CARE PROBLEMS – ADVICE FROM THIS DOCTOR
All developing countries suffer from the same problem
– a lack of money, the consequences of which are poor educational
standards, a lack of qualified personnel, and corruption. All these
factors affect the provision of health care. The absence of the
rule of law and the poor enforcement of regulations means that there
are some bogus doctors (including foreigners), there can be false
blood results (either fake chemical reagents used e.g. for malaria,
or falsified laboratory reports e.g. for typhoid) and fake medicines
(10% of drugs sold in some Cambodian pharmacies are fake); each
pose a threat to the unwary patient.
With the triumph of capitalism over communism,
the lust for money has hit Cambodia hard. Do not expect to find
high medical ethical standards even in some of the foreign run clinics.
For the first time visitor to Cambodia it is not as easy as it looks
to find the right clinic. Foreign guidebooks and websites are often
out of date (some clinics have closed or moved address); only 24-hour
clinics are listed, while other good clinics are not. Some locally
produced guides only list clinics that have paid for advertising
and are not concerned with whether the clinic doctor is bona-fide.
The use of the words international/expatriate should not be taken
to mean Western doctor.
Many 24-hour clinics do not have a resident doctor
on site. Remember too that the best doctors usually choose to work
during the day and the less qualified work the night shift. Personal
recommendations can be helpful but be aware that recommendations
are often based on the personal preferences, and not necessarily
on the medical capabilities, of the doctor. Phnom Penh has a large
expatriate NGO and Christian community, many of whom discriminate
on the basis of gender or sexual orientation, the consequence of
which may be that a less qualified doctor is recommended.
Some basic rules for the visitor in consulting a qualified doctor
in Phnom Penh
- Have medical insurance before you arrive – it is worth
- If you become ill, remember that your life is worth more than
money; do not try to save a few dollars by self-medicating from
a pharmacy, or looking for the cheapest, and probably worst,
health provider around. See a qualified medical doctor who speaks
your language; if you cannot even communicate with the doctor
you are already on the way to a wrong diagnosis and wrong treatment.
- Have plenty of cash on hand. Most clinics accept only US$
cash. US$100 should be enough for most clinic visits including
blood tests and medicines. The standard overnight charge in
a clinic is around US$50, but if you need to stay in a hospital
then you probably should go to one in Bangkok.
- If you telephone a clinic in advance about fees be aware that
some clinics may not tell you on the phone about the associated
fees you will be expected to pay. For example you may ask the
cost of a vaccine and be told a price, only to discover, after
the vaccine has been given, that there is an additional doctor’s
- Be suspicious of doctor fees that are much lower than in comparable
clinics – the ‘doctor’ may be a nurse.
- Look for the Cambodian Ministry of Health license on the wall;
it should have a photo of the doctor you are consulting.
- Look for the university medical diplomas hanging on the wall;
check that the name on the diplomas matches the name of the
- Remember that all bogus doctors are extremely popular, so
as to prevent complaints leading to exposure, and will do anything
anytime. Real doctors are not always so accommodating.
- If in any doubt check with the foreign embassy of the doctor
concerned; the doctor should be on the embassy list of practitioners;
in addition all foreign doctors are required to be licensed
by the Ministry of Health, and as part of the licensing process
each foreign embassy will have had to have certified that the
doctor is bona-fide and has the medical degrees he/she claims.
However, some embassies show little interest in such matters.
- Make sure you leave the clinic knowing what is wrong with
you. Ask the doctor to write the diagnosis on the receipt.
- If you are not better after 3 days tell the doctor.