I write regarding your coverage of the death of a pregnant woman in Pailin (May 27, April 30, March 20 and March 19).
In following this sad case, after a closed hearing by a Battambang provincial court, I am still unclear as to whether it was caused by carelessness and wrongdoing by the health officials or by lack of obstetrician capacity to treat the woman's serious haemorrhage.
First, there are no witnesses to prove that the health officials really demanded 100,000 riels (US$20) from her. Second, following surgical protocol, health officials do not allow anyone to enter the surgery. This makes it very difficult for the court to judge whether malpractice on the part of the obstetrician is to blame, although the government does have a code of ethical conduct for health professionals. The question is:
Where is an independent medical investigation agency that is responsible for judging cases such as these?
In the past, it was very rare that health officials were punished under the law for acts of wrongdoing. This failure to enforce the law has contributed to Cambodia still being in poor health; especially, maternal and paediatric health. According to the Ministry of Health's 2008-15 Health Strategic Plan, the ministry still needs an improvement in health equipment and facilities, as well as more staff. Currently, one medical doctor covers 100,000 people, and there are only 5.5 midwives and 12.1 nurses per 100,000 people.
Although there are 100 new medical graduates every year, this number is not enough to cope with the growth of the Cambodian population.
Compounding this is the fact that because of new job opportunities in other sectors, many experienced medical officials have left their professions to work as lawmakers, researchers or freelance consultants, or have emigrated to work in developed countries.
Unfortunately, the Sub decree on Education in Health Field, passed on March 13, 2007, does not help, as it says: "A 2.1 master's program on public health and research must be studied after a bachelor's degree in the science of medicine, pharmacy and dentistry. To study nursing, midwifery or other medical fields, at least two years' study is required with a total of 54 credits."
In my opinion, this article of the law discriminates against students with non-medical backgrounds. Because of this subdecree, non-medical background students cannot register to study master's programs of public health. Therefore, I feel that the government should reconsider amending this to allow non-medical background students to study in the medical field and take part in developing our country's health sector.
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