The Phnom Penh Post - ENGLISH: “Making a difference by saving children’s lives” plus 9 more

1 – Could you please give a short introduction about your willingness to establish a charity children's hospital in Cambodia? Can you explain why charity is important for you?
Dr Beat Richner: I was asked by His Majesty King Norodom Sihanouk and the Cambodian government to restore the Kantha Bopha Children's Hospital where I worked as a young pediatrician from 1974-75 until the Khmer Rouge entered Phnom Penh. Kantha Bopha is no charity, it is the obligation of all the civilised and rich human beings and governments to save the lives of children in a country that has been destroyed by war and civil war brought from outside. The patients are children from parents who mostly are poor. That is why all treatment is free for all. Again, it should not be a charity but an obligation.

2 – Please kindly update us so we can understand the number of children's lives that have been saved by the professional treatment they received in Kantha Bopha Hospital?
Dr Beat Richner: For 21 years we have hospitalised 1.3 million severely sick children, and 14 million were treated in the outpatient stations. Last year we had to admit for hospitalisation 150,000 severely sick children. Among the hospitalised children at least 80 per cent would not have survived without this hospitalisation. We treat 85 per cent of all Cambodian children. In the case of the Dengue Fever it is 92 per cent!

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3 – Could you explain to our readers about the professional standards used to treat children's diseases? What are the most difficult cases to treat for Kantha Bopha Hospital?
Dr Beat Richner: In order to do a correct and effective treatment which is saving the child and not killing them you first should do a correct diagnosis. That is why all our hospitals are equipped with correct but expensive
facilities such as MRIs, Ultrasounds, CT Scanners, laboratories, blood banks and so on. The standard of the medicine and drugs are corresponding to the standard you have in the US or in Europe too. The standard of surgery (60 surgical operation per day) too.

Now every day we do heart surgery and interventional heart-catheter too. Every child has only one life if living in Cambodia, in Switzerland or in Washington. The rule by the WHO and other international organisations is wrong and fatal that the medical facilities should correspond to the economical reality of the country. For 80 per cent of Cambodian people it is zero as a consequence of the wars.

4 – What is your biggest achievement in the history of your hospital? Could you give us some idea about how you promote awareness of Cambodian healthcare and better living standards in Cambodia?
Dr Beat Richner: Today our annual budget is US$40 million. Three million dollars are contributed by the Cambodian government, US$4 million by the Swiss government, US$1 million by the Cambodian Red Cross. The other US$32 million comes from private donations I have to look for. This US$32 million should be given by the governments that have brought war to Cambodia or have supported the civil war in Cambodia.

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The main problem of health in Cambodia is, for example, Tuberculosis. It is a consequence of the war. But it is underestimated and not understood by the WHO. Already the TB infected but not sick child is weakened in its immunity balance and so more vulnerable to other diseases. And TB infected children are malnourished too.

5 – Please tell our readers about your experiences with Kantha Bopha Hospital in Cambodia. Will your hospital be able to fund and support child care projects for another 10 years or more?
Dr Beat Richner: As long as the Cambodian government cannot contribute more to Kantha Bopha we go on looking for donations as long as we can. I hope that the many rich Cambodian people with their huge villas and castles and cars will contribute more money to Kantha Bopha. They should share this responsibility in favour of the poor. It is an obligation of love and justice.

6 – We Cambodian people and our government are impressed and proud of you for doing a very difficult mission. What would to tell to all your fund donors about your achievements in Cambodia?
Dr Beat Richner: The Kantha Bopha hospitals are effective because there is no corruption. All the 2,450 Cambodian staff are doing hard work, day and night. They do not work outside in private clinics or private
businesses. But they get a correct salary. And still our hospitals are the hospitals worldwide with the best correlation costs/healing rates! I think that will be the model not only for Cambodia but for all poor countries.

Europ Continents has 20 years of experience in Cambodia. It opened its office in 1992, and this major company has been involved in many business sectors, but focuses on healthcare and laboratories.

Since it started in Cambodia the business environment of competency and autonomy are a critical component to the satisfaction of its customers, partners and collaborators.

According to Managing Director Thibaud Sournia, the increase in the healthcare and laboratories sectors has been substantial – today they have 60 professionals in three offices made up of doctors, biochemists, pharmacists, biomedical engineers, technicians and logisticians. This has created a lot of expertise among local people in these respective fields.

"Here every one of our team works hard and are spread across the country," Thibaud said. "They have been continuously trained by our principals and have been consistently upgrading their know-how and skills on our installation and maintenance sites to insure a minimum response time."

Thibaud added that this is not only Europ Continents: "Our partners we represent in the country are leaders in the market, do have the capability and the will to support this country.

"As an example, Philips Healthcare that we have been representing in the country for over 10 years, having installed the only two super-conducting MRI (3T) in Cambodia. We do have in Singapore a regional hub for spare parts to ensure fast deliveries and equipment on a minimum standby.

"As well, they set up long ago their Singapore Learning Center: all their equipment is displayed and running to organise end user application trainings as well as biomedical engineering training.

"Most of our partners are from Europe (Germany) and the US, with some potential companies in the region.

"Europ Continents Cambodia offers support and takes benefit from a group of nine countries (Cambodia, Indonesia, Laos, Malaysia, Myanmar, The Philippines, Singapore, Thailand and Vietnam) and has 14 offices in Southeast Asia, with the support of more than 350 professional collaborators," Thibaud added.

"The group expertise with equipment and consumables as well as project development has extended today to seven main divisions, such as healthcare, laboratories, environment, gourmet, security, geosystems and the infrastructure and industries."

With a history of two decades of Europ Continents in Cambodia, Thibaud has seen that consumer demand in the healthcare industry has grown rapidity.

"The market has been continuously evolving for the last 20 years. NGOs at first, then small private clinics with freshly graduated doctors from the Phnom Penh University of Medicine," he said.

"Then if the public sector is still supported by international cooperation, there is a real improvement. First because the freshly graduated now have experience; some of them having followed specialties in Europe – often in France supported by cooperation, or in the region."

"And recently returning Cambodians who have been studying and working in western countries like Canada, France, Germany and Australia, they come back to join the public sector such as Calmette Hospital, which offers them primary care and specialty platforms and/or opening their private clinics.

"For example Kantha Bopha, to use just one, we have been constantly improving and developing our knowledge and services to support their dedication to Cambodian children, endlessly focusing on providing international care standards.

"Although we may have few customers for advanced equipment, niche activities (specialties), they all share the same requirements; they care for quality and expect an added value.

"If we install some equipment for the first time in the country, we commit ourselves to providing turnkey solutions.

"I have to admit that when five years ago we were asked to install the first MRI 3T (Magnetic Resonance Imaging) in the country, Philips refused to accept the project. Not that it was not appropriate to the country, but that this very sensitive imaging system required prerequisites that did not exist at that time.

"With several partners such as architects, civil engineers, power specialists and movers, we developed specific solutions carried out by motivated and committed people and today the system is run every day by Cambodian doctors and supported by Cambodian engineers.

"Today we are proud to say we are market leaders in various segments: Imaging, Endoscopy, Infections control, Clinical Diagnostic, Cardio-Vascular and Open-Heart surgery, Neurosurgery, Oncology, etc," Thibaud said.

Making false teeth is a new profession in Cambodia that has only started in the past five years, but it is opening doors by creating new services to the general public.

After eight students graduated in making specialised orthodontic teeth from the University of Health Sciences in Phnom Penh in 2008, dentist Kak Tola was among that first batch and opened the Khmer Dental Clinic at No 8, Street 149 near the Bantuok High School.

"For many years our people have been less concerned about orthodontic services, because their buck teeth or crooked teeth just grew naturally," Tola said.

"But these things can be helped by specialists in many developed countries in the world to straighten them and make them look better.

"In fact, buck teeth can be a naturally occurring thing, but because of the advances in science people with buck teeth can use modern science to modify them and look better," he added.

Tola explained some of the benefits of having new teeth.

"The specialist orthodontic teeth can provide many advantages for people, because after straightening, they can chew their food better to bring more nutrients to feed them better and help straighten the jaw bone. They also make the mouth and face look better, adding more beauty to people's lives," he said.

"To be highly effective to curve and straighten the teeth, parents who suspect their children are growing buck teeth or that their teeth are not straight need treatment when they are between eight and 13 years of age.

"They can bring their kids to consult with specialised orthodontic doctors because at that period of age the treatment is the best and takes a short time," he said.

"Normally, curving and straightening the teeth takes between sic and 18 months, depending on each individual case. The cost of orthodontic services in the Cambodian dental care market is cheaper than abroad by at least two or three times.

"Here the actual fees are between $1,500 and $2,000 and this cost covers medicines from the beginning to the end."

To avoid having buck teeth, parents should bring their children to a dentist to get their teeth checked while they grow their second generation of teeth, because that is the best time for treatment and the expenses are also less, he said.

Angkor Hospital for Children (AHC) is a non-profit pediatric teaching hospital that operates in cooperation with the Cambodian government to provide free, quality healthcare to impoverished children in Siem Reap.

According to Sinketh Arun, the external relations manager of AHC: "Today the number of children-patients have increased to 500, sometimes rising to 600 per day; while when we started in 1999 our Outpatient Department (OPD) saw an average of 67 children per day.

"In 2013, from January to August, 61,433 children were seen in OPD and 187 heart surgeries were performed," Arun said.

"In the same period in 2012 there were 79,584 patients – because of the outbreak of hand, foot mouth disease and dengue fever.

"In July 2013, there were 10,945 patients who have been treated here, while 26-27 per cent of them were infected by upper respiratory infections, diarrhea patients were between 6-7 per cent and dengue fever patients only 2 per cent," Arun added.

She said that from 1999 until now, the AHC has provided more than 1,000,000 medical treatments, educated thousands of Cambodian health workers and given prevention training to hundreds of families.

Arun said the hospital offers inpatient and outpatient care, surgical services including heart surgery, ER, intensive care treatment, dental care, ophthalmologic services and antiretroviral HIV therapy to more than 150,000 children each year. 

The hospital also has a pharmacy, physiotherapy and radiology services, a medical laboratory and a social work program.

"Along with providing quality healthcare to children in Cambodia, AHC is a training site for improving the skills of healthcare workers," Arun said.

"In 2005 it was officially recognised as Cambodia's first teaching hospital, one of only two in the country. Today it serves as a training site for the World Health Organization's Integrated Management of Childhood Illnesses Program.

"The most common ailments treated at the hospital include pneumonia, malnutrition, dehydration, diarrheal illness, HIV/AIDS, dengue fever, malaria and other tropical diseases," she said.

"The majority of patients travel from rural areas to seek better care than can be found in their own communities. For the neediest of patients, not only are they provided with free healthcare, but their travel costs are reimbursed."

Founded in 1999 by Kenro Izu, AHC has been supported by US-registered NGO Friends Without A Border for the past 14 years.

It has always been a goal of the hospital to become an Asian-supported foundation and ultimately an established Cambodian foundation.

This year marks the year when Angkor Hospital for Children will become an international NGO incorporated in Hong Kong, transitioning from a US to an Asian foundation. During this time the operation of the hospital, its management and its vision remain the same.

On September 13 AHC will hold an opening ceremony for its new neonatology ward, which will enable it to play a much greater role in addressing one of the major contributors to Cambodia's child mortality – neonatal illnesses.
This new unit is a major step forwards for AHC and it will replace the temporary unit which was created early in 2012, sharing space with the Inpatient Department.

One of the hospital's success stories was with a one-month-old boy named Makara.

After Makara was delivered at home, with help from a traditional midwife, warning signs presented themselves. These included a low temperature, difficulty breathing and pale skin.

His parents took him to a health centre, but staff rejected hospitalisation because he required treatment from highly skilled doctors, which they did not have. The health centre staff recommended his parents take him to Angkor Hospital for Children (AHC).

Makara's father borrowed money from a neighbour in order to travel in a shared taxi from their village at Banteay Meanchey province about three hours to reach Siem Reap city.

Upon arrival at AHC, Makara was immediately admitted to the ICU ward where he was treated in an incubator for a week with a strong antibiotic medicine called Imipenem.

In addition, he was given oxygen, intravenous fluid and warm blankets to keep his body at its proper temperature until his condition stabilised.

After seeing an improvement the pediatrician transferred him to the IPD where he stayed for two weeks.

Finally, Makara was discharged after he gained weight and his condition has greatly improved.

With the Angkor Body Building Championship just a month away, Siem Reap's strong men are working hard in anticipation of flexing their pecs on stage.

In a true display of good sportsmanship, all 35 Siem Reap competitors train together at the same place, the ABBA gym. Filled with pumping music and sweaty brows, the gym not only sponsors the competition but is also where the event's organiser – Rocky Lee – works as trainer.

"I've been interested in body building for over 10 years and always wondered why other countries had this competition but we don't," he says. "After attending a competition myself in Thailand, I decided it was time to start one here."

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The competition is now entering its third year, and Rocky notes that it has been instrumental in encouraging other young men to take up the sport. His real ambition, however, is to promote body building as a form of fitness.

"Until recently people only knew about kick boxing, but this is about fitness not fighting. It's about health care, diet, and discipline," he says. "I want to encourage people to look after their health."

Rocky also admits that the competition is crucial for motivating those who are already involved in the sport, and in that sense it certainly seems he has been successful.

On any day of the week the gym is packed full of Schwarzenegger-wannabes dedicating their free time to building bulk, and 34-year-old Bun Neang is no exception.

"I used to eat and drink too much and became quite fat, so I decided I wanted to change. Now I train for four hours every day. I am fitter and healthier, and look more handsome," he says.

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In just two impressive years Neang has gone from self-confessed couch potato to winning a silver medal in last year's 66-70 kg category, and next month he is off to compete in Ho Chi Min.

Another person keen to repeat his previous success is Iload, a 27-year-old fitness trainer who won gold in last year's 56- 60 kg category. Unlike Neang, Iload was drawn to body building after losing too many games of American football.

"I wanted to be stronger, so I started coming to the gym. Now I love it, and love helping other people achieve their training goals," he says.

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Echoing Rocky's sentiments, Iload states, "I join the competition to encourage other people to exercise. I want to show people what you can achieve when you work hard."

Happily, the gym's owner Sok Sour reports that "the gym has definitely been busier in the last two years."

He adds, "I'm so happy to see so many young people here. When they come here they learn about looking after their bodies, and understand that staying fit and healthy is cheaper than paying hospital bills."

The ABBA gym is near the Crocodile Farm, and is open daily from 7am-8pm.

The third annual Angkor Body Building Championship will be held on September 21, at Rosanna Broadway on National Road 6, past Psar Leu.

Adrienne Philson, the operations manager of Pharmalink, told the Post "this pharmacy was established in 2008, with the opening of our first branch at Naga Clinic".

"We now have two more new branches in Phnom Penh; one in BKKI and another new branch inside the Thai Huot Supermarket in Toul Kork.

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"Our Pharmalink brand is the only Western standard pharmacy open 24/7 in Phnom Penh," Adrienne added.

"Pharmalink was founded with the goal of increasing the standards for pharmacies in Cambodia by working closely with doctors, prescribers, providing reliable, certified medicine, carefully controlling the stock for expired or damaged products.

"And offering quality advice and counseling about side effects, drug interactions, etc."

She said Pharmalink also provides consultation and supplies medicine and customised first-aid solutions for companies, international schools, NGOs, clinics and hospitals.

To make people more aware, Pharmalink always uses medicine that comes with instruction from a doctor. Adrienne said that "it begins with education".

"There needs to be better general education in the Cambodian curriculum regarding medicine, health, disease and proper standards for health care."

She explained that this must be an ongoing conversation among friends and family. People need to demand to know what they are being prescribed and what their medicine is treating.

No one should ever accept packets of unlabeled medicine without asking to inspect the packaging first and making sure the batch number and expiry dates match the box and the bottle/blister packs.

"I think a key to improving the medical system in Cambodia is that doctors and pharmacies need to work together and form partnerships," she said.

Now there seems to be a disconnect in the medical process, she added. Many patients avoid doctors based on the expense and go straight to pharmacies.

However, this can be dangerous as pharmacies do not know people's medical histories or have the ability to conduct testing. Also, many of the staff at traditional Khmer pharmacies are not certified pharmacists and therefore have limited knowledge of drug interactions and side effects.

Patients should not go to pharmacies for a diagnosis and pharmacies need to encourage patients to see doctors for testing and more accurate evaluations.

Adrienne graduated from the University of Toronto with an honors and a bachelor of science in Molecular Biology and Neuroscience. She also spent time researching host-immune response to severe malarial infections with a specific project focusing on interventions to improve birth outcomes in pregnant mothers with placental malaria.

Of the many private hospitals in Phnom Penh, Central is the only one equipped with modern equipment for treating general diseases, especially its Sarne machine from the US that plays a key role for heart treatment and surgery.

Dr Morm Bunsocheat, a specialist in heart surgery at Central Hospital, said that in the modern theatre for heart surgery heart disease is the most dangerous one as it can kill the patient suddenly when it turns to become a serious condition, and no doctor can save that life.

"The rate of heart patients in Cambodia and in the region is not far different, but the difference is that in highly developing countries and lowly developed countries, they are going in the opposite direction," Dr Bunsocheat said.

"In Cambodia, the high rate of heart patients is caused by a lack of sufficient nutritious food and low hygiene in their daily living conditions. On the contrary, in developed countries such as Thailand, one of our neighbours, the high rate of heart patients is caused by excessively eating, particularly food that is rich in cholesterol, and some people who are too lazy to do excise.

"Nowadays, the treatment of heart disease is carried out according to two stages. The first one is the treatment by using medicine based on each actual case of the disease, while the second is the surgery or change of heart (in some more advanced countries), and in the future the treatment could be carried out in a new way without surgery," he added.

"Treatment by surgery is a case that we are careful with the most so that we achieve the result from 98 per cent upwards. As a heart specialist, I need a 100 per cent clear diagnosis, need modern machines and equipment for heart surgery and other specialist teams to cooperate before, during and after the surgical operation.

"In short, we have specialists not fewer than 10 for each case of surgery. We all work in a team and we all have only one role; that's to save the life of the patient," added Dr Bunsocheat.

The Central Hospital was established at the beginning of last year, and this expert team have been operating and doing heart surgery on hundreds of cases, and they make sure all patients are well cared for.

Being a specialist in giving diagnosis by using high-tech machines along with his extensive experience in examining and treating general heart diseases, Dr Sok Hay said that "before giving a diagnosis for any patient on working out how to treat it, we must examine and monitor the disease appropriately. This must be based on the results of the scanning by high-end technology which is the most accurate".

"So then we can decide which is the best way to choose the right treatment, because all treatments and surgeries are carried out according to the diagnosis.

"Generally, heart diseases are divided into two major types: heart disease from birth and heart disease when people have already grown up. We have noted that most of our patients who are suffering from heart disease from birth come from poor families and the disease started when they were unborn babies or in their first three months."

This is why pregnant women are asked to consult with a doctor during the early stages of their pregnancy so they get some way of knowing how to take care of their baby in a healthy and appropriate manner.

During this stage, pregnant women are not allowed to drink alcohol, smoke cigarettes, take drugs or some medicines and food that contain some poisonous substances.

For heart disease that occurs when people have already grown up, it is mostly caused by people who lack hygiene in their daily living, especially children or people who often have sore throats and chronic respiratory disease, the doctors said.

Dr Sok Hay emphasised that the symptoms for heart disease are slow growth in babies and a slow weight gain, tiredness, laziness to breast-feed, coughing or frequent bronchitis, pale lips, swollen fingernails and toenails. Other symptoms include being pale, an abnormal heart beat, chest pain, dizziness, headaches, falling unconscious and a thickness of the blood.

DANCE TROUPE'S INTERNATIONAL DEBUT

Ravynn Karet-Coxen is one of Siem Reap's most lovable – and busiest – eccentrics and, as the chair of the Nginn Karet Foundation for Cambodia, she's constantly championing the cause of her delightful troupe of little dancers, who are dedicated to preserving the purity of traditional dance styles, not to mention preserving their virginity under her watchful and ever-vigilant eye.

And now the indomitable Ravynn has pulled off a biggie: a tour of the US by her Sacred Dancers of Angkor troupe, comprised of 30 dancers and musicians, aged from 12 to 19.

This will, of course, be the troupe's international debut and is a culmination of about six years of training.

An email missive from Ravynn this week revealed, "For the first time a troupe of children from the heart of our cultural heritage is going to the US with the mission to bond and bridge the Cambodian American to the Motherland on the month of the Pchhum Ben.

"We will be travelling for just over one month from the east coast to the west coast, to Boston, New York, Washington and Los Angeles. We will be staying at the pagodas since the children are truly spiritual and they all have been ordained as monks and nuns last April for ten days and are still joining the meditation of the Observance Days (Thngai Sel) at the Banteay Drei Pagoda.

Ravyyn adds, "I know that you will be pleased that we are not only supported by His Majesty King Sihamoni, Princess Buppha Devi, UNESCO Phnom Penh and the government, but also by American congressmen.

"For the first time a Cambodian troupe is invited to visit and do a workshop with prestigious and renowned American institutions such as the Boston Ballet, The National Dance Institution, Washington Ballet and Los Angles Ballet. Also we will be performing at such distinguished venues as The Asia Society in New York, The Smithsonian's and THEARC Theatre in Washington, The Colburn Zipper Hall in Los Angeles and the Martha B. Knoebel Dance Theatre in Long Beach.

"It is so wonderful for such humble background children to achieve this by their sheer dedication and passion for their culture and the dance and music. All our compatriots should be proud to know that the children of the Borameis of the land of Angkor are going on such an exciting journey of their life time from the shadow of their temples and nature, making the sculptures of the bas reliefs come alive."

The tour will be in Lowell-Boston from September 16-23; in New York from September 24; in Washington from October 1-10; and in Long Beach from October 10-23.

In an official press release, Princess Buppha Devi, the Cambodian Royal Ballet's former prima ballerina and patron of the Nginn Karet Foundation for Cambodia is quoted as saying, "These children are inspired by the truth of who they are: children of Angkor. They were born to walk in the footsteps of our greatest ancestors."

The press release adds, "Performing rare classical, folk and centuries-old sacred dances and music, this will be a unique opportunity for American audiences to experience the revival of an exquisite and beautiful tradition that was almost wiped out by the Khmer Rouge.

"The dances are part of the sustainable rural development work undertaken by the charity Nginn Karet Foundation for Cambodia, which set up a performing arts school catering exclusively for children from the rural communities within the World Heritage site of Angkor.

"The Sacred Dancers of Angkor is the only dance troupe able to perform ancient sacred rituals at the re-dedication of Cambodia's oldest temples, from Angkor to Bayon to Preah Vihear and as far as Wat Phu in Laos."

Living in tropical climes, one might imagine there is little call for hearty French food from Alsace-Lorraine, but The Frenchy Gecko restaurant has been pulling in happy diners since its opening at the end of last year.

Christophe and Evelyne Plociennik's restaurant is in the Charming City complex on Charles de Gaulle Road, where the duo serves up a small, largely meat-based menu of traditional recipes passed down through their families, from boeuf bourguignon to saucisse lentilles served with crème fraîche.

Christophe first came to Siem Reap to clear landmines in 1992. As the saying goes, he fell in love with the place and relocated last year. It was his wife's idea to open a restaurant.

"My wife said, 'Why don't we open a business with just French food, home-cooking – the food we grew up with?' Food her mother made, food my mother made – we haven't changed the recipes," he says.

Hungry expats have delighted in the Plocienniks' hachis parmentier – a kind of Gallic shepherd's pie – and poulet basquaise, a chicken stew made with tomatoes and peppers.

Many ingredients such as sausage are sent over or brought from France by obliging visiting friends.

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"Sometimes when my friends come they bring items, or my family sends me a box. Now we have some sausage from Lorraine – the real one," he says, indicating a plate of assorted smoked sausages.

Christophe says he is a little surprised these warming wintry dishes have proved as popular as they have in Siem Reap.

"Sometimes we make boeuf bourguignon which is a big dish and the first time we made it my wife said, 'Wow, nobody will eat that here – it's so hot. But everybody eats it," he laughs.

"We have some expats, some English people and French people living in Siem Reap, who come and eat here. And now we are starting to get Korean people coming to taste the food. We had nine Korean guests the other day who ordered all the different plates just to try each one."

The best-selling dishes, he says, are the mashed potato-topped hachis parmentier and escalope Normande.

"Escalope Normande is chicken escalope cooked with cream, onions, mustard and mushrooms with a lot of French Gruyere cheese and then we grill it. It's served with roast potatoes," he says

"The menu always stays the same, but sometimes in the week I make the 'plat du jour' like quail stuffed with meat, olives, bacon cooked with wine sauce – Khmer people like that."

For the sweet-toothed, Christophe also turns his hand to desserts, even making his own fromage frais for the cheesecake. Also on the menu is rhubarb tart and apple tart.

"I make the fromage frais myself, you cannot find it here," he says. "It takes two days to make."

Christophe says Khmer people are always highly amused by the restaurant's name and sign which bears a picture of a smiling, froggy-looking gecko.

"We chose 'Frenchy' because we must have 'French' in the name and 'gecko' because it's part of Cambodia, the tokay. When Khmers pass here they take pictures, joking all the time, when they see the big frog with The Frenchy Gecko."

The French Gecko is open from Tuesday to Saturday, 12 – 9pm.

1. When did JICA's projects, which promote public welfare, care and treatment of the people, start? What kind of projects do you do and where are they?
JICA has been supporting the health sector in Cambodia since 1992, utilising funds from the government of Japan by grant aid (GA) to improve health infrastructure and equipment and technical cooperation (TC) for human resources development and administrative systems improvement, mainly in the field of maternal and child health, tuberculosis control, health professional development and medical equipment management.

2. Among those projects, what is the most dangerous health risk for Cambodian people related to diseases? What are the causes? What is the percentage of people directly affected by these diseases? And how many per cent of the population are affected?
JICA's support aligns with Cambodia's development strategies. In the health sector, following the government's Health Strategic Plan and to help achieve the Cambodian Millennium Development Goals (CMDG), JICA works together with the Cambodian government in areas such as tackling the prevalence of tuberculosis, improving the maternal and child health status, strengthening medical equipment maintenance systems and human resource development.

3. Until now, which of JICA's welfare projects is the most successful? How many Cambodian people get services from this project, especially on tuberculosis?
For the tuberculosis control project, JICA started sending individual experts here in 1997 and conducted technical cooperation projects from 1999 to 2012. TB control projects successfully carried out two TB prevalence surveys. When the first prevalence survey was conducted in 2002, there were 437 smear positive TB patients per 100,000 above age 15.

JICA supported to pave the way to expand diagnosis at health centre level and DOTS treatments in health centres and at community level free for all people. The second prevalence survey in 2011 showed that the prevalence rates were down 38 per cent to 272 per 100,000.

In the field of human resource development, JICA have been supporting capacity development of health professionals in order to improve the quality of services provided to people. Especially, JICA is now supporting the draft Nursing Regulation to ensure the quality of nurses by prescribing fundamental points such as the definition of nursing and nurses, responsibilities and qualification of nurses.

At the same time, 26 nurses have been supported to obtain the degree of Bachelor of Science in Nursing in Thailand. They're strongly expected to be core human resources to lead the further improvement of nursing in Cambodia and the implementation of the Nursing Regulation. This will benefit the entire Cambodian society.

4. Since the establishment of the public welfare projects in Cambodia until now, how much in Japanese Yen does JICA spend in total? Which project cost the most, and why?
As for the grant aid projects, which aim at supporting construction or renovation of health facilities and the provision of medical equipment, the total amount is about 8.8 billion yen (US$90 million). As for TC, the total amount is about 5.5 billion yen ($56 million).

The construction of the National Maternal and Child Health Centre in 1995 is the biggest project, because JICA supported the establishment of the whole building, while the other projects mainly focused on renovation or expansion of existing facilities.

5. How many doctors and JICA staff in total are working on this health project? How many Japanese staff are there?
I'm sorry, there is no specific data available on this.

6. From 2013 on, what projects does JICA have to help improve Cambodia's public welfare sector and how long will they run?
The current projects in tuberculosis, maternal and child health, medical equipment maintenance and human resources development will all be completed by 2015. In preparation for post-2015, JICA is going to review the strategy in the health sector this year based on the achievements of CMDG and other relevant goals.

7. JICA sends health officers to get training overseas. Until 2013, how many students and health officers has JICA provided scholarships to? What kind of subjects do they study, where do they study and how long does each subject take?
With support from the Project for Strengthening Human Resources Development System of Co-Medicals, 26 students have been dispatched in three separate groups and 20 of them have already completed the bridging course for a Bachelor of Science in Nursing in Saint Louis College in Bangkok. The remaining six students are now studying. In addition, six more students will start studying from September with the project's support. The course duration is 18 month.

8. How much is the scholarship's expenditure in total?
It will be about $600,000 for 32 students in total.