- Dr. Beat Richner, Kantha
Bopha Children's Hospitals
-
- Phnom Penh / Siem Reap
Angkor, 27.
Oktober 2004
-
-
- Mrs Carol
Bellamy
- Executive
Director, UNICEF
- Copy to HE Secretary General
Kofi Annan,
- to the Minister of the Swiss
foreign affairs, HE Madame Micheline Calmy
Rey
-
- Excellency,
-
- in your recent Child Survival
Report Card (Vol 1 2004, published early October 2004)
Cambodia is told to be a country where under - five
mortality rate has increased since 1990.
-
- Excellency , be assured of my
high respect to the worldwide activity by UNICEF for
the benefit of our world's children.
-
- Excellency , let me explain
why this information on increasing child mortality by
UNICEF is wrong, why the strategy by UNICEF in
Cambodia in the Health sector is not only not
efficient but dangerous. These alarming statements are
due to Cambodia only, not to other countries where I
do not know the situation. And only due to UNICEF's
- health sector. Not to other
important sectors as Protection, Education and others.
-
- As a pediatrician, working
since 13 years in Cambodia (first time I was here
1974/75), having created three Children's Hospitals
and a Maternity , hospitalizing 85% of all Cambodian
Children being hospitalized in Cambodia, I know the
Health situation of Cambodia's children. I know the
situation of Cambodia's Public Health System. As
medical doctor I have the duty to tell you the
truth.
-
- The Child mortality in
Cambodia has not increased since 1990
-
- Excellency, who can tell you
the figures of the Child Mortality in Cambodia in 1990
or 1980 or 1975 ? At this time the access to many
regions was not possible for different reasons. So
nobody can tell you these figures.
-
- So nobody can compare any
actual figures with figures of 1990.
-
- The figures in a recent
report which nobody has the chance and the privilege
to see and nobody has the chance to know the methods
used to figure out these strange figures...., these
very figures were told to the medias in Phnom Penh on
June 2nd 2004. But this so called report is
based on mere estimations of the years
1998/1999.
-
- At this time the children in
the north of Cambodia had really no chance to get a
correct and efficient medical treatment.
-
- 1999 we opened in Angkor, the
north of Cambodia, our third Hospital, the Jayavarman
VII Hospital. The last 12 months 25 000 severely sick
children were there hospitalized. 80 % among these
children would pass away without this Hospital, which
is free of charge for all. (People here are very poor.
If they should pay, they would not have any access
to.)
-
- Since 1998 the rate of
Hospitalizations in Phnom Penh (Kantha Bopha I and II)
has increased by 35%. The last 12 months we
hospitalized in Phnom Penh 45 000 severely sick
children. 80 % of these children could not survive
without this Hospitalization.
-
- The children arrive from all
over the country. The roads are now much better. The
security situation too.
-
- So the mortality of children
in Cambodia has not increased.
-
- The alarming and strange
attitude of UNICEF
-
- Excellency, in 1998 the
representative of UNICEF in the province Siem Reap
told people in Swiss Television (Swiss people are the
main donators of the Kantha Bopha Hospitals), that the
Hospital Jayavarman VII at this time under
construction is not necessary. The needs are covered
by the 10 Health Centers managed by UNICEF the Swiss
people were told....Other Health Experts told the same
nonsense in the medias. The figures above tell us: The
last 12 months 22 000 children more would have died in
Cambodia without this Hospital opened in Siem Reap
1999, and UNICEF thinks this hospital is not
necessary. This error was never corrected or excused
by UNICEF. In contrary UNICEF thinks that the way we
are doing the job together with 1500 Cambodian now
well trained employees is wrong: Not adequate to the
economical reality of the country. Most childhood
death occurs for simple reasons, they are telling you.
That is why you have to do a simple medicine, which is
not expensive. This philosophy by UNICEF and WHO is
wrong and a reason why the health situation in
Cambodia is still so bad. UNICEF and WHO have their
permanent offices in the Ministry of Health and they
dictate its policy.
-
- All this above mentioned 10
Health Centers by UNICEF in Siem Reap province are not
working. The model project, the Hospital Sotnikum
(under the so called New Deal contract between
Ministry, Unicef and MSF) does not work
too.
-
- Fatal and frequent stories
about pregnant mothers, not being operated because no
power, because the money for the generators' Diesel is
stolen, about mothers or sick children not beeing
transferred to our center until there is money for the
Diesel of the ambulance the families have to borrow .
If with convulsions (Eklampsia) or if bleeding, first
they ask for money poor people cannot pay. Corruption
and the lack of facilities are fatal. The Laboratory
is empty. A correct diagnosis can not be done. And
without correct diagnosis no correct treatment is
possible.
-
- The future strategy of
UNICEF
-
- On June
2nd UNICEF has told the medias in
Phnom Penh that you must " refocus on simple ,
low-tech and doable interventions". This is exactly
what UNICEF is doing here since 13 years without any
efficiency. The Public Health system is
zero.
-
- And this strategy is
dangerous. They use cheap and dangerous drugs and
medicines forbidden for children in the so called
civilized world, where they are still produced for the
poor world and stocked in the central pharmacy of
UNICEF in Kopenhagen, they use drugs which do not work
because of the germ's resistances. They implement
simplified medical protocols neglecting the main
killer of Cambodia's children, the Tuberculosis, and
so on.
-
- The success of the Kantha
Bopha Hospitals (Kantha Bopha I and II in Phnom Penh
and Jayavarman VII in Angkor) with its low mortality
rate of 1,2 % is firstly explained by the transfer of
the technology and by the transfer of correct drugs
and medicines allowing a correct diagnosis and
treatment, and secondly by the exclusion of the deadly
corruption. All families have access. All is free of
charge. We give the money to the families for their
travel costs too, the families arrive from all over
Cambodia. The compliance of the follow up of TB
patients is 90 %. Cambodians are cooperating if there
is no corruption and correct information. The
compliance of the folow up of the HIV positiv mothers
with their children is 100 %! But they cannot pay. And
the UNICEF and WHO, dictating the policy of Health,
are thinking patients must pay by
themselves.
-
- Excellency, let me send "The
Angkor Declaration" , now signed by 200 000
Cambodians, by the victims themselves , not by
ambassadors , stars and VIPs of the so called
civilized world, asking for correct medicine for all
sick children. Free of charge for the poor. I think
that should be the idea of UNICEF too, but it is not
corresponding to the way UNICEF is working in reality
in Cambodia.
-
- We have the idea that most
functionaries not only of UNICEF , but of WHO and
others too, are accomplices of local officials. Wrong
figures are not disputed and blindly accepted in order
to sustain a bad virtual situation to keep their
status as lords of poverty in the poor countries. (85%
of the International Organizations' money is for the
salaries of their functionaries). This spirit of
intellectual corruption with its severe
consequences, Excellency, must be changed in Cambodia
in the Health sector. I do not hope there is the same
problem in other countries.
-
- By a budget of 15 Millions
USD per year the three Kantha Bopha Hospitals are
saving 60 000 or more lives per year. And by the 700
000 consultations per year thousands of sick children
are prevented from being severely sick. And thousands
of healthy children are vaccinated.
-
- By 15 Millions this all can
be done. The Budget by the Ministry of Health is 58
Millions USD (excluded all the money pouring in
Cambodia by UNICEF, WHO, USAID, JAICA , the British,
the German, the French cooperation, Safe The Children,
Care , and so on). On June 2nd 2004 it was
told that 64 000 children under 5 are passing away per
year. Why these lives, if the figure should really be
true, can not be saved by the Ministry's Budget and
the Ministry's policy directed by UNICEF and
WHO?
-
- Excellency, allow us to
invite you to see our Hospitals and some other Health
Centers to show you this alarming and not tolerable
situation.
-
- Sincerely Yours, Dr. Beat
Richner
-
- NB: the Angkor Declaration
can be found in the last chapter of the book enclosed
:Hope for the children of Kantha Bopha
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