Being on holiday is pretty hard work if you just sit
around and enjoy real Namibian hospitality and breath in clean crisp air. We visited
friends and family especially our grandma’s and ate all the good food available,
so we are stuffed up and round cheeks and ready to go Home again, or not?? We
so enjoyed seeing the beauty around us in the beautiful nature, Namibia has to
offer and will treasure this again for a full year while being back in
Cambodia. Not that the Land of Wonders is not beautiful!! But the beauty in
Namibia is what we always long for, wide open spaces and huge dunes with lots of
Animals.
This time around we realised that we are getting to
the point in our lives to where we need to start making plans for the near
future. We could lay that pans aside and move on for a while but we need to address
some issues right now. With the help of our pastor we had to lay down some
future plans and hope that we can stick to it. So for the next 5 years we will
still be in Cambodia, waiting for Anton to finish school. After that, well we
say:” Whatever Lord.” We believe that the Lord wants us still in Cambodia and
so it will be.
Please pray with us as we will be going back and
continue our work there. Immediate challenges we face is off course the visa
problems. The boys and Mordegai’s visa expire in less than 2 weeks and I need
to get down to Phnom Penh to renew it. Toinette’s will expire soon as well and
need to be renewed as well. That means that she needs to leave the country
again and come back in again.
Please pray for the following people:
Deon Botha went back for some tests and it is not good.
The cancer started to grow in his bones. Please pray for him and his family as
they seek further treatment.
I leave you with the following.
The Trouble With Cambodia’s Health System
The poor state of the country’s healthcare system
remains a major issue.
This month, the Cambodian government made clear that
“fake news” about Prime Minister Hun Sen’s death on Facebook would be treated
as a criminal matter, following yet another trip by him to Singapore for
medical treatment. Seeking care overseas is common for some of the country’s
wealthy elite. But for regular Cambodians, the country’s own healthcare system
is the only choice they have to address their issues.
Amid the focus on many other headline developments,
including Cambodia’s alignments with China and the United States, the state of
the country’s healthcare system is often not explored in depth, particularly
among international outlets. But periodic crises tend to point to the issues
therein, and the most recent one is the ongoing dengue epidemic hitting
Cambodia.
The director of Kantha Bopha Children’s Hospitals, a
network of charitable hospitals, has said that as of July 1 his hospitals in
Phnom Penh and Siem Reap have seen 30 children, out of more than 16,000 dengue
fever patients, die from the virus this year. In more rural areas, hospitals
are showing signs that they cannot handle the influx of patients. The Cambodian
Red Cross had to set up tents around one referral hospital in Stung Treng
province because of a shortage of beds. To the news of hospitals being unable
to cope with the dengue crisis, Ou Virak, president of the Future Forum
think-tank, tweeted: “Very alarming and a national emergency. Our health care
system is broken and the poor are paying the heaviest price.”
“Broken”
might be too strong, but the problems facing Cambodian healthcare are sure to
become more daunting unless the government stumps up more money. The statistics
make this clear. Cambodians still live, on average, some six years less than
their neighbors in Thailand, and seven years less than the Vietnamese. On
average, they only live 0.1 years longer than the people of Timor-Leste, the
poorest nation in Southeast Asia, with an economy a tenth the size of
Cambodia’s.
Cambodia has made clear strides in healthcare. In
1990 the average life expectancy from birth was just 53.6 years. But between
1997 and 2019 the average life expectancy from birth rose by 13 years, from
56.2 years to 69.3 years, according to United Nations Development Program’s
data. Almost all other indicators point to similar progress over the last three
decades. For instance, between 1990 and 2015 the maternal mortality ratio went
from 1,020 deaths per 100,000 live births to 161, while the percentage of the
population using improved sanitation facilities rose from 12.3 percent to 48.8
percent. Between 1990 and 2016 the mortality rate of infants (per 1,000 live
births) decreased by 68.9 percent.
But look more closely at the numbers and one finds
that progress is slowing. Take life expectancy, for instance. It rose by 4.8
years between 1990 and 2000, then almost double that rate (8.2 years) between
2000 and 2010, but afterwards slowed down and grew by only 2.7 years between
2010 and 2017, the latest year on record. Or take the infant mortality rate,
which decreased 6.1 percent between 1990 and 2000, then more than halved
between 2000 and 2010, before falling by just under a third between 2010 and
2016. For almost every indicator, the same pattern emerges: little progress in
the 1990s, then a fundamental change at rapid rates during the 2000s, but much
slower progress this decade.
In one sense, this is only to be expected. Cambodia
began at a woefully low starting point, before a considerable injection of
foreign aid and capital investment in the 2000s allowed for quick progress. But
as standards rise, it becomes increasingly more difficult for the country to
maintain progress without an equally audacious financial commitment from the
state.
Sift through UNDP data and you find that the vast
majority of countries have increased their spending on healthcare as a
percentage of GDP over the last three decades. Thailand spent 3.2 percent in
2000 and 3.8 percent in 2015. China increased spending from 4.5 percent to 5.3
percent, while even Timor-Leste increased it from just 1.3 percent to 3.1
percent.
But the amount the Cambodian government spends on
healthcare as a percentage of GDP is decreasing; from 6.4 percent in 2000 it
rose to 7.5 percent in 2011 before dropping to just 6 percent in 2015.
Government data show that government allocations to the health ministry as a
percentage of the overall state budget also declined this decade, from 7.2
percent in 2013 to 6.6 percent in 2019. In fact, spending on healthcare fell in
real terms by $30 million in this year’s budget compared to last year’s, down
to $455 million.
Beyond those aggregate numbers, the government’s
approach to healthcare is also worth noting. The government has been moving the
costs onto either patients (through allowing the rapid expansion of the private
healthcare sector, which is arguably larger and more competent than state clinics)
or onto the private sector itself (with the National Social Security Fund,
which workers and employers pay into).
What one finds, then, is that at a time when the
government needs to pour increasing amounts into the healthcare system, it is
putting on the brakes. And unless it is prepared to stump up more money,
progress will slow down and public anger will grow, as the wealthy elite
continue to travel abroad for treatment while most ordinary Cambodians struggle
at underfunded local hospitals.
Thank you for continuous prayer
Love
Rossouw-clan
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