Your Excellencies, Ladies and Gentlemen,
Today on this joyful occasion, I am greatly honored and delighted to join you all in the degree presentation ceremony for doctors, pharmacists, as well as dentists, together with the ground breaking ceremony for the construction of a new building at the University of Health Science, which represents a newly proud outcome of the government in responding to the demand by Cambodia in improving well-being of the people and alleviating the poverty.
Indeed, we all remember that only after the liberalization day of 7 January 1979 that the University of Health Science has been restored and actively contributed to the development of human resource in Cambodia, with the aim to produce a large pool of intelligence with high skills and specialization in surgical, medical and dental fields that represents a solid foundation for the health sector in Cambodia. Those students who have completed their degrees at the University of Health Science have been working in almost every corners of Cambodia.
I would like to express my warmest congratulation for those doctors, pharmacists and dentists, who have freshly completed their trainings and to call for them to utilize the acquired knowledge to strengthen the health sector toward another level. Along with this glorious day, I am greatly honored to attend the ground breaking ceremony for the construction of a new five-story high building with 545 meter in length and 115 meters in width forming a total area of 3162 meter squares which is funded by the University of Health Science itself.
I would like to take this opportunity to express my sincere compliment for the leaders of Ministry of Health as well as every other leaders, government officials, staff and professors at the University of Health Science who have devoted their hearts and souls to strengthen and enlarge the development of human recourse in the health sector which represents the key to alleviating poverty by aiming at improving the living standards of the people and to enhancing the competitive advantage of Cambodia.
During the last few years, the Royal Government and its development partners have jointly-cooperated to build and promote the health sector from the destruction by genocidal regime and detracted wars. These commitments have faced many obstacles, especially, through the media where some national as well as international institutions have raised a question about whether or not Cambodia can achieve its millennium development goals in reducing the maternal and child and infant mortality rates?
I believe that even though there are many obstacles to these commitments, we have achieved some outstanding results, especially, the health sector has crucially contributed to the positive change of the people’s well-being. Recently, a national report shows that the health situation in Cambodia has been noticeably improved, the life expectancy at birth increased from 52 in 1998 to 60 in 2003 for men and from 56 to 65 for women, hence, a 15% increase on average for a 5-year period, which is approximately equal to the average percentages increase made by other developing nations for a 15 or 20-year period. At the same time the mortality rate of children under the age of 1 has declined from 93 to 66 out of 1000 (a 29% decrease), and the mortality rate of children age between 1-4 years old has decreased from 31 to 17 out of 1000 (a 45% decrease).
It is noticeable that the size of this decrease in mortality rate makes us predict that the outcome that we have achieved over the last 5 years is approximately equal to the average achievement that many developing countries are experiencing for a 10-year period. As for the maternal mortality rate in Cambodia, it has been reduced from 900 in 1987 to 437 in 2000. The epidemic disease prevalence which causes some problems for public health has also been reduced. The number of people infected with HIV has gradually decreased from 3.3% in 1998 to 2.8% in 2000, 2.1% in 2001, and 1.9% in 2003, respectively. Polio related diseases have been completely eradicated, and skin cancer is no longer a threat to public health in Cambodia. Tuberculosis (TB) prevalence contracted over 100,000 people has been reduced from 470 in 1997 to 360 in 2002 (a 23% decrease).
In particular, the provision of public services has been extended by focusing mainly on the delivery of basic health services at the health centers and referral hospitals along with public health programs especially those combating epidemic or infectious diseases and health education. At the same time, the prevention of the spread of SARS out-break and Bird-Flue has been actively implemented by a close cooperation between the concerned countries in the region through the contribution of technical assistance from the World Health Organization and other international cooperation programs.
The Royal Government has been giving the top priority to the development of human resource in health sector through training and deploying of staff to support the development and progress of referral hospitals and health centers in providing basic health. Therefore, besides the continuous training programs conducted at the University of Health Science, it should be noticed that the basic surgery skills achieved from the training have been distributed to the referral hospitals including 36 trainees who have so far graduated during 1998-2003. Moreover, about 12,000 trainees from health centers have participated in the trainings on minimum package of activities. Moreover, the management training for provincial and district officials has fulfilled the 2003’s objective by having 84% for district health offices, 75% for provincial and municipal health offices. Besides, during the year 2004 we have also concentrated our efforts on retraining in the country, it includes the training for health centers’ staffs and basic surgery training skills for surgeons, and specialized-training in anesthesia and emergency for female nurses who are government officials from referral hospitals. In order to speed up the training of nurses-midwives, the Ministry of Health has re-established the 1-year class for primary nurses and midwives for those who are originated from Northeastern region of the country. Moreover, the National Institute of Public Health Research has also provided training on hospital management for duration of 1 year for government officials from 5 referral hospitals and training on the management of health services for 6 months period for managers including those from many provincial and district health centers.
We are all clearly aware that a sound healthcare system can positively contributed to the economic development because health is a key element which leads to the increase in productivity and investment and saving rates through the ability of the people in absorbing education, doing the jobs and adapting to the changing demography. The developmental experiences of countries in the region revealed that, improving the health standard is one of the key elements among others which creates“Economic Miracle of South-East Asia”, even though good health alone is insufficient to promote high economic growth. Nevertheless, I would like to stress that the government policy is not ultimately aiming at improving the economy alone, while it emerges from the great concern for the well-being of the people of Cambodia.
With this conscience, the Royal Government has considered strengthening the competency and health of the people as an important action in responding to the poverty reduction scheme and the implementation of reform programs for every sector.
For instance, in order to achieve this objective according to the allocated budget, the Royal Government has set out a priority spending policy through providing more funds for the economic development and social activities, especially, by reducing security and military spending, and reorienting funds for socio-economic development such as education and health. Besides, the Ministry of Health’s budget has doubled during 5 years period (1998-2003). In addition to this increase in budget earmarked for the Ministry, the Royal Government has offered to pay for the import taxes incurred for medicines and medical equipments and for all the imported goods funded by international donors.
In combination with the quantitative budget increase, the Royal Government has made a reform on the management of state budget by choosing the Ministry of Health as a leading Ministry in the piloting process, facilitating cash release to the sector and especially enforcing decentralization and reducing unnecessary regulations. These reforms include the introduction of the budget item “Chapter 13” to support the priority activities at health centers and referral hospitals in provinces and especially for key health interventions on some important public health programs such as maternal and child health programs and programs in combating infectious diseases. At the same time, the Ministry of Economy and Finance has scaled up decentralization of public procurements by allowing the Ministry of Health to conduct its own procurements for any expense less than 1,000 million Riel.
Another important factor is that the Royal Government has advised the Ministry of Health and the Ministry of Economy and Finance to discuss and work out appropriate procedures for the utilization of budget “Chapter 13” to extend the service for poor people, especially, to allocate the budget for 3 main spear-heads including: (1) the creation of remuneration system for staffs and government officials who work at isolated rural areas (2) the creation of a proper funding for the payment of health service for poor people, and (3) strengthening primary health services such as management, investigation, pricing, and paying door-to-door visits at villages.
Indeed, these reform programs have the objective of ensuring the increasing number of poor people living in rural areas to receive high quality health services through the introduction of Operating Districts, which operate under decentralization or de-concentration and who are the ones to provide comprehensive primary health services.
Key objectives of the reform strategy are to:
(1) Provide basic health services for every poor citizen, especially, those who actively participates in the community.
(2) Strengthen morality and access to basic health services with high quality, efficiency, and cost effective.
(3) Target specially at women, children, old people and handicaps.
(4) Introduce and implement administrative and financial decentralization and de-concentration policy.
(5) Encourage competition between public and private health service providers.
(6) Educate people about healthy living and personal hygiene.
Moreover, a number of institutions have been transformed into “administrative public entities” who can impose additional charges to raise funds for their operations and construction of buildings. Such examples are the Calmette Hospital and the University of Health Science.
In order to strengthen the health sector toward a fruitful progress, I would like to take this wonderful opportunity to make some apparent recommendations for the graduates who are receiving their degrees today as well as for those students who are undertaking their studies, and for the government officials, staffs and the Ministry of Health as follows:
First, I would like you to use your acquired skills and knowledge to serve the people of Cambodia with high effectiveness and efficiency in order to join the government in the development and reducing poverty of the people through the treatment of diseases without discrimination and with high conscience.
Second, you must always practice the profession with high moral. Indeed, health profession is generally perceived to have the highest dignity and as the most human profession on planet. However, dignity and humanity are all depend on the person who practices this profession who always fulfill the job with high moral. Doctors, pharmacists and nurses who do not possess morals and conscience would not deserve dignity.
Third, I would like to take this opportunity to inform all of you who are here today that long-lasting knowledge must always be renewed because what you have received today is only a fraction of knowledge that you have acquired from here. In Fact, the success in work and in daily life demands more than just what you have learned from here. This would mean that experience is a key factor. Experience from life and work can be gained without having to go to school. Therefore, experiences derive from direct participation and problem-solving according to the real changing working-life which you are all going to start or for those of you who have already started.
Fourth, I would like all of you to remember that today’s graduation provides an important meaning for human resource development in Cambodia in the pursue for changes toward the development of the economy and the society of our country. This is because the new era requires us to closely relate the quality of training to the overall management quality. The enhancement of training needs reforms and consideration about the certainty of costs and benefits by not adopting the old habit or easy thinking. There must be a change in the process of how to begin, how to end, to avoid wasting time and to have it done quickly with good quality and reasonable price. I would like to take this opportunity to remind all universities, faculties, and institutes that good education needs to consider quality first and strive to meet the quality standard of education.
The University of Health Science must continue to strengthen and improve the quality of its education and must consider paying professors their “hour fees” equivalent to those paid to their counterparts in the private sector. It must also improve the education infrastructure while strengthening the management, internal rules and disciplines, and eliminating any irregularities.
In conclusion, on behalf of the Royal Government and myself, I would like to express my warmest compliment for the Ministry of Health, concerned ministries/institutions, the University of Health Science, national and international organizations, civil society, and the private sector who have devoted their hearts and souls to promote the health sector, improve well-being of the people. This represents a strong and legitimate contribution in reducing the poverty in Cambodia.
Finally, I would like to wish you all, Excellencies, Ladies and Gentlemen, honored national and international guests, and graduates who are here today, the five gems of Buddhist blessings.