Sonja Kill Hospital Center of HOPE

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1 Who saves the life of a single child saves the whole world. Kampot, Cambodia Project Information 25 th November 2010 (DRAFT version)

2 Kampot, Cambodia (draft version) 2 1. Executive Summary The (SKHCH) is an innovative social enterprise which will provide sustainable, high quality, affordable health care to the underserved southern provinces of Cambodia. In doing so, the hospital will contribute to a healthier populace, to the development of the Cambodian Health System, to poverty reduction and to economic growth. The value proposition for SKHCH is that it will uniquely meet the health needs of the poor; the health needs of the middle and upper class; the infrastructure needs of visiting international professionals seeking to train and transfer capacity; and the development needs of the Cambodian Health System. Funding to support the development and operations at SKHCH will come from a corresponding set of sources. A fee for service model will capture enough revenue from the middle and upper class residents to sustain operations. Visiting professionals and organizations conducting medical missions, and philanthropists wishing to support health care to the most vulnerable and needy will make contributions to cover the initial capital outlay required to cover start up and operating costs until the hospital reaches break even status. Lastly SKHCH should benefit from the support of development donor organizations since its mission aligns with Cambodian Health policy, priorities and strategy. SKHCH will be developed as a general hospital with children as a priority focus. It is expected that children will comprise at least 50% of the patients treated initially at SKHCH and that ratio will grow with time. SKHCH s primary mission is to provide high quality medical care to the poor and needy of Cambodia while simultaneously helping to build capacity in the country s health system. In order to operate sustainably, SKHCH will market its services to the middle and upper class and use fees generated to provide subsidized care for the poorer segment of the population. The ratio of beneficiaries from the target market to beneficiaries from the poorer population segments will be 1:1 at the opening of SKHCH but this ratio will change to allow an even higher proportion of the poor to receive care once the hospital has achieved break even financial status. In addition to this quota method, SKHCH may seek to participate in whatever equity funds or other social insurance schemes are available to improve access for the poor. In seeking to contribute to Cambodia s health care infrastructure, SKHCH will work closely with Kampot Referral Hospital (KRH) to seek opportunities for collaboration and to reduce the possibility of competition. SKHCH will also seek collaboration with Kampot Regional Training Center (KRTC) in the training of nurses and nurse-midwives. SKHCH is aware of the Ministry of Health policies and strategic priorities and will seek to harmonize its strategy and operations accordingly. In particular, SKHCH wishes to help reduce maternal and child mortality in Cambodia and will develop an Obstetrical Unit as a priority once funds allow. The will become a part of Cambodian Civil Society. It will be a private non-profit institution with a culture of partnership with the public sector. SKHCH will seek ways to generate local Cambodian input into the development of its policies and programs. The managing partner of SKHCH should build capacity in local governance and administration such that international inputs diminish over time. The SKHCH will open in at least 2 phases. Phase 1 will include a General Medicine-Pediatric Clinic, Ward and Support Services (such as Laboratory and Radiology). Phase 2 will include the Emergency Department, Operating Theater, Labor and Delivery Wards as well as a more complete array of Support Services. It is proposed that SKHCH enter into a strategic partnership with the Sihanouk Hospital Center of HOPE (SHCH) ( ) to achieve synergy and mutual benefit.

Kampot, Cambodia (draft version) 3 Services The hospital when fully operational will be a community based acute care hospital with the following services: 24 hour Emergency Room Services Licensed for

3 Kampot, Cambodia (draft version) 3 Services The hospital when fully operational will be a community based acute care hospital with the following services: 24 hour Emergency Room Services Licensed for 134 Inpatient Beds with the following departmental deployment: o 18 Bed Surgical Ward o 36 Bed Medicine-Pediatrics Ward ( 18 bed infectious ward, 18 bed non-infectious) o 32 Bed LDRP / Gynecology Ward/with 2 dedicated operating theaters o 14 Bed ICU Ward (can include NICU) o 36 Bed Flex Purpose/Overflow Ward Adult Internal Medicine Clinic Women's Health Clinic Pediatrics Clinic General Surgical Clinic o Orthopedics Clinic Cardiology Clinic Two Operating Room Suites Clinical Laboratory Pathology

4 Kampot, Cambodia (draft version) 4 Radiology o Imaging o CT Scan o Ultrasound Pharmacy Rehabilitative Services Dietary 2. Background Cambodia Cambodia is still suffering from the aftermath of the bloody civil war which lasted almost 30 years. Particular during the four year tyranny of the communist Khmer Rouge regime from 1975 to 1979, at which time the country s intellectual elite were systematically annihilated, around two million people were killed, almost a fifth of the population at that time. Not until 1999 did hundreds of thousands of Khmer who had fled to Thailand return to their destroyed country. As a result of the elimination of academic potential, up until today there is still a lack of qualified personnel in commerce and administration as well as in the field of education and healthcare. Only 50 of the then around existing Cambodian doctors survived the genocide. Despite its constant economic growth, Cambodia is still one of the least developed countries in Asia. More than one third of the population still lives below the poverty line. This means that around five million Cambodians must survive with an income of less than one US dollar per day. Health Care Situation The Cambodian health care system is classed as being one of the most underdeveloped systems in South East Asia. Particularly in rural areas in which 84% of the population live, hospitals and health clinics are in a desolate condition. The main causes are the lack of technical and material equipment, insufficiently qualified medical staff and a lack of staff in general. The resulting consequences are Lack of trust in public health facilities. Only 18,5 percent of all patients use the governmental health facilities. However for most people medical treatment in private facilities is unaffordable. High costs for medical treatment in relation with the loss of income during the illness are major causes of impoverishment of many families in Cambodia. Many people are forced to sell their houses or cattle in order to afford medical care. Cambodia has one of the highest infant, child and maternal mortality rates in Southeast Asia. The child mortality rate is at 90 deaths per live births (UNICEF 2008). Maternal mortality is at 540 deaths per births.

5 Kampot, Cambodia (draft version) 5 Malnutrition of women and children is another major challenge. According to UNICEF 42 percent of all children under five years of age are chronically malnourished. Cambodia is the country with the highest HIV infection rate in Asia. According to UNAIDS, currently more than people are infected with the virus. Ten thousands of Cambodian children are directly confronted with the tragic consequences of the disease. They have to witness how their parents fall ill and die of AIDS. Many of the children are themselves HIV positive. 3. Project location The is located in a rural area around 5 kilometres west of Kampot, a small town situated on the coast in the south of Cambodia, 150 km away from Phnom Penh. The province of Kampot is one of the least developed areas in Cambodia since it neither plays an important role for industry nor for tourism. The population survives mainly from agriculture and from fishing. 44,9 percent of the population are under 15 years of age. Through the intervention of King Norodom Sihanouk the Cambodian government provided the land free of charge to Sonja Kill Foundation in order to build the hospital. Project site Goals The most important task of the is to improve the health situation of children and expectant mothers. The main aims of the hospital are: Paediatric primary health care with treatment of the most common acute and chronic clinical pictures, a simple surgical range of services, extensive outpatients clinic, palliative care as well as the care of long-term hospitalised patients for instance due to a tuberculosis illness. Formation of an obstetric department to offer support and supervision during birth, intervention during pathological births, the possibility of surgical childbirth if required and small surgical procedures during and after pregnancy, newborn screening and the establishment of pre and post care for pregnant ladies. Improvement of the health care situation of the population through medical health care and health provision. Reduction of baby, child and maternal mortality. Containment of infectious diseases such as malaria and tuberculosis as well as a reduction of the HIV infection rate. Prevention of the transfer of HIV/AIDS between mother and child. Heightening of the population s awareness of the following themes: hygiene, HIV/AIDS, family planning, etc.. Training of medical staff. Know-how transfer by means of active cooperation with international specialists on site. Cooperation with state and regional health care facilities as well as international organisations which are active locally in the field of health care.

6 Kampot, Cambodia (draft version) 6 4. Next steps The hospital is the third major project of the Sonja Kill Foundation, a charity started by German businessman Winfried Kill and his wife Rosemarie Kill. The Foundation focuses on serving some of the world s most vulnerable children in honor of the memory of their daughter Sonja Kill who died in a tragic cycling accident in 1993 at the age of 21. The Sonja Kill Center Hospital of HOPE represents a dream to provide state of the art healthcare to the children and adults of Cambodia. After years of planning and construction the 8 million dollar, 27 building campus is nearly complete and ready to start seeing patients. The funds necessary to equip the hospital hire staff and begin operations still needs to be raised. HOPE worldwide has agreed to manage the once these start-up funds have been raised. HOPE worldwide has successfully managed the Sihanouk Center Hospital of HOPE one of the nations top charity hospitals in Phnom Penh for 14 years. 5. Contacts Please address all contacts and inquiries to: HOPE worldwide Dr. Gary Jacques 353 West Lancaster Avenue, Suite 200 Wayne, PA United States of America Phone: +1 (610) x4400 Mobile: +1 (484) Sonja Kill Stiftung Gereon Wagener Sanggenbühl Sigriswil Switzerland Phone: +41 (33) Mobile Switzerland: +41 (77) Mobile Germany: +49 (163) Website: gary_jacques@hopeww.org Website: gereon.wagener@skmh.org

Minister. Secretaries of State. Department of Planning and Health Information. Department of Human Resources Development

Minister. Secretaries of State. Department of Planning and Health Information. Department of Human Resources Development KINGDOM OF CAMBODIA NATION RELIGION KING 1 Minister Secretaries of State Cabinet Under Secretaries of State Directorate General for Admin. & Finance Directorate General for Health Directorate General for