Parents and their children queue for treatment outside the Kantha Bopha Hospital I near Wat Phnom in Phnom Penh.
I t's 5:30 am and more than 1,000 parents with infants have lined up outside two hospitals near Wat Phnom in Phnom Penh to receive free vaccinations and examinations for their children.
They've rushed to Kantha Bopha's Children's Hospitals I and IV from all over Cambodia. Some left their home provinces at 11pm the night before, most others left between 1am and 4am.
Many parents interviewed by the Post said they needed their children treated as soon as possible and could not get proper treatment in the provinces.
Sos Siem, 54, said she left Takeo at 11pm the night before to bring her three-year-old granddaughter to Kantha Bopha.
"I was the first to arrive at the hospital. I wanted to be at the front to have my granddaughter vaccinated for Japanese encephalitis because people in my village told me that a lot of people come to the hospital," Siem said.
Chun Hin, 28, who came from Kampong Cham, said she and her one-year-old son arrived outside the hospital at 2am.
There are four Kantha Bopha hospitals for children, three in Phnom Penh (the third is beside the Royal Palace) and one in Siem Reap. The hospitals' success is due largely to Dr Beat Richner, a Swiss doctor from Zurich also noted for his cello playing. He opened the first Kantha Bopha children's hospital in 1992 at the invitation of the government.
Dr Denis Laurent, Biologist and Deputy Director of the Kantha Bopha Foundation, said there are 1,500 children in the four hospitals as inpatients, and every day 2,500 children are treated as outpatients.
"For a serious case, the patient will be admitted to hospital without waiting," Laurent said. "We have a doctor waiting at the entrance of each hospital 24 hours a day looking for any seriously ill patient who needs urgent treatment."
Laurent said people from throughout Cambodia bring their children to the Kantha Bopha hospitals for treatment. There are no fees: everything is free.
He said the hospitals' running costs are $18 million a year; 80 percent of that comes from private Swiss donations, 10 percent from the Swiss government and another 10 percent from the Cambodian government through the Ministry of Health.
Sim Navy, 28, from Pring village, Bantheay district, Kampong Cham, said she often comes to Kantha Bopha's Children's Hospital when her children get sick, because her village has no private clinic and it was very difficult to get any service from the village's government health center, especially at night.
Cambodia's child mortality rate remains much higher than rates in neighboring countries.
Public health indicators are among the worst in the world, according to the World Health Organization (WHO). Cambodia's mortality rate for children under five was 138 per 1,000 live births in 2003, an appallingly high figure compared with the estimated mortality rate in East Asia of 40 per 1,000 live births, according to the Cambodia Economic Watch published in October 2004 by the Economic Institute of Cambodia.
However Mam Bunheng, Secretary of State at the Ministry of Health, said that in the last five years the child mortality rate had decreased 30 percent.
Bunheng said that according to the National Institute of Statistics at the Ministry of Planning, the death rate for children less than one year old in 2004 was 66 per 1000 (6.6 percent). He said infants died mainly of acute respiratory illness or from diarrhea.
"The decrease in the child mortality rate is attributable to concerted efforts at vaccination and education," Bunheng said. "We get a lot of support from Japan, from UNICEF, from the UK-DFID - and we have Dr Beat Richner's Kantha Bopha Children's Hospitals.
"Cambodian health care has progressed a lot in the past few years," Bunheng said. "We have many health centers and have set up many health posts for people who live in rural areas."
Sann Sary, director of the hospitals department of the Ministry of Health (MOH), said Cambodia has four national hospitals, 69 referral hospitals, 965 health centers and 77 health posts. Each health center has from two to 20 staff depending on the number of people living in the area.
But even though Cambodia now has more health centers in provinces, thousands of people are still seeking the free, high-quality health care that the Kantha Bopha Children's Hospitals have developed a reputation for.
Choeuy Sokun, 23, who brought her 18-month-old daughter to Kantha Bopha IV from Kampong Speu, said the infant is recovering well from diarrhea after three days of medicine at the hospital.
Sokun said that before coming to Kantha Bopha she had spent 100,000 riel every night for a week having her daughter treated for diarrhea at a private clinic in her province - without any improvement in the child's condition.
Although 85 percent of Cambodia's people live in rural areas, most hospitals and health personnel are in urban areas, resulting in an unequal distribution of health care for Cambodians. Approximately a quarter of the population do not have access to health care at all, according to The Atlas of Cambodia (2006) National Poverty and Environment Maps.
The MOH's Sary acknowledged that state hospitals and state health clinics have shortcomings.
"We lack many things, both materials and human resources," he said. "And the lack varies for each hospital and health center."