Life in Cambodia - Part 4 - Healthcare

I recently had the occasion to go to a hospital, and to a dentist (hospital & dentist for a couple of the Honour Village kids, and dentist for me yesterday).  I'll be writing about my personal experiences in an upcoming blog, but for now, here's an overview of healthcare in Cambodia, as I know it.

When it comes to healthcare, I think we Canadians know we're among the most fortunate on the planet, yet all too often we complain bitterly about long wait times in doctors' offices or emergency rooms, not being able to get a family doctor, or having to wait forever to get elective surgery or referred to a specialist.  It isn't until I came to Cambodia that I learned just how bad it really could be, and how absolutely blessed we are.


Hospitals

In Cambodia, you had just better hope you don't get sick, especially if you're an adult.  (That is, of course, unless your rich or you are a foreigner with good medical insurance).  Medical care is 'pay-as-you-go' here, and although most doctors and hospitals probably charge only a fraction of the cost we'd pay in our own country, people here are just too poor to afford even the smallest fees.  Even worse, you can't trust that the doctor's office you visit has a 'real' doctor.  There are no strict regulations in place in Cambodia, and it seems that just about anybody can print up a medical degree and practice medicine if they want to.  Here it's 'buyer beware' in more things than just trinkets at the Old Market.  So you'd better get a referral from a reliable source if you need a doctor.


There are a few free medical clinics scattered around the countryside, but often people don't know about them, or they're too far away to get to.  Our friend Dr. Hahn was volunteering at one of these free cllinics.  Unfortunately it's now been closed indefinitely. 

Sign outside the free medical clinic

If you want good medical care, you can go to the Royal Angkor International Hospital, you'll be paying top dollar, so better make sure you've got good medical insurance or a pot of gold.  I heard one story of someone who went to this hospital with food poisoning.  They were given an IV, a prescription for antibiotic, then released....after they paid out $800! 

Where the select few go

  
Free medical care is available for children under the age of 16, but be prepared for a long wait..  The Angkor Hospital for Children in Siem Reap, funded by Friends Without a Border is a great place doing good work, but if you live in a remote village and have no way to get your kids to this hospital, it doesn't do you much good. 
A Cambodian friend of ours who is pregnant is also receiving free prenatal care.  I'm not sure who is funding this, but I'm glad to know there are more programs popping up to help this country get healthy.


Our friend Dr. Hahn recently visited The Angkor Children's Hospital and The Siem Reap Provincial Hospital, which is where adult Cambodians might go.  According to his account, the SRPH is ghastly.  You can read his account and description of both places here.  It's an enlightening account.


So what do people do if they get sick?  Out in the remote areas, they go to their village healer who performs 'magic'.  Supposedly many people are cured by these rituals ( the placebo effect, maybe?)  Most people in Cambodia believe in karma -if you do good, you get good, and vice versa...So if you get sick, you must have done something bad.  If you die, they chalk it up to something bad you did.  Same goes for somebody who gives birth to a deformed child, or breaks a leg. 

I have no idea what goes on here.....

Pharmacies

Almost anywhere you go in Cambodia, you will see an abundance of pharmacies.  Just today, I counted no less than six in one block (I'm not exaggerating!) 

Here a pharmacy

Everywhere a pharmacy

Anyone can go into a pharmacy without a prescription and buy just about any drug you can imagine.  They will sell you any number of pills no questions asked, without a prescription.  Most prescription drugs are really cheap, however, there are a lot of phoney drugs that get into this country and there's no sure way of telling if what you're buying is the real thing, so you're better off bringing what you need if you're coming here.  Interestingly enough, I priced some vitamins, and they were very expensive.

 People here use pharmacies as a way of getting free medical advice, because they can't afford doctors. They describe their symptoms to the person behind the counter (probably not a pharmacist), who will recommend a medication to alleviate the symptoms.  It's a crap shoot, and very dangerous.  I recently heard about a woman who complained of shortness of breath, and was given a drug for asthma by the pharmacy.  As it turned out, a medical doctor finally diagnosed her with high blood pressure associated with congestive heart failure, which causes shortness of breath.  The drug she'd been taking actually exacerbated the condition!


More scary is the fact that some poor people often can't afford to buy the full course of antibiotics 'prescribed' by the pharmacy, so end up buying only a few, hoping it will do the trick.  You can't blame them, they only want to do what's best for their child, yet this practice could be one of the reasons we are seeing the development of so many drug resistant strains of bacteria. 

Medical Laboratories

I've seen the occasional sign for medical laboratories.  They're usually out front of some tiny shop along the street, but I have no idea whether the people inside are qualified to take blood, or what happens to the specimens once they are received.  Interesting.

Dentists

Dentists here are almost as common as pharmacies, yet most people don't get dental care for the same reason they don't go to doctors.  Money.  The same rule also applies to dentists regarding licensing.  Anyone can print up a license and hang up a shingle.  So better beware before you get your teeth looked at!