Hospital hell

Imagine that you have just been involved in a traffic accident. You are taken to a neraby hospital where, on arrival, you are told: "No money, no treatment."

Even though you are seriously injured, no Doctor will see you unless you pay first. You can not lie on a bed unless you pay a first. You can not get any medicine unless you pay first.

This is exactly what happened to our friend Dina this week. The 18-year old was hit by a Moto while riding her bycicle along one of Phnom Penh's busy roads. She has just spent the last week in hospital, paying several dollars per night for the priviledge of lying on a metal bed without a mattres. She has had to pay extra for painkillers, Doctors assessments and a CT scan - all of which was more than she or her family could afford.

This is the current state of healthcare in Cambodia. Officially, the Government provides free healthcare for its citizens. The reality, however, is "no money, no care." Hospitals across the country, which are officially part of the Government's 'free' healthcare, are operating a system whereby patients must pay each step of the way for their treatment. Stories abounde of Cambodians being left lying on the doorsteps of local hospitals, without the money to access the treatment they so desperately need.

The question of who is to blame is not easy to answer. The Government does not provide enough funding for hospitals and pays Doctors too low a salary for them to survive (between $30 - $40 per month). The Doctors believe that they have no option but to ask for bribes from patients, a system they enforce ruthlessly and without compassion. The Non-Governmental Organizations (NGOs) keep stepping in to plug the gap in inadequate and unaffordable healthcare, which only encourages the Government to do nothing and allows the Doctors to keep taking bribes.

This sad state of affairs was revealed to us first-hand when we went to visit our friend Dina in the nearby Russian Hospital last week. We were shocked to find blood stains on the walls, used wound dressings on the floor, a foul stench in the air, dust and dirt on the floor, patients crammed together in small rooms and no Doctors or Nurses in sight. The people you see in the picture above are relatives, who must provide constant care for their loved ones in while they are in hospital, bringing in essentials such as a mattress and food.

What will take to rectify this situation, to change the culture and infrastructure of Cambodian healthcare? I don't know the answer but from what we have heard and seen, it is one of Cambodia's most pressing problems.