T HE government-managed part of Calmette Hospital gets about $2000 a year in
official funding, according to hospital director Dr Heng Tay Kry.
with a chronic money shortfall, he said the hospital had no choice but to charge
patients as it tried to meet yearly operating costs of more than $1
The hospital got five million riels ($2000) a year from the
government, which last gave medicine supplies to it in 1989.
"If we did
not charge patients, our hospital would have shut down a long time ago." he
Current charges varied from $30-100 per day, depending on the
condition of the room, and $120-200 for operations. Foreigners are charged
Dr Kry maintained that hospital staff treat emergency patients
without concern for whether they had money.
He said poor people were not
charged for rooms, but acknowledged that they were often asked to buy their own
medicine and bandages. Some, he said, borrowed money or sold property to do
The hospital tried to pay for the medicine and treatment for
patients, and later seek reimbursement from them.
But patients who
promised to repay the money often did not, or paid less than they had agreed
Dr Kry said half of the revenue from patient charges went toward
buying hospital materials, 40 per cent was spent on staff bonuses and 10 per
cent was given to the government.
Conditions at Calmette - or at least
the "A-building" and other wards funded by the government - have long been the
subject of criticism.
One Westerner who recently visited the hospital
with her maid, who had a tumor, was shocked at the conditions there, with little
attention to the most basic hygiene standards.
"I was outraged at the
medical conditions, which were unacceptable even for a country like Cambodia,"
the woman said.
She said she went to great pains to decide whether to
have her maid's tumor checked at Calmette, or go overseas, but was assured by a
French doctor there that the procedure was easy.
The doctor told her the
operation to remove the tumor for a biopsy would cost $200, which she
The operation was conducted - and the tumor left in a bottle on the
patient's bed. The woman said she eventually found out a biopsy could be
conducted at the School of Medicine, which reported that the tumor was
She took her maid to Bangkok for surgery - where it was found
that the tumor was in fact not cancerous.
Of Calmette Hospital, she said:
"I was misled into believing I could get some semblance of quality medical care
there by the Western doctor. I wonder how any Khmer with little idea of
acceptable medical care could survive in the Cambodian medical system without
money, to say the very least."
Referring to the privately-funded Kantha
Bopha children's hospital, she said: "I'm also outraged when I hear criticisms,
particularly among Westerners, of the one medical facility which is providing
top quality, free medical care to more than 1000 patients per day. The price tag
is high but the results speak for themselves and I see no reason why Cambodian
and international organizations involved in medical care should not be aspiring
to the same.
"I think that in a country where multi-million dollar deals
are being signed for casinos and other businesses, there should be some way of
finding funds to meet more basic needs.
"In my experience, Calmette seems
to be neither providing care for the masses, nor quality care for the
Others tell similar tales of inadequate treatment at
One Khmer medical student said he waited for almost an hour at
the hospital's emergency room for treatment, before deciding it was simpler to
go and buy bandages and antiseptic and treat himself.
Dr Kry, the
hospital director, said staff should always respond to emergencies. He defended
hygiene at the hospital, suggesting that any dirt was from patients or their
relatives who did not clean up after themselves.
To combat this, he had
issued instructions limiting the times that relatives - who others say are often
called upon to look after patients - can be in the hospital.