After settling into the Victoria Angkor, the delegation visited the Angkor Children’s Hospital (AHC) (www.angkorhospital.org). AHC is a project supported by Friends Without a Border. The visit started off with a brief presentation by hospital director, Bill (Dr. Bill) Houseworth, MD and Director of Nursing, Mr. Som Sophal. In setting the context for the operation of AHC, it was important to understand that Cambodia has only had peace for 13 years, and the infrastructure to support healthcare and hospitals is still being established. The hospital opened in January 1999 and has two goals: 1) to provide high quality care for children in a warm, supportive environment, and 2) act as a medical education center for Cambodia. Care for children at AHC is free, and patients come to AHC from long distances.
Basic nursing education in Cambodia is 1 – 3 years. A Primary Nurse has one year of training. Three years of training leads to an associate degree, and four years of training leads to a bachelor’s degree. There are no master’s or PhD programs in Cambodia currently. The 142 nurses working at AHC (70 female and 72 male) graduated from five surrounding area schools. The nurses that work at AHC are interested in enhancing their leadership skills and obtaining their bachelor’s degrees. Nurses work 12 hours shifts, and have nurse-patient ratios of 1-to-1 or 1-to-2 in the intensive care unit and 1-to-6 in inpatient care areas outside the Intensive care unit. The hospital serves as a clinical training site form healthcare students. Units are crowded, overflowing into the hallway, and non-clinical space has been converted into clinical space. Recently, increased numbers of patients with Dengue fever have forced AHC to turn patients away.
Nurses have been placed in key leadership positions throughout the hospital over the past few years, and Dr. Bill has been a strong proponent of this change. The AHC nurses have implemented the nursing process and are exercising nursing judgment in the delivery of care. The Cambodian Ministry of Health has asked AHC to serve as a model for the country in implementing the nursing process.
The lack of infrastructure is one of the unique challenges of providing healthcare in Cambodia. The high rate of poverty is another factor. The common health conditions that AHC treats include acute respiratory conditions, severe malnutrition, and infectious diseases. AHC has received funding from USAID to improve home care for HIV/AIDS. The delegation was impressed with the number and type of education programs for families offered at AHC, including cooking and nutrition classes.
The delegation left the visit with tremendous admiration for the strength of nursing and medical leadership at AHC and their commitment to caring for the children of Cambodia.