|Tuk Tuk, a three-wheeled taxi, stands in front of the emergency room at Siem Reap Provincial Hospital.|
The old walls had cracks here and there. The building seemed to be on the verge of collapsing. Suddenly, the vrooming sounds of Tuk Tuk, a small three-wheeled taxi, captured my attention. On the back seat of Tuk Tuk, a woman was crouched, apparently in pain. People wearing white gowns came out, quickly moved her on a stretcher, and hurried back into the building.
The frail building turned out to be the “emergency room.” Outdated, was my first impression of Siem Reap Provincial Hospital.
The hospital is the largest general hospital in Siem Reap Province where 890,000 people live. Comprised of more than 20 buildings, the hospital looks like a small village. From early morning, the hospital was crowded with patients.
Despite its large size, the hospital offered a glimpse of poor healthcare service of Cambodia.
“We’re very short of sick beds. We’re trying our best to do something,” said a hospital staff who helped me navigate the hospital in front of a patient ward.
As he said, sickbeds were extremely short. The hospital had more than 300 beds, but there were more patients. Some patients were lying down on mattresses on the floor of the ward or resting on the stairs. Some were lying on hammocks outside the ward to receive IV fluids. The ward and the operation room were dim apparently because of the minimal use of light. Patients had to depend on the ceiling fan only to keep them from heat.
Due to the heat, many patients complained of the thirst, but drinkable water was available only at limited places. At the center of the hospital, there was a water supply facility built by Japan’s aid. Guardians were getting water in their plastic bottles traveling from the ward to the water facility, but only half of the six water taps worked properly. One local staff said although they had a separate worker to manage the water facility, the water taps have been left out of order for a long time. It was faster to buy water outside, he said.
|The left photo shows the front view of the general ward of Siem Reap Provincial Hospital, and the right, an IV bag is hung on a tree for a patient on a hammock outside the hospital due to the shortage of sick beds.|
The miserable facilities at the hospital lowered the quality of healthcare service. A French plastic surgeon, who came to Cambodia to help local physicians enhance capabilities, said physicians find it difficult to treat patients because there was not even CT, MRI, or portable X-ray in the operation room.
“More than nine patients visit the hospital after a motorbike accident. Because we don’t have basic tools for a diagnosis, we can only observe patients to provide care,” the French doctor said.
The doctor went on to say that most of the physicians worked in the morning only at the hospital because of low salaries. In the afternoon, they go back to work at their clinics, he said. The state-run hospital pays only $300 in wage, which is too low for a doctor to make ends meet.
Cambodia's healthcare system turned to the worst in the 1970s due to the Cambodian Killing Fields when nearly a third of Cambodia’s population was killed. The Khmer Rouge regime killed about 2 million people just because they were intelligent. There were fewer than 50 physicians who survived the mass killings. Hospitals were destroyed, and medical staffs were rare. Educational institutions that were supposed to nurture doctors were burned down. Since the Killing Fields, Cambodia has been relying healthcare service on international aid and private capital.
The gap in capital and capacity between state-run hospitals and private ones has widened. In Cambodia, the rich can enjoy better treatment and medicines at private hospitals. The poor, however, are rejected from hospitals. If a patient visits an ER, the hospital checks if the patient can pay medical bills first.
For such reason, Cambodia needs to reinforce the capacity of the public health system, experts said.
Twenty-four provincial hospitals in Cambodia receive support from different countries to enhance their capabilities.
KOICA built the Maternal Child Medical Center (MCMC) and Korea-Cambodia Medical Training Center at Siem Reap Provincial Hospital as part of the “Siem Reap Hospital Capacity Building Project (10-13).” Soonchunhyang University Hospital invited Cambodian physicians, nurses, and medical technicians to Korea to receive training until 2016.
Siem Reap Provincial Hospital said it would push another project with the Korean government after completing the current program.
Despite the inadequate equipment and troubled finance, medical staffs at the hospital never forgot to smile. During each different interview, they gave each different answer.
However, asked what was needed the most at the hospital, their answers were the same – “To share knowledge, and to share the experience.”
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