Since 1991, Dr. Beat Richner, Swiss pediatrician, has set up five children’s “Kantha Bopha” hospitals and one maternity hospital in Cambodia’s major cities, including two in Phnom Penh and one in Siam Reap. Over the last 20 years, one million seriously ill children have been treated in his hospitals and 10 million as out-patients. Treatment is free of charge since 90% of the children come from families whose income is less than one dollar a day. Most of the children are treated for Japanese encephalitis, malaria, dengue fever, thyroid and tuberculosis (TB) which is the number one killer in Cambodia. The high TB rate is a direct consequence of the war. The mortality rate in Dr. Richner’s treatment centers is very low – only 1%.
The total cost to date for these hospitals is 400 million Swiss francs. Donations from Switzerland have provided 87.5% of this amount. The cost covers building of the hospitals, medical supplies, medication, training and salaries of the medical staff which currently numbers 2,400 Cambodians and two ex-patriates (Dr. Richner and a pathologist). Families of patients are even provided allowances for travel to the hospitals.
The Kantha Bopha Academy of Pediatrics was established in 2009. Courses include organization and management of children’s hospitals and maternities in poor, tropical countries, general pediatrics, infectiology, immunology, and diagnostic imaging.
Dr. Richner started his life as a professional cellist and entertainer as a clown-like character, “Beatocello”. He received his medical degree in 1973, specializing in pediatric care at the Zürich Children’s Hospital. From 1974-75, he worked for the Swiss Red Cross in a hospital in Cambodia until the Khmer Rouge came to power. In 1991, the Cambodian Government asked him to rebuild the hospital.
The World Health Organization (WHO), other international organizations including UNICEF, and the Cambodian Government have criticized Dr. Richner for setting up these hospitals with state-of-the-art equipment and treatment which is “too expensive and too luxurious” for a poor country like Cambodia. The WHO Representative in Cambodia (1995-99) told Dr. Richner and the media that in Cambodia “there are simple diseases requiring simple (cheap) care”, however health centres, such as UNICEF’s, cannot fully cover the needs of sick children. There are no facilities for undertaking correct diagnosis and treatment.
Dr. Richner has drawn attention to the origins of HIV, which he says was brought to Cambodia and spread by UNTAC forces, the 1992-93 United Nations peace-keeping operation in Cambodia. He said that in 1994, there were no cases of HIV at the Kantha Bopha hospital, but in the year 2000, 518 new cases were hospitalized in the first seven months, most, children less than 5 years old.
Chloramphenicol, a broad-spectrum antibiotic, which is on the WHO list of essential medications, is being used by international organizations to treat infections in children because it can be easily and cheaply produced. Since 1970, this drug has been banned in the West due to dangerous side effects which includes bleeding and can eventually lead to death.
Dr. Richner has gone to the International Court of Justice in the Hague to plead the case for the irresponsible handling of HIV and Japanese encephalitis (refusal to vaccinate children) and the use of chloramphenicol by international organizations, which he says is “causing passive genocide” amongst the Cambodian population. The Court could "provide no answer" since international experts are outside the law.
“The policy and strategy of WHO applied to Third World countries can be described as poor medical care for poor people in poor countries”, says Dr. Richner. There is a different standard of care for rich and poor. The media is sowing propaganda about the excellent work that international organizations are doing in the field of health care. “Everyone has the right to access correct medical treatment… With the money the rich are spending for WHO alone, you could install 400 hospitals like Kantha Bopha and save all the children of Southeast Asia and Africa,” he says. “What you need are proper hospitals and adequate salaries (to discourage corruption).”
by Meris Michaels
(Ref: "Reflections on the Health System", speech given by Dr. Richner at IV Journées de Médecine et de Pharmacie, Phnom Penh, 2000, and Dr. Richner's Website.)