Royal Angkor International Hospital
As the name says, its location is near the temples of Angkor in the town of Siem Reap, Cambodia. Located just a few km between town and airport. The following experience does make you wonder what exactly Royal means and what their idea of International is. Certainly not the standard of help and more related issues. The prices charged could only be affordable for a Royal and equal to some countries international. The service and quality were at least doubtful at Royal Angkor International Hospital.
At 10 am an old lady is found on her stone floor at home. Lying there motionless but conscious for 12 hrs already after an ugly fall. Seemingly having fractures at different places (hip / elbow area) in the body. Royal Angkor International Hospital is called to send an ambulance. The estimated time between call and arrival is over 30 minutes, in a town with little traffic and just 4 km away. The ambulance seemed of international standard regarding equipment and medical personnel. Two doctors, a nurse and a (medic) driver. A friend could join with the passport & insurance card of the patient, plus a small bag of needed belongings. Around 11 am was there the arrival at the Royal Angkor International Hospital.
Friend or patient
The patient on stretcher is put in a corner. Where the doctors from the ambulance went is unclear. The friend hands over the insurance card and passport of the patient to a receptionist who seemed to be nurse too. He takes a seat and waits. Now strange and unusual things start to happen. Someone from the hospital turns up with questions to the friend.
Even stranger is that the questions weren’t about the patient but about the friend himself. Not any questions about his relation to the patient and background information of the patient. Nothing related to use of medicines, alcohol or drugs for example. The questions were pure and only focused on the friend. His own supposed problem and why he was there. The patient was pretty much left alone in the meantime.
Soon a paper was handed to the friend. A standard form to write the patient’s personal data. Passport number, name, birth date, phone number, signature, etc. The friend hands back the paper saying that he still isn’t an injured patient. They could find the needed info in the patients passport that they’d copied. Eventually he wrote his phone number as contact person. Next round of questions were about how or who to contact from the family of the patient. Finally a question that didn’t sound as being either a suspect at a police station or on a job interview instead of a friend and contact person of a just brought in patient in a hospital.
Now another employee comes to ask the friend about money. The payment for helping her and the ambulance ride, which was alone already $145. They said that this insurance company from Denmark was unknown to the hospital. Any help to the patient was therefore still lacking. The friend is unaware of the cover of patient’s insurance, personal financial situation and so, again the wrong person to ask.
Another strange thing again: when a hospital asks about if you’re able to pay. Shouldn’t first be clear what exactly the injuries are, what the damage is both in health as financially? Only then an answer can be given if a patient has enough money for that to pay. Having an insurance card was obviously worth nothing. Smart doctors and nurses are usually trained and educated to think in ways of solving problems. How to help as soon as possible a seriously injured patient or what else they can do or try as alternative to start that process of help. Example: by mentioning a price for just an x-ray. Often that’s affordable in cash and they could make a start. Unfortunate or stupid, whatever label, it wasn’t brought up.
So you do have insurance but it doesn’t seem to be enough to get help. The friend in hospital was in direct contact online with another friend of the patient in Denmark. She was in direct phone contact with the mentioned insurance company. How simple, direct and fast can contacting be and an issue solved. Only thing needed is someone thinking in solving problems. One nurse/receptionist walks the few meters from the desk to patient with a phone.
The patient, after being in pain on a floor for 12 hrs and hours in the hospital without care is by now dehydrated and exhausted. Can no longer be called clear in mind for a talk on a phone about things of which she hardly knows anything and expected to give answers. It seemed to be part of the procedure to change from non-active to some movement in the hospital. Finally they decide to hand over the phone to the friend.
On the phone a person of the Danish insurance company tells that they worked with this hospital before. No issues regarding that. A contradicting statement was given by the hospital earlier. Things were already moving, the case was accepted and already got a case number. The only thing was that they worked with a local organization, SOS International. Sounds interesting. It can give the idea that a local organization is able to speed up things. It turned out that this extra step slowed down things even more.
A Phone call later from SOS international to patient was an example of extra time wasting because of the state of the patient by then. The friend came in again for support. As per new EU rules, they had to send an email to patient in her native Danish language about privacy rules and giving permission to use her personal data. She had to click a link and reply with ‘I Agree’ in Danish. Decided was to send the mail to the friend, who could quickly reply on his phone. Done by using Google translate, as the friend didn’t understand Danish either. Two more mails came in from SOS international in Danish language. Even after a mail sent by the friend to stop sending Danish emails, as nobody there understood.
Even the original insurance papers were completely in Danish language. Clearly stating the amount she was insured for and the complete list what was included and excluded, in Danish. That’s an issue to be improved for any travel insurance, to use an internationally used or known language. Again, none of the hospital employees were thinking in terms of solutions, like the idea to use translate to check what was in the stated list. It all kept the whole situation at a stand still.
Time is on my side
A famous Rolling Stones song. By then it’s around 2 pm and the friend was no longer needed on site and agreed with the hospital to leave and come back around 6 pm. A bit earlier he returns and the patient asks the friend for water. She got nothing, no food nor water and you may doubt any medicines. Looking around for water, one device was found with a paper on it saying ‘out of operation’. Just as the complete hospital you could suggest. No small corner shop in the waiting area to buy drinks for the comfort of people who need to wait a long time.
Now it was from 11 am to 6 pm and not one thing had been done. No x-rays, not a bit of food and not even a glass of water. Time will definitely not be on your side in case of heart issues or other urgent injuries, with such a mentality or working method. The friend now raises his voice and names the facts of the lack of service and quality of the hospital. He would go out and buy water, food and medicines himself for the patient without needing a refund confirmation from an insurance for $0,20 cents of water.
First some nurse or doctor told that food and water were not allowed in the body with some tests of blood or urine or abdomen. Okay, that made sense. Why nobody informs the patient hours before is questionable. When the friend tells this same information to someone else of the hospital soon after, that nurse simply tells a contradicting version. In case any x-ray would find fractures at certain places, the patient needed to be transferred to another hospital. In Bangkok or Phnom Penh. Therefore food and water could’ve been given.
Suddenly action took place at nearly 7 pm. Not clear what made them finally going over to action. Taking those x-rays with someone in that condition would take time. Just as waiting for the results. After that, doctors needed to meet about the injuries and the options of how and where to fix. Then a report had to be made to send to the insurance, who then had to decide which option to choose and give it a go.
In previous 7 hrs not one single step had been taken regarding actual help on the body of the patient. The friend assumed that this whole next process as just mentioned, would take that much time for the patient to stay overnight. It was discussed with the nurse/receptionist who agreed and the friend therefore left hospital to come back again next morning for a third time. Agreements, discussions, contact person, it had all no value whatsoever.
The next morning the friend tried to call the hospital just before going there. A number on the visiting card turned out just as the water device and the hospital itself not in operation. When finally got in contact by a different number, they told that the patient had been transferred at 1 am that night to another hospital, in Phnom Penh. At a 5 hrs ride 330 km distance. For further updates you can call to that hospital.
An example of a mess
When you read this article. You can clearly see that almost everything is an example of a mess that needs to be improved in many ways and as soon as possible. Missing of certain needed specific skills by all employees in one or more fields of their jobs. Most of them were busy with questioning the wrong people about the wrong topics. It looked more for the idea to just look busy than out of help, vision and knowledge.
It added to what seemed a chaotic, disorganized bunch of people running headless around without actually having a clue of their duties. Where not even 10% was busy with medical things but rather with paperwork and worse, non medical or hospital related issues. Ever seen in an ‘International’ Hospital a young nurse discussing about immigration issues? Misunderstandings and a lack of clear communication to the patient and friend but also to one another. You can just hope not to end up in the Royal Angkor International Hospital. It must be said that other parts of this mess were the responsibility of insurance and Third party.
An explanation is needed to understand more of this kind of behavior and failures. You need to know more of the corrupt Cambodian system and culture that started in 1979 after the genocide. For interested readers there is a book recommendable named Cambodia’s Curse by author Joel Brinkley. It’s about corruption in every sector, level, rank of the system and society. Health care and educational sector are among the detailed explanations. Students had to bring money from home to give to the teachers. Starting at primary level all the way up to university level. This in order to get good results. Even when exam pass level was only 25% of correct answers, that hardly any student reached. Paying teachers, buying the answers of exams. Teachers paid their share to the principal who then paid his share to the minister of education and all in between or even higher up.
Examples of doctors without any or doubtful training or education for their jobs. Normal to buy your job by paying. Mothers who died together with the baby while delivery was starting but doctors asking a $100 bribe to help. From poor people who had not even $5 to eat. Patients were left alone and died when no payment was given. Shockingly detailed information and examples up to 2010 can be found in the mentioned book. When you’ve read those detailed stories and explanation of corrupt system it will make you understand more about the experiences and topics of this article. You actually see with your own eyes that it’s impossible that those employees followed a proper training and education to work as per international standards.