Last time in the Big Brother House

I have rejoined the magnificant seven for our second language training session at the BB house in Kampong Cham. Its great to get together again, not only to learn more Khmer, but to have picnics in the surrounding countryside, frighten the buffalo, and tania and Sam to have their tailor made boat trips!

New Bike From Bangkok

As some of you know i had a few problems flying my bike out from England, so a trip to Bangkok was required to replace the much needed mountain bike to cope with the Cambodian roads. Whilst there, of course one had to indulge oneself to delights such as high tea in the Shangri La Hotel! Great weekend, the contrast to Phnom Penh is amazing and I am glad I don't work there!

Off road in Kampong Chaang

A weekend in Kampong Chnaang had us three intrepid explorers out on our bikes and going off rood across bridges. Tania and Helen making an extra special effort with this particular bridge!

As part of completing the circular route, Helen skilfully negotiated a ride in a boat for us and the three bikes…….and all in Khmer! Impressed me and Tania!

Cambodian Coastline

Life isn’t all about the work and I have certainly taken every opportunity to get and about at weekends. Cambodia has a great stretch of relatively unspoiled coastline to the south of Phnom Penh. I had a weekend here with Sam the dog, Helen and Tania and we had a great time swimming in the warm seas and staying out of the sun!

Thmar Pouk Referral Hospital

Situated circa 50kms from the main provincial town of Sisophon, Thmar pouk is a level 1 referral hospital serving a rural and mainly poorer agricultural community. The history of the hospital is that it was developed following the civil strife with the support of MSF. Thmar Pouk is one of the places in Cambodia where civil unrest continued until the late 1990’s! The Hospital has poor infrastructure, lacking basic amenities such as running water and electricity! Water is bought from a water seller who draws it from a pond, and if needed at night, electricity is provided from a generator ! But the hospital staff do a good job in-spite of the very difficult circumstances which they work in. Most of the staff trained in the refugee camps across the border in Thailand, and have recently been retrained either in Phnom Penh (doctors) or Battambang (nurses). There is a new Director reappointed following his graduation from retraining in Phnom Penh, and he has good ideas about the direction he wants the hospital to go in. I am spending time here in Thmar Pouk getting to know the staff and trying to grasp the complex system of MOH, Operational District and Provincial District management system which both Thmar Pouk and Mongkol Borei operate with in.
For both hospitals, it is a challenge to see children and adults admitted on a daily basis with conditions or accidents that have a major impact on lives, and yet simple interventions could make a huge change. For example, very few people wear helmets when riding mottos (mopeds), and yet road traffic accidents account for a large percentage of all traumatic accidents and deaths for both adults and children. It is not uncommon to see a whole family riding on one motto! What an impact wearing helmets and a maximum of two people to one motto would have on the number of accidents and death rates!

Mongkol Borei Referral Hospital

Mongkol Borei Referral is the main provincial hospital serving Banteay Meanchey Province in the North West of Cambodia. The Hospital has been in existence since circa 1950’s, and has seen a lot of action over the years, through the Khmer Rouge era and then the civil war in the 1980’s. A new hospital was donated by the People of Japan, and was opened as recently as May 2007. The benefits the new hospital brings are numerous: modern surgical and operating facilities, emergency care and modern facilities for maternity care. The Hospital is quality assessed annually and achieves a level three (highest level for a referral hospital in Cambodia). The Hospital Director is Dr. Sereywichouk, who manages the hospital as well as being a surgeon! Dr. Sereywichouk demonstrates amazing leadership skills: vision and direction, has the complete respect and loyalty of his staff, and is able to make major strides in quality improvement in health care despite the lack of infrastructure and public funding. One of the major challenges facing Mongkol Borei Referral Hospital is the ongoing maintenance of the new hospital and equipment, especially when the guarantee expires in March 2008. There is a high risk that when equipment failure occurs, the hospital will not be able to afford to either fix or replace it. This is an area I am currently working on with the lead Deputy Director and the Director alongside the ongoing quality improvement assessment closely linked via a health insurance type system for poorer people to income generation for the hospital.

Back to Blogging

It is already February 9th as I write this latest addition of my blog! A lot has happened since the beginning of the New Year, and time is flying by. I have also been doing a lot of travelling up and down to Phnom Penh, Kratie, Mongkol Borei and Thmar Pouk which makes it all the harder to settle to submit my experiences to words and then to the blog. As I said in the last submission, I will go into a bit more detail about the two hospitals I am working in here in Cambodia.