A new high speed boat has joined the flotilla at The Lake Clinic, the health project bringing medical care through the waterways to the floating villages of Tonlé Sap. The Norwegian-designed TLC-4, aka ‘The Taxi’ was built for speed and will enable to doctors to cover more ground and reach their patients faster.
The Lake Clinic, founded in 2007 by former executive director of Angkor Hospital for Children Jon Morgan, already has three boats in operation but with the addition of five floating clinics last year, The Taxi has been designed purely for speed not comfort.
“When The Lake Clinic first became operational we required a boat, TLC-1, that could not only transport staff and materials, but could also serve as a guest house providing privacy, sleeping, toilet, shower, cooking and dining areas,” Morgan says. “In those days the clinical staff used to work in whatever communal space was available in our target village – sometimes a pagoda, a school, or the house of the village chief, wherever was large enough to set up tables and chairs for the doctor, nurse, midwife and registrar.
“In 2012, with money from Impact Norway and Kids International Development Society, we constructed five floating clinics – four on the lake, and one on the Stung Sen River in Kompong Thom. These clinics provide both working and living space, and with them in place we no longer needed the comfort provided by TLC-1.”
Built therefore specifically for fast transportation, The Taxi travels at speeds of up to 30kph, as opposed to the 10-12kph reached by TLC-1. This means the medical team can dedicate more time to seeing patients, rather than travelling to them.
Morgan says The Taxi’s interior is rather Spartan. He adds, “but it can be configured to carry a staff of up to 10 people and supplies, or 15 people as passengers.’
There are two clinical teams – the Lake Team on Tonlé Sap, and The River Team on Stung Sen River. Both teams have a doctor, two nurses, a midwife, a registrar for medical records, and a boat’s pilot. A dental nurse and a cook are shared between the teams and all are Khmer.
The 14 metre by 3.3 metre Taxi is a catamaran powered by two Yanmar diesel engines. Designed in Norway, it was built in Phnom Penh by Southeast Asian Fabricators, and Morgan says it was “a work of the heart” for everyone involved.
It was meant to have surface-piercing propellers, but a funding shortfall mean the clinic had to opt for the “local solution of two long-tails.”
“We hope to raise funds someday to change to the original specifications,” Morgan says, “as that will increase the speed and reduce fuel consumption.”
In addition to TLCs 1 and 4, there are two other boats which Morgan describes as work horses.
One is a small runabout that carries three people plus the pilot, and the other is used primarily as a tow boat for moving the clinics. Floating villages move five or six times a year, and the boat gets a workout moving five clinics.
The Lake Clinic sees around 200 cases a week, providing regular service to eight villages on the Tonlé Sap – all of them remote, off the tourist trail and several hours or even over a day away from the nearest doctor. It also services a village on the Stung Sen that is cut off from roads for most of the year.
Cases range from the common cold to chronic diseases such as hypertension and diabetes.
“The nearest village is 30km from a paved road,” Morgan says. “The most isolated village is almost 100km from a paved road. We see everything, from runny noses to trauma, from children needing immunisations to chronic disease in the adults and the elderly.
“In fact, after providing routine care in these villages for almost six years, the number of chronic disease patients is climbing. This is one reason I feel negatively about groups of well-meaning, and sometimes well-funded people who do a "shotgun approach" to medicine. They come and go… maybe once, maybe again next year. Good medical care demands consistency. It requires complete medical records. The Lake Clinic returns to these villages on a regular schedule, and people can count on us, they can trust us.”