In a bid to boost health in rural Cambodia, a group of visionary Cambodian doctors have taken on the challenge of reaching out to some of the Kingdom’s poorest and most isolated communities. Writer Jessica Sander joins them on a trip. Photography by Sam Putaroth.
In a dusty elementary school located deep in rural Battambang, there is flurry of activity occurring, and it’s unrelated to study.
The Doctors Alliance (DA), which sits under the Union of Youth Federation of Cambodia (UY-FC), is visiting the district of Banan, on one of its monthly missions to provide free treatment to villagers, of all ages, who flock from far and wide. Today, there is a crowd of almost 1,000 people gathered at the school grounds to receive treatment from the proactive medical professionals in one afternoon.
On the Ground
After an official address across the loudspeaker about how the clinic will operate, a bell sounds and chaos ensues as droves of people rush to receive referral vouchers and find the appropriate classroom for specialist treatment. General medicine is by far the busiest, with crowds pushing and shoving while frantic volunteers attempt to organise patients into orderly queues.
Disabled landmine victim, Meas Mea sits patiently on a bench under the dappled shade of a tree as he waits for a general checkup. He took the 10-kilometre walk from his home after the village chief told him the clinic was coming to town. “I get free treatment and medication, which usually costs me $10,” he says. “The clinic is good.”
As well as offering medical care, dentists are also on hand to dish out treatment in make-shift clinics, moving patients towards light streaming in through windows so they can see better.
Up until now, Phan Thoan has never seen a dentist, but the 60-year-old is in pain, and a tooth extraction is necessary. , “I don’t normally see a doctor, I just go to a traditional healer,” she says. “The clinic is very good because it’s free and saves me 15,000 riel.”
Doctors Do Good
Formed in November 2014, DA is a response to the limited healthcare access for impoverished people living in remote areas. Started by a bunch of like-minded Cambodian clinicians in private practice, trained both domestically and abroad, their vision is a healthier Cambodia, achieved through providing free health care to Khmers.
Covering everything from general medicine, minor surgery and ophthalmology, to pediatrics, gynecology and psychiatry, DA’s mobile clinic travels to all 25 provinces, picking one or two each month and asking village chiefs to spread the word.
During last year, the DA treated more than 14,000 Cambodians for free. “His Excellency Hun Many, [director of UY-FC] has been instrumental in facilitating our work and spreading the word in the rural regions,” says Dr Reasey Sreng, dermatologist and DA deputy executive. “Our goal is to provide more qualified practitioners into these hard-to-reach areas in the treatment of acute and chronic diseases. We want to transfer our knowledge to other doctors operating in provincial health centres; to assist them with chronic disease management and ongoing health promotion within these communities.”
Dr Veng Heng, a pediatrician who previously worked at the Jayavarman VII childrens hospital in Siem Reap, has been involved with the alliance since its inception. “Today I saw 70 patients, mainly with respiratory problems,” he says. He sees the alliance as an opportunity to share his knowledge about treatment and prevention with patients, while improving the health knowledge of Cambodians overall.
Psychiatrists, Dr Chhuor Sokha and Dr Kim Sophea, are busy assessing patients’ mental health. “Today we issued antidepressants and benzodiazepines to treat people suffering from anxiety, depression and somatoform disorder”, explains Dr Sokha.
Both doctors strongly encourage their patients to follow up. “There are only 55 psychiatrists to service the whole population of Cambodia, with the majority practising in Phnom Penh, so we know that their chances of follow up are slim,” says Dr Kim. “Yet still we try.”
DA is currently securing a series of Memorandums of Understanding with provincial hospitals to ensure patients are able to follow up on necessary referrals. Dr Reasey says, “We urgently need a more organised healthcare system while improving the overall standard of treatment in both the public and private sectors.” He notes that treatment guidelines along with inter-clinic cooperation need strengthening, and the development of one overarching model of care is key to addressing some of the gaps in the current healthcare system.
As the heat of the day starts to dissipate and the queues of patients subside, Dr Reasey wipes the sweat off his brow after frantically overseeing operations. “I think today was a success,” he says with a smile.
Paying sentiment to the old adage, a doctor’s work is never done, he adds. “Tomorrow, we will do it all again in Pursat province.”