The Director of the Diabetes Ambulance (Day Clinic), Dr. Chea Touch, PhD med.

For many years of her medical profession, Dr. Chea Touch has been noticing the diabetic problems of her country. She successfully completed her medical studies after the Pol Pot era and the return of the French professors at the University of Phnom Penh / Cambodia. Cr. Chea Touch was fortunate to earn practical experience during her stays in the countries of Bangladesh and Thailand. Further masters studies in endocrinology and cardiology contributed to her interest in diabetology, which she pursued in increased depth.

Besides for her work as a lecturer at the medical faculty Dr. Chea Touch collected material on the situation of diabetes in her country and the resulting deaths of the untreated illness. A WHO study quoted 5% as the number of ill people among the population of Cambodia. The actual amount of ill people must be a lot higher than that.

She heard of institutions and organisations that were collecting diabetic data and studies with the help of foreign aid. These scientific findings went into the oblivious after the money was consumed.

Dr. Chea Touch saw the necessity of helping especially the poor part of the population. She decided to approach the problem from the practical side.

There is no such thing as national health insurance in Cambodia as there is in Western societies. The majority of the population lives off an income of less than 1$ per day, which often has to feed 8, or so, members of the family. So, in case of illness, one consults the help of old house remedies and of traditional healers. The rural state-funded ambulances are only served in long distances of time and geography, and they only specialise in infectious diseases and fevers.

After having consulted the ministry of health, Dr. Chea Touch decided to found a Diabetes Organisation and to open the first diabetes ambulance of Cambodia. The ministry supports this initiative generously ideally, however is unable to support it financially at this point.

An empty building on the premises of a major hospital in the centre of Phnom Penh was given to Dr. Chea Touch at no cost. Here, she started to treat her first diabetes patients in May 2002. But soon it was found that a necessary reconstruction of the old, but solid, building would cost a huge amount of money. In addition to that, it was found that the rooms of the diabetes ambulance were in a difficult to reach spot of the building for the patients. Despite many signs the diabetes clinic remained unknown to a large number of patients for a long time.

On the same hospital premises, yet situated at a minor entrance in the surrounding walls, a dermatologist granted the diabetes clinic of Dr. Chea Touch temporary refuge. Despite the treatment room being small, it was in a good location. Patients could wait in the hall way. Finally, the number of patients started to grow.

A European pharmaceutical company sponsored representative signs that the outer walls adjoining the road. There were 100 registered patients by the end of July.

Dr. Chea Touch’s worries became reality soon. Every patient required at least one treatment of diabetes related illnesses, and education of hygiene was necessary. Additionally, the majority of patients suffered consequences such as hypertension, illnesses to the heart and eyes, circulation and endocrinology related illnesses, and kidney-, bladder- and skin-infections.

After a short period of time it became clear that a vast amount of medication was required.

Weakened from resulting illnesses, many patients brought with them infections that required antibiotic treatment.

In the beginning of September over 160 patients followed their treatments and took on them long and tiring daytrips.

In July, Dr. Chea Touch was looking to extent her clinic. The hospital leaders offered her a building site of her own. Again, it was a site without direct street access, accessible only via a dermatological clinic. Only after further negotiations the optimal solution with fully right of usage was found. The only condition is that it is built upon as fast as possible.

Now, Dr. Chea Touch hopes to find one or more donators to give her the $6,000 to $8,000 required for the financing.

Meanwhile, in September Dr. Chea Touch renovated and extended into another bigger part of the dermatological clinic. Now her team consists of three doctors and two medical assistants. She herself is not only the initiator and director of this diabetes ambulance, but she also trains her team and examines and treats many of her patients. Besides for these activities, she is collecting and evaluating statistical figures.

In order to meet the cost, especially the staff costs, she highly depends on donations from western countries. Only the more affluent patients can pay for their treatment themselves. And until this date only one doctor can receive a monthly wage.

Until now the diabetic treatment can only extend over Phnom Penh city centre with its ca. 1 million population. But as soon as the capacity is extended, Dr. Chea Touch is planning to open ambulances all over the country.

Her ultimate future goal is the development and upgrading of means for early diagnosis and to strengthen preventative practice.