Cambodia

This country located in mainland southeast Asia has a relatively undeveloped medical care system. Cambodia was a French protectorate from 1863 until 1953, being a part of French Indochina. It gained its independence in December 1953, as the Kingdom of Cambodia, and was the scene of a bitter civil war from 1970 until 1975, and again from 1978 until 1991 when it was occupied by a pro-Vietnamese government. During the periods of war, its health system was devastated, although there is now a relatively good service for wealthier people. Cambodia with a population of 13,363,000 (2004), has 30 doctors and 74 nurses per 100,000 persons.

In medieval times, the Kingdom of Angkor, covering much of what is now Cambodia, relied mainly on faith healers, and there is also evidence of Chinese medical practices and herbal cures. The first European “doctor” to visit Cambodia was Charles Lister, a British merchant who moved to the country in 1701, and pretended to have a knowledge of medicine. He managed to cure the then king, Chettha IV, and was appointed the court physician, a position which was subsequently filled by his descendants who were still in the same position in 1822.

With the arrival of the French in 1863, there was a medical service established in the country primarily for the treatment of Europeans and also wealthier Cambodians. Most of it was centered on Phnom Penh, the country's capital, although there were small clinics at Kompong Cham and other regional centers. The Preah Keth Mealea Hospital was established in 1891, and until 1955 it was the only hospital of any size in the country. After independence, the government of Prince Norodom Sihanouk massively enlarged the provision of healthcare to all towns and also many villages [Page 333], and also embarked on a program of eliminating areas where mosquitoes could breed, thereby significantly reducing the incidence of malaria. At this time, a number of Cambodian doctors became important administrators with Dr. Sonn Mam (1888–1966) being minister of health in the late 1940s and early 1950s. In 1940, he had founded the Psychiatric Hospital at Takhmau, and when he retired from politics, he continued to run the hospital, as well as becoming a professor at the newly established Royal School of Medicine. The other important hospital in Phnom Penh during the 1950s and 1960s was the Calmette Hospital, but again it generally treated members of the foreign community or urban elite.

Many of the senior Cambodian government officials sought treatment overseas, with longtime defense minister, later prime minister, Lon Nol seeking treatment in France after a car crash in 1967, and, while he was president, in Hawaii after a stroke in 1971. His adversary Prince Norodom Sihanouk also sought medical treatment from rest cures in Grasse in the south of France. He later sought treatment in China for cancer.

The civil war which raged from 1970 until 1975 saw the medical services, which had been relatively good under Sihanouk, destroyed or drained of resources. Doctors from Médicins Sans Frontières worked in the country, as did an increasing number of Cambodians who had been trained in medicine. One of these was Haing S. Ngor who was later to settle in the United States, and star in the Hollywood film The Killing Fields (1984) in which one of the most dramatic scenes was at the Preah Keth Mealea Hospital on April 17, 1975, when the Communists, the Khmer Rouge, won the civil war and evacuated all the cities and towns in the country.

...