"Dr. Beat" - Free Health Care for Cambodian Children

Kantha Bopha photo This 21-year-old Khmer mother and infant child receive free health care at Kantha Bopha Hospital.

James Loving/National Radio Text Service

In 1992 Richner started with 12 expatriate and 62 Cambodian staff.. The hospitals currently employ two expatriate and 1250 Cambodian staff. Richner's huge task is overwhelming. The plight of the sick in Cambodia is strong. Many Cambodian families have lost their land to pay off medical expenses. His hospitals in Phnom Penh and Siem Reap treat 2,000 outpatients per location a day and over four million patients per year FOR FREE.

Wednesday August 28, 2002

4 THE LOVE of LIFE

"He gave his life for this," an American from the city of Chicago said of the performer of a music concert. . He…is, Dr Beat Richner who was about to perform a solo cello concert. The this... the tourist was referring to, be Jayavarman VII Hospital in Siem Reap, Cambodia where Dr. Beat was about to perform.

For the past ten years Richner has raised funds and has overseen construction of three Kantha Bopha Children's Hospitals in Cambodia. He is the founder and acting head of the facilities.

In 1992 Richner started with 12 expatriate and 62 Cambodian staff.. The hospitals currently employ two expatriate and 1250 Cambodian staff.

The hospital has set in place an infrastructure where doctors and nurses are trained. That helped deal with the results of three decades of civil conflict that left the country drained of qualified medical staff.

In a recently prepared statement Richner summed up his approach. "Work with the health sector is by definition governed by a humanitarian kindness to which he or she is entitled."

Richner's huge task is overwhelming. His hospitals in Phnom Penh and Siem Reap treat 2,000 outpatients per location a day and over four million patients per year FOR FREE.

The plight of the sick in Cambodia is strong. Many Cambodian families have lost their land to pay off medical expenses.

"If you arrive (at a Cambodian hospital) as a common Cambodian as a case of emergency, traffic accident or appendicitis, as an adult in a hospital you have first to pay a $100 (to get into the hospital for care) otherwise nobody is touching you. You are lost... you will die" Richner said.

"I would say in Siem Reap 95% of the families and here in Phnom Penh 85% of hospitalized they cannot afford one dollar cash for hospitalization. They would have to pay outside to the security guard already, (and) $50 inside (or) they would have no access to medical care.

"The only way to treat the children is free of charge otherwise they have no chance.

"Small economic systems have collapsed because of the high costs of bribed medical care in the province or in Phnom Penh," he said.

"They (families) have to sell the moto (bike) first, then they have to sell the ox and they have to sell the land and then their whole economic system is collapsing and the child is dying. They are taking a lot of money, these private sectors of medicine here in this country."

Kuntha Bopha's 2001 activity figures state they gave 560,000 consultations. Forty two thousand children were hospitalized and 5800 surgeries were performed. The figures note that 2600 children would pass away each month without the hospitals services. Eighty Five percent of Cambodia's hospitalized children are hospitalized in the Kantha Bopha hospitals.

On our visit in Phnom Penh a throng of patients waited patiently in the hospital courtyard to be registered and given an ID card prior to treatment.

Kantha Bopha photo Dr. Beat Richner

As Richner walked us through the facilities he was passionate in his explanation of the functions of each department. The six-footish somewhat stout man walked at a vigorous pace as he moved from department to department while interacting with staff.

The hallways were filled with sick children on cots with their parents beside them. Inside the rooms each bed had two children placed at opposite ends. Space and beds are scarce and the need requires this procedure.

The 55-year old pediatrician noted that there is always member of the staff in every room at all times.

This is unusual in Cambodia. There is no such thing as a 24-hour watch over patients by staff. If a person is confined to a hospital, the Khmer way is for a member of the family to be with them to care for their needs. Richner endorses the family support at bedside feeling that it boosts the patients morale.

The site of the overcrowded conditions stress the need for more space. It's a difficult situation that Richner doesn't like but it's also one that he has to deal with.

He mentioned that the Ministry of Health wouldn't give any more land to build new hospitals.

Eighty five percent of the $12 million annual budget is from private donations, 12% from the Swiss Government and 3% from the Cambodian government.

Half of the budget is spent on drugs and medicines. Richner insures that the drugs used in Kantha Bopha hospitals are pure and from a central pharmacy in Copenhagen authorized by UNICEF. The medicine is from the original manufacturer and not copies. "Not to be criminal is very expensive," he pointed out.

"It's very important that in the hospital there is no corruption. That means nobody takes money under the table by the parents or is selling medicine outside. That's why you have to give correct salaries, which people can survive," he said..

Richner pointed out that government doctors in Cambodia receive $20 a month. Doctors must work outside and take money from the patients to survive. This situation results in the public hospitals being empty since the patients can't afford to pay and his hospitals are overflowing with those patients in need of free hospitalization.

In a country where police, soldiers, teachers and government workers receive a $10-20 a month salary and that it takes $260 a month to live in Phnom Penh (according to Richner) he pays his staff well.

Cleaners receive $200 a month to start, nurses $200-300 and doctors and surgeons $600-700.

Pride in their job is another essential part of the hospitals success as Richner mentioned.

"The success promotes motivation of the staff to do a good job. Good salary (equates) to the success of their work."

Richner noted the three top medical problems that the hospitals deal with are (1) TB, (2) HIV (3) Malaria.

Seventy percent of the mothers can't read. An explanation is given to 40-45% of the patients of how to take any prescriptions given to them.

Twenty-five surgeries per day are performed in Kantha Bopha's Phnom Penh hospitals, 12 in Siem Reap. A surgery patient averages an 11-day stay after surgery, five for all other patients. According to Richner, the average cost of hospitalization is $210.

The Siem Reap hospital has a maternity facility that was designed to prevent mother to child AIDS and TB transmission.

Jayavarman VII hospital (Kantha Bopha III) performs 300 deliveries a month. Though Richner doesn't know the exact national figures of the age that a mother would conceive her first born, his maternity facilities records indicate they are aged 24-32.

Kantha Bopha photo The Khmer way is for a member of the family to be at a patients beside at all times to take care of them and give morale support.

Many babies delivered HIV positive at other hospitals are sent to Kantha Bopha for blood transfusions.

"Transfusions in provinces were not controlled," Richner commented.

Kantha Bopha hospitals take meticulous care in testing the blood at a cost of one million dollars per year. Up to 7% of the blood inspected per day tests HIV positive and 16% hepatitis positive.

A clean blood supply is vital. Patients are asked to give and replace blood used in treatment. Some locals will donate blood and receive a meal, coke and a T-shirt.

Richner says 250 young tourists per month donate their blood. "We ask old tourists to give money and young tourist to give blood," he said.

The demand for free health care continues to grow. Richner is adjusting and bringing his plight to the attention of the public through his concerts.

Richner has been criticized for spending too much money to give free health care for the poor people of Cambodia. Some of Richner's critics pay $340 a day to stay at the Hotel Sofitel Royal Angkor next door to the hospital. Compare that to the $210 to treat a sick child and it is shocking.

"Our hospital is even an economic factor," Richner said. "First, we give 2200 Cambodians a good salary. They can survive with their families. And second we prevent the small economic system of these families of these farms we prevent them from selling their ox's, and their land in order to save their child because it's free of charge.

"Without these hospitals 2800 children would die every month. Eighty percent of the hospitalized patients could not survive without this hospital," Richner said in a another riveting comment.

Richner's no corruption statement can raise the eyebrows of some observers of Cambodia's history. The three words are like oil and water.. they don't mix… (1) No... (2) corruption..., (3) Cambodia....

In the case of his hospitals Richner had an explanation.

Part 2: NEXT

© Copyright: National Radio. Any use of these materials, whole or in part, is prohibited unless authorized in writing by National Radio. Contact: nationalradio@yahoo.com ALL RIGHTS RESERVED