Japan is helping Cambodian rural hospital to be able to do surgery

Tin Sokhavuth

A typical health center in Cambodian rural area. Photo supplied

With financial help from the government of Japan, the referral hospital in Chamkar Leu district, Kampong Cham province, will soon be equipped with modern technology, and doctors will be trained to be able to do surgery for local patients living in the district if needed.

A local online newspaper reported that during the signing ceremony of memorandum of understanding (MOU) on Monday at the Embassy of Japan to Cambodia, Ambassador Hidehisa HORINOUCHI said that among three projects helping Cambodia to improve its health care and irrigation system, the first project is to equip Chamkar Leu referral hospital with surgery equipments and blood test machine so that the hospital will be able to treat and/or do surgery for about 660 patients a year.

"I hope these projects will help strengthening the existing friendship between people of Japan and Cambodian people," added Ambassador Hidehisa in his speech at the signing ceremony.

The Cambodian healthcare system is very weak and is making a big different between rich and poor people, and between rural and urban populations. Child malnutrition is very high – in 2014, 32 percent of children under five or about 500,000 children were stunted.

During the civil wars for more than 30 years, many hospitals and healthcare centers all over the country were destroyed. After the wars, the government, in close cooperation with NGOs, has reconstructed the Cambodian healthcare system by trying to implementing different schemes of healthcare such as state supervision healthcare system and Health Equity Fund (HEF) that is funded by various development partners and the government.

However, access to health services is not easy for people living in poverty or close to the poverty line, people with disabilities and older people. Only about one fifth of Cambodians have access to the healthcare insurance and many households fall into poverty due to the high cost of health services.

The existing state controlled healthcare system does not provide health service with efficiency for the poor and for Cambodian people as the whole due to the lack of materials, equipment and qualified staff. Low salary in healthcare sector is also an obstacle for the motivation of the healthcare staff.

According to German International Cooperation (GIZ), a German NGO sponsored by the German Federal Ministry for Economic Cooperation and Development (BMZ), which experienced the implementation of the HEF in the province of Kampong Thom, Kampot and Kep, the access to healthcare services for the poor and vulnerable population has improved due to the implementation of the HEF.

The HEF allows poor people to be covered without paying the contributions. For households with the income allowing them to live just above the poverty line, they were encouraged to join the HEF by paying a small annual contribution.

The HEF implemented by GIZ also provides special services such as the payment of transport cost to persons with disabilities. Basically, the HEF has provided healthcare service for one third of the people living in the provinces where the HEF was implemented by GIZ.

The GIZ added that since the implementation of the HEF, the public healthcare institutions have been improved. The quality of health personnel has also been improved. In consequence, more people used health institutions when they were sick. Four out of five births now took place in public healthcare centers.

The GIZ has been working closely with selected commune councils and NGOs. Besides that, they have informed local people about their rights and the possibility to give feedback. According to the GIZ, to strengthen mutual understanding, trust, transparency and accountability, the discussion between patients, sub-national councils and health institutions was needed.

The implementation of the HEF by the GIZ took also in account persons with disabilities, persons with non-communicable diseases and older persons. Hence, special measures for them to access healthcare services have to be included in healthcare service.

The advantage of the HEF is not only for poor and underprivileged people, it also provides additional income for healthcare staff to improve their living cost and for the maintenance and the improvement of healthcare facilities.