Sitting on a mat next to a suitcase full of her belongings, 21-year-old Chok Yoeun feeds her one-year-old son as he waits to receive cancer treatment.
“When I examined his belly, I felt there was something inside his stomach, but it did not hurt him or affect his eating habits. I tried to apply balm on it but it became bigger,” says Yoeun.
The mother and son travelled from Sihanoukville for treatment at Kantha Bopha Hospital in Phnom Penh, but they were referred to a private centre located on Ponhea Leu Referral Hospital’s campus in Kandal province: the Japan Heart Children’s Medical Centre.
“Since I don’t have money to pay, I chose to come here, where there is free service,” says the young mother about her choice between Calmette Hospital, Khmer Soviet Friendship Hospital and Japan Heart Children’s Medical Centre.
The centre is the brainchild of Dr Hideto Yoshioka, a Japanese doctor who gained an interest in providing medical assistance to developing countries when he worked with impoverished people in Myanmar in 1995.
Yoshioka says: “Among 10,000 child cancer patients, there was not a single hospital to treat such a deadly disease.”
Yoshioka learned that child death rates in Myanmar, Laos and Cambodia were high and he noted that the medical services available in the countries were insufficient.
Just as importantly, patients struggled to pay for medical services, due to their high cost and long periods of treatment.
He says if someone in a family gets severely sick, their finances suffer because either the father or mother has to come to take care of their child at hospital.
Yoshioka, 55, notes that wealthier families can afford to travel abroad for medical treatment to countries such as Thailand or Vietnam, but he says it’s better to have these services in their home country.
He says he understands the hard situation facing Cambodians because he has lived in a similar situation in Myanmar for years.
Yoshioka decided to help, and he put an extra emphasis on helping children.
“I wanted to build a hospital that could provide medical services for all Cambodian people and poor people from other countries,” he says.
Yoshioka launched the Japan Heart Organisation in 2004 in Japan and in 2008 he started providing medical treatment in Cambodia before building the medical centre in 2016.
His main approach to saving children’s lives is detecting symptoms early and he makes it a point to alert parents to any potential problems.
“Parents should pay attention to whether their children’s appearances look abnormal or if they have any swelling on their body. When you examine their body, try to see if there is any notable tumour or strange things. And pay attention to if they frequently vomit.”
Besides the centre, Japan Heart also trains Cambodian medical professionals in Japan and offers scholarships for them to advance in their profession.
“I want our medical standards to compare with neighbouring countries such as Thailand and Vietnam. In the future, I hope our hospital will expand.”
Japan Heart’s mission is based on three ideas: simplicity, beauty and compassion.
Yoshioka borrowed from the idea of cha no yu, a Japanese term for a tea ceremony which brings together bodies and hearts.
“Embracing this concept, Japan Heart will strive to provide health care that is capable of rescuing not only the bodies but also the hearts of people in the world who need it most. We are here to help,” says Yoshioka.
The power of early detection
A pale, bald 12-year-old boy wearing a yellow T-shirt smiles for the camera with a group of medical staff before he is discharged after being hospitalised for several months.
In early October, he successfully completed a round of treatment for a tumour and was finally able to return home with his parents.
He was one among several other young cancer patients at the Japan Heart centre, which saw an increase in patients when the borders closed due to the Covid-19 pandemic.
According to data from the centre, 26 child cancer patients were admitted to the centre, an increase from the nine patients admitted in 2019.
“Four of the seven young cancer patients who arrived this September came from rural villages located near the borders between Laos and Thailand. They had to spend about eight hours travelling,” according to Japan Heart’s Facebook page.
Though the treatment costs are high, Yoshioka and the staff at the Japan Heart centre are happy to incur the fees to save Cambodian children lives with early detection and treatment.
Yoshioka tells The Post: “When we successfully treat a child at a very young age and when he or she grows up, he or she can have a job and help society as well as share his or her knowledge with younger people.
“People with cancer can also live as normal a life as other people.”
People who seek treatment from the centre should present a medical referral letter issued by medical staff from the Ponhea Leu Referral Hospital. Patients with serious health issues are also welcomed from around the country.
The centre, a one-storey standalone building, currently serves hundreds of patients each month.
Kanan Nakamura, the public relations and marketing manager at the centre, says: “It depends; normally we have between 400 and 600 patients per month. So, on average 15 people receive medical treatment from the Japan Heart centre per day.”
Nakamura, who has worked in Cambodia for more than a year, says patients who need further examination, consultation, specialised treatment or surgery are sent to Japan Heart for special care.
The centre has 39 beds for adult patients, 45 beds for children and 27 beds for young cancer patients. It has a medical staff of 95 employees, including 20 Japanese specialists.
Surgery and cancer treatments like removing tumours require skilled practitioners and the centre recruits specialists from different medical fields in Japan to help ensure patients receive the best care.
Nakamura says: “We also take many other patients from private clinics and hospitals everywhere in the country for further treatment in severe cases.”
Nakamura, who graduated from the School of International Health at the University of Tokyo, says the centre has admitted a total of 50,000 outpatients since it opened.
“There are more than 1,380 operation cases per year and we have performed around 5,000 operations since we opened. More than 90 cancer patients have been admitted to our hospital since we started offering cancer treatment in 2018. More than 70 surgeries have been performed for cancer patients,” she says.
“Japan Heart can treat cancers that originate in the abdomen. Such types of cancer often require surgical treatment as well.”
Yoshioka says some kinds of cancers can be treated at hospitals in Cambodia but complicated cases cannot be handled by most hospitals.
“It is better to be here because the operation procedure is so difficult. Other treatments like chemo therapy is done by Japanese specialists,” he says.
Challenges to healthcare
Aside from the usual challenges of raising funds that every charity hospital faces, the hospital’s biggest challenge is overcoming the barriers that prevent patients from coming.
Nakamura says: “Because childhood cancer usually cannot be prevented, the best solution is early detection and treatment.”
Getting people to come to the hospital early to give their child the best chance at surviving isn’t easy for several reasons.
“First is the issue of money. Most hospitals that treat difficult diseases like cancer cost money, which is why our hospital is free,” says Nakamura.
“However, it isn’t as easy as it sounds.”
When a child is admitted to the centre, Yoshioka says the father or the mother has to stay with their child, sometimes for several months. This means that either the mother or the father will lose their job and they have no time to care for other children at home.
Spreading the word about the free medical centre is also a challenge. The centre needs its budget for treating patients, which leaves little extra money for advertising.
“We rely on word of mouth, social media, relationships with other hospitals and occasionally radio or TV to let people know about our hospital,” Nakamura says.
She says it requires a long time for any hospital to gain a reputation of excellence in Cambodia, where some mistrust hospitals. A positive recommendation from a former patient can save someone’s life, she says.
Nakamura adds that “influential supporters such as monks and business people are extremely important in helping Cambodian people trust our hospital too”.
A lack of education about the symptoms of many diseases such as cancer is another obstacle. The survival rate is much higher the earlier these diseases are detected, making it of vital importance that any child feeling unwell is brought to a hospital immediately.
“We hope that in the future Cambodian people will confidently bring their sick children to our hospital to be saved,” she says.
Operating on children and adults
Besides its main focus of treating cancer patients, the Japan Heart centre welcomes patients suffering from any disease, especially patients who may need surgery.
Yoshioka says: “Our patients are our biggest priority. Beyond technology and technique of treatment, we want to establish good relationships between our patients and medical staff. They treat patients from their heart, just like they look after their children.”
The centre has performed a range of surgeries on children, including surgeries for abdominal masses, hernias, genital disorders, abnormal anal issues and gallbladder constrictions.
The centre has also operated on adults for goitres, ovarian cancer, breast cancer, anal abscesses and abdominal masses.
The centre also has a maternity ward and cares for babies during and after delivery.
A mobile health care unit from the centre is sent to rural areas and other hospitals to treat and operate on patients for free bimonthly.
Recently, Japan Heart sent medical staff to Pursat province, where residents faced severe flooding.
Being a Japanese-based NGO, almost all of Japan Heart’s support comes from Japanese private donors and companies. Many donate directly or buy equipment and supplies for the centre.
This year, the centre started receiving more support from private Cambodian donors.
Nakamura tells The Post: “Cambodian people rely on trust when they decide to support a charity, so friends or family getting treated at our hospital or influential Cambodians recommending us means our trust with the Cambodian people is growing.
“Cambodian donors or companies sometimes bring supplies to our hospital as well. While the donation amount is still low so far, it is heart-warming to see the amount of support regular Cambodians are giving to our patients.
“A 10,000 riel [$2.50] donation represents hope for those children [suffering from cancer],” she says, noting that there are several donation boxes in and around Phnom Penh.
Japan Heart Children’s Medical Centre is open from 8:30am to 5pm Monday to Friday and is located at Ponhea Leu Referral Hospital along National Road 5 in Vihear Loung commune, Ponhea Leu district, Kandal province, about 40km north of Phnom Penh.
For more details, visit the centre’s website – https://www.japanheart.org/en/ – or visit their Facebook page. They can also be reached at 077 95 94 71.