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A woman is injected with anesthesia before surgery in 2013. Experts at a conference yesterday said that access to surgical care in the Kingdom was severely lacking.
A woman is injected with anesthesia before surgery in 2013. Experts at a conference yesterday said that access to surgical care in the Kingdom was severely lacking. Nick Street

Surgical care lags in Kingdom

There’s just one surgeon for every 88,874 people in Cambodia’s Kampot province, a situation that experts yesterday said was reflected across the Kingdom, and which bodes ill for patients’ access to crucial surgical care.

Medical professionals gathered yesterday for the start of a two-day conference on essential and emergency surgery and anesthesia in an effort to find ways to improve the Kingdom’s woefully inadequate surgical care system.

“In countries like Cambodia, nine out of 10 people are unable to receive life-saving … surgical care,” said Dr Kee Park, a Harvard University Paul Farmer Global Surgery Scholar and Consultant Neurosurgeon at Preah Kossamak Hospital.

The dismal figures for Kampot appear to closely mirror those nationwide. Although several officials with the Ministry of Health couldn’t provide specific statistics on the number of surgeons in Cambodia, Dr Kim Savuon, deputy director for the department of hospital services at the ministry, estimated the figure to be at about 200, not counting specialists, who number around 50, he said.

Training for more surgeons is “urgently needed”, he said.

Lack of access to neurosurgery in particular has become a significant problem. In 2013, about 62 per cent of road accident fatalities succumbed to head injuries, said Bud Hattaway, Asia Regional EMS advisor for Medical Teams International.

In Kampot, however, the province’s seven surgeons are unable to perform operations related to head trauma because there’s no neurosurgeon in the area, said Neak Saroeun, deputy director at Kampot Referral Hospital.

Medical professionals are forced to transfer patients with head injuries more than 140 kilometres away, to Phnom Penh, and of the two ambulances available, only one is currently working, Saroeun said.

“We still face a big, big problem with head injuries,” he said.

Dr Iv Vycheth, president of the Cambodia Society of Neurosurgeons, said his organisation had only 25 members and 14 residents. The majority of the neurosurgeons, 21, are in Phnom Penh, he said, with two in Siem Reap and two in Battambang.

“They are working very hard, especially since head trauma is a major problem” in the country, he said. But the lack of enough surgeons is not the only problem.

More services to help get patients to the appropriate medical facilities need to be strengthened as well, experts said. Availability of surgical equipment is also currently lacking.

Doctors in Kampot don’t have access to a CT scan, Saroeun said. “We have a small budget only for repairs, but no budget to buy new equipment.”

The conference yesterday concluded with plans to form a committee that will work to improve access to surgical care.

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