On vibrantly patterned straw mats, crowded around small plastic hampers of food, children – some with balloons, others with neon-coloured fans – huddle against their parents under the noon sun.

But the parents are unblinking; some of the children barely have a pulse.

Families have travelled up to 10 hours to this small square of dappled sunlight to wait in a crowd of thousands at one of the five Kantha Bopha Children’s Hospitals for free health care.

The man behind the hospitals, Swiss doctor Beat Richner, said that unless the Cambodian government and the international community stepped up, the delivery of free, world-class medical care would disappear with him.

“I am an old, old man, and when I am not here any more, well, who can play the cello?” 64-year-old Richner said yesterday in the canteen of Phnom Penh’s Kantha Bopha hospital complex.

Richner was referring to his 20-year odyssey of Saturday-night Siem Reap cello performance fund-raising efforts.

“We get US$3 million from the Swiss government, $2 million from the Cambodian government and we are always looking for $30 million in personal donations,” Richner said.

Hospital costs were expected to increase this year based on a 30 per cent increase in patient numbers in the first five months of the year, he said.

In 2011, 120,000 children were hospitalised at Kantha Bopha.

Richner recently published a series of advertisements in local media titled “Why is there no help?” calling on the government and the international community to think about the “severe situation” at the hospitals.

“The public health system does not work. Its staff is cheating escaping in the private sector. And the private sector taking a lot of money from the patients is extremely bad (including Phnom Penh),” Richner wrote in the advertisements.

On Sunday morning, Richner said 2,340 children had already been admitted to Kantha Bopha hospitals by 6am.

“It is a situation like a war. Nowhere else in the world you would see this,” he said.

Meningitis, congenital heart defects, dengue and dengue shock syndrome plague the thousands of children rushed to the Intensive Care Units of the hospitals.

There are so many patients, in fact, that most have to share beds.

“Here, nobody takes money, and our staff is getting a proper salary every month,” Richner said. “The $2 million government contribution was established only six years ago. And they should give more money, because there is a law that every government hospital, and we are a government hospital, a university hospital, gets $27 per hospitalised patient.

“So they must pay the contribution, this is the minimum amount.”

Richner said one of the most endemic health problems apparent in his hospitals was tuberculosis, and it was robbing the country of its future – its children.

“Sixty-five per cent of Cambodians have tuberculosis, and this is the legacy of the war that the international community brought to Cambodia in the 1970s. This is why the international community must contribute to the hospitals.”

Minister for Health Mom Bun Heng said he was aware of the funding troubles faced by Kantha Bopha.

“Of course, the ministry examines this case because the Kantha Bopha Children’s Hospital plays a main role in helping with citizens’ health, especially children,” he said.

Chor Meng Chuor, director of the National Center for Parasitological Entomology at the Ministry of Health, agreed that Kantha Bopha was an important hospital and carried out important work, but highlighted the government’s capabilities in public healthcare.

“In case Kantha Bopha loses some funding, it would not affect the whole health system, especially not for treating dengue fever,” Chor Meng Chuor said. “We still have federal hospitals, and all hospitals work together to defend children.”

Swiss Red Cross project co-ordinator Rob Overtoom said that health care capacity building in Cambodia is more effective when local level governments are fully engaged.

“We work under a contracts system with the government, which ensures transparency and creates a smooth exit at the end of the project, where a government entity can take over formerly aid contracts,” he said.

“This is now a normal procedure in a country, to work under and with the permission of the government, not outside this,” he added.

“Cambodia is now a country where we are stable, and it is more sustainable to operate health systems [under the auspices of government partnership],” Overtoom said.

To contact the reporter on this story: Bridget Di Certo at [email protected]