Dysfunction in Cambodia’s health care system

Dysfunction in Cambodia’s health care system

Anyone concerned by Cambodia’s poor health system knows Swiss doctor Beat Richner, the founder and head of the Kantha Bopha Children’s Hospitals.

For nearly a quarter of a century he is, without doubt, the person who has saved the most lives in this country.

It is nationally recognised that the four hospitals Dr Richner keeps running in Siem Reap province and Phnom Penh form an island of probity, dedication and effectiveness in an ocean of corruption, neglect and ineffectiveness in this country’s health system.

On July 20, Dr Richner published a moving appeal in The Phnom Penh Post titled "A Request To The European Union".

Its content exposes striking facts and challenging evidence: “The Kantha Bopha Hospitals are treating 85% of all severely sick Cambodian children (...). All treatment is free (…). 85% of the budget (2015: 43 Million USD) [come from] private donations (…).

The Kantha Bopha Hospitals are facilities with western standard and without corruption. No one of the 2500 Cambodian staff is taking money from the patients.

No one staff is working outside of Kantha Bopha in a private clinic or elsewhere [as is usually the case for the staff working at state-run hospitals and health centers all over Cambodia].”

Dr Richner is right to point to the fact that the Kantha Bopha Hospitals are among health care institutions that can boast the most cost-effective healing approaches worldwide.

With a relatively limited annual budget of $43 million – representing less than 20 per cent of the entire state budget allocated to public health – Dr Richner’s private but non-profit hospitals treat and, whenever possible with modern medicine, save 85 per cent of all Cambodian children in need of medical care.

Any occasional donation to the Kantha Bopha Hospitals from the Cambodian government or the Cambodian Red Cross may help some people look good but is not the right and responsible way to address the chronic dysfunction in the country’s health care system.

The very existence of the facilities run by Dr Richner is a permanent reminder of this dysfunction.

As Dr Richner himself puts it, “Saving the life of a child is a human obligation. It should not depend on charity.”

As for any endeavour resting on the shoulders of a single person, the future of the Kantha Bopha Hospitals seems uncertain, if not worrying, with Dr Richner preparing for his retirement and calling for a scheme paving the way for his work to continue without him.

Given the high stake associated with the future of the Kantha Bopha Hospitals I can only express shock and anxiety when noting that Dr Richner’s appeal seems to have not been heeded by those government officials who should feel most seriously concerned.

Actually, ensuring continuity over the years and decades to come for the unique work performed at the Kantha Bopha Hospitals represents a triple challenge:

• For the Cambodian government, this is a golden opportunity to consider putting in place a real and effective public health policy.

This includes training professional health economists while analysing, comparing and choosing health care models on the basis of their respective efficiencies.

• For the international donor community, this is also a unique opportunity to reconsider its aid approach and to exert adequate pressure in order to help overhaul Cambodia’s derelict public health sector.

• For the Cambodian people, when casting ballots at the forthcoming national elections, the choice is clear between a corrupt and irresponsible system resting on an everlasting beggar mentality and an alternative system based on transparency, probity, dignity and responsibility that are part of good governance and democracy.

Sam Rainsy
CNRP President
Minority leader

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