Not Only the Rich, but Also Middle Class People Go to Foreign Doctors – Thursday, 5.2.2009

Posted on 6 February 2009. Filed under: Week 598 | Tags: adhoc, adoptions, advisers, are, border, bribes, courts, defamation, dey krahom, doctors, emergencies, ethics, ethos, eu, france, gay, generals, germany, hor namhong, hospitals, impunity, intravenous drips, investments, khmer rouge, korea, kr, kr trial, labor law, land disputes, language, law enforcement, medical, middle class, national election committee, nec, north korea, norway, pra vihan, preah vihear, prescriptions, rich, sam rainsy, serbia, singapore, sri lanka, taiwan, tamil, training, treatment, tuol sleng, usa, vietnam, vocational training |

The Mirror, Vol. 13, No. 598

“Phnom Penh: Disobeying medical ethics, the lack of human resources, the shortages of modern tools for analysis and treatment, result in a situation where many Khmer doctors no longer are considered as serious providers of care for Khmer citizens. The number of Cambodian citizens going to receive medical checkups and treatments in neighboring countries is greatly increasing.

“As the reasons behind, we found that the prices of treatments in foreign countries, especially in Vietnam, are similar to the prices in our own country, but the friendliness of foreign doctors towards patients is probably another factor that provides the warm feeling towards patients receiving health checkups and treatments in foreign countries, even though they know that it requires higher expenses contributing to the economy of other countries.

“Mr. Kosal (name changed to maintain his privacy), who frequently goes to Vietnam to receive health checkups said that in Vietnam, before a doctor treats an illness, they thoroughly check, they do not just say something and then inject drugs, or to set up a bag of fluid for an intravenous drip, as doctors in Cambodia almost every time do, to get money.

“He added that doctors in other countries speak friendly and from a position of medical ethics, hospitals show to have sanitation standards, and they have modern tools which make patients feel confident when going to have health checkups and treatments in other countries.

“He emphasized, ‘When I say so it is not to advertise their country, or to humiliate our own nation, but the lack of a medical ethos of Khmer doctors, besides their unprincipled words, uncertain checking methods and treating people just for money, demanding money before the treatment, extending the illness [so that patients have to stay longer and spend much money for the treatment], and unqualified skills, make patients no longer feel warmly toward such doctors.’

“He continued to say, ‘I don’t believe that there are no outstanding doctors in Cambodia, and these do not adhere to immoral values,’ adding, ‘but white doctor’s clothes represent pureness, but not all who wear such clothes do respect what the value of their white clothes indicates.’

“Whether those who go to foreign countries are mostly the rich was explained by Mr. Kosal like this. The fees for treatment in the country mentioned are comparable to Cambodia, but there are additional expenses: for the service of interpreters, for accommodation, food, and for travel. Mr. Kosal added that middle class people also go for treatment, not only the rich. In addition to the mutual trust between those providing health checkups and patients in Vietnam or in other countries, pharmacies in these countries sell medicine to customers on the basis of prescriptions from expert doctors, and especially, in these countries, if a doctors do not have the specialization to treat a certain illness, they will not try to provide treatment, but they will help to refer such patients to another hospital with experts for the illness which a patient has.

“Mr. Kosal went on to say that in general in Cambodia – besides treating any kind of illnesses whether or not they are specialized, and injecting bags of fluid through intravenous drips, which is a method they prefer to use to get much money – some of the doctors scare patients, recommending to receive [unnecessary] operations, so that they can earn more money without really caring about people’s health and lives.

“Mr. Bunthoeun (name changed to maintain his privacy), who frequently goes to receive regular checkups for his liver disease, said, ‘Doctors in Vietnam carefully check illnesses. We learn from them and in their country, they work around-the-clock, making regular visits to take turn caring for patients, unlike in Cambodia, where doctors demand free time on Saturdays and Sundays.

“He added that in that country, people prefer to go to state hospitals rather than to private hospitals, because doctors at state hospitals earn bigger salaries than doctors at private hospitals, which are required to pay high taxes to the state.

“The basis for such trust is explained by Mr. Bunthoeun by saying that in that country, the government often sends doctors to be upgraded by training in foreign countries according to their skills, but not based on nepotism. On the contrary, in Cambodia doctors pay bribes to receive training, and if they fail exams they demand to continue their studies. As a result, when they become doctors, some do not have qualified skills for their career, and then they treat patients without certainty what to do, by just injecting drugs based on vague assumptions.

“Mr. Bunthoeun criticized also that some doctors in Cambodia, who have little knowledge, become proud of themselves, and even when they have almost created more problems for patients, they do not call them, and if they write prescriptions, they write them in French, in order to show off that they are knowledgeable, and their handwriting is difficult to read.

“He asked, ‘Why don’t they write in Khmer? If it is “vitamin,” why not write “វីតាមីន​” in Khmer, so that it is understandable? Why is it written in French?’ Creating trust will help reduce that patients leave to foreign countries, which wastes resources of the national economy, because if ‘doctors can create trust in the country, people will not go abroad.’

“The director of the Mekong Phnom Penh Clinic, which always sends patients to foreign countries according to their requests, Mr. Kong Kimchan, said that to send a patient to Vietnam costs between US$300 and US$400, adding that not only the rich, but also middle class people can go, and the fees for treatments are lower than in Cambodia, but a lot of expenses are needed for accommodation, food, and travel.

“As for the fact that many Khmer patients leave to go abroad, he said, ‘I do not know what to say about human resources in Cambodia, so that many people no longer have trust.’

“Mr. Kong Kimchan added that many factors influence people to no longer have trust; talking about human resources, we also have many, but the private services at some places, and the uncertainty people in general feel, and insufficient knowledge, are reasons affecting other human resources. He went on to say that also belated transportation facilities in emergencies at some localities affect the trust of the people. Although patients are transported to state hospitals, they no longer have trust.

“He continued to say, ‘Reorganizing the system for all people at the basis is good, because patients are not only in the cities, and I do not believe that Khmer doctors exaggerate the general situation of illnesses, because they also want a good reputation.’

“Regarding the lack of tools as a problem, he said, ‘We have received assistance to have many tools, and human resources are also many, but we do not share information well. Therefore, people do not know what we did and how many people we saved. After we would have published such information, what can we do? Are there enough arguments to be presented? In other countries, they have arguments and they have tools.’ He added, ‘We still have shortages; we need additional tools and additional training of human resources.’

“Do hospitals in Cambodia really have the problems as mentioned above? The director of the Khmer-Soviet Friendship Hospital, Mr. Say Sengly, recognized, ‘The quality of our services is really limited if compared to neighboring countries, but at present, we are reforming everything, the medical ethos, the techniques, and the procedures for the care of patients.’

“He added, ‘If we talk about the rights of customers and of service providers, the service providers have to take care of patients, but we do not restrain patients, if they want to go to neighboring countries to find better qualified treatment. He continued to say that as for making patients afraid, and the excessive use of too many intravenous drips, it seldom happens at state hospitals, but frequently it happens in private clinics so as to receive much income.”Rasmei Kampuchea, Vol.17, #4813, 5.2.2009

Newspapers Appearing on the Newsstand:
Thursday, 5 February 2009

Cheat Khmer, Vol.1, #12, 5.2.2009

• Mr. Sam Rainsy Will Appear to Explain His Position to the [Phnom Penh Municipal] Court on 11 February 2009 [on a complaint lodged against him by the National Election Committee, as he has not paid Riel 10 million, approx. US$2,500, for defamation – related to a speech during the election campaign in 2008]
• [Around 3,000] Workers of a Shoe Factory Strike to Demand that the Factory Owner Obeys the Labor Law

Deum Ampil, Vol.3, #112, 5-6.2.2009

• [Adviser to Prime Minister Hun Sen and President of the Cambodian Human Rights Committee] Mr. Om Yentieng Reacts to a Report of the Cambodian Human Rights and Development Association ADHOC [voicing concerns over serious land disputes, poor law enforcement, and impunity in 2008 – Mr. Om Yentieng said, ‘I think I cannot agree with the ADHOC’s report, and though some problems arose, I do not deny them, but it seems that I cannot agree with the assessment, and it is not done well.’]
• [Former director of the Phnom Penh Department of Education] Mr. Chea Cheat Is Appointed to Replace Mr. Oum Hoeung, Who Is Sent into Retirement

Kampuchea Thmey, Vol.8, #1865, 5.2.2009

• Serbia Deploys Ambassador [accredited in Indonesia also] to Cambodia for the First Time
• A US Ten-Stories Tourist Cruise Ship [with around 1,393 tourists from more than 100 countries] Docks in Sihanoukville
• Agricultural Researchers of Singapore and Taiwan Come to Study Land Availability and Quality in Cambodia for Investment
• The United States of America Warns North Korea about Missile Testing as Creating Trouble

Khmer Aphivaot Sethakech, Vol.7, #335, 5.2.2009

• 19 Generals Are Appointed Advisors to Samdech Hun Sen after the Shift of H. E. Ke Kim Yan [as the Royal Cambodian Armed Forces commander-in-chief]

Khmer Machas Srok, Vol.3, #337, 5.2.2009

• [Minister of Foreign Affairs] Hor Namhong Demands Euro 100,000 [approx. US$130,000] Reparation from [opposition party president] Sam Rainsy, but the French Court Reduces It to One Euro [regarding Mr. Sam Rainsy’s book, defaming him, that he was, as Boeng Trabaek prison chief, also victimizing innocent Khmer citizens; but the court allows the publishing of the book after deleting one sentence defaming Mr. Hor Namhong]

Khmer Sthapana, Vol.2, #197, 5.2.2009

• Dey Krahom Residents Protests in Front of the Headquarters of the 7NG Company to Demand US$20,000 as Compensation [among the 1,465 Dey Krahom families, 45 try to demand US$20,000 compensation]

Koh Santepheap, Vol.42, #6570, 5.2.2009

• Appeals to the Tamil Tiger Insurgents [by the USA, the European Union, Japan, and Norway] to Surrender [because their fate comes almost to and end through the Sri Lankan government military forces]

Moneaksekar Khmer, Vol.16, #3679, 5.2.2009

• A Person Who Was Close to [top Khmer Rouge leader] Pol Pot [Van Sith, an important former Khmer Rouge official in charge of commerce] Died. It is a Significant Loss for the Khmer Rouge Tribunal [according to the Documentation Center of Cambodia, he died in late 2008]

Rasmei Kampuchea, Vol.17, #4813, 5.2.2009

• Not Only the Rich, but Also Middle Class People Go to Foreign Doctors
• Negotiation in Bangkok: Thailand Continues to Demand to Use the Word Pra Vihan [พระวิหาร in Thai – Preah Vihear ព្រះវិហារ in Khmer] Which Blocks Border Marker Settings

A personal note:

In Europe, at the French-German border, we use, of course, both languages on the border signs: “France” and “Frankreich,” and “Allemagne” and “Deutschland” – no problem.

As for a big city which, during the centuries, was sometimes German and sometimes French – the French call it “Strasbourg” and the Germans call it “Straßburg.”

It is surprising that this common sense question of the two languages is mentioned as posing the difficulties, while there has no mutual agreement ever been announced where to put the markers in the widely contested area – always considering the very restricted Cambodian claim – “for the time being” – expressed by the Cambodian side in the Joint Communique of 18 June 2008.

• Five Children Found to Have Survived the Tuol Sleng Prison [in videos about the Tuol Sleng prison recently provided by Vietnam, taken at the time of the liberation of the prison by Vietnamese soldiers in 1979, who documented it on film] the Documentation Is Now Being Sought to Be Used as Witness Material
• The Government Creates a New Committee to Solve Investors’ Problems
• France Asks to Permit again International Adoptions of Children from Cambodia, but Cambodia Suggests to Consider Some Conditions [1. Should single persons be allowed to adopt children or not?, 2. Should families that already have two children be allowed to adopt another child?, and 3. Should gay families be allowed to adopt a child?]

Samleng Yuvachun Khmer, Vol.16, #3480, 5.2.2009

• The Khmer Rouge Tribunal Has Received 94 Civil Party Victim’s Complaints for the Case of Former Tuol Sleng Prison Chief Duch [Kaing Gek Eav]

Have a look at the last editorial – you can access it directly from the main page of the Mirror.

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