Report on our work as dentists in Siem Reap, Cambodia
Introduction
Medical care in Cambodia, especially in rural areas such as Siem Reap, is extremely inadequate. During our stay, together with an international team of dentists and helpers from Germany, Canada and the USA, we were able to make a small but important contribution to improving dental care for children and young people at a rural school. This report describes our experiences, the challenges on site, cultural impressions and the importance of our work.
Why help is urgently needed
In Cambodia, many people have limited access to dental care. Particularly disadvantaged population groups, such as the so-called "Poor1" (*) and "Poor2" (*), are often unable to afford treatment or medication. The few surgeries available require high co-payments, which is why many people only seek medical help in extreme emergencies.
Arrival and organisation
Our trip began on 30.01.2024 from Bremen in Germany. After our arrival in Siem Reap, we were greeted by a driver from the aid organisation "Global Dental Relief" and picked up from the airport. This organisation works closely with the Husk Foundation and the ShintaMani Foundation, which provided us with logistical and financial support.
The first day - getting to know each other and preparing
On the first day, we were taken to a nearby monastery, where we met Buddhist monks and were given an insight into Cambodian culture. From there, we walked to a village school, which became our workplace for the next few days.
The work on site
The school's computer classroom was provisionally converted into a dental clinic. We improvised our 7 workstations with extremely limited resources. Simple chairs were adjusted in height with metal extensions and armoured tape, and a pressure cooker was used to sterilise the instruments. A small headlamp replaces the operating light for the doctors. The dental equipment is tropicalised, without any electronics and powered by compressed air. The electronics only break down under the climatic conditions. Powerful compressors driven by a petrol engine supply the necessary compressed air.
We treated between 100 and 150 patients a day, mostly children aged between 5 and 15. The most common procedures were fillings and/or tooth extractions, as many of the children's teeth were severely decayed or irreparably damaged. In total, we treated 641 patients in six days, carried out 478 fillings and 435 extractions. At the end of the day, our patients were given detailed instruction and training in dental care by our local helpers. This was particularly important because the Khmer language is a closed book for us.
Excellent cooperation and team spirit
One of the best experiences during our stay was the close cooperation with the dentists from Canada and the USA. Their expertise, support and commitment made our work not only successful but also very stimulating. The numerous volunteers from the Husk Foundation (www.huskcambodia.org), the Shinta Mani Foundation (www.shintamanifoundation.org) and the support of the GDR Foundation (www.globaldentalrelief.org) from the USA were crucial to the success of our mission.
This co-operation not only led to more effective work, but also to many friendly relationships that have lasted far beyond the mission. The team spirit that prevailed during this mission was exceptional and motivating.
Special experiences and cultural highlights
- Visit to the temples of Angkor Wat
A cultural highlight of our stay was the visit to Angkor Wat, the largest religious monument in the world. This impressive temple complex was built in the 12th century as a Hindu temple and later converted into a Buddhist centre. Its architecture, the richly decorated reliefs and the spiritual atmosphere are overwhelming. The sunrise over Angkor Wat was an unforgettable experience.
- Visit to the Siam Reap Landmine Museum (www.cambodialandminemuseum.org) and the ApoPo Centre of the "Herorats" (www.apopo.org)
A depressing moment of our stay was the visit to the Cambodian Landmine Museum. This museum shows the terrible consequences of the millions of mines that were laid during the conflicts in Cambodia. Despite extensive clearance efforts, every year people die or are seriously injured and maimed by mines and unexploded ordnance. It was a stark reminder of the long-term consequences of war and violence.
Challenges and lessons learnt
The work on site was physically and mentally exhausting. The tropical conditions (temperatures up to 35 degrees in the shade), the improvised working conditions and the limited equipment presented a challenge, but also offered the opportunity to find creative solutions. It was particularly moving to see the poor dental condition of the children, which is often due to a lack of education and resources and the prevailing poverty.
Lessons learnt and outlook
Our time in Cambodia showed us the importance of improvisation, teamwork and compassion in dental work. At the same time, we learnt how privileged we are in Europe, that we have access to modern and efficient healthcare and that seemingly ordinary things like clean running water from the tap and safe electricity are something special.
Conclusion
Working in Siem Reap was a unique experience that we will never forget. The cultural impressions, the excellent cooperation with international colleagues and helpers and the feeling of having really made a difference make this assignment a special chapter in our lives. The aid we provided reached those in need 1:1.
Dr Martina Haasner-Keller
Dr Zina Younan
Dr Thomas Keller
Dr Wolfgang Pfannenstiel
Gloria Pfannenstiel
Mareike Henneke
Christoph Hansen
Jochen Ackermann
*1. Poor1 (extreme poverty / "ultra-poor")
- People living below the national extreme
poverty line.
- Income: Less than ~2,500-3,000 KHR (approx. 0.55-0.65
€) per day.
- Living conditions:
- No secure access to food (often hunger).
- No land ownership or only minimal resources.
- Often dependent on aid programmes (e.g. rice aid from the
government).
2. poor2 (Moderate poverty / "Poor")
- People living just above the extreme poverty line but
below the general poverty line.
- Income:Between ~3,000-6,500 KHR (approx. 0.65-1.45 €)
per day.
- Living conditions:
- Basic nutrition is mostly secured, but hardly any
scope for education/health.
- Precarious jobs (e.g. day labourers in agriculture).
- At risk of slipping into poverty1
in the event of crises (e.g. droughts, illness).
The HUSK Foundation (formerly "HUSK Cambodia") is an Australian-Cambodian NGO that has been active in the province of Siem Reap since 2005. It focuses on sustainable development projects in rural communities, particularly in the areas of education, health, nutrition and economic independence.
The Shinta Mani Foundation is a non-profit organisation based in Siem Reap (Cambodia) that is closely linked to the Shinta Mani Hotel and the hospitality industry. It was established by Cambodian hotelier Sokoun Chanpreda (founder of Shinta Mani Hotels) and focuses on education, poverty alleviation and sustainable development in rural communities.
Global Dental Relief (GDR) is a non-profit organisation that provides free dental care for disadvantaged children in developing countries - including Siem Reap (Cambodia). GDR is also active in Nepal, India, Kenya, Guatemala and Vietnam, but is particularly important in Siem Reap, where many poor children have no access to dentists.
APOPO (Anti-Persoonsmijnen Ontmijnende Product Ontwikkeling) is an international NGO that specialises in mine clearance and tuberculosis detection. In Siem Reap the focus is on: Mine and unexploded ordnance clearance Use of mine-sniffing rats: APOPO trains Gambian giant hamster rats ("HeroRATS") to detect landmines and UXOs (*unexploded ordnance*). The rats are faster and safer than metal detectors.
Cambodia is **one of the most heavily mined countries** in the world (remnants of the civil war/Khmer Rouge period)
The Landmine Museum (also known as the Cambodia Landmine Museum and Relief Centre) Siem Reap is a private initiative that educates people about the devastating consequences of landmines in Cambodia.
It was founded by **Aki Ra**, a former Khmer Rouge child soldier who later became a deminer.
He defused tens of thousands of mines himself and collected them for the museum.
Today, the museum is also an aid centre for mine victims and orphans.