transcultural

During my most recent trip to Cambodia, in November 2011, I became captivated by the tremendous increase in the sale of plastic water bottles and by the proliferation of the unique Cambodian-style labeling displayed on their sides.

Walking through the town of Siem Reap, whether along a main street or on an unpaved side way, these water bottles have achieved a ubiquitous presence in the visual landscape: stacked up in the sun by roadside stands advertising rice dishes and cheap cigarettes; sold in upscale, air-conditioned markets geared toward tourists; discarded in trash heaps that flow slowly down river; collected by children wielding wheelbarrows through the center of town at night; used as flower vases in religious offerings; or tossed aside by tourists on the grounds of the world-famous temple complex and UNESCO World Heritage site, Angkor Wat.

Taking a closer look at the labels themselves reveals further complexity to their presence. Although one finds the predictable multinational brands such as Dasani (produced by Coca-Cola) and Aquafina (produced by Pepsi), there are also a multitude of local/regional actors and producers who have entered the fray with their own “Cambodian” water products. Water bottles with Angkor-related names such as “Angkor Fresh Water”, “Bayon”, “Baray Mebonn” and “Preah Vihear” are to be found in abundance, but so are ones with monikers that aim for a more explicit Western connection, such as “Eurotech”, “Cute”, “Steve” and “Maxy Life (‘The Trusted Brand’)”.

In both English and Khmer, promotional messaging displayed on the bottles frequently brands and defines the product in terms of its technological (and therefore supposed health) benefits: “purified by reverse osmosis”, “UV and ozone treated”, “produced by world qualified technology”, “enhanced by Japanese technology” and other similar messages commonly appear on labels. In this, these water bottles represent a trend toward pathologization of non-bottled water, (filtered or otherwise), as well as a medicalization of water as such (“High quality is your health”, reads one).

Herein, however, lies a considerable irony, because in fact the majority of bottled water companies in Cambodia have failed to meet minimum production quality standards. In 2008, fewer than 20% of the 130 bottled water companies were found to be in accordance with standards established by the Cambodian Ministry of Industry, Mines and Energy. Significantly, this is in the context of a bottled water industry booming in Cambodia. In 2010 alone, for instance, sales of the Dasani brand reached $40 to $50 million USD, an increase of nearly 30% from the previous year. In short, bottled water is big business. And, it should be added, this makes the industry a political player — one seeking to secure control of and/or rights to local water resources as well as striving to ensure conditions for its own future growth.

All of which brings us full circle. The water bottle in Cambodia is not merely a water bottle. It is, simultaneously, an aspect of material culture, the expression of a marketing strategy, a health hazard, a health benefit, an environmental pollutant, an expression of cultural values, a financial windfall, a point of political conflict, and an object that has moved across cultures, assuming different meanings in the process. Moreover, its content, the water, enters our bodies and becomes a physical part of us when we drink it.

In an upscale, tourist-oriented supermarket, Siem Reap Used as a vase in a temple offering at Ta Prohm

Water bottles being sold near a tourist bar, Siem Reap Water bottle discarded by a tourist at the Bayon temple

Water bottles being sold on the street, Siem Reap

WATER BOTTLE LABELS

Mouse over the images to view caption and source information. To enlarge, click the last icon on the right. I collected most of these labels in Cambodia. A few at the end of the slide show are from Laos and Vietnam (indicated).

The Lake Clinic (TLC) is a project dedicated to bringing basic health care, as well as disease surveillance and proper medical referrals to a severely isolated and underserved region of Cambodia — the Tonle Sap. Across this freshwater lake, Southeast Asia’s largest, fishing communities live in floating villages, many as far as six to eight hours away from land by boat. I joined TLC’s medical boat in November 2011. A significant public health challenge lies in addressing water hygiene. Many residents both drink and bathe in sewage-contaminated water, as the extensive growth of water hyacinths across the Lake, especially near floating communities, obstructs extensive water circulation. In practical terms, sanitary facilities are non-existent. An important challenge therefore becomes how to inform sanitary praxis — especially with respect not just to having, but to using, clean water filters. Availability of the filters is not an overwhelming issue, as they are distributed inexpensively by area NGOs, but adoption is a hurdle. The Lake is the community’s lifeblood; people do not associate disease with its water. And yet the most common ailments reported to the Clinic include worms, dysintery, skin and urinary tract infections, jaundice and fever — from a biomedicine standpoint, all strongly related to hygiene. In this context, I conceptualized, and subsequently designed and illustrated, the water hygiene poster shown below. Created with feedback from TLC in Cambodia, the idea with this poster is for TLC staff to be able to make use of it as a tool for discussion during the doctors’ Lake rounds. This poster project continues to be in development, with feedback from the field still coming in. Click the poster image to enlarge. The photos below are from one of TLC’s Lake visits, with a makeshift medical clinic set up on the floor of a floating school. For more information about The Lake Clinic, see lakeclinic.org.

Click to enlarge poster

Rather than being used primarily for voice calls, mobile phones in Indonesia are actually most commonly employed to access the internet — with social media (1), and Facebook in particular (2), being Indonesian’s most popular online destination. This phenomenon, in combination with Indonesia’s exceptionally high mobile phone penetration rate, has led social media to play a central role in everyday personal and group communication. Thus, opportunities abound for using online social networks to communicate more than just private messages. In July 2011, I was invited to join the Indonesian-German Health Education Partnership (a DAAD-funded project) for their Summer School on Mother and Child Health in Makassar, on the island of Sulawesi, Indonesia. For the 75+ participants, mostly Indonesian and a few European, I conducted a presentation and hands-on workshop with the topic: “Strategies for Using Social Media to Disseminate Public Health Information”. Program details online at ighep.com. 1. Nielsen 2011; 2. AppAppeal 2011