I know what you’re thinking – medical care in Cambodia probably evokes visions of untrained quacks operating with rusty instruments in dirt-floored jungle clinics, chickens walking through the operating room while unanesthetized patients scream bloody murder as their sell organs are sold out the back door. But in fact, medical care all over the world – including in developing countries – can be far better than you’d imagine. In fact, more and more U.S. citizens are traveling abroad for all kinds of medical work, from dental procedures to major surgeries.
There are plenty of highly educated and well-trained surgeons, doctors, and nurses who work in medical facilities of the highest standard. The big problem is inconsistency – all the best medical facilities are in the main cities. Once you get out into the remote provinces or the ‘bush,’ as they call it, they lack good doctors, good supplies, and often work under conditions more reminiscent of medical care 100 years ago. I mean, this is a country where natural healers still are the go-to medical resource in most villages, working with a combination of natural remedies, herbs, animism, and even voodoo-like practices. Just last week, a Cambodian natural healer was killed by an angry mob of villagers. After a few of his patients took a turn for the worse and died, they accused him of being a sorcerer and about 600 people stoned him to death. I’m not bullshitting, here. Then you have modern and spotless medical facilities in Phnom Penh, only 4 hours away by bus.
I caught a ride to the clinic with Sam Sam the Tuk Tuk Man, my Cambodian driver, confidante, tour guide, and spiritual advisor. The half hour ride across town cost $3 for the round trip. Keep that number in context when I tell you what comes next.
I arrived at the clinic, a neat and tidy but unremarkable office space in a middle class PP neighborhood, and walked in to the waiting area. There were only a couple of people waiting.
“You must be Norm!” the receptionist with model looks said with a big smile. I’d called ahead an hour earlier to inquire when the doctor might have an appointment available. Maybe next week, or if I’m lucky, closer to the weekend, I thought. The doctor answered the phone herself, her Aussie accent crackling through the phone.
“Come right in whenever you want,” she said. Well that works, too!
“Ok, come on back,” she said, approximately 6 ½ seconds after I’d handed them my registration form, with no mention of payment or insurance. I’d at least expected to plant my ass in one of this little plastic waiting room seats for 4 hours or so.
We went back to a blissfully-air conditioned exam room but instead of getting up the crinkled paper padded table, the doctor directed me to sit down across from her at her desk. And we talked. That’s right, the doctor saw me without needing to go through a phalanx of cronies first, like she was the Wizard of Oz hiding behind the curtain. The doc and I just sat down and chatted – about Phnom Penh, about my life, about U.S. health care (she pointed out that it was first and foremost a medical business, or sick care, but definitely not health care!) She even discussed a lot of the medical afflictions she sees with foreigners in Cambodia – the expats who pickle themselves to death by drinking all day and night, and especially the drug users. Too many tourists buy cocaine but get powdered heroin instead, and end up OD’ing with extreme prejudice. She even told me about how there was a whole sub-class of foreigners who were sent to Cambodia by their prestigious families with a one-way ticket and a monthly stipend, and implicit instructions not to return home and disrupt or embarrass the family. They quickly end up hopeless junkies with a short shelf life.
And yes, we talked about my health and medical history. She went down the usual list:
Family history of diabetes? Nope. Serious medical conditions in the past? Nothing – just a badly dislocated shoulder 10 years ago. Do you smoke? No. Have you ever smoked? Not cigarettes. How often do you drink? As often as I can.
And then came the kicker, a question I never in a million years would expect from an esteemed Australian PHD who looked like a spunkier Angela Lansbury in Murder She Wrote;
“You been banging any strange?”
She said it so matter-of–factly I almost fell off my chair laughing. Now THIS was real down-to-earth patient care! I appreciated her candor and no-nonsense approach, but after posing the funny question, we had a serious talk about health, which I appreciated even more. And no, I’m not telling you the answer to that question. Buy the book when it comes out.
All of the nuts and bolts completed, she took a look at the bump on my back. It was nothing at all, and she poked and prodded at it a little and then gave me a Band-Aid. While I was there I figured I might as well get a complete physical, so she did the whole run down, from balancing the tires to changing the oil to checking under the hood. They even took blood to check cholesterol counts and run a bunch of standard tests. She also prescribed medicated eye drops because my eyes suffer from allergies, but handed them to me across the desk instead of me having to go to a pharmacy to fill the scrip.
When we were done, she jotted some numbers on a bill form and handed it to the gal at the front desk. After an amicable goodbye with Doctor Awesome, herself, it was time to pay the bill. I took out my credit card from my wallet but saw a sign that they don’t accept credit cards. Shit. There was no way I’d have enough money – how embarrassing. But then I looked at the bill.
It came to $87.80.
That included about an hour of personal time with the doctor, medicated eye drops, a physical, messing with the bump on my back, and a gambit of tests. If I’d just had the doctors visit without the lab work, it would have been $20. That’s $20 I said, or only $17 more than the cost of the tuk tuk ride to and from the clinic. The medication was only $4 and change. The big cost was sending out the blood work, $60, but without that, it would have been so cheap it was crazy.
I was lucky to have a crisp hundred-dollar bill on me (because that’s how I roll,) and paid, thanked them profusely, and went outside to go get a fresh coconut instead of cookies and orange juice.
Tomorrow, I’m going to the dentist. I have a filling that needs to be fixed and I suspect require a crown. I hear you can get a great international dentist to do all that for about $150. The same procedure would cost what? $1,000 in the United States?
At these costs, I can’t afford NOT to get medical care.
I did go to the dentist the next day (today.) A thorough cleaning and x-rays cost me a grand total of $20. I have an appointment to get that crown done. I had options of quality of materials and technology from $120 to $350, and they can schedule me immediately. To put that in perspective, instead of getting the same procedure in the U.S., I could spend the money to fly to Cambodia (or Costa Rica, Brazil, Thailand, etc.) and fund my whole two-week vacation AND get the dental work done!