Kantha Boptha – Children's Health is the Key for Cambodia's Future.

“Each child's life is a destiny, and this destiny becomes an absurdity when the death of a child is seen as having a different meaning for mothers in poor countries than in western countries.”

It's 1975, fighting continues as Dr Beat Richner attends to another child suffering from Dengue Fever. He's a newly qualified doctor and is working for the Swiss Red Cross in Kantha Bopha paediatric hospital, Phnom Penh. Everyday the Khmer Rouge soldiers dressed black advance upon the capital. It looks as though the capital will soon be under their control. Dr Richner knows that his time in Cambodia is limited and an evacuation order will soon be passed down from above. All he can do is continue with what he does best and help as many children he can until that point.

It wasn't long before Dr Richner received that message and had to leave the country and his extremely vulnerable children behind. On 17 April 1975, the Khmer Rouge soldiers seized control of the city, the country and meticulously and bureaucratically organised genocide began which saw 2 million victims. Among those killed were the intellectuals that could possible threaten the regime including doctors, nurses, teachers and professors. Believe it or not, prior to the Lon Nol government, Cambodia had a health care system that outranked Thailand and Malaysia. The Khmer Rouge's attempt to wipe Cambodia clean and return everybody to an equal place in society destroyed that system.

Following Cambodia's independence in 1991, His Majesty King Norodom Sihanouk and the government invited Dr Richner back to Cambodia to help rebuild Kantha Bopha children's hospital. It's now 2011 and Dr Beat Richner, also known to many Swiss as children's television star Beatacello, is still in Cambodia treating children from across Cambodia. In ten years an impressive five hospitals and a maternity ward for HIV-positive mothers have been built and a fully operational.

Government run healthcare in Cambodia is not free and is thriving with corruption, money simply disappears and it is believed that 80% of drugs used in these clinics are counterfeit, of which 10% of toxic. The Kantha Bopha children's hospitals provide free healthcare to children and mothers throughout Cambodia and are completely independent from the government. 85% of all children admitted into hospital for treatment come from families who are unable to pay the smallest fees. With 80% of Cambodian families earning a maximum of $0.5 per day, Kantha Bopha hospitals represent the only chance for their children to get the medical treatment they need. Every child has a right to proper medication unhampered by corruption. Without these hospitals, an estimated 3,200 additional children would die every month from treatable diseases. Despite this, the World Health Organisation insist that patient families must pay for the cost of treatment in order to take more responsibility for their health.

Dr Richner and his team of doctors

To beat corruption Kantha Bopha have employed 2,230 local Cambodian staff who are paid a decent wage that they can comfortably live on. Dr Richner claims that to this day there have been no thefts in any of the hospitals and no cases of vanishing medicines. Staff are also completely dedicated to their roles within the hospitals as they do not have to rely on second jobs to get by and this means the hospitals can run 24 hours a day. The hospitals provide on the job learning for 100 medical interns and nurses. This training is akin Artisans D'Angkor's goal and that is to regenerate the once great Cambodian healthcare system.

During 2010:

• 108,000 children were hospitalised in the five hospitals (Kantha Bopha I, II, IV and V in Phnom Penh and Jayavarman VII in Siem Reap Angkor,) The average length of hospitilisation was 5 days.
• 733,070 ill children received treatment in the outpatient departments.
• 580,000 healthy children were vaccinated.
• 16,100 surgical operations were carried out.
• 91,136 pregnancy control with 14,171 births in the maternity ward which has been designed to prevent mother-to-child AIDS and TB transmission
• 3,000 families received daily health care education
• The Kantha Bopha Hospitals cover 85-90% of the country's sick children.

The above statistics prove the great importance of the Kantha Bopha hospitals to Cambodian families. The annual budget for the running costs is US$30m which is sourced from donations the Cambodian and Swiss governments, but the majority of the funds are from private donations (approx US$22m per year).

In order for the hospitals to provide the healthcare that Cambodian children deserve and need, the assistance of modern and fully functioning equipment, proper and effective medicine and sufficient disposable medical equipment is required. The constant development of the hospitals is needed and at the moment, Siem Reap Angkor is being extended to accommodate 300 more beds and also house a new MRI scanner. The MRI scanner is indispensable when it comes to faster diagnosis of Tuberculosis and checking the subsequent bone and brain infections which is commonplace in northern Cambodia. Kantha Bopha's research on Tuberculosis in children is incredibly important in gaining further understanding on the affects of the disease and to improve the efficiency of treatment.

Unfortunately this is the sticking point. MRI scanners are incredibly expensive to purchase, run and maintain. Dr Beat Richner takes to the stage every Saturday evening as Beatacello and holds a cello recital and talk in order to raise funds for the hospitals. He starts off by stating what he wants. He says “From the young people, I want your blood. From the old people, I want your money. And from the people in between I want blood and money.”

Admitted children with their parents

The biggest threat to Cambodian children is Tuberculosis which also makes increases susceptability to HIV, Dengue Fever and Encephalitis. Should Encephalitis and Dengue Fever be diagnosed early enough, the effects on the brain are dramatically decreased and the chance of a full recovery is improved. The only way to gain this early diagnosis is through an MRI scan. The World Health Organisation (WHO) have become the bane of Dr Richner's life as they insist that he's doing too much in Cambodia and that he should take a step back. Their idea that medical care should be reflective of the countries economy is constantly grating on his mind. It is saying poor medicine for poor people. Dr Richner claims that it costs US$250 to save a child's life who is suffering from TB. How can the WHO stand by and say Cambodia are too poor to have medicine that's readily available in the richer western countries. Are western children lives worth more than that of a Cambodian? Does a Cambodian mother love her child less than a western mother? Should a Cambodian father accept that because his country's GDP is less than that of other countries, his child shouldn't deserve treatment that is there and available to western child? How can a person's life have a price on it? How can rich people who get rich peoples healthcare turn around and say, you're too poor to get proper contemporary treatment like I do?

When there is was a serious Dengue Fever outbreak, no one cared, but when there was an outbreak of Avian flu the WHO were there straight away to quarantine sites and take control of the situation because it is a global threat and can affect the richest western countries whereas Dengue Fever is localised to certain areas? Dr Richner dubs the WHO's health policy as passive genocide of Cambodian children and continuously urges them to revise their stance. It's not just the WHO or other 'charitable' organisations that refuse to offer assistance. A big grievance of Dr Richner's is with those countries that were implicit with bringing the war that reeked havoc in Cambodia.

In 1968 The United States of America were on the loosing end of the Vietnamese war and turned on the heat by raging a secret war against Cambodia in an effort to cut off supply lines and support for the Viet Cong. Cambodia was, at the time neutral, yet between 1968 and 1973 700,000 tonnes of bombs dropped on Cambodia and an estimated 500,000 innocent Cambodians were killed. In 1973 Cambodia fell victim to more bombs than Japan were during the entire second world war. Dr Richner believes that this secret war was clearly a huge factor in motivating broad swaths of the population allying themselves with the Khmer Rouge. At the same time, the Central Intelligence Agency of the USA financially, politically and strategically supported the 1970 military coup that successfully overthrew Prince Norodom Sihanouk as Head of State and thrust Lon Nol to power of Cambodia.

Dr Richner persistently approaches the USA for support, but they continue to refuse. The aid they do pay goes to governmental agencies and most of the funds simply disappear through the back doors and sticky hands of those in charge. Richner continues to be surprised with the attitude of the US superpower and their lack of responsibility for the part they played in the loss of 3.5 million lives during the war. Yet Washington insists that the money loaned to the Lon Nol government between 1970 and 1975 is paid back. Without officially declared war on Cambodia , the US bombarded the country for four months, killing hundreds of thousands of Cambodians, toppling Sihanouk through the CIA and replacing him with Lon Nol, and Cambodia are expected to pay back $300 million dollars to the US!

Another disgusting intervention of the US has been revealed. In 1979, Vietnamese troops marched into Cambodia and took control of the country as they had grown tired of constant encroachments of the Khmer Rouge along the Vietnamese border. 400,000 Vietnamese troops remained in Cambodia for nine years and President Regan took this opportunity to fund the Khmer Rouge $100 million to continue the fight against the Vietnamese. How can the US believe that they are within their rights to intervene in this way and fund a regime that had just wiped out nearly half of their population. What right do they have to insist on repayment of any monies that may have been loaned to Lon Nol. If it wasn't for their intervention in Cambodia, Prince Sihanouk would have never been deposed and the Khmer Rouge may have remained that small radical fraction with no power.

Beatacello in concert

Richner continues to approach agencies worldwide in an effort to secure long term funding for the hospitals. The model of these hospitals where they are run by the country's people for their fellow countrymen works well and it is believed more sustainable than that of voluntary organisations, such as the Red Cross that rely on western doctors, nurses and volunteers in the delivery of their service. Once the western volunteers leave, there are no experienced local people to continue treatment. By training locals up, paying them a decent wage, treating them with the respect they deserve and entrusting them with the honour of looking after their own people is the best way to ensure sustainability and development. These people continue to train up new doctors and nurses, and before you know it, a whole country will be filled with highly skilled professionals that have the ability to treat severely ill people.

I will never understand the principals of the US and organisations such as the WHO. The key to a countries success is through a healthy workforce. If you constantly hinder health services by either refusal or changing patients, then you will never have a healthy country. The work Dr Richner is doing in Cambodia is inspirational and I hope we will see other countries take up this highly efficient health care model. He has already stated that he wants to start a similar scheme in Burma but cannot attempt that until sustainable funding is sourced for Kantha Bopha.

During Richner's talks about his work, the hospitals and the problems of Cambodia, his split personality of Beatacello takes over and he plays his cello. It is a highly enjoyable, informative and shocking presentation given every Friday and I would recommend this to anyone that visits Siem Reap.

After leaving the hospital with my tuk-tuk driver who had waited for me for only $2(!), I felt deep sense of appreciation of the health service we receive in the United Kingdom, although the NHS may need a slight reorganisation, there is no reason for people to despise it and want private healthcare. If you care about your friends and your family, the NHS provides healthcare for them should they need it. I don't mind paying my taxes to ensure my friends and family health. So the next time you feel about complaining about the NHS, just think how lucky we are.

Please check out KanthaBopha's website to get a better understanding of Dr Beat Richner's work.