... Their choice was to spend about a month’s earnings to buy the diesel fuel and get themselves to a health centre.

Compared to the other boats moored on the banks of the Tonle Sap lake, Jon Morgan’s craft might not look all that special, but first appearances can be deceptive. Unlike the other boats that ply their trade upon the lake, The Lake Clinic’s purpose is not to make money for its owners, but to help save lives.

Growing up on Rhode Island in the United States, Morgan says part of the reason he decided to establish a floating clinic on the lake was his natural affinity for water.

Morgan worked for eight years at the Angkor Hospital for Children, before establishing The Lake Clinic in early 2007. Morgan says that when he first came to Cambodia in 1994, he was struck by the plight of the people who live on the largest freshwater lake in Southeast Asia, but at that stage he felt he was not in a position to do anything about it.

“I walked out of the [Angkor Hospital for Children] and said what am I going to do now, and immediately knew I was going to focus my attention on the people living on the lake,” he says. “With the help of some friends I was able to build a boat, hire staff and get to work.”

The boat is not so much a clinic as a craft that enables his Cambodian team, consisting of a doctor, a nurse and a midwife, to reach remote communities based around the lake.

They provide routine medical treatment as well as perform minor surgery under local anaesthetic. Patients who need more complex treatment are taken back on the boat to Siem Reap, or in an extreme emergency given petrol money so a local boat can take them to the nearest permanent health facility. “Before we came, their choice was to spend about a month’s earnings to buy the diesel fuel and get themselves to a health centre,” says Morgan. “Those villages are about 35 kilometres from the nearest health facility as the crow flies. Given the realities of transportation, some of the villages are 100 kilometres away because you can’t travel in a straight line.”

Departing Siem Reap each week, TLC sails to seven villages around the lake, providing basic health care to between 10,000 and 12,000 people. Operating on an average annual budget of US$140,000, this works out at about $13 per person per year. All treatment is provided free with TLC’s income coming from major donors such as Impact UK.

TLC also has village health volunteers who promote healthy living .

“We want to expand this, as keeping people healthy is where you really get bang for your buck,” says Morgan.

One example of this philosophy is midwife Srey Mom. Instead of delivering babies, her primary focus is to identify pregnant women most at risk, who are then brought back to Siem Reap on the boat to avoid any potential miscarriages.

Morgan plans to expand the programme up the Steung Sen River in March. This will involve employing another nurse and hiring a second boat. Ultimately he would like to establish a floating health clinic hub.

As for the overall prospects for Cambodia’s remote lake communities, Morgan is not optimistic.

“The lake is dying,” he says, attributing this to the damming that is reducing the Tonle Sap lake’s water levels and altering the timing of its traditional reverse flow.

“Productivity in the lake is falling dramatically. People are going to become hungry and desperate. I suspect all of these villages are going to be in crisis over the next five years.”