In a small office off Mao Tse Toung Boulevard’s lavish Parkway Square building sits three women behind a row of computers. Each is busy at the keyboard, organising for Cambodian nationals and expats to travel 900 kilometres west and back – but they are not ordinary travel agents, and their clients are not ordinary tourists.
Their destination is Bangkok’s Watthana district, the city’s commercial hub and a mecca for tourists the world over. The sprawling Sukhumvit Road bustles day and night, with locals and expats swanning past an endless row of restaurants, bars and counterfeit DVD stalls as the Skytrain glides back and forth overhead.
Set back from Wattana’s main thoroughfare is the large grey edifice of Bumrungrad Hospital, blending inconspicuously into the backdrop of the surrounding skyscrapers. Most passers-by wouldn’t think it from a glance, but this establishment is responsible for a growing proportion of Thailand’s foreign visitors.
Of the one million people admitted to Bumrungrad last year, 300,000 patients came from outside of the country. Of them 16,000 were Cambodian, a consequence of a rising middle class and a domestic medical system that lacks the ability to provide adequate services to them.
“My sense is that Cambodia is similar to a lot of countries in the region,” says Kenneth Mays, Bumrungrad’s marketing manager. “In a way, the economy has outpaced the medical infrastructure. The training for doctors, the whole infrastructure that produces a good doctor, that’s something that takes a long time. In a short period of time, you can build a textile factory ... even an auto-assembly plant, but it takes longer to grow a good doctor.”
Dr Verapan Kuansongtham, a neurosurgeon and director of the Bumrungrad Spine Institute, concurs, noting training is critical “especially for doctors that specialise”.
“It’s like what Thailand experienced decades ago. Maybe [there are ] enough doctors practicing in Cambodia, but as general practitioners, not spine surgeons, heart surgeons, or specialists. It will take a long time to establish training programs, even if the economy is booming to the point where people can afford these services,” he explained.
To cater for international demand, the hospital has authorised representative offices in 17 countries. Its Cambodian flagship office in Parkway Square recently hosted Verapan, who spent the first few days of March providing consultations for citizens of Phnom Penh who suffered from spinal ailments.
Along with a team of doctors from the St Anna Hospital in the German town of Herne, Verapan has pioneered the use of endoscopes in spinal surgery. The small instrument, less than eight millimetres in diameter, serves as a diagnostic camera and a surgical tool, allowing a much smaller incision and a greatly reduced recovery time. Endoscopic surgery is now used to treat several common degenerative illnesses associated with old age and overexertion of the back through heavy lifting.
Often, the burden of an ailment lies not in the treatment’s cost but in the recovery time. With an economy that has grown at a swift clip over the last decade, Cambodia may now have, on paper, a growing body of citizens who can afford complicated medical treatments. Factor in a month spent off work recuperating, however, and the option shifts. Verapan visited to tell those who have borne the pains of chronic spinal illnesses, in some cases for years, that a cure may no longer be beyond their reach.
“Especially with older people, if you perform open surgery then mobility and even mortality risks are high,” he says. “If you do open surgery then they will have to lie in bed for a week, but with the use of an endoscope, they can wake up and walk almost immediately after their procedure. You stay less in the hospital, there’s less operative time and much less recovery time, and as a result the procedure is much cheaper.”