In May 2023, 22-year-old Chhan Saloeng was halfway to the hospital when she gave birth to her baby. But this wasn’t a typical sudden childbirth — she and her husband had been traveling overnight by boat across the Gulf of Thailand, the fastest way to get to the nearest hospital from their home in Cham Yeam, a remote village in the mountainous province of Koh Kong, Cambodia.
In the early morning, when they approached land, her husband ran 2.5 kilometers (about 1.5 miles) to the hospital to find help, rallying on-call midwife Thlang Sotheavy. They jumped in an ambulance and drove 20 minutes back to where the mother and newborn waited. Their boat was stuck and couldn’t reach shore, so Sotheavy waded through the water and climbed into the small boat, barely big enough to fit them both.
“When I arrived, I wiped the baby and then put the baby close to the mother’s skin,” she says. “We needed to cut and care for the umbilical cord, remove the placenta, and help them change clothes … and the waves made it difficult for us to hold the baby.”
Despite the challenges of giving birth on a boat, Sotheavy ensured that the new mother and baby benefited from skin-to-skin contact and early breastfeeding, thinking on her feet to ensure the baby had a healthy start to life — even outside the comforts and controls of a birthing room.
After about 90 minutes, they helped a grateful Saloeng and her newborn out of the boat and went to the hospital.
Originally from the province of Kampong Speu, Sotheavy came to work in Koh Kong because of how remote it is, knowing she could be a great help. She has been at the Koh Kong Provincial Hospital since 2014.
Sotheavy learned about the importance of skin-to-skin contact and early breastfeeding through training supported by Cambodia’s Ministry of Health and Alive & Thrive, an FHI 360 initiative funded by the Government of Ireland that focuses on improving maternal, infant and young child health and nutrition outcomes.
“Before attending the training, I did not have much skills and knowledge when performing my work,” she says. “I didn’t know how to position the baby to breastfeed. Now, I know how to notice the signs when the baby is hungry, the value of breast milk, and so on.”
Training supports healthier starts to life
The hospital has seen significant improvements in newborn health as a result of sharing early essential newborn care information with mothers.
“Before, we didn’t pay much attention to breastfeeding,” shares hospital deputy director Dr. Pin Sereyvathnak. “Babies in the neonatal care unit often experienced abdominal distension and the effectiveness of treatment remained limited.”
Thanks to this new knowledge, Sotheavy says, there has been a decline in sickness and hospitalization among newborns.
“After learning and receiving the training [from Alive & Thrive], our medical staff and midwives began to understand the importance of breastfeeding,” says Dr. Vathanak. “The quality of life for newborn babies has improved, and there has been a reduction in referral cases requiring treatment to Phnom Penh.”
Since 2023, with support from Government of Ireland, Alive & Thrive has supported maternity wards and neonatal care units in nine provincial hospitals across Cambodia. The initiative is currently expanding to reach health workers in 10 more hospitals throughout the country, so midwives like Sotheavy can provide mothers with foundational information and support unexpected births of all kinds, whether inside the hospital, on the road or at sea.
Another baby born at sea
Saloeng’s childbirth was the first time Sotheavy had supported labor in a boat, but it wouldn’t be the last. In May of 2024, a year later almost to the day, Sotheavy was called to the shoreline to assist in another childbirth at sea. Un Theda, 33, had been traveling to the hospital from a military camp on the Cambodia-Thailand border, where her husband is stationed. She had given birth to their first two children at the military health outpost. This time, they decided to journey to the hospital because there weren’t any female health staff on duty — but they had less time than they thought. Their son was born on the boat.
Sotheavy was ready. She coordinated quickly with her team and the ambulance driver, and they arrived on the scene shortly after. She had already prepared a delivery kit with all the equipment she needed and handled the case with confidence and ease, using what she learned last year to offer counseling to Un Theda and provide care for her and her baby.
“I am so happy that I can manage this case successfully,” says Sotheavy. “Both mother and the baby are healthy.”
