Set up his clinic in 2010, Ken clinic is known as Cambodia's first Japanese practitioner. For many years, Dr. Okuzawa, the director of the clinic, has worked in the medical field here in Cambodia.
We asked him about the current situation of Cambodia. (Interviewed at: August, 2017)
Ken Okuzawa: Director of Ken Clinic.
Diabetes is the most common disease for foreigners
What kind of diseases or injuries does the clinic patients visit for?
What is overwhelmingly high in number is the common cold. As for Japanese patients, many people visit for abdominal pain and diarrhea relating to food poisoning. Injuries are mostly caused by accidents that occur while riding a motorcycle. Such as being in contact with cars and other motorbikes, slipping, being dragged while being snatched etc. Bag snatching is also occurring while walking or when riding on a tuk-tuk. In the worst case, we have had a patient with a shoulder joint dislocation which is a condition where the collarbone and shoulder blade ligament is completely cut out.
In some cases, people will get bone fractures caused by bag snatching. Although many of our patients are Japanese, I would say that the number and the damage of bag snatching is increasing.
Could you tell us about diseases that are outstanding to foreigners in Cambodia?
Diabetes is the most common disease. Also, hyperlipidemia, triglycerides with elevated triglycerides and cholesterol levels are also prominent.
I see many Japanese people who have gained weight in Cambodia, but the reason for this is believed to be the diet in Cambodia. Dietary habits of Cambodians tend to ingest abnormally large amounts of white rice, even though there are few side dishes, and the proportion of side dishes and white rice is different from what we eat in Japan. The main cause of obesity, diabetes, and hypertension is carbohydrates such as white rice, I think that it is becoming easy for these diseases to occur when people live on diets like Cambodian people.
Also, Cambodian drinks contain more sugar than in Japan. I see savory sauces containing sugar are being sold and even milk contains sugar. There are an increasing number of Cambodians who are obese compared to a few years ago, and the sugar contained in sweets and drinks is causing this, obesity of children is also increasing. In the past, things that were not common in Cambodia is now imported, this is a positive point for the country but it is causing health damage too.
Malaria is common in rural areas, dengue fever occurs in urban areas
What should we do in order not to get sick or get injured?
If you are staying long-term of over a year, we recommend immunization. At our clinic, we recommend hepatitis A, hepatitis B, tetanus, rabies, Japanese encephalitis and typhoid fever. There is also a mixed vaccine for type A and type B hepatitis, and it is also possible to receive the second round of vaccinations in Cambodia after you arrive from overseas.
In Thailand, there are quite a few people who die of rabies, but in Cambodia I think that it is more common to develop tetanus than rabies. However, this may not be accurate because we do not have detailed statistics of such cases here in Cambodia, in many cases the cause of death is not clear either.
How common is malaria and dengue fever in Cambodia?
Malaria is common in rural areas, dengue fever occurs in urban areas such as Phnom Penh, Siem Reap and Sihanoukville.
Because there are four types of dengue viruses, there is a possibility for you to catch dengue fever four times in a lifetime. Most Cambodians will get sick four times as a child. So, by the time you are an adult, you already have been immunized and not many people get sick from it. In Cambodia, dengue fever is thought to be a “child’s illness” and many deaths due to dengue fever are common amongst children who are not resistant to the virus.
By the way, the dengue vaccine has already been completed to the clinical trial, but it has not been on the market yet.
Overseas experience is important to develop the medical care in Cambodia
Cambodian people and Cambodian doctors seem to have limited knowledge towards medical care, what kind of qualifications are necessary to become a doctor in Cambodia? Also, have you ever felt a discrepancy in recognition with a Cambodian doctor about medical care?
First, Cambodia does not have national qualifications for doctors like we have in Japan, if you graduate from medical school then you will get a doctor’s qualification.
Discrepancy in recognition with Cambodian doctors is very common too. For example, there is a blood test called “QFT” in the examination of tuberculosis, but some medical personnel do not know the existence of this test.
Also, there was a case where a patient was diagnosed with diabetes mellitus, but a blood test called “HbA1c” which is an essential test in Japan was not performed. The tests are available in Cambodia and they should be able to conduct the test, but I think such cases arise because they are not firmly recognized within the medical staff.
Will the knowledge level of Cambodian doctors get better in the future?
We have more and more information from abroad and I think that it will get better in the future. Most Cambodian physicians have some oversea medical experience. I think that overseas experience is very important to develop the level of medical care in this country.
This April, the International University of Health and Welfare established a Faculty of Medicine in Narita City, Chiba Prefecture. 140 students enrolled for the first year, and 20 of whom are international students from overseas. Two Cambodians are enrolled in the university too. They will study in Japan for 6 years and will take the Japanese national qualifications exam in Japanese. After studying medical treatment in Japan, they will return to Cambodia to educate medical staff, and I expect that they will contribute greatly to the medical industry in Cambodia.
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