Doctor's Review: Medicine on the Move

October 18, 2021

© Wong Yick Heng /

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Rise and fall of the Mekong

Along Cambodia's storied river, life drifts by as it has for centuries. But for how long?

As the sampan drew close to the river boat that would be our home for the next week, I did a double-take. We expected to be boarding the MV Jayavarman, a $2.8-million cruise vessel in its first month of service on the Mekong River between Siem Reap in Cambodia and Saigon in Vietnam. The ship certainly looked like the pictures we had seen of the Jayavarman — but the name on the bow was the more prosaic RV Mekong Explorer.

Once on board, Thomas Peter, the Swiss entrepreneur behind the new venture, explained: “I wanted to call the ship the Jayavarman, in honour of one of Cambodia’s greatest kings. But it seems that using a god-king’s name for your ship is not the best way to start a business here.” Nonetheless, everything else on the ship bore the Jayavarman name. That things were not quite what they seemed was somehow quite fitting in a country full of contradictions. What else can you say about a country in which one of its rivers flows backwards for part of the year?

Launched in late 2009, Heritage Line's Jayavarman is the first self-styled boutique cruise ship on the Mekong. Operating from July to March, the ship has 27 ensuite cabins, all with private balconies and floor-to-ceiling sliding glass doors. Of the half dozen or so cruise boats on the river, it's the first with central air conditioning.

The boat is operated by a Vietnamese crew while the room and restaurant staff is Khmer. Half of the hotel staff was hired from a Cambodian training school for orphans. Since its initial season, the range of excursions has broadened to give clients greater insight into the people and communities, particularly focussing on education. This includes a long-term pro-bono literacy project bringing teachers from Thailand to train local teachers.

Endangered waterways

Cambodia, bordered by Thailand, Laos and Vietnam, is about one-third the size of France. It’s one of the poorest countries in Asia and is still recovering from the horrors of the 1975-79 Khmer Rouge regime when up to two million people — 20 percent of the population — were starved to death, tortured and murdered in a fanatical attempt to turn Cambodia into an agrarian utopia.

The life-blood of Cambodia has always been the Mekong River. It drains most of the country and only the Amazon produces more fish. This richness comes from the unique effects of summer floods on one of the Mekong’s tributaries, the Tonle Sap River. For seven months of the year, it flows out of Tonle Sap Lake to join the main stream of the Mekong at Phnom Penh, Cambodia’s capital.

But annual summer floods produce more water than the main channel can possibly hold so it backs up the Tonle Sap River. The reversed flow of the river causes Tonle Sap Lake to flood vast areas of forests which become one of the most productive ecosystems on earth, as billions of fish grow to maturity. When the lake level drops each November, the Tonle Sap River again flows downstream. And so do the fish. In an event celebrated in Phnom Penh since the 12th century, masses of fish swim into the main stream of the Mekong — and into the nets of thousands of fishermen. Those nets feed millions of people; it’s no wonder Cambodians eat fish at almost every meal.

But unfortunately for Cambodia, the Mekong first passes through China, Myanmar, Thailand and Laos. And China, in a frenzy of dam building, is completing a cascade of eight power dams for its section of the river. A United Nations report warns that these dams are “the single greatest threat” to the future of the Mekong. The natural annual flood would largely be eliminated — along with the ecosystems that depend on it.

According to Oxfam, in no other country do river fisheries make a bigger contribution to food security than in Cambodia. Over 60 million people depend on the river for their food or livelihood. China doesn’t seem to care about the downstream effects of its dams but the loss of the fisheries here would be truly catastrophic.

Balancing on stilts

When we boarded the ship in early December, the water level was still high and the tops of trees poked above the surface of the swollen Tonle Sap Lake. The next morning. we passed the first of many floating houses of ethnic Vietnamese fishing families. Built on platforms that rise and fall with the changing water level, the flimsy looking houses are covered by woven palm leafs. Almost every house has a hammock swinging from a tiny veranda — and, of course, the family fishing boat is moored to the house.

The lives of these stateless families are played out entirely on the water. At Kampong Chhnang, we boarded sampans to get a closer look at 300 or so of these floating houses knitted together in a makeshift community complete with stores, gas stations and schools. Many of the buildings, particularly the stores, are solidly built — and almost invariably painted blue for good luck. Other vendors pole their narrow boats loaded with fresh produce through the channels, stopping from time to time to make a sale. Kids are everywhere and their agility and skill in handling boats is astonishing.

Cambodian gondoliers

As we floated down the Tonle Sap River towards Phnom Penh, the channel narrowed bringing us closer to life along the shore. Houses of palm leaves stood three metres above the ground on spindly stilts while along the bank people were tending fields of vegetables and water hyacinths right to the water’s edge. Overturned boats drawn up for repair were being worked on while in other places new sampans were being built. Further along, a farmer stood up to his waist in the river carefully washing a bullock before nudging it up the bank.

Upon opening the curtains of our cabin each morning, we never ceased to be amazed at the timeless life of the river; a life that could possibly vanish in a few years. At first light, I watched a narrow unpainted pirogue moving across the river. The grace of the standing boatman with his single out-thrust long oar was familiar. Add some black paint and red velvet cushions, give the fisherman a striped shirt and a different type of straw hat and he would be quite at home on Venice’s Grand Canal.

Would visitors a decade from now still see what we witnessed one golden evening as groups of a dozen men, lined up in long narrow fishing boats, hauled up massive nets? Some waved at us as we passed, others just got on with the job. Behind them huge funnel-shaped nets, placed to catch the fish travelling with the river’s flow, were already out of the water.

On the third morning of the trip we awoke to find ourselves approaching Cambodia’s capital of Phnom Penh. Once a city of 2.5 million people it was evacuated and left to ruin by the Khmer Rouge. Now with a population half that size, it has come back to life as shiny new SUVs shoulder their way through swarms of motor scooters.

Thirty years ago land in Phnom Penh had almost no value. Today speculation — and corruption — is rife and property prices approach those of major European cities. Signs for land development companies and global law firms are likely a harbinger of what’s to come. Elegant colonial mansions behind walls capped with razor wire are being restored and side streets teem with people and tiny businesses; everything from machine shops to foot massage parlors.

But the most infamous building in the city is the Toul-Sleng Genocide Museum. Formerly a secondary school, in 1975 the Khmer Rouge turned it into a notorious prison. Known as S-21, the educated and elite of Cambodia were brought here to be interrogated, tortured and then slaughtered. Over 17,000 doctors, teachers, bankers, government officials, even young children and babies, passed through S-21. Seven people came out alive.

Scooter Central

The next day after crossing the Vietnamese border, the amount of river traffic increased noticeably and the fishing boats got bigger. Fishing boats on the Mekong range from simple unpainted gondola-like craft of eight or nine metres in length to large brightly decorated planked boats bearing painted oculi on the bow. Along the coasts of many countries, fishermen have painted symbolic representations of the eye on their boats for centuries. The intent is to give their boats a living character — a female one at that — and to fend off evil spirits.

In Vietnam, I was told the eye was to ward off crocodiles — even though the few that exist these days are raised in cages on farms. Some of the boats were loaded so heavily they looked in danger of swamping, but apparently on a river they are reasonably safe.

Approaching the Mekong Delta with its myriad side channels, we moored mid stream and transferred to small boats in order to visit the Cai Be floating market with its boats loaded with produce. Returning to the Jayavarman, we cruised down the Tien River, one of the Mekong’s nine arms in the delta, towards our final destination of My Tho.

Because of the water levels, we could not cruise all the way to Saigon and completed the last part of the journey by bus. It seemed strange to be among traffic again after the peacefulness of river travel. In Saigon — or Ho Chi Minh City, as it is now called — we found ourselves amid four and a half million motor scooters and pondered what the traffic would be like when all those riders could afford cars. Garish Christmas lights festooned buildings, carols burst incongruously from loudspeakers and the gentle flow of the river life seemed worlds away.

I thought back to those poor but well-fed children, smiling and waving from the decks and hammocks of their floating houses a few days earlier and wondered again what their future held. Would that annual cornucopia of fish still pour out of the Tonle Sap Lake to support them or would the impact of the upstream dams make the worst predictions come true? We can only hope for the best.

This article was accurate when it was published. Please confirm rates and details directly with the companies in question.


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