Activity One: Providing A High Volume of High-Quality Trauma Care
Road accidents in Cambodia increased by almost 30% per year from 2012 through 2015, and since 2015 have somewhat leveled off thanks to new road safety laws. The cases presented at the World Mate Emergency Hospital have increased significantly over the past decade, and a higher percentage of them now involve complex head trauma. Today road accidents claim more victims in Cambodia than HIV, Malaria and TB combined.
In addition to road accidents involving pedestrians, bicycles, motorcycles, cars, trucks, buses and other common vehicles, there are many other types of trauma victims who are also cared for at the hospital. Common sources of trauma include household injuries, accidents related to falls from trees and other structures, industrial accidents in factories, accidents involving agricultural equipment, trauma from domestic violence (including gun shots and knife wounds), land mine injuries that are often very complex, and unfortunately an even higher number of accidents related to unsupervised children and young people who find, open and then ignite unexploded ordinance left over from the war.
There are very few trauma centers in Northwest Cambodia and even fewer that can accept complicated cases. For this reason, the World Mate Emergency Hospital receives more than 1,000 trauma victims per month, and more than 250 of these patients require a complex surgical procedure, inpatient care and some form of rehabilitation.
Many of the patients who are hospitalized at the World Mate Emergency Hospital arrive with a life-threatening condition. Because the hospital has only 110 beds and a limited amount of resources, the total patient volume has to be controlled by following a patient admittance policy that gives the highest priority to the patients with the most life-threatening conditions.
Activity Two: Continuous Improvement
The management team of the World Mate Emergency Hospital is constantly striving to find the right balance between the quantity of patients who can be cared for on any given day, and the amount of training that can be provided to the staff members delivering that care. This is especially true in a busy trauma hospital. Careful attention is given to how many hours each staff member spends providing patient care, and how many hours the same staff member spends on training and being trained. Continuous improvement in the pursuit of medical excellence is a key part of the culture.
The average level of education provided to medical professionals in Cambodia, both during their university studies and in the field, is very low. For this reason, it is very difficult to hire well-trained doctors and nurses from the community. Instead, new staff members at the World Mate Emergency Hospital need to receive additional training for one to three years to maintain the high standard of practice maintained at the hospital. This training is provided by both foreign and local medical professionals, and by both employees and volunteers. Every doctor and nurse on staff at the World mate Emergency Hospital is required to spend time every week receiving both classroom instruction and on-the-job training.
In addition to recruiting long-term foreign medical professionals, the hospital has established partnerships that bring medical professionals to the hospital from Stanford University, Curtin University, and the London School of Hygiene and Tropical Medicine. The management team has also launched a three-year training curriculum designed to help younger Khmer surgeons learn the theoretical and technical skills they require to become senior surgeons in the hospital’s system.
Activity Three: Providing Equal Care & Support To The Poor
In most parts of the Cambodian health care system, patients receive care based on their ability to pay for that care. If a patient is poor, or when a patient runs out of money, they are often left alone or transferred across to a lower cost, lower quality facility. At the World Mate Emergency Hospital, we are devoted to doing exactly the opposite of this.
This is, of course, only made possible through the generous funding that is provided every year by the World Mate organization in Japan. However, the needs in Cambodia far exceed the amount that one organization can provide. To maximize the impact of the World Mate Emergency Hospital, efforts are being made to attract additional resources to the hospital.
The World Mate Emergency Hospital works to attract additional resources in the form of grants, in-kind donations of supplies and medicines, the development of individual donors (including funds raised through charity concerts) and the recruitment of long-term medical professionals who are willing to work as volunteers or for a small stipend. The hospital has been fortunate to receive grants from several organizations, in-kind donations worth tens of thousands of dollars, and dozens of medical volunteers willing to provide both care and training.
Another source of funding is locally collected donations. The country of Cambodia has been growing at 8-10% per year, and an increasing percentage of the population have the ability to travel and pay for their medical care. As the only hospital in the region providing complex trauma care, both the rich and the poor alike can arrive and expect to receive high-quality care and support while they recover from their trauma.
Statistics From The World Mate Emergency Hospital (December 2016)
Originally Opened: March 1998
Total Active In-Patient Beds: 98 (Surgical ICU 10, Three Surgical In-Patient Wards 88)
Total Employees: 190 (Foreign Medical Professionals 5, Foreign Administrator 1, Doctors 10, Nurses 78, Pharmacy 3, Radiology 5, Laboratory 3, Housekeeping 30, Security 20, Administration 5, Finance 3, Procurement/Warehouse 3, Maintenance 7, Physiotherapy 5, Social Work 4, Cooks 5, Gardeners 3)
Total Patients Served: 1,725 per month (a run rate of 20,700 per year as of Dec. 2016)
- 875 of the patients each month are trauma victims, and another 850 are treated in mobile clinics
- Of the 875 trauma patients per month, about 200 receive major surgery and are admitted for about two weeks
- The remaining 675 trauma patients per month are out-patients who receive minor procedures and first aid
- Overall 45% of the patients are men, 30% are women and 25% are children
Historically: Since 1998 the hospital has served more than 140,000 trauma victims, performed more than 111,000 minor procedures and performed more than 32,000 major surgeries. The trauma patients are victims of road accidents, landmines and other accidents. Minor Procedures include setting closed fractures and treating all kinds of burns, cuts and abrasions. Major Surgeries include single and multi-fracture orthopedic cases, abdominal & thoracic surgeries, and craniotomies.