NYEMO Cambodia IN BRIEF

NYEMO Cambodia runs a drop-in center for pregnant women or women with one or more children who are marginalized and isolated by society. The drop-in center provides support services and assists in socio-economic reintegration. NYEMO Cambodia does this with the support of a local network and using local resources

The NYEMO Cambodia drop-in center is set up to accept women who are in great difficulty. These women can be alone or accompanied by their children.

Terms of access

A request can be submitted by the woman herself, a public sector service (ministry, hospital,..) or an NGO in the referral network (referring organization).

Right of entry is decided by the social workers within the NYEMO Cambodia team. Following space available, the urgency of the woman's situation and the woman's expression of her motivation to want access to a better quality of life for herself and for her children, admittance can be granted immediately. In the event the center's services are full, an alternative support situation is ensured, through referral within the network.

The center is open for new clients Monday through Friday, from 7 till 12 AM. The admittance process involves listening to the woman, discussion, and suggestions of support adapted to the woman's needs and request.

Who is accepted ?

All women, alone or accompanied by their child(ren), in a situation which justifies counseling and socio-medical support: abandoned, rejected by their family, homeless, in need of protection, etc.

All situations are taken into account, whatever may be the problem (social problem, health,…)

As from entry, the women who are pregnant and/or accompanied by children have access to:
- individual and specialized (social, psychological, economical) counseling
- assistance in problem identification
- support services adapted to their needs
- health/medical counseling

Terms of temporary shelter and related issues

Temporary shelter is provided to women and children in crisis, depending on whether there is space available at the shelter, case-by-case analysis of the crisis situation, and motivation of the woman requesting shelter.

NYEMO Cambodia provides temporary shelter in two 2-story houses. The shelters are integrated within the neighborhood's structure (health center, district leader, director of the local public school, neighbors).

The NYEMO Cambodia centers include: offices, reception, meeting room, skill training room, educational training room, kindergarten, and a basic clinic.
NYEMO Cambodia centers also include rooms for temporary shelter.

The structure of the NYEMO Cambodia center follows a communal housing model: women and children in temporary shelter share rooms and share in the duties of housekeeping and cooking, thus forming a micro-community with related advantages of learning to plan household tasks, sharing of problems, inter-aid, sharing of tasks, development of support groups, etc…). NYEMO Cambodia does not provide cleaning or catering services, it is the women in the temporary shelter who are in charge of these tasks themselves.

Duration of accommodation provided and objectives of shelter

The maximum duration of shelter provided by NYEMO Cambodia is nine months. In exceptional situations, justified by a supporting report, shelter can be extended once for three months.

However, it is to be noted that the duration of accommodation is an end in itself, nor a right. Temporary shelter is provided with the aim to facilitate reintegration into "normal" life as quickly as possible ("normal" taking into consideration the wishes and views of what normal life is for the woman herself), achieving socio-economic independence in function of the capacity of the woman, the difficulties she faces and "time".

It is essential, that the duration of the temporary accommodation provided stay within reasonable limits, to ensure that over time NYEMO Cambodia can respond effectively to the needs of new beneficiaries who are in crisis.

Social and health follow-up

A social worker-supervisor follows up each beneficiary. In addition to this follow-up, which is essential to ensure that the support provided by NYEMO Cambodia is conform to NYEMO Cambodia's objectives, all beneficiaries are assisted by the family support workers in the center (social workers, matron, midwife) who work closely with the beneficiaries on a day-to-day basis.

Furthermore, the matron, whose key task is to oversee the security of the people within the center and the building itself, also is responsible to help the beneficiaries at night - when it is common that the burden of depression and need is felt more strongly than during the day.

The medical doctor consults, examines, diagnoses and refers women and children with medical needs to public sector services with which NYEMO Cambodia has established a referral relationship. He also provides pre- and post HIV test counseling services.

The midwife assists the medical doctor in his work and the education team in education relating to health issues (i.e. health education, basic care education, assistance with referral to external services, accompanying beneficiaries when they are referred to public sector services, etc)

Activities offered to beneficiaries

All activities described below were developed following the needs and request of beneficiaries. Participation is open to all (internal and external) beneficiaries and their children.

1. The discussion group : are facilitated by a woman seconded by the Ministry of Women's Affairs. The discussion group meets once per week, on Fridays. An average of 15 beneficiaries join the discussions on a voluntary basis. Frequently discussed topics include: domestic violence, repeated breakdowns and problems, the passing on from generation to generation of cultural practices and norms which burden women, the relationship between parent and children in a single-parent setting and/or in a context of past or present violence. NYEMO Cambodia's experience has been that the discussion group is a strong tool to facilitate both listening and the sharing of often painful experiences among participants.

2. The psycho-social support group provided by the pagoda: facilitated voluntarily (free of charge) by two monks seconded by the pagoda. The monks offer psychological support to women and children affected by AIDS. They come to NYEMO Cambodia twice per week, listen and counsel the women and children. They ease the pain of those who are ill by bringing support within the Buddhist cultural context, especially with regard to questions on death and the related separation with children.

3. The educational sessions: health, hygiene, HIV prevention, etc. : are facilitated free of charge by NGOs within the network NYEMO Cambodia has developed. Sessions are organized daily (for women or children) following a planning developed by NYEMO Cambodia and the NGOs together, two months in advance to the organization of activities. Besides giving access to education, these sessions permit a re-socialization of beneficiaries because the activities are organized and facilitated in sites outside of the NYEMO Cambodia center.

4. Literacy sessions: are facilitated by a Khmer-language teacher trained in non-formal education. The Ministry of Education seconds this teacher. Over the years, these sessions have complemented the public school education accessed by beneficiaries very well, and also assisted with the schooling of children of the neighborhood with learning difficulties.

5. Skill training sessions: are facilitated and managed by trainers and their assistants (often ex-beneficiaries). Training is done following modules of gradually increased levels of learning and with regular tests to monitor progress and difficulties experienced by the students. Sessions include:
- Hygiene, cooking, basic catering (restaurant)
- Laundry (shop)
- Sewing of furnishings and items for interior decoration (shop)
- Tailoring, including accessories (shop)
- Weaving
6. Gender sessions: the facilitator for this session was trained by the Oxfam Hong Kong Women's Agenda for Change project, and continues to receive support from the WAC project when necessary. During these sessions the women express their voice, through song, drama, writing or other forms of expression. These sessions are often very revealing in terms of the level of suffering the participants experience.
7. Sessions for children: are animated by a social worker, educators from within the network and three ex-beneficiaries (who join in the facilitation depending on the program planned). These sessions are designed to be both educational and recreational and include:
- Singing, dancing, swimming, educational games
- Public school education support classes, hygiene education, HIV prevention, etc

A restaurant, a shop, a tailoring atelier and laundry are open to clients, both offering NYEMO Cambodia program beneficiaries the opportunity to work in a "real" situation, and generating income which is shared between the beneficiaries and supports their growth towards independence.

The job placement office is an interface between employers, the beneficiary accessing employment, and NYEMO Cambodia.

Management and coordination meetings

Management and coordination meetings take place at regular times throughout the year.

1. Internal management meetings: all beneficiaries residing in the NYEMO Cambodia shelter and representatives of the NYEMO Cambodia team (the social workers and the Director of the Center) join these meetings. These internal management meetings take place once every quarter. Usually there is no pre-set meeting agenda. General issues relating to the functioning of the center are brought up, discussed and dealt with. This forum serves to discuss and settle conflicts, to explain the functioning of the center and the rules and regulations in place, to suggest improvements or changes. Individual personal issues are not discussed in this meeting.

2. Team meetings: every Monday morning, all staff (except for the guards and driver) come together for a team meeting. Information is shared on what happened the week before, activities with other network partners are shared, project ideas and collaborative activities are developed, activities are evaluated and lessons learned assessed, project objectives are taken into account and elaborated, and personal experiences shared.

3. Technical meetings: once every 15 days, all staff facilitating skill training meet for a technical meeting. Information is shared, problems people experienced are analyzed and discussed to jointly identify solutions, and local market demand is analyzed.

4. Network meetings: once every quarter, the members of the network meet, including all social/medical service providers NYEMO Cambodia works with. There is a pre-set agenda for these meetings. Participants share their feedback from workgroups they belong to, results they achieved as partners in the network, and experiences and lessons learned.

NYEMO Cambodia in a NETWORK
WORKING TOGETHER TO BROADEN OUR FIELD OF WORK

OBSERVATIONS

The increase in single-parent families with the mother being "obliged" to become head of the family is a form of social structure change in Cambodian society that, in recent years, is occurring more frequently and is accompanied by an increase in poverty. In the last years, single-parent families are the population group which has been most touched by destitution and absolute poverty.

Following abandonment, widowhood, or other forms of family separation, the mother generally keeps the children with her. But the loss of income due to the separation with her husband makes it difficult for the woman to make ends meet, and in some instances she and her children end up living on the edge of survival and facing dangerous situations daily.

An accumulation of several factors puts the woman at a disadvantage and prohibits access to a "normal" life. We distinguish several levels of disadvantage that place the Cambodian woman in a situation of inferiority:
· Illiteracy ( 53% of the female population)
· Lack of professional training (1% of the population has access to professional training)
· The education of women (traditionally women are not prepared to take on the role of head of the household)
· The spread of the HIV epidemic tears apart and destabilizes the socio-economic fabric of the family

The combination of these disadvantages generates a process of social exclusion, which leads to even more impoverishment of women and their children. The harm done to the individual persons involved, to social life, and to the human capacity necessary for the development of the country, is vast.

The consequences of the social exclusion of the woman are not only economic. Psychologically, many of these women are in fragile state, they often feel guilty about putting their children in a difficult situation, which reinforces the negative image they have of themselves and the process of self-depreciation they are in. These women are often overwhelmed by the situation they are in, burdened by the weight of a tragic family history. Thus the relationship between mother and child deteriorates. Too taken up by the difficult situation she is in and not knowing what to do, she barely is able to take on the most basic care of her children (feeding, hygiene, school).

Then there are those who no longer have their children with them, left them with a neighbor or simply abandoned them. It is very difficult for these mothers to deal with this; they feel guilty, angry, ashamed and in pain; and lose the little respect they had for themselves. Only a few are able to comfort themselves with the consciousness that their children would have been worse off if they had kept them.

It is critical to assist these mothers to reunite with their children and with other relatives, and to assist them to learn to provide for their own needs and those of their children!

Vulnerability:

These marginalized women mostly are excluded from the employment market. They have lived through mourning; separation with their husband, family, and friends; or are in a conflictual relationship and dependent. These women are rarely in a happy and supportive relationship. They belong to a stigmatized group in society, because of illness, their origin, their sex, their age and their history…

They do not easily find their position in society and are usually in a situation of need.

Dependence and exclusion :

The women assisted by NYEMO Cambodia are not, at least at the time of request for assistance, able to find a way out of their situation by themselves. A series of obstacles, both internal and external, inhibits their autonomy and puts them in a situation characterized by different levels of dependence.

· Economic dependence: job- or income-less, in a situation of economic destitution with debt due to illness followed by death of the husband, or with occasional income from prostitution or begging.
· Institutional dependence: for some women reintegration in her previous environment can lead to anxiety. This can be observed as a slowing down of the woman's involvement in the reintegration process. The women feel apprehensive about being alone again, and thinks that she'll not be able to take on her new situation without the support or security provided by the NGO. She doubts her own capacity and needs reassurance.

To address this last problem, NYEMO Cambodia works with the woman leaving the shelter to establish an "external" follow-up, and encourages women to set up a support group among several women leaving the center.
The NYEMO Cambodia social worker involved in the "external" follow-up needs to be attentive to situations of vulnerability that being HIV positive may re-generate among those reintegrating into society.