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Cambodia - Healthcare

Medical services are an issue in Cambodia. The health system is very third-world. Like in Vietnam and Indonesia, serious illness often means that you have to travel to Singapore, Malaysia, Thailand or back to Australia. And, of course, if you are too sick to travel and you do not have medical evacuation cover, you could be in a lot of trouble.

This is a very real issue for a retired person or anyone on a budget. Cambodia is not a medical desert, though. Private Western clinics, like International SOS, a medical and travel security services company with clinics in 70 countries, do exist but they are expensive. There are some other cheaper Western-quality health services as well, like the French Cambodia clinic.

Again, the sensible path is to ensure that you have health insurance and, if you can afford it, medical evacuation insurance as well. Remember, Australians who live outside of Australia for more than five years will lose Medicare cover. So private health insurance for Australia or your country of choice for medical attention is critical.

Joanna has no health insurance—at 70 years of age, it would be hard to get anyway—but she still regards herself as an Australian resident. She owns a house in Victoria in which her family reside. As such, she regards herself as being covered by Medicare in Australia. Even so, she became ill recently and did not have time to get to Australia.

‘I was very sick in August,’ Joanna said. ‘I had a bacterial infection in my leg. It was cellulitis. That can be dangerous. I had fever and chills and I was nauseous. ‘My daughter made an appointment for me with an Australian doctor and he diagnosed it straightaway. He drew a circle on my leg around the infection site, but while he and my daughter were discussing which hospital to go to, the infection spread outside the circle.

‘I was admitted into the French Cambodia clinic—it wasn’t hard to get into the hospital—and stayed for ten days on an antibiotic drip. I had three doctors there—two French and one French Cambodian. It didn’t cost much but if I had gone to the SOS clinic it would have cost a lot.’

And thankfully, Joanna recovered, so she was more than happy with the quality of care she received.

Janet and Rick recognise that the medical situation is a real issue in Cambodia, but they, too, have no private health cover. Janet said: ‘We had health insurance when we first came here with a Hong Kong insurance group, but we decided it wasn’t worth it. They were too unreliable. A friend of ours died while the doctors argued with the insurers about whether she was really sick enough to evacuate. We had actually dropped it before this sad incident with our friend because it was getting too expensive.’

Janet recently had to have heart surgery, so she returned to Sydney for it. She was lucky; the surgery was necessary but not an emergency. Even though she still has Medicare cover, she wanted it done quickly. ‘We paid for it upfront as overseas patients and it cost $45,000. The way we looked at it, $45,000 is ten years of health insurance.’

An important tip for those living overseas but who still have a residential address in Australia is to ensure you can prove your residency—such as with an Australian driver’s licence, council rates, electricity bills and so on. And make sure that you tick the ‘resident returning’ section of your inward immigration form when you land in Australia.

Garry and Rita have medical evacuation insurance and $1 million cover in hospital, but only in Southeast Asia. This costs them a total of A$1400 a year for both of them. Though Garry, who is 58, warned: ‘The minute you hit 60 it rockets.’ But what it means is that they can be medivaced out to Bangkok and receive excellent medical services there. Alan said that most people will go to Bangkok or Vietnam for medical care. ‘But it is getting a lot better here. A couple of big Thai hospitals have been built and they are quite good. And SOS is here.’

Cambodia’s flagship international hospital is Calmette Hospital, a government-run medical centre located on Monivong Boulevard in Phnom Penh. It is funded by the Cambodian and French governments. It is a fee-for-service hospital and is targeted at both locals and expatriates that need affordable, high quality medical care. This 250-bed hospital offers a wide range of medical services, from surgical and obstetrics, to radiology and microbiology.

In Siem Reap near the famous ruins of Ankor Wat, the Royal Angkor International Hospital provides a high standard of health and medical care. It is owned and operated by Thailand’s Bangkok Hospital Group. Patients, however, need to pay in cash or with private medical insurance.

James has also been living in Cambodia for over a decade. He has deep interests in Khmer culture and architecture, he has worked at the Museum, he has taught English and he is actively contributing to the country. ‘I simply can’t consider returning to Australia,’ he said. ‘I am over 65 now. So what would I be doing in Australia?’

James would be looking at a bleak and short future in an aged-care facility, and that’s not for him. He will stay in Cambodia, where he intends to have carers look after him in his home until, hopefully, the very last days. He can afford to do that here, with home help readily available and cheap. He also emphasised that the general attitude towards the elderly in Cambodia is respectful.