Mam Bun Heng, Minister of Health, has just expressed his concern on how to distribute doctors to various parts of the country … he said about 73,78% of health workers work at the provincial level and 26.22% work at central level and Phnom Penh … he also mentioned about incentive provided by the Royal Government which has led to increase of birth attendance of health workers from 39% in 2006 to 58% in 2008 and all issues relating to midwife.
I used to say that it is inappropriate to have 30% of the Doctor to serve 70% of the population while 70% of Doctors serve 30% of the population … Many medical staff never like to work in the province. Like under the former State of Cambodia, in order to enroll with priority, students sought approval from the provincial authority of their birth places and native residence, but when they graduated, because they are not living in those provinces in the first place, they always get themselves stay in Phnom Penh … There are many issues concerned, and many problems concerning this have been discovered, not just for medical personnel but also teachers. Take for instance we have decided to send 100 teachers from Takeo to Ratanakiri, and by this time only two or three stay there – the war was on, no road, malaria infected area, no infrastructure, etc. Here we have a different situation, and they all are related with peace if we were to have no peace nothing could be achieved …
I have seen a poll published in the Cambodia Daily that Cambodia has high political risk than countries like Sudan, Zimbabwe, Angola, Chad, etc. Some neighboring countries are not stable because of political uncertainty has been better in the poll … Two NGOs disagreed with the finding anyway … Sri Lanka is still in fighting – why it is not in the high political risk category? Cambodia in 1970 and under Pol Pot – why were then they not in high political risk? The poll has been formulated in such a way that its result is being exploited for political purpose …
We have a different state of situation now – we have peace all over the country, better infrastructure and more roads and bridges … more facilities in place so we have to make better progress in sending medical staff to all parts of the country … Before I frequently talk about how to distribute educational facilities to local level but now I am talking health geography as where to put medical centre, referral medical clinic, etc.
We should also benefit from the present situation to increase further birth attendance in the presence of midwife as we have already achieved 58% birth attendance at health centre now … birth attendance is important and some situation could have gone beyond knowledge and practice of traditional midwife … therefore, properly trained midwife would be key in this matter ..
To guarantee good maternity and childbirth while reducing death for both mother and child, our solution is to continue to train more midwives and they have to be redistributed while putting up an appropriate incentive policy for them to take up this job … Those provide assistance to midwife should be included in this package of incentives …
It goes without saying that we cannot just send doctors to local hospitals while no proper equipments being equipped … I would also urge not to implicate world economic crisis as impacts on medical expenses and medically related matters … What has been decided and adopted in the Budget Law seems to leave the Ministry of Health unaffected, so, it would not be acceptable if lateness of medical supply is being pointed at the crisis …