March 1, 2010 — One-legged Nurse Pan Hean is a proud man. So are all the staff of Chakrey Health Center, which Pan Hean heads. The new health center opened three years ago with 10 patients a day coming for consultation. Now 30 patients come every day. Sitting in his consultation room, Hean smiles and says: "This health center is just the right place for staff to provide good-quality health care, and more and more patients are attracted to it. For instance, we have private consulting rooms where we assure patient confidentiality. It’s a huge improvement over our old health post."
Chakrey is one of 18 health centers that was constructed and a further six renovated through the Health Sector Support Project (HSSP), financed by the World Bank.
Chakrey Health Center was opened in 2007. Most people come for five main services: birth spacing, ante natal care (during pregnancy health checkup), delivery, vaccination, malaria, and general consultation for illnesses such as diarrhea and fevers. The Chakrey center covers eight villages with more than 15,500 inhabitants, but it welcomes other villagers from outside the coverage area.
Chakrey was the scene of heavy fighting between the Government and the Khmer Rouge in Phnom Phoeuk district, Battambang province, and was where the war ended in 1996. Hean lost his leg to a land mine in 1982, and several mines and other unexploded ordnance (UXOs) were cleared from the grounds of the new health center before it could be built.
The World Bank Newsletter spoke with some of the health center’s patients.
Touch Mao has come with her two children from Spien Tom Neap village, 25 km away. Both children have colds.
Leng Sreynou, 21, from Boeung Kap village, Chakrey Commune, has brought her two-year-old daughter, Phath Nita, who also has a cold. She echoes Touch Mao and adds: "The quality of service is good and I rely on this center."
On a long cement bench-seat attached to the wall of the health center on the front veranda, pregnant Hak Eng sits waiting for her turn for ante natal care. "I come here regularly to check my health because I want my baby and myself to be healthy," she smiles. "I see a lot of people come here, and they are happy."
A 40-year-old farmer, Som Vanny, who has brought his pregnant wife for ante natal care, says he is very confident that the Center is the right place to bring his wife. "I will bring my wife here again for the baby’s delivery," he says. "I rely 100 percent on this center and I don’t want to take any risks by using a traditional birth attendant."
Khuy Samnang, the Deputy Head of Chakrey Health Center, is pleased because people are using the center for delivering their babies and they understand the importance of health care checkups during pregnancy. He says more than 90 percent of pregnant women in the villages of the coverage area come to deliver their babies at his Center. The small minority continue to use the traditional birth attendant. The center charges a standard fee of 20,000 riel (US$4.80) per delivery. But poor farmers are charged only half price, and the very poorest sometimes get the service for free.
"Our center has adequate equipment for delivering babies," Khuy Samnang says, "and if we see any danger signals of complications we send the pregnant woman to the hospital."
He said the center charges 2,000 riel (50 cents) for every new case and 1,000 riel for each return visit. The fees are manageable for most patients. The center's income is around 750,000 riel in average per month (US$180.00). Of this, 60 percent is used for staff incentive; 39 percent for running the health center and 1 percent for state revenue.
Sometimes his staff contributes part of their incentive payments to save someone's life. "Because we have problems transferring a seriously ill patient to hospital, our staff pay towards renting a taxi," he said. "We cannot close our eyes and let them die. We have to help them."
Khuy Samnang believes that 30 percent of the successful treatment of patients can be attributed to the new building, clean facilities and the positive attitude of his staff. Some patients bring their relatives to see the new building as well.
"The new and smart building, the clean environment, and the warm welcome by our staff are also parts of mental treatment," he laughs. "When they feel welcome, they are happy, and when they are happy their illness is also released."
However, the new health center has its own problems: it runs short of medicines for a whole month every three months.