Sam Rainsy: A necessary overhaul of the derelict public health sector

០៦ សីហា ២០១៥ / 06 August 2015 – A necessary overhaul of the derelict public health sector.

របៀបគ្រប់គ្រងមន្ទីរពេទ្យ គន្ធបុប្ផា គឺជាគម្រូសម្រាប់រៀបចំឡើងវិញ ប្រព័ន្ធសុខាភិបាលដ៏ទ្រុឌទ្រោម នៅប្រទេសកម្ពុជា។
មន្ទីរពេទ្យ គន្ធបុប្ផា ទាំងបួន ដែលព្យាបាលកុមារ នៅទីក្រុងភ្នំពេញ និងទីរួមខេត្តសៀមរាប ត្រូវបានបង្កើតឡើង និងដឹកនាំដោយលោកវេជ្ជបណ្ឌិត សញ្ជាតិស្វីស ឈ្មោះ Beat Richner ។ នៅក្នុងមន្ទីរពេទ្យទាំងបួននោះ មិនមានអំពើពុករលួយទេ សូម្បីតែបន្តិចក៏គ្មានដែរ ពីព្រោះគ្រូពេទ្យ និងបុគ្គលិកសុខាភិបាលទាំងអស់ ទទួលបានប្រាក់ខែខ្ពស់សមរម្យ ហើយមិនចាំបាច់ទៅធ្វើការក្រៅមន្ទីរពេទ្យគន្ធបុប្ផានោះទេ ដោយពួកគេទាំងអស់គ្នាគោរពវិន័យយ៉ាងត្រឹមត្រូវ។ គ្រូពេទ្យ និងបុគ្គលិកសុខាភិបាលទាំងអស់ គោរពក្រមសីលធម៌ ដ៏ល្អប្រសើរ គឺពួកគេចេះគោរពអ្នកជំងឺ មិនថាអ្នកមាន ឬអ្នកក្រឡើយ។ មន្ទីរពេទ្យគន្ធបុប្ផាទាំងបួននោះ ព្យាបាលអ្នកជំងឺជាទូទៅដោយមិនគិតថ្លៃ។ ថវិកាប្រចាំឆ្នាំ នៃមន្ទីរពេទ្យទាំងបួននោះ មានចំនួនត្រឹមតែ ៤៣ លានដុល្លារអាមេរិក គឺតិចជាង ២០% នៃថវិកាជាតិទាំងមូល ដែលផ្តល់ឲ្យក្រសួងសុខាភិបាល នៅប្រទេសកម្ពុជា។ តែមន្ទីរពេទ្យទាំងបួននោះ ទទួល និងព្យាបាល យ៉ាងត្រឹមត្រូវ រហូតដល់ ៨៥% នៃចំនួនកុមារទាំងអស់ មកពី ទូទាំងប្រទេសកម្ពុជា។ ដូច្នេះ ការបំបាត់អំពើពុករលួយ និងការគោរពក្រមសីលធម៌ នៅ មន្ទីរពេទ្យ គន្ធបុប្ផា គឺជាការបង្កើននិងធានាប្រសិទ្ធភាព ព្រមទាំងយុត្តិធម៌សង្គម គួរឲ្យកត់សម្គាល់ និងយកធ្វើជាគម្រូ។
តែយើងបារម្ភថា ក្រោយពីការចូលនិវត្តន៍ របស់ លោក Beat Richner ទៅ តើមន្ទីរពេទ្យ គន្ធបុប្ផា នឹងមានអនាគត យ៉ាងណាទៅ? គួរតែមានការរៀបចំឡើងវិញ នូវ ប្រព័ន្ធសុខាភិបាលទាំងមួល នៅប្រទេសកម្ពុជា ដៅយយក មន្ទីរពេទ្យ គន្ធបុប្ផ សព្វថ្ងៃ ធ្វើជាគម្រូ។

Opinion as published in today's edition of The Phnom Penh Post

DYSFUNCTION IN CAMBODIA’S HEALTH CARE SYSTEM

Anyone concerned by Cambodia’s poor health system knows Swiss doctor Beat Richner, the founder and head of the Kantha Bopha Children’s Hospitals. For nearly a quarter of a century he is, without doubt, the person who has saved the most lives in this country. It is nationally recognised that the four hospitals Dr Richner keeps running in Siem Reap province and Phnom Penh form an island of probity, dedication and effectiveness in an ocean of corruption, neglect and ineffectiveness in this country’s health system.

On July 20, Dr Richner published a moving appeal in The Phnom Penh Post titled “A Request To The European Union.” Its content exposes striking facts and challenging evidence: “The Kantha Bopha Hospitals are treating 85% of all severely sick Cambodian children (...). All treatment is free (…). 85% of the budget (2015: 43 Million USD) [come from] private donations (…). The Kantha Bopha Hospitals are facilities with western standard and without corruption. No one of the 2500 Cambodian staff is taking money from the patients. No one staff is working outside of Kantha Bopha in a private clinic or elsewhere [as is usually the case for the staff working at state-run hospitals and health centers all over Cambodia].”

Dr Richner is right to point to the fact that the Kantha Bopha Hospitals are among health care institutions that can boast the most cost-effective healing approaches worldwide.

With a relatively limited annual budget of $43 million – representing less than 20 per cent of the entire state budget allocated to public health – Dr Richner’s private but non-profit hospitals treat and, whenever possible with modern medicine, save 85 per cent of all Cambodian children in need of medical care.

Any occasional donation to the Kantha Bopha Hospitals from the Cambodian government or the Cambodian Red Cross may help some people look good but is not the right and responsible way to address the chronic dysfunction in the country’s health care system. The very existence of the facilities run by Dr Richner is a permanent reminder of this dysfunction. As Dr Richner himself puts it, “Saving the life of a child is a human obligation. It should not depend on charity.”

As for any endeavour resting on the shoulders of a single person, the future of the Kantha Bopha Hospitals seems uncertain, if not worrying, with Dr Richner preparing for his retirement and calling for a scheme paving the way for his work to continue without him.

Given the high stake associated with the future of the Kantha Bopha Hospitals I can only express shock and anxiety when noting that Dr Richner’s appeal seems to have not been heeded by those government officials who should feel most seriously concerned.

Actually, ensuring continuity over the years and decades to come for the unique work performed at the Kantha Bopha Hospitals represents a triple challenge:

- For the Cambodian government, this is a golden opportunity to consider putting in place a real and effective public health policy. This includes training professional health economists while analysing, comparing and choosing health care models on the basis of their respective efficiencies.

- For the international donor community, this is also a unique opportunity to reconsider its aid approach and to exert adequate pressure in order to help overhaul Cambodia’s derelict public health sector.

- For the Cambodian people, when casting ballots at the forthcoming national elections, the choice is clear between a corrupt and irresponsible system resting on an everlasting beggar mentality and an alternative system based on transparency, probity, dignity and responsibility that are part of good governance and democracy.

Sam Rainsy
CNRP President
Minority leader