On January 9, the Ministry of Health determined that the HIV infections in Battambang province’s Roka commune were spread through injections and intravenous (IV) drips. We all know that a bad preference for IV infusions has existed for a long time among the population of Cambodia, in towns and in rural areas, from the rich to the poor.
Since 1993, when the government officially liberalized the economy, private hospitals and clinics have been established in Phnom Penh, in provincial capitals and districts across the country. Most of them are run by physicians who also work in state hospitals. Most, if not all, of the private health facilities attract patients by offering them regular IV infusions (the more the better is the prevailing opinion), even for simple health problems. Patients have no appreciation for the effectiveness of oral medicine.
And in the countryside, village and commune doctors—licensed or unlicensed—simply follow the example of doctors at the upper level, doing good business despite malpractice.
The people’s harmful preference for IV infusions and physicians’ malpractice are two public health problems in Cambodia that must not be overlooked or underestimated.
The Ministry of Health must use the Roka case as a lesson and an opportunity to correct the beliefs of the general population and eliminate the malpractice of health workers. By doing so, the ministry will improve health services in Cambodia and help people spend less on health care, thus contributing to poverty alleviation.
To achieve these goals, the Ministry of Health should launch a campaign to educate the general population about the value of oral medication and the inappropriate preference for IV infusions. At the same time, the ministry should set up a mechanism to closely monitor the medical practices of health workers. Without taking vigorous measures, Cambodia will experience a disaster bigger than what has happened in Roka commune.
Dr. Hun Chhunly is the former director of the Battambang provincial health department and was a national consultant for the World Health Organization in Phnom Penh between 1995 and 2004.