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.
