the next academic year, Rule in conjunction with the French Chamber of Commerce (CCFC) will introduce a course to promote technical-commercial skills.

Addressing a growing demand by the business community for quality recruitment, the CCFC initiated a careers forum five years ago to connect employers with qualified students and to prepare students for effective job hunting.

“Based on last year’s figures, we expect more than 10,000 visitors to this year’s careers forum in March, a figure that indicates the lack of career guidance available at schools and universities,” says Denis Gambade, director of the CCFC. He says that communication skills are most in demand. D’Amico agrees. The initial criterion a company is looking for is not the level of education but communication, the ability to think critically and analytically coupled with problem-solving skills. Employers can provide on-the-job training for the rest. “But with 250,000 people looking for jobs every year, there is a much larger problem to be dealt with,” Gambade adds.

Statistics from the Ministry of Education say that 12,987 students graduated from higher education institutes in 2008. “But we’re looking for redistribution. There are too many university students and not enough people at the vocational training level,” stresses D’Amico.

The majority of students go from school to university and not to vocational training institutes, but this does not represent the needs of the industry. “There is a skills shortage at the technical and operational level,” says Paul.

“Technical Vocational Education and Training (TVET) can relieve the economic crisis by creating job opportunities as well as reducing poverty and maintaining a sustainable economy,” says Eric Beugnot, French Development Agency (AFD) director.

While Vorng Soth, the labour minister, stressed the need to boost vocational training opportunities such as carpentry, bricklaying, masonry and office skills for low-skilled workers at a two-day Ministry of Labour conference in March, associations are looking to establish training institutes. The Garment Manufacturers Association of Cambodia (GMAC) is hoping to raise $5m to fund an institute to train and upgrade workers’ skills. “The lack of productivity in the garment industry stems from the workers, not the machines,” observes Ly Tek Heng, operations manager for GMAC about the findings of a recent study by AFD that state garment factories in Cambodia are 50% less productive than competitors in neighbouring countries.

Meanwhile, the Cambodian Hotel Association has organised a meeting between the ministries of tourism and education, educational and vocational training institutions and hoteliers to find ways to tackle the shortage of qualified staff. “There is a need for hotels to improve training capacity. Because of a shortage of competent staff, a waitress may be promoted to captain level and her salary will double,” says Meng. “But has her value doubled? No. She will still, like many middle to higher managers, lack basic skills in business and marketing.”

The problem is the same for the garment industry, says Beugnot. “Insufficient training and foreign managers at the middle management level means the global economic impact affects the garment and hospitality industries equally.” Last year in the garment industry, 350,000 workers were managed by 8,000 managers, most from China, Singapore and Taiwan. While of the 5,000 people who entered the tourism industry in 2008, only 800 were trained, and they were taught by non-government organisations, says Paul.

Although employment figures for the tourism sector are hard to come by, the Ministry of Commerce says it represents 10% of the country’s gross domestic product and directly employed 32,500 in 2003. To bring them up to international standards, Meng estimates $2m is required to set-up a national training school.

Though financing and sustaining such training institutes is a stumbling block the burden, AFD suggests, could be shared between the “three stakeholders”: the worker, the employer and the public sector.

A research project by the AFD concludes that a trained worker after five years’ experience will earn on average $145 a month more than an unqualified one. With a $2,000 investment, the company would see an average profit increase of 42% after five years, as well as higher productivity, better service quality and customer satisfaction, enhanced competitiveness and reduced reliance on higher paid foreigners and, finally, the country as a whole would see significant social and economic benefits.


“If companies can replace 50% of foreign managers at middle-management level the difference in cost could be as much as $500 a month per person,” says Beugnot. “The garment industry could save $12m a year, which is not a negligible amount.”

Fears are mounting that Cambodia faces rising unemployment due to reduced demand for Cambodia’s exports, particularly garments, as a consequence of the global economic slowdown. Export figures for the garment industry are 58% lower than February 2008 and more than 51,000 workers have lost their jobs since September, according to figures released by Cham Prasidh, the commerce minister, in March. In addition, the International Monetary Fund has predicted that Cambodia will go into recession.

“To diversify the economy and ensure we have a skilled, competent and productive labour force to match, there is a need to better understand our labour market information system that will help us be proactive and not reactive during challenging economic times,” says D’Amico. “Is the education system ready to retrain? Is it able to upgrade skills in different professions in a timely manner?”

National skills standards are useful for policy makers, planners, curriculum developers and businesses and become a benchmark for the quality of vocational skills. This, Sophea warns, is not an easy process but a skills standard is vital to boosting employer confidence to hire a local labour force into positions of responsibility, otherwise they will be forced to import skilled workforce, including frontline management. “The difficulty is ensuring local demands are met as well as regional expectations. To do this we need to work closely with the private sector so we can understand the market and what skills are needed. When this is achieved, countries can look to Cambodia for labour.”

If funding is approved, the ADB plans to invest $17m into TVET by the end of this year. There are 36 TVET government institutions and 250 in the private sector, according to Laov Him, head of Ministry of Labour and Vocational Training (MLVT) TVET’s department. “Some skills standards are set, especially where export markets are involved. International businesses operating in Cambodia also have set their own standards, for example the hotel industry,” says Dasgupta, “but these are not national standards.”

Once skills standards compete with regional norms, the MLVT can accredit institutions. “In the next five years we will see Cambodia achieve a skill standard and industry will move forward. The standard can then be linked to general education.”

“International industries are constantly seeking skilled labour,” says Dasgupta. “Although these industries might train workers to their standards, the trainee must possess the required education level and basic skills of the trade first. Cambodians who are skilled and good at their job will always be sought after.”

“Skilled workforces whether in the agriculture, industrial or service sectors are the engine to improve agricultural and industrial productivity and economic development. Shortage of a skilled labour force is one of the critical barriers for Cambodia’s competitiveness to attract foreign investors who look for new opportunities during the global economic downturn,” says Sophea. “The potential is there and in the future I am sure we will see more assembling factories – in agri-processing and mechanical work – opening in Cambodia, once the skills standard is raised. It will take five to 10 years, so the time to act is now.”

Doctors Probed Over Woman's Death

2009-06-02

Poor women die in childbirth every day in Cambodia, but who's to blame?

Parents care for their children at a hospital in Phnom Penh, Sept. 14, 2006 (AFP)

PHNOM PENH—Authorities in the northwestern Cambodian province of Pailin are investigating six doctors over the death of a pregnant woman in their care, sparking renewed concerns about how the country's health care system treats the poor.

Van Yoeub, 37, died along with her unborn baby after trying to get medical help at the Pailin Referral Hospital on March 20.

Widower Mit Ran, 48, who has only one leg and has been left to care for the couple's eight children, said he was summoned to the hospital late in the evening after his wife went into labor, but was told he had to pay 100,000 riels (U.S. $25) in medical fees.

...Doctors didn't care about the victim, causing her death."

Pailin Governor Y Chhean

Mit Ran said that he was also told to prepare to pay a service fee of 1,000 Thai baht (U.S. $29) once his wife had given birth.

"A demand of 100,000 riels is what they actually said to me. They said it was a service fee—a bed fee," he said, adding that several doctors repeatedly ignored requests for help after his wife experienced severe abdominal pain and profuse bleeding.

Removal sought

A court in neighboring Battambang province has called doctors Prak Sokhon, Luy Chantha, Yin Buntha, Taeng Saraoth, Suon Thida, and hospital deputy diretor Ang Neang in for questioning as officials probe what happened on the night of Van Yoeub's death.

Pailin's provincial governor said the doctors hadn't done their duty as medical professionals and called for their removal.

"The important factor is that the doctors didn't care about the victim, causing her death," governor Y Chhean said.

"Secondly, there will be measures taken to ensure that the doctors will not continue like this. They have to be replaced to improve treatment—the doctors have to be replaced as a lesson for the future," he added.

Pailin provincial health department director Sang Ran said responsibility for Van Yoeub's death lay with the state-run hospital, which has been ordered to treat people regardless of their ability to pay medical fees.

"The doctors are to take responsibility, because it is somehow related to a technical issue on the night," Sang Ran said.

"We didn't check everything well. We didn't conduct an examination when the patient arrived, so this case fell through the net for a clear assessment."

Pleas ignored

Van Yoeub and her husband's pleas went unheeded by doctors, despite her feeling that she would die without medical help.

"My wife said to the doctors, 'Please help me, because without an operation, I will not live.'"

"Then I asked, 'Can you help her, doctors?’ They didn't say anything, so I said no more. I paced back and forth until my wife died. She died at 5 a.m. with the baby inside her," he said.

Hospital authorities said Van Yoeub died because of extreme complications surrounding her pregnancy.

"She was bleeding too much," deputy hospital director Ang Neang said. "I gave her blood, oxygen, and serum, but we couldn't save her life."

He confirmed Van Yeoub's death at 5 a.m.

"Doctors from everywhere gathered to help to save her life. The doctors told them that the fee for delivering a baby which is in a serious condition is 100,000 riels," Ang Neang said.

Commonplace issue

Many Cambodians have reported similar experiences, leading to many deaths among women in labor.

Battambang Regional Doctors' Association president Sao Soeun said many similar cases had occurred across the country but had later been covered up by the authorities.

"This is the doctors’ fault, not the patient’s, because she came to get medical services," he said.

"The doctors didn't treat her—they thought only about money. It definitely contradicts the code of conduct," he said, adding that similar cases would continue to arise unless doctors were constantly aware of their professional ethical code.

Article 2 of Cambodia's physicians' code of conduct, adopted by the Council of Ministers in 2003, states that doctors must respect people’s lives, bodies, and dignity.

Repeated calls to Cambodian Health Minister Mam Bun Heng went unanswered during office hours.

Layers of bureaucracy

A village chief in the central province of Kompong Chhnang said only a few people could get easy access to health care in his region of the country.

"Most people complain that the hospital takes too much money from them, so some people who get sick just stay at home until they die," Ou Russey village chief Ly Loh said.

"However, a number of people who are rich get medical services in time."

He said poor people also face an additional layer of bureaucracy before they can get medical attention.

"The people who are very poor are required [by the health center] to be certified by village and commune authorities, which takes too long," Ly Loh added.

A 2006 study published in the British medical journal The Lancet found that user fees, adopted by low-income countries during the 1980s as a way of offsetting spiraling health care costs, left poor patients at a disadvantage, although health care equity funds in Cambodia had improved the attitude of hospitals and clinics to the poor.

The study's authors concluded that universal free health care offered the best approach to redress social injustice in societies still recovering from conflict, in which a high proportion of the population lives in impoverished rural areas.

Original reporting in Khmer by Sophal Mony and Tin Zakariya. Khmer service director: Kem Sos. Translated by Uon Chhin. Executive producer: Susan Lavery. Written for the Web in English by Luisetta Mudie. Edited by Sarah Jackson-Han.