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   The pigsty only lies a few feet away from the kitchen counter where pots are heated and food is prepared in Seng Rom’s home. Three pigs grunt and wallow in their waste inside the dilapidated, wooden house that rests on pylons, a few feet above the polluted water.


    Outside, a woman carrying a beige woven basket on her head strides past. Children, smiling and laughing, skitter on the open planks held together by rusted nails, past the handmade nets for drying fish.


They look down to avoid falling into the polluted water.


   Pak Long is across the waterway from Koh Kong City, the capital of Koh Kong province in western Cambodia. It’s a community so remote that online search engines can’t retrieve it.


   In the morning, the Prek Kaoh Pao rises, a body of water that channels through the homes as it flows into the Gulf of Thailand. The stream recedes in the evening, serving as a toilet where coconuts, clothes, plastic bottles and foil wrappings drift into the gulf.


   Rom is a middle-aged fisherman whose family has lived in Pak Long, Cambodia for 25 years. His family lives a life with poor sanitation, polluted water and raw sewage. “Any person would like to have a cleaner environment,” says Rom, swaying his crossed legs off the side of the floorboards. “But if you’re the only one who wants it, then what kind of difference can you make.”


    Rom knows his village isn’t important enough like Phnom Penh, the capital, to develop a trash collecting system.


   Surrounded by the filth and poverty of Pak Long, Rom and his family dry fish and peel the shells of crab and shrimp to sell.His wife sits next to him on the floorboards, peeling the gray, raw crustaceans — shrimp by shrimp. She discards the translucent exoskeletons of the raw shrimp in one bowl and the bodies in another.


   The exoskeletons are thrown into the dark murky sludge, patterned with moss-like life, and becomes the ecosystem below her. They laugh, exchange thoughts and work together under corrugated metal roofs and weathered blue tarps held by timber.


   The sanitation risks in Cambodian villages like Pak Long begin in the water where people defecate and discard their trash. Preventing public health risks is important in preventing the transmission of disease, says Kevin Curry, a biology professor at Bridgewater State University who is a visiting scientist in aquatic biology at Pannasastra University of Cambodia.


   “Boiling the water is the number one method of killing bacteria and viruses,” says Curry. “If they are working with fish, food, defecating and not washing hands, they transmit bacteria to their food, their kid or themselves.”


    Light bulbs and Styrofoam litter the ground. Flies secrete in the seeping sewage and land on the food, in the process transmitting health risks to the hands and mouth. To avoid getting sick, his wife boils the water over traditional Lao stoves, a ceramic pot stove that uses charcoal for heat.


   “The trash is a problem because the flies will pick up diseases from it and carry them anywhere where there is a food source,” Curry said.Avian and swine flu, bacterial diarrhea and typhoid fever are common illnesses. With repeated contact with the pigs and roosters in Pak Long, people are at high risk of developing the flu.


   Visiting Pak Long on a recent trip, Dr. Daniel Chan, a family physician and vice president of Cambodian Health Professionals Association of America (CHPAA) who grew up in a village like this, explains the health risks.


    “Food-borne disease include hepatitis A and gastritis, which cause ulcers. If untreated for years, can cause stomach cancer,” says Dr. Chan. “I would also imagine respiratory illness, diarrhea and malnutrition.”


    A noxious mixture of putrid excrement and burning wood, ash, rubber, chemicals and dirt assaults the sense of smell.


    Trash is abundant. A rooster feeds off of the profusion of carton boxes, plastic spoons and metal cans that mix with the mire and medium-sized rocks; whether the trash lives in the mud or the mud lives in the trash creates ambiguity for passersby.


    “Any of the trash is going to impact marine life, some of which may depend on food,” Curry says. “The more nutrient and waste we put in the bay, the more toxic the waste and the greater the impact on the lower level food chain,” he adds.


    The trash is not used as a resource. A ceramic pot, a rubber slipper, IV bag and decomposing dog teeth help form the expanse of trash that families of the fishing village call home.


    “If they have a pit and they’re going to the toilet, it goes underground,” Curry says. “But if the tide comes in or water level changes, the pit may be full of water.”


    The smell of sewage overwhelms the smell of burning trash. The waste water pit invites insect vectors like mosquitoes to carry diseases from the pit to the people.


    “Putting sewage in the ground just puts it out of sight. It needs time to break down in a natural environment,” says W. Richard Laton, professor of hydrogeology at California State University, Fullerton.


    Living in sewage, garbage and poor sanitation is the fate of thousands of residents in Pak Long where Rom’s living room floor is made of splintered wood that is used as the dinner table.


    The hammock makes for a cozy bed, which hangs next to a shabby window with no glass to keep out the noxious smell that comes from the outside.


    A closet envelops red, orange and green clothes that hang on a rack. The kitchen and a back deck help construct Rom’s 600-square-foot home; an area where Rom’s family gathers, eats and sleeps 10 feet away from where the pigs grunt and wallow in their waste. There, they lie in a pen where flies hum and continue the cycle of transmission.


“It’s a self-struggle,” says Rom. “No one is going to come and help us.”


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