Living Mission: Medical care hit or miss in Cambodia

Father Charles Dittmeier

In many parts of the world, as COVID-19 rears its head, normal practices and ways of life have been changed or abandoned. Life in the U.S. is different now from what it was just two or three months ago.

Difference from U.S. practice is always the norm here in Cambodia. Very few of the institutions and services we take for granted in the U.S. function well here.

For example, there is no mail delivery and pick-up in the country. If you want mail you get a post office box. Now, because of the pandemic, all international mail has been stopped.

Education is supposed to be free, but teachers are poorly trained and poorly paid, and students, if they want to pass, have to bribe the teachers or take private extra tuition classes from those teachers — for a fee.

There is no central records system. Births, deaths, marriages and other life events are recorded in a family book that the family keeps in the home. The village chief stamps it to make it official.

Healthcare is a special concern for Cambodians. A first problem is a widespread lack of understanding of what causes illness and disease. There is little knowledge of germs and bacteria and viruses. For example, the woman who cleans our office kept the toilet brush and the sponge for cleaning the sink in the same container.

Many of the population blame disease and illness on witchcraft, curses and evil spirits. Scarecrow-like figures called “ting mong” are now appearing outside houses, especially in the rural areas. They have been set up to scare away the demons causing COVID-19.

The Pol Pot regime killed a generation of doctors and nurses along with other professional people. Then after the war, to fill the gap, a group of kroo Khmer arose, basically witch doctors practicing whatever natural medicine they could. They are still the prevailing medical resource in many areas because they can be paid with a chicken or mangoes rather than with the dollars needed at a government clinic.

Public medical facilities don’t exist in all parts of the country and the medical staff are not well trained. Because their salaries are low, government doctors in the provinces often set up their own private practices and refer patients coming to the government hospitals to their own clinics where they can charge a fee.

Basic equipment and services are lacking in most government clinics and hospitals, too. Most do not have a nursing staff or food service. A patient must bring bed linens, water and someone to prepare meals and care for the patient.

On one visit to a hospital ward, I found a family cooking a meal on a charcoal fire on the floor beside the patient’s bed. On another occasion, I was with a father when he had to acknowledge that his newborn daughter had died. He had been squeezing a rubber bulb all night long to pump air, not oxygen, into his baby’s lungs.

Except in the big government hospitals in Phnom Penh, family also must often run around to pharmacies for drugs that have been prescribed. And, even then, the medicines they locate can be counterfeit and useless.

Most foreigners, faced with serious injury or illness, go to Bangkok or Singapore, sometimes by air ambulance. I have made three evacuation flights, to be the sign language interpreter for foreign deaf staff.

Things are getting better here though. I had cataract surgery here at a Cambodian eye hospital set up by the Maryknoll missionaries. And, an oncology unit and a dialysis unit here are both rated highly. Still, though, medical situations are too often hit or miss and can be one of the real difficulties of life in Cambodia.

Father Dittmeier is a priest of the Archdiocese of Louisville, is the co-director of the Maryknoll Deaf Development Programme in Phnom Penh, Cambodia, and is also pastor of the English-speaking parish there.

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