Dostal joins the CHC from the Catholic Relief Services, an organization she joined in 1993 to oversee the rebuilding of medical services in the Battambang province of western Cambodia, an area devastated by the Khmer Rouge genocide and years of war. Before that, she was the medical coordinator for the American Refugee Committee on the Thai-Cambodian border, where she worked with CHC co-founders Sok Thim and Anne Goldfeld.
Dostal brings to the CHC years of management experience, and a commitment to helping Cambodians build local, sustainable health programs that address illness and its root causes of poverty and ignorance.
A New Challenge in Children’s Care
One of Dostal’s first challenges comes with the steady expansion of the CHC’s children’s programs at the Joseph P. Sullivan Outpatient Center of the Khmer Soviet Friendship Hospital [link to story on ped ward]. At the KSFH, the Maryknoll Missionaries and the departing Medicins sans Frontieres-France organizations recently transferred the care of 300 children living with HIV to the CHC and the pediatric ward. “The challenge for CHC will be to assist the Pediatric Ward physicians and nurses to continue that level and to enhance their skills to make this a Cambodian Center of Excellence for children,” says Dostal.
An important part of Dostal’s job will be to join the medical programs of the Pediatric Ward with the services of the Maddox Chivan Children’s Center [link to MCCC page], the CHC’s model program for delivering medical, social, educational and psychological support to children and their families affected by HIV. “Integration of social and psychological programs developed at the Maddox Chivan Children’s Center into the work of the pediatric ward of the largest public hospital in Cambodia will give Cambodians a unique program with outstanding global care for kids infected or affected with TB and or AIDS,” Dostal said.
Dostal will also serve as a supporter and advisor to the Cambodian manager and staff who run the MCCC to help to improve and expand existing programs.
Do Something Useful
Growing up on a farm in Iowa, Dostal says she just wanted to do something useful. That urge led her to nursing school and then in 1963 to a stint in the newly established Peace Corps, where she spent two years training nurses in Turkey. After returning to the United States, Dostal went back to school, eventually earning a BS in nursing, a master’s degree in Health Services and becoming a certified nurse practitioner. She worked with the poor, first in Chicago where she knew the Reverend Martin Luther King, and then in Northern California, where she practiced family medicine and trained residents and nurse-practitioners.
In Stockton, California, in the 1980’s, Dostal first met Southeast Asian refugees, including many from Cambodia who had fled the Khmer Rouge genocide and subsequent war with Viet Nam. Over several years that she spent mentoring one Cambodian woman, Dostal learned a lot about the plight of Cambodians, who were increasingly immigrating to the area. Many of the new arrivals were from the refugee camps on the Thai- Cambodian border and they were clearly traumatized. “There were a lot of people who really had difficulty functioning,” Dostal recalls. “I felt I was not able to help them with moving on, because I didn’t really know what they had been through.” At that point, Dostal thought if she went to the camps for a year she could learn their Khmer language and come back better equipped to help her clients in California.
Dostal took a position with the American Refugee Committee, training medical assistants in the Site II camp. Arriving there in 1989, Dostal immediately met Anne Goldfeld, who was working as the medical coordinator for the camp. When Goldfeld returned to her research position at Harvard Medical School in Boston, Dostal took over as medical coordinator. She also worked there with Sok Thim, who went on to found the CHC in 1994 with Goldfeld. Thim was overseeing the TB program for all the camps; now he is the Executive Director of the GHC/CHC in Cambodia.
For Dostal, the year turned into two, then three. “It was a very challenging situation in the camps,” she says. “There was a large population and ARC ran a hospital, two outpatient clinics, a public health facility, and a tuberculosis ward. It was an active war zone. There was a lot going on and my job was to coordinate the whole project.”
The ARC philosophy appealed to her, with an emphasis on training Cambodians to take over health care for the future. A large part of Dostal’s duties involved training Cambodian staff and moving toward Cambodian management of the whole project.
That was strength of the ARC, Dostal says. “ARC was very forward-looking. They saw and implemented an approach before all the other international groups working in that environment.This is an approach that everybody now knows and believes, which is that international organizations need to build the capacity of the local people, but at the time it was a paradigm shift. While we were there, we helped the Cambodians to learn to do things for themselves, so that in the future they would be able to continue on their own. If you don’t do that, how will what you do be sustainable?”
The same approach was at the root of the CHC when it was founded in 1994, with Dostal as a founding board member.
From the Border to Battambang
Dostal was still working for ARC in 1992, when the Paris Peace Accords ended the war in Cambodia. Repatriation began and the camps slowly emptied as Cambodians returned home. Work on the border was winding down, and Dostal thought she would like to see Cambodia, and perhaps she could be of some help in the repatriation process. She took a post with the Catholic Relief Services working in Battambang province in western Cambodia, where many of the refugees were headed.
What Dostal found was daunting. The country was destroyed, and health care was practically nonexistent. She oversaw a project to help rebuild and restaff the district hospital to begin to provide the most basic medical care for returning refugees. All this was done under continued rocket attacks as the remnants of the Khmer Rouge continued to fight government forces in the area.
“We worked on the basics, on child survival, sanitation, strengthening the health system, and eventually began to do some work in HIV/AIDS and TB. Always, we worked to strengthen the capacity of both the government staff and our own national staff to be able to take over what we were doing, and moving Cambodian people to the positions of being managers rather than us continuing to do that,” Dostal explains.
Anne Goldfeld recalls visiting Dostal in Battambang in 1993. “We went to visit one of the health projects she was overseeing in Bavet around 50 kilometers outside of the city, which was focusing on upgrading skill of traditional midwives. Once in the hospital, we heard a large and terrifying explosion. A shell had been lobbed into the hospital courtyard by Khmer Rouge troops. It didn’t miss the structure we were in by much. Lori was cool and calm and made sure everyone was safe. She was fearless in her soft-spoken manner. I had already come to admire her greatly on the border where she was a cool headed, tough Iowa farm girl, who steered a clear course uninfluenced by the many competing agendas that were there at the time. In those early years in Battambang, she had a very dangerous job and could have easily been kidnapped or blown up. She knew why she was there and was unfazed helping to provide care and build the infrastructure of the country.”
When Peace finally came to the region, Dostal stayed on as project manager until 1998, when a Cambodian doctor took over. In recognition of her abilities, Catholic Relief Services asked Dostal to become the regional advisor for the organization covering Southeast Asia. In that capacity, she has worked in crisis areas including Banda Aceh, Indonesia after the 2004 tsunami and done assessments all over the region including North Korea. She continued as advisor to the Battambang project, always with the goal of creating a locally sustainable organization. That goal was realized in August 2007, when the project became a local, Cambodian-run NGO called Action for Health Development (AHED).
Since CHC’s founding in 1994, Dostal has been on the CHC board, serving as chair for several years. She watched the CHC develop from a small organization working on TB in rural Svai Rieng, to adding microcredit programs, and on through its expansion into research and developing centers of excellence for TB and AIDS care across the country. “It’s been incredible,” Dostal says. “The CHC, and now the GHC, has done and continues to do amazing things.”
As a board member, Dostal was continually impressed with the energy and the vision of the CHC founders and staff, and their capacity to find resources and put them together with practical, community-based programs and research. When the Catholic Relief Services scaled back their activities in Cambodia, Dostal agreed to bring her skills to the CHC and come on board as a staff member.
Twenty years ago, Dostal came to spend a year working with Cambodian refugees. At 68, and past the age where many people seek out a comfortable retirement, she remains in the country, ready to take on a new challenge. What has kept her? She answers simply, “The people. They have so many needs.”
“And, I am still interested in doing what I can do to be useful.”