Welcome today's guest contributor Wilton, my father-in-law and practicing ear, nose, and throat doctor in Troy, Alabama. He had retired some years ago but soon missed caring for people and returned to practice. He is one doctor that greatly exemplifies what a doctor and person should be. His research and thoughts on the topic of the health and available healthcare of Cambodia will help you appreciate the healthcare we have here in America and more developed countries.
{Click on photo of waiting room above to visit the photographer's photo essay on this topic.}
Sounds impossible, but this is exactly the scenario faced by Cambodia in 1979 when the brutal Khmer Rouge regime, headed by Pol Pot, was finally removed from power. The Khmer Rouge, a fanatical communist group, took control of the country in 1975 and attempted to reinvent the country as a communist agrarian society. They did this by brutally removing all the educated elements of the Cambodian culture. Teachers, intellectuals, engineers, doctors, nurses, bankers and other educated factions were systematically murdered, executed or deported. At the end of this reign of terror, over one and one half million Cambodians had died, completely decimating the country’s health system.
{Patient room in Preah Sihanouk Hospital}
{Choeut Sarouen, manager of the renovated Pulmonary Ward at Khmer-Soviet Friendship Hospital, the largest public hospital in Cambodia. Click on photo to read more.}
Most villages have no health workers, with most medical facilities being in the larger cities. In Cambodia, there is no organized transportation system. For a sick rural villager to get to a hospital in a city he must get transportation via bicycle, motorbike or walk. Practically no villagers own an automobile. The average time of motorbike transportation to a hospital is over two hours at a cost of over $1.00 which may be 5-10% of a rural worker’s monthly wage. As a consequence, most of these people will seek medical help from local people, monks or faith healers, who practice “traditional medicine” (local plants, herbs, etc.) reserving a trip to the hospital when they are far advanced with an illness. A visiting physician from New York State who worked in Calmette Hospital in Pnom Pouh observed that, of his hospital admissions, 20% had aids and 10% had tuberculosis. Interestingly, 3% had aplastic anemia because chloramphenicol, an antibiotic with aplastic anemia as a side effect, can be bought without a prescription. Though pay for doctors is small compared to U.S. standards, it is considerable compared to the average Cambodian salary. Many physicians will work in a hospital in the AM with an average monthly salary of $50.00, and then conduct a private clinic in the afternoon with a monthly salary of around $500.00 (U.S.). Hospital care is sometimes free, however, inconvenient. Private clinics are preferred but the cost is (2-3 dollars per visit) is impractical for most Cambodians. Most hospitals have basic equipment such as lab, plain x-ray machines and ultrasound but lack CT or MRI, services deemed essential to a good practice of medicine in the USA.
Though the practice of medicine in Cambodia would be judged third world by our standards, one should judge their progress, not from where they are, but from where they are now relative to from where they started. Most critics would acknowledge great progress from those humble beginnings in 1979 with a beginning cadre of only 10 physicians.
Friends without borders website.
http://angkorhospital.org/default.php
Related Links
http://www.cambodianhealthcommittee.org/news_hivtb.html
http://www.pbase.com/nickdemarco/photo_essay_angkor_hospital_for_children
http://www.surgicalroundsonline.com/issues/articles/2007-11_01.asp
http://www.directrelief.org/WhereWeWork/Countries/Cambodia/Angkor.aspx
http://www.parish-without-borders.net/cditt/cambodia/dailylife/2004/dailylifekh04.htm
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