- 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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