Cambodia launched a health strategic plan in 2002, in an effort to improve services to areas that lack medical personnel and resources. But in many rural areas, there has been little progress, and even an awareness of basic hygiene and disease prevention remains considerably low.
At the Preah Dak health center in rural Siem Reap province, home to the famed temples of Angkor Wat, health workers say they do what they can, but sometimes they run out of medicine or time.
Nurses here say they are short staffed, which does not allow them to spend enough time with patients. And some people in the area say they would rather just visit a pharmacy than take their children to the center.
Preah Dak’s problems are not uncommon. Cambodian health care is regularly underfunded and under-prioritized by the government.
Common health complications in this community involve flu, diarrhea and dengue fever, according to Phoeng Sophary, who has been a midwife at the health center for more than 20 years. “We have enough vaccines, but occasionally we run out of medicine,” she said.
Improving quality public health service is a challenge without a full team of medical staff, she said. “We spend limited time with each patient, as we are short-staffed.” At times, she has had to do the diagnosis, write the prescription, and issue the medication, all for one patient, she said.
Thy Sreyneang, a 23-year-old mother of two, told VOA Khmer that going to a local pharmacy for medication is more effective than seeing medical staff at the Preah Dak health center.
“Normally they ask what is wrong with my children, and after that they conduct a physical diagnosis,” she said. “Then they just give some medicine.” But that doesn’t often work, she said. Accessing public health service is cheap. But when the medication is not effective, the cost increases, as she then has to go to the local pharmacy for more medicine, she said.
Health officials say there is still much that can be done at home to prevent a trip to the health center, which is not always well understood.
Midwife Phoeng Sophary said maintaining a hygienic household can help keep infectious diseases away. Part of her job is to tell people this, she said, but they don’t always follow her advice.
“We advise them to drink boiled water if they want to avoid diarrhea, but they just listen and never do as they are told,” she said.
Proeun Nai, a 46-year old farmer who lives nearby, said she drinks water from the well without boiling it, even though she knows it’s not clean. “With hot and humid weather like this, cold and fresh water from the well tastes good, so that’s the reason why we don’t boil the water,” she said.