T HE future of free, high-quality medical treatment for poor Khmers at Calmette

Hospital may be in jeopardy, as French NGO Medecins du Monde (MDM) considers

withdrawing its aid.

The NGO appears likely to pull out of Calmette, its

main activity in Cambodia, in what others say would be a disaster for free

health services.

Dr Jean-Claude Prandy, head of the MDM Calmette mission,

flew to Paris last Sunday to try to get a final decision on the NGO's Cambodian

future.

Before going, he stressed that there was "no question of a

complete departure for the moment" by MDM.

But he acknowledged the NGO's

priorities might see its resources transferred elsewhere.

"Cambodia is

probably not a priority for Medecins du Monde any more.

"Have a look all

over the world. Cambodia has now started its take-off. Perhaps the Paris office

judges that there are more urgent situations to take care of in the

world.

"We have accomplished our mission [at Calmette]. However, I assess

that we can still be helpful. What I hope is that the MDM mission will start a

new way..."

He suggested MDM could start a new hospital or clinic for

poor patients outside of Calmette because "there are still poor people we have

to take care of - that's MDM's mission".

MDM has managed Calmette

Hospital's B-building - where, unlike the government-run A-block, patients are

not charged - for three years.

The B-building has developed a wide

reputation for both quality treatment and free service, to the extent that it is

said that the poorest patients get the best treatment at the

hospital.

Just over a third of the patients at the B-building last year

came from Phnom Penh, the rest from neighboring provinces.

If MDM

withdraws, it is feared that the B-building could become like the A-block, where

accommodation, food and medical care are charged.

While the B-building

could be taken over by other donors, some are worried they may not share MDM's

commitment to free care for the poor.

"If the Medecins du Monde left

Phnom Penh, it would be a catastrophic decision," said Dr Flye Sainte Marie,

director of the Pasteur Institute.

"The B-building is the only place in

Cambodia where poor people can be well treated, without paying

anything."

The French Embassy said it was possible that Paris - which

helps MDM finance the B-building - could take over the funding entirely, if

asked to by Cambodia.

"But caring for poor people fits more with MDM's

mission than ours," said embassy cooperation department head Bernard

Millet.

Mam Bun Heng, Under-Secretary of State of Health said the

Cambodian government "deeply hopes" MDM could remain in Cambodia.

Besides

training and technical assistance, MDM finances 65% of the running cost of the

B-building - the remainder comes from the French Ministry of Cooperation. The

NGO spends $340,000 each year.

After training Khmer staff, MDM has only

one French doctor and a nurse left at the B-building.

The doctor,

Pierre-Regis Martin, said the Khmer staff were skilled and

well-motivated.

"But everyday, I meet the Khmer doctors and work with

them to keep pressure on them. It is a kind of intellectual stimulation for

them.

"That's the reason why the presence of French training staff is

still compulsory, even if only for a one-year transition, to avoid the collapse

of our training work."

Dr Martin said the best solution could be for MDM

to remain at the hospital for another year, and a new donor found to provide

funding and one part-time consultant-doctor. MDM had already withdrawn from

other projects in such a way.

Dr Khuon Pichith, the Khmer head of

service of the B-building, said he could not start looking for other funders

until MDM made a final decision.

He hoped any departure by MDM would be

gradual.

"If Medecins du Monde leave suddenly, we will be obliged to

cancel the free admission," he acknowledged.

Dr Sainte Marie, of the

Pasteur Institute - which sends rabies patients to the B-building - said: "If

[it] is not free any more, it will mean some patients will give up the treatment

just because they will not be able to stay in Phnom Penh."

The 60-bed

building hosts about 100 patients a month, some of whom have to sleep on

stretchers in the corridors.

MDM also runs an outpatients clinic,

treating some 400 poor people a month at Calmette and a program to send children

with heart diseases for surgery in France. Seventy children are on the waiting

list.

Some of MDM's activities are already threatened by lack of money.

The NGO has yet to replace a foreign doctor at a Rattanakiri hospital who left

early this month, and has sought funding from the European Union to continue its

work there.

MDM jointly runs a hospital in Sihanoukville with the

European Union, which funds 80 per cent of the costs.