I was glad for the opportunity to the Angkor Hospital for Children (AHC) today at Siem Reap, Cambodia. This is a private non-profit hospital established in 1999 as a result of Japanese photographer Kenro Izu’s efforts – the touching story can be read on the hospital’s website here. It is a paediatric hospital for Cambodian children, for whom treatment is provided basically free. It is also a teaching hospital, with an independent 3-year pediatric residency programme that it has run for several years. Costs of operations are met by charity donations and funds raised by its board of directors and other well wishers.
The hospital is also the site of the Cambodia-Oxford Medical Research Unit (COMRU), which has performed and published groundbreaking biomedical (primarily clinical infectious diseases) research in Cambodia for the past decade or so. My colleague and I were given a rapid tour of the facilities by Dr Paul Turner – professor at Oxford University and director of COMRU – and were deeply impressed. Unfortunately, photography of the wards/clinical areas was not permitted hence I mainly have photos of the Visitor Centre.
There were already 400+ children registered for the day at the outpatient clinics when we reached the hospital at 2 pm (we were told that during busy periods, up to 800 kids would be seen each day). The place had just been renovated and looked bright and clean, organized despite being pretty crowded. The clinic rooms were spacious and well designed – there was an ophthalmology and echocardiography clinics situated within.
The inpatient areas were also neat and clean. Most of the 14 beds in the ICU were placed in a single large room, but spaced well apart to minimize the risk of cross-infection. In general, infection prevention seemed to be heavily emphasized here, with regular audits of the 5 moments of hand hygiene performed. I was quite astonished and proud to learn that a neonatal team from Singapore’s National University Hospital visits AHC on a regular basis to impart clinical training.
The general wards are also built as nightingale wards, with many beds arranged in single open rooms. Most beds were occupied by two persons – the child and the parent (usually the mother). This is quite understandable, especially given that many of the children had traveled long distances to get to the hospital. We were bemused to see the open kitchen behind the wards – the mothers had to cook for their ill children, with rations provided free for poor families (a form of means testing is done by AHC on admission). Nutritional education is provided to the parents by the hospital team.
Because of the COMRU involvement, the hospital’s microbiology laboratory is the most impressive I have seen among the several developing country hospitals that I have visited. There is no automated blood culture system, but the lab uses culture media produced by Phnom Penh’s University of Health Sciences, and performs susceptibility testing according to US’ CLSI. They even use Etest strips judiciously, including for ciprofloxacin against Salmonella, penicillin and ceftriaxone against the pneumococcus, and cotrimoxazole against Burkholderia pseudomallei. Perhaps most impressive was the poster below, seen on the walls of many of the wards.