A. Executive Summary
Cambodia lies in the middle of the Great Mekong sub-region, in Indochina. As the heir of the once glorious Khmer empire, it has been a country of war and great poverty for decades over the last century. The new millennium, however, saw an impressive improvement in the living conditions of its 17 million inhabitants, thanks to the efforts of both national and international institutions, and many organizations operating in the country. Yet the Kingdom still faces enormous challenges. Its mainly rural population, predominantly from ethnic minorities, continues to live on the verge of poverty, suffering dire conditions and an increased risk of abuse and exploitation.
Though urbanization is on the rise, migrants – both internal and international – face many burdens and adversities. They are increasingly vulnerable to trafficking, abuse, and exploitation. The families they leave behind also suffer significant hardships. Internal migration is prevalent, especially from the countryside to the urban areas, and so is emigration. The vast majority of Cambodians migrate to Thailand, seeking job opportunities and higher wages. Approximately two thirds of Cambodia’s emigrants use unconventional and often illegal means to find a job and migrate, otherwise relying on brokers and recruitment agencies. This framework exposes them to a high risk of abuse or exploitation, as well as human trafficking, usually by means of debt-bondage and passport confiscation. Internal migrants struggle to get health assistance and decent housing, while emigrants are often underpaid and undocumented, thus increasing their vulnerability. Children who are left behind often suffer negative impacts on their development, representing a significant challenge for their caregivers.
Cambodia is frequently exposed to natural calamities with thousands of displacements every year. As most of its population heavily relies on agriculture, the impact of natural calamities is even more detrimental. Cambodia hosts very few refugees and asylum seekers, with roughly 200 officially declared in 2020. Statelessness is an extremely significant issue in the country. Cambodia has never signed either of the 1954 and 1961 Conventions on the matter. Official data are lacking and hard to find, but the number of stateless individuals is surely high, including many Cambodian Vietnamese, Khmer Krom, and other minorities.
Trafficking in persons is another very relevant issue. Men are mainly exploited in the fishing industry in Thai-flagged vessels, while women are forced into illegal marriages and sex labour. Sex tourism is widespread, including child sex. Child labour is also widespread, particularly in brick kilns around the country. Cambodian authorities have developed several legal and administrative mechanisms, as well as action plans, to address most of these issues. However, additional efforts will be required and many of these matters are still left mainly in the hands of civil society and international organizations.
B. Country Profile
I. Basic Information
The Kingdom of Cambodia (hereafter Cambodia) is a country spanning 181,000 km2 in the southern portion of the Indochinese Peninsula. It is bordered by Thailand to the northwest, Laos to the north, Vietnam to the east, and the Gulf of Thailand to the southwest. Phnom Penh, in the central south, is the capital and largest city. A low-lying central alluvial plain cuts the country from the northwest to the south, connecting with the Mekong River, which crosses Cambodia from north to south. These lowlands are surrounded by low mountains and uplands to the southwest and to the northeast. Cambodia’s population of 17,300,000 is very young, with a median age of 26.4 years old. The population primarily consists of Khmer (Cambodians), who account for up to 97.6% of the inhabitants. The rest of the population is Cham (1.2%), Chinese (0.1%), Vietnamese (0.1%) or other (0.9%). Theravada Buddhism is the official religion, practiced by roughly 96.9% of the population. Muslims represent 1.9% (80% of whom are ethnically Cham) and Christians account for 0.4%, according to the last census in 2019. Over 60% of the population lives in rural areas. Slightly less than half of the population lives in the central plains and over 30% live on the Tonlé Sap, which is the largest freshwater lake in Southeast Asia.
Dominated by the Siam (Thai) and Vietnam empires, the Khmers sought the protection of France at the beginning of the nineteenth century. They became a protectorate, part of French Indochina, until 1953. During the Vietnam War, a communist insurgency in Cambodia established the Khmer Rouge dictatorship. The regime lasted 5 years, from 1975 to 1979, and caused at least 1,500,000 deaths out of a population of 7,000,000. Khmer raids beyond Vietnam’s borders triggered the Vietnamese invasion in 1978, resulting in 10 years of occupation and 20 years of civil war. The country still faces the plight of landmines and explosive remnants of war (ERW), especially in rural areas, that were deployed during these three decades of war. After the end of the war in 1991 and Khmer Rouge’s final surrender in 1999, several attempts were made by both the monarchs and the United Nations to establish a democratic government. After the opposition party, the Cambodia National Rescue Party (CNRP), was dissolved by the Supreme Court in November 2017, the ruling Cambodian People’s Party (CPP) triumphed in the 2018’s election, making Cambodia a de facto one-party state.
While the rate of overall poverty continues to decline, rural poverty remains high at 40%. Cambodians employed in the informal economy represent about 85% of the population, working mostly in agriculture, forestry, fishing and in small and micro enterprises. In the formal sectors, textiles are the main export, with knit clothing accounting for 65%, followed by 10% footwear and headwear, employing more than 600,000 workers, mostly women. Tourism is the other main economic resource.
II. International and Internal Migrants
Internal migration in Cambodia is more prevalent than international migration, with up to 20% of Cambodians having been migrants at least once before 2019. As of 2019, approximately 1,260,000 people had migrated in the previous 5 years. Rural to urban migration was the most common flow, representing 34% of the total internal migration in 2019, followed by urban to urban migration at 30. Rural to rural migration, which represented the main flow in the past, continues to decline and currently sits around 29%. Rural to urban migration is fostered by several conditions. The more educated Cambodians struggle to take advantage of their skills in a rural environment that has been slowly developing since the civil war. Furthermore, as agricultural land is divided among children with each successive generation, parcels became insufficient for more than subsistence farming. Livelihoods have also been undermined by deteriorating land and water conditions. These conditions create a pool of underproductive labour in rural areas, with a workforce that is willing to be employed in urban areas. Phnom Penh remains the main destination for both international and internal migrants, followed by other economically relevant provinces such as Battambang, Kampong Cham, and Siem Reap. Interprovincial migrants represented 58.8% of the total migrants living in Cambodia in 2019. According to the 2019 census, migrations were mostly triggered by marriage (19.7%), search of employment (19.4%), and transfer to a new workplace (10.8%), with the majority of migrants moving to follow their family (38.9%). Almost half of the migrants were between 20 and 39 years of age, both among males and females. As suggested above, migrants are more educated, on average, than the rest of the population. Even so, only about 67% of them have completed primary education, and slightly less than 10% are still illiterate. About a third of migrants are engaged in rural activities, with the rest being mainly employed in urban jobs. Migrants reportedly work in the wholesale and retail industries, especially for females, as well as vehicle repair and manufacturing. Many are also involved in other unskilled or semi-skilled jobs. Men work mainly in the construction sector and women in the garment industry. Garment manufacturing is, with tourism, the main driver of economic growth, accounting for 80% of Cambodia’s exports. Internal migrants face dire conditions, with many working over ten hours per day and seven days per week. Moreover, only a small portion of migrants have health insurance. They have to travel a long distance for medical help and will resort to a pharmacy to receive medical assistance instead of going to a doctor or a clinic.
The UN Department of Economic and Social Affairs (UNDESA) reported 79,341 international migrants living in Cambodia, primarily from Vietnam (49.3%), and Thailand (41.7%). Most immigrants work in agriculture, though the number is proportionately fewer than within the overall population (38% versus 55%). A higher proportion of migrants are employed in the wholesale and retail sectors compared to the total population, with the majority being female. As of March 2020, following Thailand’s measures to tackle the COVID-19 outbreak, at least 322,000 Cambodian migrant workers returned to the native country. Many of them are facing underreported difficulties and challenges, such as unemployment, a significant decrease in their household income, debts, and insufficient support in their mental health, as well as their psychosocial and social well being. Returning migrant women may experience a particularly higher risk of workplace, family, and domestic violence.
III. Emigration and Skilled Migration
Cambodia is a major source of both irregular and regular migrants, due to its geographic position, permeable borders, and widespread poverty. The UN Department of Economic and Social Affairs reported 1,104,819 Cambodians living abroad as of mid 2020, mostly in Thailand (62.6%), in the United States (14%), Europe (7.8%), and South Korea (5%). As many migrate illegally, it is difficult to establish how many leave the country per year. Moreover, many young Cambodians use temporary passes to migrate short distances across the Thai border to work in agriculture. According to a survey conducted in Thailand by IOM, in 2019, Cambodians migrating across the border were primarily seeking better job opportunities and higher wages. The research found that one third of them received less than the minimum wage of the respective Thai province. Documented migrants usually receive higher pay than those who are undocumented and those who work on a day-pass. They are commonly employed in fishing, agriculture, livestock construction, manufacturing, and the domestic sector. Shortage of employment opportunities and substantial differentials with overseas wages are the main factors fostering migration. Cambodian workers seldom migrate using regular channels, in order to avoid high costs, delays, and bureaucratic intricacies. More than two thirds of them rely on other means, especially unlicensed brokers and social networks, to find a job, and their migration is often facilitated by smugglers. Nevertheless private recruitment agencies still play an important role in labour migration from Cambodia. Many migrant workers need assistance to find a job abroad and to get the requested documentation. However, if charged excessive fees, they are likely to be at the mercy of their employers and creditors, often unable to leave their job, facing abuse, or exploited. Many children of migrants are left behind, especially if they are younger than 15 years old. They are often left in the care of their grandparents or other relatives. Parental absence can have negative impacts on children’s development, behaviour, and health, as well as causing significant strain on the financial situation and health of the caregivers. Furthermore, the COVID-19 pandemic worsened the situation of the many Cambodian households that rely on migrant worker’s remittances to meet their basic needs, including food and health expenses, due to a fall in the wages and employment of migrant workers.
IV. Forced Migrants (internally displaced persons, asylum seekers, and refugees)
Cambodia is frequently exposed to storms, floods, and drought, and sometimes to forest fires and landslides. Flooding patterns of the Tonlé Sap Basin are particularly affected by climate changes. Several floods and storms in the area, took place in recent years with huge humanitarian and economic costs. The coastal provinces of Kampot, Koh Kong, and Sihanoukville provinces are susceptible to seawater intrusion, while the northwest province of Battambang is notably vulnerable because of its high rates of poverty and a population that relies primarily on agriculture. As of December 2020, the UN Internal Displacement Monitoring Centre (IDMC) reported 260 people being displaced in the country, and as many as 66,000 displacements throughout the year.
Cambodia is a signatory to the 1951 Refugee Convention and started registering and processing asylum claims in late 2009. According to the UNHCR, there were 167 asylum seekers and 34 refugees hosted in the country as of 2020. The vast majority are male, under sixty years old, commonly coming from Vietnam. Dozens of Vietnamese from various ethnic groups, known under the umbrella term of Montagnards (also Degar) have been reported fleeing Vietnam to hide in Cambodia’s eastern highland jungle. Many Khmer Krom from the Mekong Delta in Vietnam have also fled to Cambodia. However, many refugees have been deported back to their country of origin by Cambodian authorities. As of 2020, there were 11,901 Cambodian refugees in the world (compared to 11,986 in 2019), of which 10,894 were hosted in France, as well as 916 Cambodian asylum seekers (up from 865 in 2019), primarily in Australia (515), and Thailand (112).
Cambodia is not a party to the 1954 Convention Relating to the Status of Stateless Persons or the 1961 Convention on the Reduction of Statelessness. The total number of stateless persons and individuals at risk of statelessness residing in the country is unknown. However, the UNHCR reported 57,444 stateless individuals living in Cambodia in 2020, though the real number could be much higher. Several research studies and NGOs report high numbers of Vietnamese-Cambodians living in the country (up to 750,000), even though a survey in 2015-2017 only reported 180,690. Since they are not recognized citizens of Vietnam or Cambodia, they often lack even a birth certificate. Some of these Vietnamese have lived in Cambodia for generations. Despite residing in Cambodia for many years, being married and having children with Cambodian citizens, some refugees and asylum-seekers have been still unable to acquire citizenship, even if they would be eligible under Article 5 of the Nationality Law. Stateless people remain excluded from several welfare services and rights, due to their condition. They have no means of identification and are forced to work illegally.
V. Victims of Human Trafficking
Human trafficking and labour exploitation have long been major problems in both Cambodia and the entire Greater Mekong area. Cambodia is a notorious hub and a country of both origin and destination for victims of trafficking. Most Cambodians use brokers to migrate abroad illegally, as it is cheaper and faster than through formal channels. Before the COVID-19 outbreak, between 30 and 40% of the 1.5 million Cambodians working in Thailand were undocumented workers. This has increased the risk of persons being trafficked for forced labour and sexual exploitation. An increasing number of Cambodian men are subjected to abuse and exploitation in the fishing industry. After being trafficked to neighbouring countries, especially Thailand, they are often stranded abroad. At the same time, the National Committee for Counter Trafficking (NCCT), reported another recent trend concerning domestic workers and the forced marriage of women abroad, mostly to Chinese husbands. These women are vulnerable to confinement and domestic servitude. Several workers were also found to be trafficked by a licensed recruitment agency. At least 261,000 people were living in conditions of modern slavery in Cambodia in 2018, according to research by JRS Cambodia.
Poverty, together with a lack of education and skills, are the main traits associated with victims of human trafficking. Other factors that foster trafficking include increased sex tourism, weak law enforcement, corruption, and the lack of safe and affordable legal channels for migration. Undocumented migrants and stateless individuals are also at high risk, due to the lack of identification documentation necessary to travel or access formal employment. Debt-bondage is the main means of coercion, as well as passport confiscation. Most of the victims willingly decided to migrate following the promise of jobs agreements and the opportunity to send remittances to their families back home. Instead, they are fraudulently sent to be exploited in other Asian countries, and increasingly to the Middle East. Vietnamese women and children, particularly from impoverished rural provinces, are usually the victims of trafficking in Cambodia. Other known countries of origin are Bangladesh, China, and Nepal. Vulnerable migrants may also become involved in human trafficking, as perpetrators, either through recruitment or client referral. As of 2018, more than half of convicted traffickers and brokers were women. Since most of them recruit victims within their own social circle, their gender and socio-economic level influence those who are usually targeted. Some victims were reportedly sold by their own parents and spouses for money. Children from impoverished families are vulnerable to being forced into domestic service, where they are at risk of further abuse and exploitation. Others are forced into begging and street vending in Thailand and Vietnam, often with the complicity of their own families. As many as 4,000 children and more than 10,000 Cambodians work in Cambodia’s 486 brick kilns, where episodes of coercion, abuse, and exploitation have been continuously reported. The debt-based coercion system is also exacerbated by an extensive, largely unregulated network of predatory micro-finance organizations and private creditors. Cambodian women and girls from rural areas, especially ethnic Vietnamese, are exploited in brothels and clandestine sex establishments in cities and tourist destinations. While Cambodians men remain the larger source of demand for children exploited in sex trafficking, tourists from other Asian countries, as well as Australia, Europe, South Africa, and the United States, increasingly travel to Cambodia to engage in child sex tourism. This is increasingly facilitated through social media contact. Children of migrants who are left behind are particularly vulnerable to sex trafficking. Thankfully, child prevalence in sex trafficking and sex tourism seems to have declined during 2020 due to COVID-19 quarantine requirements and travel restrictions. However, both NGOs and local authorities reported a parallel increase of online child sexual exploitation over the same period.
Cooperation with countries neighbouring Cambodia, in particular Thailand and Vietnam, is a key element to preventing human trafficking and prosecuting the perpetrators. Regional partnerships and formal agreements have been developed, although the implementation of such agreements remains challenging on both sides of the border.
VI. National Legal Framework
Labour and employment in Cambodia are regulated by the 1997 Labour Law, which was amended in 2007, as well as the Law on Social Security of 2002. These have been accompanied by several governmental decrees (kret), sub-decrees (anu-kret), regulations (prakas), decisions, memoranda, and notices. These are issued by the Royal Government and in particular by the Ministry of Labour and Vocational Training (MoLVT). For example, MoLVT Prakas No. 235 on Work Condition for Houseworkers extended several rights, already guaranteed to workers in general, to migrant domestic workers. These include the requirement of written contracts, twenty-four hours of weekly rest, paid holidays, and some social security coverage. In 2013, the MoLVT issued the Prakas No. 249 on the Complaint Receiving Mechanism for Migrant Workers. Through this mechanism, migrant workers can file a complaint against employers, managers, foremen, brokers, or recruitment agencies, with a Provincial Department of Labour and Vocational Training (PDoLVT) or directly with the MoLVT. Family and friends of migrant workers can also lodge complaints on their behalf whenever they are unable to do so. This framework is part of a wider mechanism for the implementation of the Global Compact for Safe, Orderly, and Regular Migration, including the implications of COVID-19. The Government of Cambodia has put in place a national mechanism that sees the MoLVT as the leading ministry for the management of migrant workers. The mechanism includes three policies: the Employment Policy for Cambodia 2015-2025; the Technical and Vocational Education and Training (TVET) Policy for Cambodia 2017-2025; and the Labour Migration Policy for Cambodia 2019-2023. Within the mechanism, labour migration abroad is regulated by the 2011 Anu-kret (Sub-decree) No. 190 on the Management of the Sending of Cambodian Workers Abroad through Private Recruitment Agencies, which replacing Sub-decree No. 57 of 1995. There are also eight Prakas that supplementing this Anu-kret. Cambodia has also secured several Memoranda of Understanding with receiving countries, such as Vietnam, Thailand, and South Korea. Immigrants shall also comply to the Law on Immigration of 1994. In addition to the provisions of the law that address issues related to brokers and recruitment agencies, the Association of Cambodian Recruitment Agencies (ACRA) and the Manpower Association of Cambodia (MAC) adopted a Code of Conduct. The code was developed with technical support from the MoLVT and ILO, in order to implement ethical and responsible recruitment practices.
As mentioned above, Cambodia is a signatory to the 1951 Refugee Convention. Regarding asylum seekers and refugees, Sub-Decree No. 224, enacted in 2009, established the Procedure for Recognition as a Refugee or Providing Asylum Rights to Foreigners in the Kingdom of Cambodia. According to this Procedure, “a refugee shall have the same rights and be subject to the same obligations as a legal immigrant foreigner…” However, the Law on Immigration does not mention specific rights provided legal immigrants. Nonetheless, refugees and asylum seekers have the right to a residence card, the right to work and operate a business, the right to sponsor a family member to immigrate to Cambodia, and the right to travel documents if they wish to depart from Cambodia.
Cambodia is not a signatory of the 1954 Stateless Persons Convention, which grants several rights to stateless individuals, such as education, employment, housing, and administrative assistance, nor of the 1961 Convention on the Reduction of Statelessness. Statelessness remains a major issue in the country. Even though certain rights are accorded to stateless individuals, refugees, and their spouses and children, many still face difficulties in accessing their rights and benefits.
Cambodia’s Ministry of Justice passed the Law on Suppression of Human Trafficking and Sexual Exploitation in 2008, resulting in an increased prosecution of perpetrators. The law criminalized sex trafficking and labour trafficking, prescribing penalties of 7 to 15 years of imprisonment for offenses involving an adult victim, and up to 20 years for those involving child victims.
VII. Main Actors
The State and International organizations
Immigration in Cambodia is overseen by the Ministry of Interior (MoI), especially through its General Department of Immigration. On the other hand, the Ministry of Labour and Vocational Training (MoLVT), is the main authority responsible for handling labour matters involving migrants. The MoLVT is also the authority in charge of signing Memoranda of Understanding with receiving countries, on behalf of the Royal Government. Within the General Department of Immigration, the Refugee Department is the actor responsible for the registration of new refugees and asylum seekers and the approval of asylum requests. The National Committee for Counter Trafficking is the mechanism that coordinates the efforts of ministries, institutions, national and international NGOs, the private sector, and other stakeholders in fighting human trafficking. The Committee is responsible for promoting the implementation of laws, national and international policies, and government policy plans related to the fight against human trafficking, as well as thoroughly monitoring and evaluating the human trafficking situation. Within the Ministry of Interior, the Anti-Human Trafficking and Juvenile Protection Police (AHTJPP) leads the gathering of evidence to support the prosecution of the traffickers.
Cambodia is a member of the United Nations and the Association of Southeast Asian Nations (ASEAN). Founded in 1967, ASEAN’s main purpose is to promote cooperation and mutual assistance between Member States in order to accelerate economic progress and increase the stability of the region. Within the UN network, the International Organization for Migration (IOM) provides technical assistance and training to several ministries and governmental authorities, such as the National Committee to Counter Trafficking and the Ministry of Foreign Affairs. It coordinates several programs with an expanded focus on adult male victims of trafficking, given the lack of services available to this particular group. Direct assistance is provided to trafficking survivors upon return to Cambodia, including medical aid, food supplies, and temporary accommodation. The International Labour Organization (ILO) collaborates with the Royal Government to protect the human and labour rights of migrant workers. The ILO also supports the establishment and operation of Migrant Worker Resource Centres (MRCs) across Cambodia. The ILO also supports the implementation of the Tripartite Action to Protect the Rights of Migrant Workers within and from the Greater Mekong Subregion (GMS TRIANGLE) and the Tripartite Action for the Protection and Promotion of the Rights of Migrant Workers in the ASEAN Region (ASEAN TRIANGLE project). These Projects aim to significantly reduce the exploitation of labour migrants in the region through increased legal and safe migration and improved labour protection. The MRCs offer a space for workers and their family members to obtain information on migrating for work, to lodge complaints and receive legal assistance. The United Nations Children’s Emergency Fund (UNICEF) in Cambodia promotes the healthy development of children, defending their rights and helping them to fulfil their potential, with a particular focus on children who have been left behind as a result of the migration of their parents. UNICEF works closely with government ministries to strengthen Cambodia’s child protection system, build a child-friendly legal framework, and support children and adolescents with appropriate crime prevention and response measures through the training of social workers and institutional staff.
Cambodia has the second highest number of Non-Governmental Organizations (NGOs) per capita in the world. There were at least 6,000 national and international Civil Society Organizations (CSOs) operating in Cambodia as of 2018. CSOs play a fundamental role in addressing migrant issues in Cambodia, often compensating for the inadequacies and the lack of intervention by the authorities, for instance delivering medical assistance. The majority of NGOs focus on human rights, health assistance, child support, fighting human trafficking, and providing micro-credit to households and family enterprises. The Cambodian Red Cross is one of the largest humanitarian organizations in the country, as part of the International Federation of Red Cross and Red Crescent Societies. It has been recognized by the Royal Government as the main auxiliary to the public authorities in humanitarian services. The Red Cross intervenes with relief services, medical support, and humanitarian donations to displaced people and refugees.
The Catholic Church
The Catholic Church in Cambodia does not have its own Bishops’ Conference, but is part of the Bishops’ Conference of Laos and Cambodia. It is divided into 3 jurisdictions: the Apostolic Vicariate of Phnom Penh and the two Apostolic Prefectures in Battambang and Kompong Cham, totalling 84 parishes. Within these three areas, there are eleven missionaries from the Pontifical Institute for Foreign Missions (PIME).
The Salesians of Don Bosco operate 45 schools in rural villages throughout the country. The Don Bosco Children Fund operates both a primary and secondary school in Battambang, with a focus on making sure young girls have access to education. More than 2,000 girls who live in poverty have access to basic education and continued vocational and technical training through this project, bringing the possibilities of employment and independence within reach. A multifunctional centre for children has also been established in the city of Sihanoukville.
The Jesuit Refugee Service (JRS) in Cambodia is involved in several projects, assisting refugees and stateless people as well as migrants from ethnic minorities and people with disabilities. JRS runs a welcome centre in Phnom Penh and the Arrupe Centre for people with disabilities in Battambang. They provide social assistance, education, livelihood, and health care to migrants and publish research on relevant issues concerning refugees. JRS Cambodia also provides legal and social services, such as housing, to urban asylum seekers and refugees in Phnom Penh and Siem Reap. In collaboration with Australian Vietnamese Lawyers at the Khmer Rouge Trial, JRS also conducted research into stateless Vietnamese persons.
Addressing transnational trafficking is the focus of Caritas’ Catholic Network Against Trafficking in Thailand (CNATT), which collaborates with the governments and fellow Catholic organizations across Myanmar, Laos, and Cambodia. Its aim is to raise awareness by providing information in schools and parishes and through publications. The network fosters capacity building of government agencies and officials, to help identify victims and respond to trafficking. It also runs drop-in centres for seafarers.
The Order of Malta (SMOM) distributes food and hygiene materials and conducts educational activities for children who are imprisoned with their mothers in Cambodia. The Order of Malta also deals specifically with the treatment of and research on the Hansen disease, through the CIOMAL programme. A grant from its Global Fund for Forgotten People has enabled the project to support 100 children, mothers, and pregnant women since 2012.
The Catholic Relief Service (CRS) collaborates with Cambodian government actors, the private sector, and local NGOs to address challenges such as health assistance and education, addressing malaria, tuberculosis (TB), HIV/AIDS, and the overall strengthening of the health system, as well as working for an inclusive and early childhood education. In 2019, CRS directly benefited 402,877 people.
Other relevant Catholic actors are the international mission agency of the Catholic Church in Australia, Catholic Mission, the Jesuit Service in Cambodia, and the Metta Karuna program, by Jesuit Mission, which focuses on children and people with disabilities – a persistent issue in Cambodia due to landmines from the civil war.
VIII. Other important issues
Although Cambodia has increased public expenditures for health, reaching 16.5% of the entire government budget in 2015, services are still not enough to meet the demand. Consequently, many Cambodians rely on the private sector for health care, despite the higher cost. Malaria is a significant issue in Cambodia, which has been the epicentre of resistance to multiple antimalarial medicines, such as artemisinin. The government has continued its intensive response to malaria elimination through Cambodia’s National Centre for Parasitology, Entomology, and Malaria Control (CNM), even during the COVID-19 pandemic, and reached a historically low malaria incidence level in 2020. In Cambodia the highest malaria risk is among adult men, who constituted 81% of all malaria cases in 2020.