A n g k o r H o s p i t a l f o r C h i l d r e nANNUAL REPORT 2013

2013 was a very

sp

ec

ial

year for Angkor Hospital

for Children.

Since first

opening its

gates in 1999, the goal of

founder Kenro

Izu w

as to

make

AHC

“a w

orld class

hospital for Cam

bodians run by Cam

bodians.” With the

end of a one-year long transitional

phase that

took place in January of 2013,

Kenro’s original

vision for

the hospital

was realized w

hen AHC

became an independent

organization firm

ly rooted in Siem

Reap and led

by an

outstanding Cam

bodian team.

Dear friends,

It is exciting to think of the many accom

plishments of Angkor

Hospital for Children (AH

C) in 2013. These were not im

aginable w

hen the hospital opened 14 years ago. This year’s annual report highlights three m

ajor medical successes: the beginning of cancer

treatment at AH

C for eye cancer patients, the opening of a new

neonatal ward, and the grow

ing independence of AHC’s cardiac

surgery team. Another defining success of 2013 w

as a renewed

focus on quality and transparency in administrative processes.

The transition of Angkor Hospital for Children to a localized

Asian-based organization with diversified w

orldwide support and

stakeholders has

created new

opportunities.

Importantly,

the essential education that AH

C provides is set to expand. We in the

medical leadership are very excited and thankful to have a grow

ing influence on the training of m

edical students and junior doctors in Cam

bodia. We believe that this w

ill impact children’s healthcare

in Cambodia for years to com

e and assure that every dollar contributed to the hospital has lasting effect. The staff at Angkor H

ospital for Children remain com

mitt

ed to Kenro’s founding vision to treat all children w

ith high-quality and com

passionate care regardless of ability to pay. Through this annual report w

e hope to convey many of the w

ays we achieve this goal.

Always, w

e remain thankful to the m

any stakeholders, volunteers and partners w

ho enable us to do this vital work.

Sincerely,

Pheaktra Ngoun M

.D, DCH

,DTMH

Deputy D

irectorAngkor H

ospital for Children

Medical

Leadership M

essage

An

gk

or H

os

pita

l for C

hild

ren

in 2

01

3

Cambodian children have access to quality

medical care w

herever they live, regardless of their ability to pay and Angkor H

ospital for Children exists as a center for excellence in pediatric healthcare and training, fostering developm

ent and expansion of the public healthcare system

.

Our Vision

Our M

issionTo provide quality pediatric health care to Cam

bodian children and free care to those living in poverty, as guaranteed by the Cam

bodian constitution; to w

ork with the Cam

bodian Ministry

of Health to strengthen Cam

bodia’s healthcare system

through the training of doctors, nurses and health w

orkers; to play a central role in improving

public health for all children.

““I w

ill never forget the first day w

e opened our doors. I think we

saw just over 10 patients. I w

as one

of the

10 original

Cambodian

nurses. There

were

many

foreign staff m

embers at the tim

e and very little

Cambodian.

The hospital

was

one building

comprised

of a

single O

utpatient Departm

ent.

Within

the first

year, an

Inpatient D

epartment

opened w

ith tw

o m

ore beds,

and then

15 or

so m

ore nurses w

ere hired. Then came m

ore departm

ents, more beds, m

ore staff, and m

ore Cambodian nurses.

Today, we are 448 em

ployees strong, 438 of w

hich are Cambodian. W

e are 174 nurses strong and 172 of these nurses are Cam

bodian. It is amazing to

have witnessed this hospital transform

into

a Cam

bodian-run organization

comprised of 99 percent Cam

bodian staff.

It is even more am

azing to now w

atch this enthusiastic and com

mitted team

of staff go out and teach other health departm

ents and medical professionals

throughout the country what w

e have learned

and how

to

implem

ent it

themselves.”

- Sophal Som,

Director of N

ursing

“As the Medical D

irector at AH

C, words cannot describe

the excitem

ent I

feel in

seeing the

faces in

the O

perating Theater go from

a team of prim

arily Western

volunteers to

a team

com

prised of

99 percent

Cambodian

staff—this

to m

e is one of the greatest achievem

ents.”– D

r. Ngeth Pises,

Medical D

irector

“AHC

has already

been recognized

as a

center of

excellence for teaching, it is now

my m

ission and the mission of

the hospital, to establish AHC

as a center of excellence for hospital adm

inistrators too.”

– Tep Navy,

Chief Operating O

fficer

“The nursing

culture at

AHC

is one

unlike m

ost hospitals in Cam

bodia, one w

here nurses

are valued

and respected,

working

alongside doctors as equal partners.”

– Sin Chhhomrath, ER/ICU

N

ursing Unit M

anager

VO

IC

ES

O

F

AH

C

“The heart of AHC is helping

people accom

plish their

dreams so they can go on to

help others do the same.”

– Ky Siek, Deputy Chief

Financial Offi

cer

“What AH

C was built upon -

the idea of treating all children like your ow

n - has inspired a great heart to be at the core of this hospital. It is because of this core and the people it has att

racted, that allows AH

C to be received in the com

munity,

and welcom

ed in helping other health centers im

prove their quality of care.” – Prak M

anila, External Program

Director

“The mission of AH

C is to teach everyone - not just AH

C staff, but

government

healthcare providers,

medical

students and

teachers throughout

the country - how to provide

excellent medical care, treating

every child like they would their

own.”

– Seng Phearom,

IPD N

ursing Unit M

anager

“For four years in my youth I

observed the hospital from just

outside its gates, as my high

school was located across the

street. I was im

pressed by the entire operation. N

ow, after 12

years working inside the gates

having seen the hard work and

dedication, I can say more than

ever how proud I am

to be a part of this team

.”– Visal M

aray, Director of

Administration D

epartment

“Anytime

someone

asks m

e about AH

C, I tell them that it is

unlike any hospital I have ever seen in Cam

bodia—one w

here the entire team

of staff, from the

doctors to the housekeepers, treats and cares for every child from

the heart.”– Sinketh Arun, External Relations M

anager

“As a mother of tw

o children, I enjoy m

y job most because

every day, I see children being cared

for w

ith the

highest level

of com

passion and

I am

happy to play a part in it. Since m

y children were

very little, I have taken them

here

when

they w

ere sick

because I trust the care they w

ill receive.”– Srey Ya,

AHC H

ousekeeper

Outpatient D

epartment

The Outpatient D

epartment continues to be the busiest

unit of the hospital, with children and fam

ilies arriving here first aft

er traveling from up to 500 kilom

eters away

to seek treatment. The m

ost comm

on illnesses seen range from

upper respiratory infection, diarrhea and dog bites, to m

ore severe conditions such as dengue fever, typhoid, eye disease, m

alnutrition, meningitis and acute pneum

onia. U

sing a

triage system

based

on the

World

Health

Organization’s Integrated M

anagement of Childhood Illness

guidelines, the OPD

team, on average, saw

450 children per w

eek day in 2013, and 200 children on Saturday mornings.

The 11 doctors, including 4 resident doctors, saw about

25 patients each every day. In order to accomm

odate the grow

ing patient numbers, four new

nurses joined the O

PD team

, ensuring an average patient waiting tim

e of around three hours and that the sickest children w

ere seen im

mediately. Additionally, a greater focus w

as placed on im

proving patient documentation, and a new

Registration U

nit was opened to store patient m

edical records from the

past 14 years.

To help distract the children while they w

ait, a group of volunteers from

Singapore painted bright animals on the

walls lining the O

PD. Furthermore, through continued

support from

AH

C’s

valued donors,

2013 began

the planning stages for m

ajor OPD

renovations to complete in

2014. The renovations - drawn up by a m

edical architect in Singapore - are designed to im

prove patient privacy, patient flow

, pharmacy dim

ensions and related operations, as well

as to provide medical team

with a separate educational

space.

Inpatient Departm

ent & Low

-Acuity Unit

Providing around the clock care, AHC

’s 47-bed Inpatient D

epartment

cares for

almost

4,000 children

a year

who need to be hospitalized. Com

ing to us with a range

of different

illnesses –

including m

alnutrition, acute

respiratory infection, HIV/AID

S, malaria and m

eningitis – the children tend to be very ill upon arriving due to delays in seeking care.

To increase both infection control and safety regulations, 2013 saw

the opening of a second IPD w

ard with 15 beds—

this allowed for greater separation betw

een beds, greater separation betw

een infectious patients and non-infectious patients and the creation of special “pre -ICU

” beds in order to provide bett

er care to more critical cases. In 2013, the

IPD w

as slightly less busy (7%) than the year prior due to

the outbreak of Dengue Fever and H

and Foot and Mouth

Disease seen in 2012. In addition to the IPD, there is a 10-

bed Low Acuity U

nit for children who need longer periods

to recover and rehabilitate before returning home.

Social Work U

nitRecognizing a grow

ing need to provide social support to the children and fam

ilies that come to AH

C for treatment, the social

work program

initiated in 2010 and was the first of its kind in

Cambodia w

here previously no hospital-based social work

program existed. W

hether at the hospital or at the patients hom

e, our team of highly trained social w

orkers provide support on a range of different issues - including m

alnutrition, abandonm

ent, sexual and physical abuse, as well as assisting

children living with chronic conditions or disabilities. In 2013,

the Social Work Team

provided 1,385 counselling sessions for 676 fam

ilies, caretakers and children. Moreover, the scope of

support for potentially at-risk children was expanded further

by developing an outreach follow-up program

—53 children

who w

ere sexually abused, 11 who w

ere physically abused and nine that suffered from

neglect, received outreach follow-

up, risk reassessment, legal referrals as needed, and ongoing

emotional support.

20

13

De

pa

rtme

nt H

igh

ligh

tsEm

ergency Room &

Intensive Care Unit

The Emergency Room

(ER) and Intensive Care Unit (ICU

) is w

here Angkor Hospital for Children sees the m

ost critically ill patients. Patients oft

en arrive late and in distress. Thankfully, AH

C has invested heavily in the ER/ICU over the

past several years. The staff mem

bers have all been trained in Advanced Pediatric Life Support and m

any have become

the trainers of others in this important course. In addition,

protocols for critical areas such as sepsis treatment, traum

a care and ventilator m

anagement have been put in place.

With the im

plementation of 24 hour a day 7 day a w

eek att

ending coverage, great improvem

ent in mom

ent by m

oment patient m

anagement has been achieved. These

investments in hum

an resources combined w

ith much

improved

technology including

ventilators w

ith strong

safety features,

new

cardiac m

onitors, and

bedside chem

istry diagnostics have resulted in improved survival

for many of the sickest patients AH

C sees. The Emergency

Room (ER) saw

18,126 patients in 2013 and 729 patients w

ere admitt

ed to the ICU.

Physiotherapy Unit

Physiotherapy is a relatively new area of health care

in Cambodia, and there are few

programs available for

children living with disabilities. Services provided include

speech therapy, orthopedic therapy, respiratory therapy, as w

ell as neurological therapy for children with cerebral

palsy or developmental delay. O

ur team of physiotherapists

also trains and educates families so they can successfully

administer the therapy at hom

e. In 2013, 2,856 children received physiotherapy treatm

ent at AHC. In addition,

AHC

’s physical therapy department has becom

e a training site for physiotherapy in Cam

bodia.

Since its establishment in 2000, AH

C’s

Dental Clinic has been devising effective

ways to solve m

any comm

on—but easily

avoidable—oral health com

plications; one such w

ay they have found most

successful in prevention is through oral health education. In 2013, in addition to

providing oral

health for

12,384 children,

the dental

team

educated m

ore than 16,000 children and their

Traveling to the homes of 172 children

residing throughout

the 12

districts of Siem

Reap Province, the homecare

team

provides follow

-up m

edical assessm

ent, treatment, social support,

counseling and health education for children and fam

ilies in the comfort

of their own hom

es. Through visiting patients in their hom

e environment, the

homecare team

is also able to provide specialized support – such as helping the fam

ilies of malnourished children

grow their ow

n vegetables, providing m

osquito nets to children and families

faced with m

alaria, or by building wells

for those without access to clean, safe

drinking water.

With 56 percent of hom

ecare patients being H

IV positive, the homecare team

w

orks in close conjunction with AH

C’s

in-house H

IV Clinic

which

provides

families w

ith regards to proper oral hygiene and tooth care. O

ftentim

es, for a m

ultitude of reasons – mainly overall

lack of awareness about the benefits of

oral health care, as well as the cost of

transportation – families w

ait too long to bring their children to be treated. As a result, tooth extractions are the m

ost comm

on procedures performed

in the Dental Clinic. To help prevent

this, the Dental Clinic has placed a high

importance

on outreach,

especially w

ith the local primary schools w

ith regards to the im

portance of fluoride m

outh rinse

in preventing

cavities. Additionally, w

orking alongside AHC

’S H

omecare U

nit, the Dental Clinic team

travels to the Tonle Sap Lake to provide the children of the floating village w

ith oral health education and dental care.

Dental C

linic

lifesaving Antiretroviral Therapy (ART) for H

IV patients. They also focus a great deal on H

IV education outreach as they have seen the results it can have on im

proving the situation for HIV patients

in their respective comm

unities - as w

ell as in preventing the spread of H

IV/AIDS. M

ost notably, the homecare

team has developed a peer education

initiative in

which

volunteer H

IV patients are trained in teaching others about H

IV—sharing know

ledge about their condition w

ith others has proven

to empow

er both children and their fam

ilies in

tackling m

arginalization. In recent years, it has been reported by U

nicef that the spread of HIV/AID

S m

ay now

be

coming

under control

in Cam

bodia—they

attribute

this to

the recent increases in HIV testing,

counseling, and

education program

s centered on prevention efforts.

HIV/H

omecare U

nit

If you look closely at the families w

e treat and our staff, you will

see many overlapping stories. The com

passion you see through these stories is the essence of w

hat we do, and to m

e, the most

beautiful thing about AHC. M

y favorite example of this can be seen through the H

IV Hom

e Care Program

. Through this program, AH

C provides treatment for children

living with H

IV throughout Siem Reap Province. In doing so, AH

C saw

that the mothers of these children w

ere oftentimes w

ithout a job due to the stigm

a of HIV in their com

munity. Through creating a netw

ork of peer educators, AH

C now em

ploys these mothers giving them

a new

sense of hope for their future and inspiring them to help others in their situation do the

same. Any tim

e a position for HIV Program

Assistant becomes available w

ithin the hospital, these m

others are encouraged to apply. If you were to go out right now

and walk through the

grounds of the hospital, you could meet eight of these m

others working here today.

The External Program D

epartment

(EPD)

works

to help

develop and

implem

ent national policy

for h

ealthcare

such as

ph

ysician

clin

ica

l p

ra

ct

ic

e g

uid

elin

es,

nu

rs

in

g protocols,

the nursing

process, and

the code

of ethics

for nurses.

This is

accomplished

by w

orking closely

with

the M

inistry of

Health,

the Physician

Council and

Cambodian

Council of Nurses.

2013 was a turning point for the

EPD. After three years since its

conception, acting as a consultant and supporter for the 38 selected hospitals, hospitals began directly approaching the EPD

in request of their services. This bott

om up

approach means that a grow

ing num

ber of

public hospitals

are taking

responsibility for

self-im

provement

and turning

to AH

C for assistance. Moreover in

2013, the

EPD

expanded w

ith

the integration of the Capacity Building and H

ealth Education Program (CBH

EP) com

ing under its wing to join both the

Health

System

Strengthening Program

(H

SSP) and the School Health Project.

Now

, acting as one department w

ith a shared vision and goals, the EPD

hopes to expand its outreach even further. In 2013, thanks to the generous support from

AHC donors, CBH

EP distributed 570 Bio-Sand W

ater Filters to various villages, providing over 3,431 people w

ith access to clean, safe drinking w

ater.

“Thanks to the

support from AHC,

under the USAID-URC

project, in 2013 we

were able to open the

very first Emergency

Room of Poipet

Referral Hospital.”

Dr. Ok Tinna, Poipet

Referral Hospital, Deputy

Hospital Director

External Program D

epartment

AH

C Voices

- Linne Yun, Hum

an Resources Director

20

13

IN N

UM

BE

RS

Confidence

Ho

w A

HC

He

lps

About 70% of Cam

bodia’s population lives in rural com

munities and it is from

these com

munities – w

here over 20 percent of people live on less than $1.25 a day – that com

e the majority of AH

C’s sickest patients. The cost of transportation to AH

C alone is often what hinders a fam

ily from

bringing their child here.

In working w

ith the Social Unit, AH

C offers

a travel

allowance

for poor

families

once they

arrive at

the hospital from

far away.

Families

often w

ait too

long to

seek treatm

ent for their sick child as they are not confident in the quality of health care they w

ill receive at the local level. By the tim

e of arriving at AHC, the child’s illness

has often reached advanced levels making

effective treatment m

uch more diffi

cult or perhaps im

possible.

Working in direct collaboration w

ith the m

inistry of health, the External Program

Departm

ent, and the various program

s it is comprised of,

are working adam

antly to improve

the quality of health care throughout the country. The m

ore confidence people gain in the healthcare system

, the m

ore likely they will be to seek

medical care before it is too late.

During their stay here, AH

C’s nutrition program

provides children and fam

ilies with food rations,

access to a kitchen area for meal

preparations, as well as access to

clean, safe drinking water.

Out of concern for the sick child, along w

ith m

any other reasons such as nervousness about traveling from

their village to the city or perhaps a lack of caretakers back hom

e to watch over the other children, it

is oftentimes the case that m

ultiple family

mem

bers come along on the journey to

AHC and they cannot afford to stay in a

hotel.

At night, AHC opens up the w

aiting area in the O

utpatient Departm

ent as a place for faW

milies to sleep. These

families are provided w

ith mats,

mosquito netti

ng, access to shared bathroom

s, as well as around the

clock security.

Ba

rriers

to C

are

115,570 O

utpatient Departm

ent visits

3622 Inpatient D

epartment adm

issions

1,178 Low

-Acuity Unit patients

18,126 Em

ergency Room adm

issions

729 Intensive Care U

nit patients

1,385 Social W

ork counseling sessions

2,856 Physiotherapy consultations12,384 dental patient visits10,504

Eye Clinic consultations

337 neonate admissions

18,455 patient visits to the Satellite O

PD

1580 adm

issions to the Satellite IPD

1,663 m

ajor surgeries performed

7246 x-ray procedures

96,416 lab tests performed

� Lower respiratory infections

� Dengue Fever

� Gastroenteritis

� Neonatal infections

� Dysentery

� Sepsis� Asthm

a� M

alnutrition� Typhoid� M

eningitis

Mo

st C

om

mo

n D

iag

no

se

s

When a fam

ily is away from

home, their

income drops and even purchasing food

and having access to clean, safe water – a

key health issue in Cambodia – can be a

major stress for the entire fam

ily.

AH

C M

ov

es

Fo

rw

ar

d

int

o C

an

ce

r C

ar

e

Prior to 2013, one of the biggest gaps in AHC

’s comprehensive care

was not being able to treat cancer. For children w

ith retinoblastoma,

a rapid growing tum

or of the eye and one of the most com

mon

types of childhood cancer, the only option available to them w

as

to receive palliative care. In the developed world, if the tum

or is

contained within the eye – w

hether in one eye or in both - cure rates

for retinoblastoma exceed m

ore than 95 percent .

Saddened by seeing so many children w

ith retinoblastoma, AH

C set

out to learn how to treat these children. Through discussions w

ith

and mentorship from

St. Jude Children’s Research Hospital in the

USA and the N

ational University of Singapore, AH

C was able to m

ake

its first step in cancer care and is now able to provide com

prehensive

treatment for children w

ith eye cancer.

When N

ika was just several m

onths old, her mother noticed a w

hite reflection from the pupil of her right

eye and imm

ediately took her to the local health center. She was told that N

ika’s right eye needed to be rem

oved. Lacking confidence in the local health care facility, Nika’s m

other refused—an occurrence not

uncomm

on in Cambodia. Just over a year and a half later, N

ika’s same eye had becom

e swollen and very

painful. At this point, she was taken to the Children’s Surgical

Centre (CSC) in Phnom Penh w

here she was diagnosed w

ith a type of eye cancer know

n as retinoblastoma.

Aware that AH

C had just added eye cancer treatment to its

range of care, and not yet providing comprehensive cancer

care themselves, the director of CSC D

r Jim G

ollogly referred her here for treatm

ent.

For a family like N

ika’s, earning less than $100 a month,

affording transportation to AHC w

as a major hindrance.

Nonetheless, N

ika’s parents borrowed m

oney from friends

and family and m

ade the nine hour trip to AHC in m

id-Septem

ber 2013. Upon arrival she w

as examined by D

r. Phara, Chief of O

phthalmology. H

e confirmed that N

ika’s right eye had retinoblastom

a and he determined that it needed to be

removed as the cancer w

as in an advanced stage. Knowing

that this type of cancer can sometim

es occur in both eyes, D

r. Phara also examined her left

eye and discovered that there w

as cancer present in this eye as well, though in a less

advanced stage. The following day, the ophthalm

ology team

removed N

ika’s right eye; this was serendipitously at the sam

e tim

e that AHC w

as getting ready to initiate its chem

otherapy program

after over a year of planning.

Nika w

as seen as a good candidate to be the first patient to receive chem

otherapy, since the cancer in her remaining eye w

as in a less advanced stage and thus had a good chance to be treated w

ith chemotherapy. So shortly aft

er the surgery on her right eye, the team

began chemotherapy on her left

eye. By the end of 2013, Nika com

pleted three cycles of chemotherapy

and both her parents and the AHC team

were extrem

ely happy with the progress. Tw

ice a month N

ika and her parents m

ake the trip to AHC, once for a course of chem

otherapy and once for a check-up. She is set to finish the full chem

otherapy regiment by M

ay of 2014. Due to the frequent follow

-ups needed to carefully m

onitor Nika’s progress, and the financial burden such costs of transportation can place on

a family like N

ika’s, AHC reim

burses the transportation costs to ensure there is nothing standing in the w

ay of Nika receiving lifesaving cancer treatm

ent.

Meet N

ika, A

HC

’s first patie

nt to

rece

ive ch

em

oth

erap

y treatm

en

t

“Alth

ou

gh

the

re a

re ce

nte

rs in

Ph

no

m P

en

h d

oin

g so

me

can

cer

care

, w

e

we

re

very

ha

pp

y

to

he

ar

tha

t A

HC

h

ad

a

dd

ed

eye

can

cer

trea

tme

nt

to

its

scop

e o

f care

. As o

ne

of A

HC

’s

partners, we

are confident

tha

t A

HC

w

ill h

elp

ra

ise

the

stan

da

rds o

f on

colo

gy ca

re in

Ca

mb

od

ia.” -D

r Jim G

ollo

gly,

Ch

ildre

n’s Su

rgica

l Ce

ntre

Each year, more than three m

illion of the world’s neonates are dying. According

to the World H

ealth Organization, “Every year nearly 40%

of all under-five child

deaths are among new

born infants - babies in their first 28 days of life or the

neonatal period,” and “In developing countries nearly half of all mothers and

newborns do not receive skilled care during and im

mediately after birth.” And

the solution according to WH

O, “U

p to two thirds of new

born deaths could be

prevented if skilled health workers perform

effective health measures at birth and

during the first week of life.”

In Cambodia, although infant m

ortality has decreased, neonatal mortality rates

remain high w

ith an estimated 10,000 neonates dying each year—

the major causes

being sepsis, prematurity and asphyxia (lack of oxygen). To help m

end this sad

reality, and work tow

ard decreasing child mortality rates further, AH

C has made the

care of Cambodia’s neonates a m

ajor priority.

In September of 2013, a new

standalone neonatal ward w

as opened improving

both the quality of care for our neonates, as well as the capacity of care having

increased the number of beds in the unit to tw

elve—a seven bed increase from

2012. The new w

ard consists of two units – the N

eonatal Intensive Care Unit

(NICU

) for critical care and the Special Care Baby Unit (SCBU

) for continuing

treatment – and operates at 100 percent capacity. The neonatal team

treated over

300 neonates in 2013. Continuously improving the skills of our neonatal team

, five

nurses received continuing education training in Thailand, with respect to N

eonatal

Intensive Care. The neonatal team places a large focus on providing parents w

ith

daily education sessions that teach and encourage effective breast feeding, hygiene

practices, and fully explain the hospitalization process for their newborn.

Ne

on

ata

l Ca

re A

dv

an

ce

s

“Im

proving newborn survival is A

ngkor H

ospital for Children’s priority.”

-Dr. N

eou Leakhena C

hief of Neonatal U

nit

Moving H

eart Care

Forward

Today, there are an estim

ated 40,000 Cambodian children living w

ith congenital heart

disease. Each year, another 3,000 Cambodian children are born w

ith various forms

of the condition. All the while, there are very few

surgical resources available for these

children, with only one other hospital in the country offering any dedicated pediatric

heart surgery services.

In 2013, AHC w

elcomed six volunteer heart team

s from around the w

orld to continue to

train the Cambodian doctors as they perform

ed 130 heart operations—included in these

surgeries were tw

o Tetralogy of Fallot repairs, marking an im

portant advancement in the

complexity of cases w

hich can be performed at AH

C.

Most notably in 2013, the AH

C Heart Team

performed their first unassisted open heart

surgery, while the volunteer heart team

stood by. As AHC’s H

eart Team continues to

advance their skills through close collaboration with the visiting team

s, it is hoped that

the 1,300 children on the heart surgery waiting list w

ill soon be able to return home to

their friends and families w

ith new healthy lives and renew

ed hope for the future.

By

partnering w

ith the

local governm

ent hospital

in Sotnikum

, located 35 kilometers

outside of Siem Reap w

ith a population of m

ore than 300,000, AHC’s Satellite

Clinic seeks to provide quality health care to children in this rural district. Prior

to the

establishment

of the

Satellite Clinic in 2009, children here often had no place to turn w

hen they becam

e seriously ill or injured.

The Satellite Clinic functions as the pediatric

ward

of the

government

hospital. Shared

services w

ith the

government

hospital include

laboratory, X-ray

and pharm

acy services. In addition, a unique and vital

partnership w

ith the

hospital delivery room

has been established enabling

fast response

for diffi

cult deliveries

and im

mediate

newborn

resuscitation. Consisting of three m

ajor departments

- Outpatient, Inpatient and Em

ergency

Working in direct collaboration w

ith the local governm

ent hospital, AHC’s Satellite

Clinic seeks to provide high-quality com

passionate health care to children living in rural com

munities.

Satellite Clinic

Room -

the Satellite

Clinic treated

20,658 children

in 2013—

a 6%

increase

from

2012 and

a 40%

increase since 2010. To accom

modate

the increasing

amount

of patients,

a new outpatient consultation room

w

as created in 2013. Am

bulance Transfer Service In Cam

bodia where 70%

percent of its population live in rural com

munities,

and over 20 percent of its population live on less than $1.25 a day, the cost of transportation to the nearest hospital is

a m

ajor factor

in determ

ining w

hether a patient lives or dies. One

achievement of the Satellite Clinic is

its ambulance transfer service; w

hen a critical patient arrives at Satellite, the clinical team

provides imm

ediate stabilization and life support and then transports the child to Intensive Care at AH

C. High skill is required w

hile m

aintaining this life support care on one of Cam

bodia’s fastest and most

dangerous highways. In 2013, a total

of 139 children were transferred to

AHC. There w

ere no mortalities en

route.

Satellite Clinic Neonatal

CareThe Satellite Clinic serves as a neonatal care center for the Sotnikum

Referral H

ospital and other healthcare centers in the area. If there is a com

plication during any delivery in the Sotnikum

Referral H

ospital, the doctors at the Satellite Clinic are notified through an alarm

system and can quickly report

to the delivery room. In addition, m

ost neonates from

the 24 surrounding district

health centers

are now

referred to Satellite Clinic if they are in need of hospitalization. From

2012 to 2013, the Satellite Clinic saw

a 30 percent increase in the num

ber of neonates treated rising from

258 to 368 by year-end.

One evening w

hen 15-year-old Samnang and his

friends were out hunting for rats, his friend’s

arrow

misfired

striking Sam

nang directly

in the heart. H

is friend imm

ediately rushed to his side and began to pull out the arrow

but Samnang quickly

shouted at his friend to leave it where it w

as and go get help. Sam

nang’s father and uncle came and brought

Samnang to AH

C’s Satellite Clinic. The medical team

at the Satellite Clinic w

orked hard to stabilize his condition and ease his pain, before transferring him

to AHC by

ambulance. Arriving at AH

C’s Intensive Care Unit just

before midnight, the need for surgery w

as quickly determ

ined and the heart team perform

ed emergency

surgery which lasted six hours throughout the night.

Thanks to Samnang’s great intuition not to rem

ove the arrow

, the excellent emergency care provided by the

team at the Satellite Clinic, the safe am

bulance transfer and the highest level of skill and dedication from

the AHC

Heart Team

, Samnang’s life w

as saved with no residual

complications.

Meet Sam

nang

Medical education is a cornerstone of Angkor H

ospital for Children (AHC). Spanning

from w

ithin the gates of AHC and reaching out to the furthest borders of Cam

bodia and beyond, AH

C continued to provide new generations of m

edical professionals w

ith the highest level of clinical education while further advancing the know

ledge and training am

ong older generations.

Education and Research Departm

ent

In

2013, along

with

the thousands

of hours of bedside clinical teaching incorporated into the day-to-day care

of AHC patients, our dedicated team

of m

edical staff participated in more than

200 sessions

through the

Continuing M

edical Education

(CME)

program.

Working to strengthen the healthcare

system in Cam

bodia, they also conducted m

ore than

3,800 hours

of classroom

instruction

for m

edical students

and governm

ent healthcare workers.

Through efforts

to develop

AHC

as a

center of

excellence for

hospital adm

inistrators and

other non-m

edical staff

alike, advancing

the education

curriculum

for non-m

edical staff

was

made a m

ajor focus in 2013 and onwards.

Starting with the first N

on-Medical Annual

Workshop and extending into lunch talk

sessions, there was a total of 380 non-

medical att

endees over the course of the year, and 33 em

ployees participated

in additional

external trainings.

AHC

is com

mitt

ed to giving non-medical staff the

tools and training they need to become top

professionals in their field.

Junior Doctors

In 2003, AHC began its three-year pediatric

residency program

to

provide new

generations

of Cam

bodian doctors

with

the education and training they need to develop into highly skilled pediatricians. As it stands in Cam

bodia today, and contrary to

international standards,

completing

a residency

program

following

graduation from

medical school is not yet a national

requirement.

The residency

curriculum

was

developed to

be consistent

with

international standards

of post-graduate

pediatrics training, and the training program

is regularly assessed and reevaluated by both AH

C staff and outside collaborators. Initially this program

was heavily dependent

on the guidance of visiting physicians but today, it is w

holly under the direction of the

Cambodian m

edical leadership.

In 2013, AHC congratulated six doctors in

completing their residency, 12 residents

continued, and 22 new residents w

ere w

elcomed into the program

– the latter

an AHC record.

“In Cambodia there are tw

o physicians for every 10,000 people, w

hile the w

orld average is 14 physicians for every

10,000 people.

To im

prove on this, and to accom

modate the

growing dem

and for qualified health professionals

in this

country, AH

C w

elcomed five new

residents in 2011, 13 new

residents in 2012, and 22 new

residents in 2013. We are very

pleased to watch the program

grow

and expand greatly in recent years.”

–Sokry Chay, Medical D

epartment

Administrative Assistant

Senior D

octorsAll senior m

edical staff at AHC have com

pleted the three-year residency program

. AHC’s com

mitm

ent to providing its m

edical staff with the highest level of education does

not stop here. Through its twice-a-w

eek CME series, AH

C rem

ains comm

itted to its belief that m

edical education involves lifelong learning.

As the Cambodian M

inistry of Health is just starting to

develop a national CME system

, AHC has been asked to help

advise and support this effort. For instance, the Siem Reap

government hospital invited AH

C to join them in providing

presentations for their first ever CME conference. M

oreover in 2013, AH

C began formal pediatrics subspecialty training

for the first time, starting w

ith training curriculums in the

following areas: N

eonatology, Pediatric Surgery, and Clinical M

icrobiology. These subspecialty programs are offered to

graduates of AHC’s three-year residency program

and will

serve to meet the grow

ing need for subspecialty care among

AHC’s patients. The Education and Research D

epartment

looks forward to expanding subspecialty training to other

subspecialties which there is a great need for in Cam

bodia. N

ursesThrough developing and im

plementing nursing protocol,

nursing processes

and a

nursing code

of ethics,

AHC

set the stage for a new national standard of care for the

nursing profession

throughout the

country. In

2005, AH

C was recognized by the M

inistry of Health as the first

teaching hospital in the country for nursing and in 2010, AH

C’s Nursing D

epartment w

as invited to partner with the

Ministry of H

ealth and Cambodian Council of N

urses in order im

plement this new

standard at the national level.

The exceptional nursing care here at AHC has a direct

influence on our patient’s health and their experience during their visit. AH

C nurses are continually improving

their knowledge and clinical skills through w

eekly nurse-led presentations, physician-led lectures, and a journal club w

here senior nurses and visiting international volunteers present relevant new

literature on a rotational basis. Many

of the nursing staff attended national and international

nursing conferences in 2013.

External EducationW

orking in direct collaboration with the M

inistry of Health

through the AHC External Project, the Education and

Research Departm

ent also provides extensive educational and training opportunities in standardized high-quality pediatric care for governm

ent healthcare professionals throughout the region. Advanced Pediatric Life Support, Traum

a Care, Infection Control and Nutrition courses are

just a few of m

any training programs recently conducted

at AHC.

AHC Education seeks to im

prove healthcare for children throughout Cambodia in the follow

ing ways:

��Provide advanced pediatric training to health professionals nationw

ide ��

Implem

ent and sustain a mentor-based m

odel where those w

ho receive such training go on to use their newly

acquired skills tow

ard training other medical professionals

� Iw

ncrease the number of qualified m

edical personnel throughout Siem Reap Province and G

reater Cambodia

� Strengthen the m

edical programs of local and national governm

ent hospitals and health centers throughout

the country�

Increase collaboration between the M

inistry of Health, governm

ental hospitals, Regional Nursing Schools,

N

GO

s and private institutions�

Establish a code of ethics and conduct to be emulated by other health centers around the country

In 2013, AH

C had four studies published in international peer-reviewed journals including Journal of Tropical Pediatrics,

Transactions of Royal Society of Tropical Medicine and H

ygiene, and PLoS ON

E—several studies of w

hich were presented

at international medical conferences throughout the year. M

any research activities remained ongoing as w

ell, such as a m

ulti-country EU-funded D

engue Study (http://idam

s.eu/), an HIV-TB study in collaboration w

ith Institut Pasteur Phnom

Penh, a bacterial surveillance study and two neonatal studies just to nam

e a few.

The other big news regarding AH

C research in 2013 was that the M

ahidol-Oxford Tropical M

edicine Research Unit (M

ORU

) and AH

C collaboration was form

alized as the “Cambodia-O

xford Medical Research U

nit (COM

RU)”. M

ORU

has worked

with AH

C since 2007 to build, equip and staff the microbiology laboratory, w

hich by the end of 2013 includes molecular

diagnostic capabilities essential for both the research program and the routine high-quality care of AH

C patients. In 2013, studies led by CO

MRU

focused on two m

ain areas of microbiology and neonatal (babies less than 28 days of age) care and is

led by Dr. Claudia Turner and D

r. Paul Turner, Oxford-em

ployed doctors who are both based at AH

C.

Most im

portantly, the medical research in w

hich AHC is involved continues to benefit the children AH

C treats, Cambodia as

a whole, and even the larger international com

munity by adding know

ledge about diseases and patients from a place w

here such know

ledge is quite limited.

“The work you [AH

C] are doing in Cam

bodia will change the w

ay medicine is

practiced in that area of the world.”

–D

r. Joseph Carcillo, University of Pittsburgh

Re

se

arc

h

Medical research at AH

C continues to flourish.

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Local Com

munity G

ets InvolvedA

First for Local Fundraising

O

n July

20th, 2013,

thousands of

people flocked to the site of the event, W

at Bo pagoda in Siem Reap, to join

together with other m

embers from

the com

munity in support of the everlasting

mission of AH

C to provide high-quality care to all children in Cam

bodia.

The local senior monk from

Wat Bo

pagoda spoke about our responsibility as

Buddhists, and

as people

in this

world, to help others in need and to

always show

compassion to everyone

Working alongside m

onks in the comm

unity, AHC

organized its first ever C

ambodian fundraising event in honor of B

on Phka Prak Mahasam

aki (M

oney Flower Tree)—

a Buddhist religious event in honor of giving back

to the comm

unity, whether it be raising m

oney to help those who are ill,

or raising money to build a new

school, bridge or pagoda.

and everything around you. AHC’s External

Program

Director,

Mrs.

Manila

Prak, also

spoke about the work of AH

C and how their

support, no matt

er the size, can help change the lives of m

any children.

Through working w

ith local media including

radio, TV and press - as well as w

ith local printers

who

generously donated

12,000 invitations for us to send out to the AH

C fam

ily of friends and supporters - the word

was quickly spread throughout the province

and beyond.

The original goal of the event was to

raise $10,000 but thanks to generosity of all those w

ho joined us, AHC w

as able to raise $24,000.

Thanks to the great success of the event, and how

well it w

as received by the local com

munity, AH

C will be

holding this event every year.

In Cambodia, Buddhism

and

Cambodian culture are inseparable; w

ith 95 percent of its population Buddhist, both m

onks and pagodas play a large role in prom

oting social morality - encouraging others

to give back in the comm

unity and work together to help

alleviate poverty and improve the health of those in need.

In Photo: Venerable Master Preh M

aha Vim

oldhamm

a Pin SemSirsuvanno

Since the laboratory first began its blood drive efforts, the am

ount of blood donated from

foreigners greatly

outweighed

(more

than doubling and tripling) the am

ount donated from

the local Cambodian

population. This

all changed

in 2013. W

orking with local business,

NG

O’s

and schools,

it w

as the

first year

ever that

Cambodian

blood drive

support surpassed

the support from the local foreign

population. Not only w

as there an increase in the total am

ount of blood donated - due to AH

C’s raised efforts in holding local blood drives - but the am

ount donated

Increase in Local Blood Drive Support

2013 marks the first year that AH

C’s B

lood D

rive efforts saw an increased support from

the local com

munity.

by Cambodians nearly doubled

from the previous year. This w

as accom

plished through educating the local population about the im

portance of

giving blood

- as an active way of helping

others - and by reassuring the local population that there are no risks associated w

ith giving blood.

Graham

and Maureen Challender w

ere introduced to AH

C in 2013 through friends. Initially they volunteered briefly at AH

C’s

Satellite Clinic

with

Graham

providing

a few lectures on com

munication and

motivation,

and M

aureen providing

English lessons

for the

residents. The

Hum

an Resources Director, M

r. Yun Linne, att

ended one of Graham

’s sessions and w

as so impressed that he asked G

raham

to do the same at AH

C. Graham

graciously agreed and provided ten m

ore lunchtime

sessions.

Bringing both medical and non-m

edical skills, and coming from

all over the world,

the long history of volunteers at AH

C has helped make this hospital w

hat it is today.

After returning hom

e to Australia, G

raham

and M

aureen w

ere so

touched that they wanted to return

to Siem Reap and volunteer at AH

C for an extended period of tim

e if there w

as a need. As it turned out, AH

C had just expanded its medical

library and had a new Cam

bodian librarian.

Maureen,

as a

trained library technician, w

as a great fit to train the new

librarian as well as

assist with AH

C’S English language

program.

In addition, AHC w

as in the process of

improving

its responsiveness

to the

Cambodian

comm

unity. W

ith a background in hospitality, G

raham offered his assistance to

train Cambodian staff in custom

er care, and collection of custom

er satisfaction data. W

ith his sensitive guidance,

a Cam

bodian led

customer

satisfaction tracking

system w

as put in place.

Meet G

raham and M

aureen Challender

“Our experience here has been fantastic. W

e have been w

elcomed, em

braced by everyone w

e come into contact

with, and involved. W

e feel we

are contributing, even if in only a sm

all way. It w

ill be difficult to leave and w

e hope to be invited back again.” – Graham

&

Maureen Challender

Vo

lunteers at Angko

r Ho

spital for C

hildren

AHC is governed by a volunteer Board of D

irectors consisting of 8 mem

bers. These directors were invited to join the Board

by a comm

ittee com

posed in vast majority by Cam

bodian staff of the hospital, as the final act of AHC’s transition into

an independent organization. They were selected based on individual att

ributes and representational factors, as well as

strategic skills, experience and their comm

itment to AH

C’s mission.

The Board of Directors is responsible for determ

ining strategy and policy as well as supervising the H

ospital’s activities. They m

eet three times a year in Siem

Reap; however, in practice, the Board of D

irectors meets m

ore frequently, illustrating the com

mitm

ent of the Directors.

The Board of Directors has four specialized com

mitt

ees that report to it: Education Comm

ittee, Finance D

evelopment

Comm

ittee, M

edical Oversight Com

mitt

ee and the Developm

ent Comm

ittee. Three Cam

bodian representatives of the m

anagement of AH

C, as well as D

r. William

Housw

orth, AHC Executive D

irector, participate in all Board meetings and the

four specialized comm

ittees see a large presence of Cam

bodian staff of AHC.

Bo

ard

of d

irec

tors

Kenro IzoRobert G

azzi (Chairman)

Dr. m

ed. Katja van ‘t Ende (Head of M

edical Com

mitt

ee)Stuart D

avy (Head of Finance and O

perations Com

mitt

ee)Lindsay W

illiam Cooper (H

ead of D

evelopment Com

mitt

ee)Lisa G

enasci (Head of Education Com

mitt

ee)H

artmut G

ieseckeAkio M

atsushima

(Cambodian Leadership)

Dr. N

oun PheaktraPrak M

anilaTep N

avy D

r. William

Housw

orth, Executive Director.

Elaine Aabin

Kazumi

AkaoKim

ura AkinoriTina

AllenbyChristoph

Amann

Sajma

AnEric

AnfinsonKurisu

AoiH

ardeep S. Asi

Michael and Jo Ann

AveryB. Althof BaracAdrian

BaralStephen BarnettJudith

BarryKristina BayleeM

aria Benson

Nicole

BeyPhilip &

Daniel

Bhasken & W

heathyJoel

BleicherRom

an& H

elene Boegli Monralla

Jody Bonar

Murgaret

BradshowJeff

Brambila

Suzanne Brown

Leslye Buchanan

John Bursey

Adam

BursionD

an Burton

Lee Butcher

Eileen & Thom

as Caalan & K M

urphyAshley

Campbell

Samuel Carpio

Chi Hao Chang

Lydia Chang

Cheng Ya Cheng Ya

Jolene Chiang

Ming Yin Choy

Clemens Clem

ensYu Fang CoLindsay W

illiam Cooper

Julie D

altonClare

Dam

econeD

aniel de G

ruiteaJet &

Louis de G

ruiterJohn

Dennis

Mikael

Dilw

orthJanet

Douglas

Jane D

rabbleM

ichael S. D

udas

Robert Ellis

Amanda Esquivel

Judith Eyers

Alice Facconuni

Hellen

FairhurstSiulon

FarandeyM

arcel Ficochi

Maria

FongJonathan

FosterElisabeth

FotiTanya

FrizzellD

orothy FullerN

orman Fuyita

Ruth G

gokKristy

Ggoodchild

Hartm

ut G

ieseckeXsvier

Go Bin

Goh

Goh

Grigull

Grigull

Jonathan G

rossfeldSusan

Grossfeld

Fiona H

amilton

Luzu H

e EangRichard H

enkerN

athalie Henry

Simon

Hibberi

Susan H

ilderCatherine

Hill

Madiko H

irawa

Helen

Hogan

Steve H

ollingsworth

Philip & Joan

Hosking &

Djonohoe

William

& Lori

Housw

orthSarah

Housw

orthM

arkus Hufnagel

Julie H

uynhToshihiro

IkejiriYoshida Ikim

iBill

Iswki

Anna Iw

asaKenro

IzuSerjio &

Vanessa Jakobowicz

Avinash JalanBrian

JollyJunko

JunkoChiyu

KaiD

r. Masum

i Kam

achiJichiro

Karagawa

S. Kaw

auchi

Henneke

Kempers

Yasuda Kenji

Yuusi Khidou

Susan Killam

Sungjoo KimQ

uah Kim

SoonJulian

KornEm

merich G

. Kretzenbacher

Jennifer KrunugerN

obuo Kudamatsu

Kyle Kushnier

Deric

LamJam

es M.

LattAlyssia

Lazin KapicJoyce

LeeLoreha LeeSam

bonn Lek

Sherene Liew

Ool W

ei LimJanice

Lucy Hay

Aifred Lugo

Tan Lu Lung

Amrin

Ma

Rebecca Maboney

Malik

Malik

Saroeung M

ang Atham

an M

anoranjanTeng

Mao

Triangle Mark

M

assenallRobert

Matt

aM

ay M

ayJanet

McCahon

William

J. M

cClureE.L M

clean M

cLeanN

eil M

cMullin

Michelle M

endG

ail M

odyman

Philip L M

ortonD

avid M

udmes

Pula M

ularskiM

archia Mullavey

Thomas K.

Murphy, Ph.D

Alysha M

uzffeD

r. Robert and Nancy

Nassau

Greg and D

ianne Neeves

Hang

Nguyen

Taku N

islimae

Ayako N

umazum

a

AH

C Frien

ds &

Families

Pov O

rengM

ana O

sawa

Kou O

taTiffany

Overal

Pek & Ly Pa &

SimSashi

Panaweera

Holly

PardyZuellig

Pharma

Robin Pho

Lisa & Scott

Pho &

ForbesAdre

Pomerleau

Samia G

eorge Pratt

Wim

Prins

Voonpoj Promasa Tayaprot

Virginia RacheleauSandra

RaesonSanora

RaisonD

enis Vancerbe Rghe

Lasse Rinner

Quinn

RiordanSue

RobertsonQ

ing Rong

James

RubensChristian &

Susanne Sack

Morio

SaiseisaserukaiSaita

SakiAltam

ira Salinas

Ham

med

Samraoul

Aby Sargent

Teo Saw

ChooKraig

SchegerJessica

ScottSandy

SeegerSam

At Seung

Louise Shew

anKuniko

Shimano

AI Ichiki Shinob AbetaAkiba

Shui ChiEla

SidopG

ina Sim

psonTina

SlusherH

ossen Som

edW

innie Wong

Sooi Mooi

Dilshad Sum

arKatsuhiko

TakeuchTam

my

Tamm

yLouisa

TeakleCatheine

ThamAlistair

Thompson

Adele Thom

son

Megum

i TojoTorben

TranbQ

uyen Tu

Claudia TunerD

r. Paul TunerSonia

VagniBonenfant

VeroniqueLuigina Anna

VinciStefan

VolkenJohn

Water

Laura W

illemsem

Max N

. W

illiams

Hans W

olfD

ennis Yak Ming H

wee

Kingo YoshidaW

akita YoshinobiYani YuCorporations &

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/Direct Relief International

ABC’s & Rice

ABFAN SEA

About Asia ServiceAD

M Capital Foundation

Aglaia Investment M

anagement Pte Ltd

Americares

Anakhot Kanagawa N

ursing SchoolAngkors KinderAustralia Cam

bodian FoundationBelguim

AssociationBilan Cooper Fam

ily Foundation Bringham

and Wom

en’s Hospital

Buriram H

ospitalCarraresi Foundation Children of Cam

bodiaCooper Investors Pty LtdCore Value Training G

roupCurtin U

niversity Global

DAK FoundationD

eutsche Bank Asia Foundation Edgew

ood CollegeExpress Prom

otions Australia Pty LtdFioTec Co., LtdFriends W

ithout a Border, FranceFriends W

ithout a Border, JapanFriends W

ithout a Border, New

YorkG

lobal FundH

airdresser Without A Border

Heart to H

eart FoundationH

ongkiat Trading

Hrothgar Fam

ily FoundationInternational H

ealth ISKLJAPF Jerudong International SchoolJH

PJICA M

aneca ProjectKH

ANA

Kidmaster from

SingaporeKids International D

evelopment Society

Le Club BLeonore Strafford TravelLeShalLIO

NS Club of Bayan Baru

Mahidol O

xford Research University

The Maitri Trust

Map International

MD

ISM

ercy Malaysia

MPH

11 Mahasarakham

University

Oxford U

niversity/COM

RUPapanui H

igh School, NZ

Russey Lok /PDI

Planet Wheeler

Ptarmigan Charitable Foundation

RICE fundRoad ScholarRotary Club JapanSam

Relief IncSanofiSEVA Foundation-Cam

bodiaSingapore International FundSironaSom

edayT &

J Meyer Fam

ily FoundationTO

Holding AS

Terraw Ladies College

Tobu TravelTravel Indochina Aine U

ngarU

nite Way of M

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anyU

SAID/U

RCU

SAID/RH

ACVin M

ec International Hospital

Water4Life

Watkinson School

Wenoy Pow

erW

here There Be Dragons

A & K travel

ABA BankAm

ansaraAnantara Angkor Resort &

SpaAngkor BalloonAngkor Century Resort &

SpaAngkor Em

ilia Drinking W

aterAngkor Era H

otelAngkor H

alf Marathon

Angkor Holiday H

otelAngkor H

otel Auberge Mont- Royal

Angkor Kristine Hotel &

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Angkor Miracle Resort &

SpaAngkor Reach Restaurant Angkor Supper M

arket Angkor Tourist G

uide Association (English)Angkor Trade CenterAngkor U

niversityAnjalie H

ouseAnnAdya restaurant &

barApex Cam

bodia Travel ServiceApsara Angkor H

otelApsara H

oliday Hotel

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RS Areca Boutique VillaArtisans d’AngkorArunras H

otel Asian Square Restaurant &

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otelBabel G

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otelBID

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SpaBritish Em

bassy in Cambodia

Buffalo ToursBuffalo Trails Cam

bodiaBuild Bright U

niversityCanadia Bank PLCCasa Angkor H

otel Central ExpressChhorvy Vorn G

uesthouseCity Angkor H

otel City Villa H

otel Apartment

Clinic 777Cozyna H

otelCU

S - Cambodian U

niversity for SpecialtiesD

ESTINATIO

N ASIA

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ELM TRAVEL CAM

BOD

IA D

yna Boutique Hotel

Elephants Angkor AssociationEurasie Travel Phnom

PenhExotissim

o Travel Cambodia

FCC AngkorFeeling Entertainm

entFlorida International School Freedom

Hotel

FSUN

Tourist IncFTB Foreign Trade BankG

arden Village Guest H

ouse G

erman Association

Golden Banana Resort

Golden M

ango InnG

olden Temple H

otelG

olden Temple Villa

Goldiana Angkor H

otelG

rand Soluxe Angkor Palace Resort & Spa

Green Travel

Green Village Palace G

uest House

H.I.S Cam

bodia Travel Co.,Ltd.H

ANU

MAN

TOU

RISM

Happy G

uest House

Happy Sm

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IS TravelH

oliday Palace Casino & Resort

Honour Village Cam

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otelInternational School of Siem

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IPPON

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JHC Angkor Tour

K Four Group

KAMPO

UL ADVEN

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Khemra Angkor H

otel& Spa

Khmer Angkor (G

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Krama Tour

La Noria H

otel & Restaurant

Local C

om

mu

nity S

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otel Phnom Penh

Lin Ratanak AngkorLitt

le India RestaurantLóasi Italiana RestaurantLy Sreyvyna Clinic M

aisa Restaurant M

cdermott

Gallery

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otelM

ekong Palace Hotel Phnom

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ey Hong bus com

panyM

onoreach Angkor Hotel

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URIST

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ome Tropical G

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New

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niversity of Cambodia

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uot Hotel

Shadow of Angkor G

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Sokha Angkor ResortSokhalay Angkor Resort &

SpaSom

adevi Angkor Hotel &

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oria Boutique Hotel

Soup Dragon Restaurant

South East Asia University

Southern Breeze and TourismSovann Angkor H

otelSovanna Shopping Centre Phnom

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Reap Hotel

Tai Ming Plaza H

otelTara Angkor H

otelTerre Cam

bodgeThe City G

uest House

The Hashi

The Pizza Company

The Rosy Guesthouse

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The Villa Siem Reap

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nion Comm

ercial Bank PLC (UCB Bank)

University of South East Asia

USA International School

Vattanac Bank

Vicking House

Victoria Angkor Resort & Spa

Weaves of Cam

bodiaW

estern International SchoolX BarU

niliver Compay

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ew H

ope Cambodia

NCH

ARDs

National Pediatric H

ospitalEurop ContinentialD

ynamic

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( Cambodia ) Ltd

CMS

Central Medical Store

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ambang Provincial H

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