Two years ago, my mother received a diagnosis of liver cancer. Doctors said cancer was advanced and inoperable.
As with many cancer cases, the diagnosis of my mother was a shock. Two months earlier, I took her to two well -known private hospitals at Phnom Penh after she had complained about loss of appetite, a thick layer of accumulation covering her tongue and exhaustion extreme. After tests and consultations, including pulmonary x -ray, doctors gave their antifungal drugs and sent us back to us. They said they had found no major concern. But her exhaustion persisted and she lost weight. We decided to take him to Bangkok, where a computed tomography quickly found a large tumor of 8.4 centimeters in her liver.
A missed diagnosis such as the case of my mother and other examples of medical errors are some of the reasons why many Cambodians are looking for care in other countries. In 2023, a 22 -year -old woman died of complications after her small intestine was mistakenly removed instead of her umbilical cord in a medical procedure carried out in a private clinic in the province of Kampong Speu. The search for health services abroad was also motivated by the recent economic growth of Cambodia and the ease of regional trips through the anase framework agreement on the visa exemption.
Cambodians who go to another country for medical care come from a wide range of financial situations. A small number of rich individuals go to Singapore or other high -income countries for world class care. Those who can afford less in Thailand and Vietnam, and some poorer patients with serious illnesses undertake long terrestrial journeys to reach them. Many go into debt to pay health care.
During my last trip to help with the treatment of my mother’s cancer in Bangkok, I spoke with a 62 -year -old Cambodian who stayed in a small hotel in which my mother generally remains. He went to Bangkok for processing against back pain and said that he had more confidence in the Thai medical system than that of Cambodia. Another woman from the hotel said she was waiting for the results of a bump in the neck and visited an elderly aunt who was under surgical intervention. Each day, two dozen Cambodians fill this hotel, where the staff learned to speak Khmer and signs are written in Khmer. Some remain up to a few weeks while receiving medical treatment.
Medical tourism and cost of care abroad
There are no complete data on the number of Cambodians travel abroad for medical treatment or the amount they spend. A local newspaper said that in 2023, between 200,000 and 250,000 Cambodians would have been abroad to medical purposes. Another article estimated that up to 30% of Cambodians who visited Thailand and Vietnam between 2015 and 2016 have looked for medical services. This is aligned with what a Thai newspaper reported last year: that in a private hospital in Bangkok, 30% of its foreign patients were Cambodians and that in the first seven months of 2024, Cambodian patients spent about $ 1.3 million on treatment in this particular hospital.
Although the search for medical care abroad is the choice of a patient, many Cambodians with serious illnesses do not think they have a reliable option for quality care at home. Many would prefer to access good quality and affordable treatments in their own country. Obtaining care abroad comes with a high price and logistical complications. For example, at Ramathibodi hospital, a university hospital in Thailand, an MRI for a non -Thai citizen costs around 26,000 THB (around $ 750). There are also costs of plane tickets, accommodation, food, terrestrial transport and interpretation of languages which all increase total expenses considerably. The total cost of an MRI can easily approach $ 1,500 when including all associated expenses. To put this in perspective, the annual GDP per capita of Cambodia was $ 1,917 in 2023.
Changing health care landscape
With an increasing aging population which is increasingly faced with non -transmitted and more difficult diseases, the costs of care increases. In 2019, people aged 60 or over represented 9% of the population of Cambodia, an increase of 60% compared to 2008. This age segment will increase to 23% of the total population of Cambodia by 2050, According to the 2019 Cambodia 2019 census. Non -transmitted diseases, such as cardiovascular disease, cancer, chronic respiratory diseases and diabetes, are now the main causes of death and can “exacerbate poverty and threaten the other development objectives of Cambodia”, according to the ministry of Health.
Most families are largely not prepared. Almost all Cambodians over 50 are a survivor of the Khmer Rouge genocide. Most have no health insurance and social security net; According to the demographic survey and health, only 22% of women and only 13% of men aged 15 to 49 have health insurance. Most elderly have no savings and count on their adult children to take care of them. For example, a study of 50 people selected at random aged 60 and over in the provinces of Kampot and Takeo revealed that 76% of respondents declared that they have no income and in full office of their children or grandchildren To provide them.
At the national level, an analysis of the effectiveness of the health system and equity in the Anase indicated that Cambodia has the lowest for efficiency. With regard to health capital, Singapore, Brunei and Malaysia have a high degree of equity in the distribution of health care resources, both geographically and demographically. Cambodia is closer to Myanmar and Laos and is characterized by “inadequate access to medical resources and imbalances in their geographic and demographic distribution”.
Signs of progress, but we must do more
Over the years, the Cambodian government has worked to improve health services and provide more social protections, in particular by establishing national aging 2017-2030 aging policy and the national social protection policy (2016-2025) , among other efforts. Overall, Cambodia has two main social security schemes: the National Social Security Fund (NSSF) and the Health Equity Fund (HEF). The NSSF is a social insurance plan for employees in the public and private sector. For example, private sector employers who have at least eight employees must contribute 2.6% of an employee gross salary to the NSSF, while the employee must pay an equivalent amount. The HEF improves access to health care among a pre-identified cohort of the poorest and most vulnerable populations (called IDPOor holders) by paying health services provided by public health establishments to the eligible population .
But the implementation of these policies is always faced with challenges. The NSSF has widened the coverage, but the majority of the population (70%) still do not have access to the protection of social health, according to the International Labor Organization (ILO). Government figure places this slightly higher rate, saying that 41% of the population is covered. In addition, an ILSF ILO examination has revealed that many departments and functions perform similar tasks and operate in silos. The examination also added that the follow -up and evaluation function is “seriously limited” by the lack of statistical capacity. Likewise, the implementation of the first phase of the 2017-2030 naps has experienced slow progress in the support of the elderly population due to a lack of public awareness of politics and the lack of budget for setting work, according to a study.
Thailand offers Cambodia an example to look near his home. In 2002, Thailand launched universal health coverage to provide health services to its population then around 64 million. The coverage is funded by tax revenue. Thai citizens are now entitled to preventive, curative and palliative health services. The coverage has been extended to cover more expensive treatments such as diabetes and cancer treatment. Since the launch, Thailand has experienced great advantages: life expectancy has increased and households in the past not insured saves more, while the infant mortality rate, expenses in the process and catastrophic health expenditure incidents have decreased .
Social and cultural expectations dictate that Cambodian children must take care of their aging parents. But many adult children often do not have the financial capacity and coverage of health care for themselves. As more and more Cambodians are aging and faced more difficult non -transmitted diseases, the management of them is no longer just a family affair. It is a national economic and social affair. Cambodians and the Cambodian economy will benefit from the possibility of accessing advanced medical care at affordable costs at home.