Health experts have raised alarm over the rising incidences of diabetes among adults in Cambodia with 4.4 percent of the 16.8 million population suffering from it.

What is of great concern is the fact that out of the estimated 740,460 patients, 40 percent of them may eventually develop impaired renal function.

This was highlighted at the online webinar health talk-themed “ Healthy Kidneys for a Healthy Life” organised jointly by Parkway Hospital Singapore group and Sing Specialists Medical Center on December 19.

The objective of the health talk was to create awareness among Cambodians on the need for them to manage their hypertension and diabetes to prevent kidney problems, which if unchecked could lead to Chronic Kidney Disease (CKD).

Nephrologist Dr. Angeline Goh Ting Hui, who was a guest speaker, said diabetes nephropathy is a common complication related to Type 1 and Type 2 diabetes and this happens when a person has poorly controlled diabetes.

“If diabetes is not well controlled it can lead to kidney damage and also cause high blood pressure,” she said, adding that the prevalence of kidney and diabetes among the people was becoming common among the communities.

Dr. Goh warned: “CKD is a silent killer. One in 10 people or 10 percent of the population actually have CKD without even being aware of it. This is because high blood pressure and diabetes are the common causes of kidney disease.

She pointed out that in 1997 the prevalence of diabetes in the world population was about 135 million people, and in 2010 it doubled to more than 285 million, which is 6.4 percent of the world population. In 2030 it has been projected that 7.8 percent (around 439 million), or close to 10 percent of the world’s population, will be diabetic.

Stating that this non-communicable disease is worrying, Dr. Goh again warned that CKD is an important risk factor for cardiovascular disease.

She said the public must understand that having healthy kidneys is also a step towards having a healthy heart.

“Stay healthy and free of diabetes to prevent having complications related to the disease such as CKD, high blood pressure, fluid retention, anaemia, and weak bones,” said Dr. Goh adding that these health issues would eventually translate to people having a lower quality of life.

“To have a good quality life, you must have good kidney function. Having a good kidney also means maintaining overall good health,” said Dr. Goh who is a specialist at the Mount Elizabeth hospital in Singapore and sub-specializes in kidney transplantation.

Ministry of Health spokeswoman Or Vandine said: “Like many other countries, non-communicable diseases (NCD), including hypertension, diabetes, and kidney troubles, have become a public health concern because of unhealthy diets, physical inactivity as well as tobacco and alcohol use.”

Vandine said that the Ministry of Health, with support from the World Health Organization, developed a national multi-sector action plan creating various measures to address and prevent Cambodians from such diseases as diabetes and CKD. The measures include: identifying risk factors, increasing tobacco taxes, providing education on a healthy diet and exercise, focusing on prevention and early treatment, and working closely with development partners.

With more than 20 years of experience in clinical medicine, Dr. Goh is also an expert in the use of immunosuppressants and has spent over a decade caring for kidney transplant recipients and donors.

Having cared for more than 400 prevalent kidney transplant recipients, Dr. Goh said she understands the need for regular monitoring to keep transplant recipients in good health.

Under her capable hands, more than 100 new living donor kidney transplants have been performed in the National University Centre for Organ Transplantation from 2013 to 2019.

At the talk, Dr. Goh shared in detail about CKD, its causes, preventive measures, and effective treatments while highlighting that 20 percent of men and 25 percent of women between the age of 65 and 74 have CKD.

She has developed her own program to monitor and advise patients on how best to maintain good kidney function to ensure good overall health. She strongly believes that good kidney function is a prerequisite for a healthy life.

Dr Goh was a former assistant professor in the Yong Loo Lin School of Medicine, NUS, and external lecturer for the School of Health Sciences, Nanyang Polytechnic. She has been actively involved in research in kidney transplantation and has presented in regional and international conferences.

The event was initially scheduled to take place on November 14, at Rosewood hotel, but was postponed to December 19 due to the COVID-19 pandemic. The online webinar event was attended by members of the general public, members of the business chambers, and priority banking customers.

The SSMC Renal Dialysis Clinic was established by Dr. Stephen Chew and Dr. Ho Chee Kun from Aegis Medical Care, who have both been engaged in the care of patients with kidney diseases for more than 25 years and manage 11 dialysis clinics in Singapore.

SSMC is a first-rate medical facility in the downtown central district of Phnom Penh and has been at the heart of the provision of top-notch medical care, boosting reliable quality healthcare services, promising an exceptional and hands-on patient care experience.

SSMC in collaboration with Parkway Hospitals recently organized another health talk, this time on the liver – a very important part of the body.

Dr. Amitabh Monga, the special guest doctor, spoke about the causes, effects of and precautionary measures against diseases of the liver. Dr. Monga is a gastroenterologist practicing at Gleneagles Hospital, Singapore. He is experienced in both general gastroenterological and hepatological conditions. His subspecialty is in therapeutic endoscopies such as endoscopic retrograde cholangiopancreatography (ERCP), oesophageal, duodenal, and colonic stenting, double-balloon enteroscopy, percutaneous endoscopic gastrostomy, and video capsule endoscopy.

Dr. Monga had previously spent 11 years in Tan Tock Seng Hospital (TTSH). He is currently a visiting consultant at TTSH and Khoo Teck Puat Hospital, Singapore. He received his Bachelor of Medicine and Bachelor of Surgery (MBBS) from the University of Delhi, India, in 1995 and completed his post-graduate degree in internal medicine in 1999. He attained his Membership of the Royal Colleges of Physicians of the United Kingdom in 2005 and pursued his specialist training in gastroenterology at TTSH. Dr. Monga was accredited as a specialist in gastroenterology in 2009 and received his Fellowship of the Royal College of Physicians of Edinburgh in 2013. He was awarded the Health Manpower Development Plan scholarship by the Ministry of Health, Singapore, in 2010, and completed a fellowship in advanced therapeutic endoscopy and ERCP at the Asian Institute of Gastroenterology (AIG), India.

He was an invited faculty at GIHep Singapore 2013 to 2018 and also at Singapore Hands-on Live Endoscopy Course (SHOLEC) in 2014 and 2015. Dr. Monga was awarded the Yong Loo Lin Medical School Dean’s award for teaching excellence for 2008 and 2009. He played an active role in teaching medical students and was a core faculty in the postgraduate residency program in gastroenterology.

During the event, Dr. Monga explained in detail how to take care of the liver. He discussed the various functions of the liver and common liver diseases. The main function of the liver is to break down food and convert it into energy. It also helps the body to get rid of waste and any toxicity in the body.

Dr. Monga informed that the hepatitis virus causes liver damage, and there are 5 types: A, B, C, D, and E.

He said: “The estimated number of cases worldwide per year for Hepatitis B and C is 400 million cases, and an estimated 1.4 million people die worldwide from hepatitis every year. Hepatitis C is the most dangerous virus, however, 90 percent of the patients can be healed within three to six months, if treated properly.”

Dr. Monga added that Hepatitis A and E are caused due to a lack of food hygiene, contaminated water, and sub-standard sanitary facilities. Whereas, Hepatitis B, C, and D can be contracted through blood, sperm, and other bodily fluids.

The major causes of liver diseases are Hepatitis B, C, alcoholic liver disease, and non-alcoholic fatty liver disease. Hepatitis C is the most dangerous virus, as it is transmitted through exposure to infected blood, inadequate sterilization of needles, sexual transmission, or other objects handled by an infected person. The symptoms include abdominal pain, vomiting, and yellowing of the skin and eyes (jaundice). This may last up to six months, however, Dr. Monga said that most people recover completely with medication and strict precautions. Between 130 and 150 million people globally currently have a chronic Hepatitis C infection.

“A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer,” Dr. Monga said. “Approximately 500,000 people die each year from Hepatitis C-related liver diseases. Antiviral medicines can cure more than 90 percent of patients, however, there is currently no vaccine for Hepatitis C.”

He explained how excessive alcohol intake can cause liver damage. There are several stages of severity and a range of associated symptoms. Usual symptoms include feeling sick, weight loss, loss of appetite, jaundice, swelling in the ankles and stomach, confusion, drowsiness, vomiting blood, or passing blood in your stool.

Dr. Monga said there are three stages of alcoholic liver disease (ALD). First, alcoholic fatty liver disease, second, alcoholic hepatitis, and third, cirrhosis. “Drinking large amounts of alcohol, even for just a few days, can lead to a build-up of fats in the liver. Fatty liver diseases rarely cause any symptoms, however, this disease is reversible by medicine. A potentially serious condition that can be caused by alcohol misuse over a longer period of time is alcoholic hepatitis. The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently. However, severe alcoholic hepatitis is a serious and life-threatening illness. In cirrhosis, the liver has become significantly scarred. This is generally not reversible, however stopping drinking alcohol immediately can prevent further damage and significantly increase your life expectancy.”

“The most effective way to prevent ALD is to stop drinking alcohol or stick to the recommended limits. Men and women are advised not to regularly drink more than 14 units a week. Spread your drinking over three days or more if you drink as much as 14 units a week. A unit of alcohol is about half a pint of normal-strength lager or a pub measure (250 ml) of spirits. Even if one has been a heavy drinker for many years, reducing or stopping alcohol intake will have important short-and-long-term benefits for your liver and overall health,” added Dr. Monga.

He then explained non-alcoholic fatty liver disease (NAFLD). This is a condition in which fat builds up in the liver. It has two types, one is the non-alcoholic fatty liver (NAFL) where the liver has fat build-up but is not inflamed and the other is non-alcoholic steatohepatitis (NASH) where the liver has built-up fat and is inflamed.

The causes are obesity, being overweight, diabetes, high cholesterol, or intake of certain medicines. The symptoms usually arise when the liver disease is advanced. NASH can be treated by losing weight, treating and controlling diabetes, high cholesterol, and triglycerides, and exercising regularly.

Liver diseases can be identified by blood tests, ultrasound, CT and MRI scan as well as fibro-scans, liver biopsies, and endoscopies.

Dr. Monga said there are no particular statistics on how many Cambodians are affected by this disease. However, the majority of issues in Asian countries are due to a high alcohol intake among other factors. He added that one should not take any kind of supplements for the body, but maintain a healthy diet – intake lots of fruit, vegetables, and fish, take care of cholesterol, and exercise properly.

He said Cambodia and South East Asia mostly suffer from Hepatitis B and C, and the main cause is drug and alcohol abuse. He does not have actual figures for Cambodia, however, he has seen a lot of Cambodian patients who traveled to Singapore for a check-up. “Liver diseases can also lead to heart and kidney problems as well as damaging other parts of the body because the liver is linked to every part of the body. I request all the audience and Cambodians to please go and see a doctor and do a simple blood test to know about your liver condition and intake minimum alcohol,” he added.

This event took place at Rosewood Phnom Penh on January 30. The session started at 10.45 am and continued until 12pm followed by a question and answer session. Around 20 people attended the event, the majority from Prince Bank, as SSMC had previously done two events with Prince Bank where they jointly invited guests. Around 10 of the attendees were their premium banking customers.

Sing-Specialists Medical Centre (SSMC) is bringing Singaporean healthcare standards to patients and their loved ones at affordable prices. They have an international medical team, comprised of experienced doctors from Singapore and Malaysia, who are supported by a competent team of well-trained foreign and local nurses.

Holistic Health Screening

As a one-stop medical centre, SSMC provides a comprehensive range of health screening packages for all ages and general health conditions. For patients who require a more tailored approach, they also provide customised screening for heart, liver and kidney health.

SSMC has some of the most advanced Philips Healthcare imaging equipment and their radiology centre is managed by Radlink Singapore – Singapore’s leading private diagnostic and molecular imaging service provider.

They strive to provide a 24-to-48-hour turn-around time for consultations and all their radiology scans are sent to Singapore for clinical interpretation – providing the right results in a timely, safe and comfortable environment.

“We aim to provide efficient yet affordable care to our patients,” says Peter Ng Meng Cheng, Chairman of SSMC. “True to the Singapore brand and culture, SSMC values our patients’ health as well as their time.”

Renal Dialysis Centre

The SSMC Renal Dialysis Clinic was established by Dr Stephen Chew and Dr Ho Chee Kun from Aegis Medical Care, who have both been engaged in the care of patients with kidney diseases for more than 25 years and manage 11 dialysis clinics in Singapore.

As a first of its kind in Cambodia, the SSMC Renal Dialysis Clinic is fitted with the world’s leading hemodialysis machines from Gambro Baxter International. The local clinical team has also been trained by Dr Chew and Dr Ho to provide the same high level of quality dialysis care services in SSMC.

“Our dialysis machines are extremely important as they are part of the care for our patients,” explains Dr Chew. “We are very stringent about the quality of water used, and therefore are using the latest reverse osmosis machines to treat our water supply in SSMC.”

SSMC currently has comprehensive yet flexible dialysis packages to support the needs of patients requiring hemodialysis and chronic renal care in Cambodia.

Sing-Specialists Medical Centre (SSMC) is a new medical facility in Phnom Penh offering medical services to the community since its opening in September 2020. SSMC aims to build trust with patients by having qualified clinicians to achieve the best health outcomes, giving quality care by having modern equipment and providing personalized healthcare services for patients and their families.

SSMC is a one-stop medical center providing advanced and fully equipped radiology diagnostics, general medical advice for both acute and chronic conditions, and specialized holistic services for kidney and heart patients. Our general practitioners (GPs) provide primary, comprehensive, and continuing medical care for patients in the community.

Our services include:

• Acute and chronic disease management such as diabetes, hypertension and high cholesterol
• Lifestyle and weight management
• Men’s health such as erectile dysfunction and prostate disorders
• Women’s health such as breast examination, Pap smear and HPV screening
• Children’s health such as child vaccination and developmental assessment
• Executive and pre-employment health screening
• Minor surgical procedures and wound care
• Specialized cardiac screening and diagnostics

We also provide specialized hemodialysis facilities for outpatients with chronic or acute chronic renal failure requiring treatment.

Having our foundations built on longstanding relationships with Singapore public and private hospitals, SSMC is also the official Representative of Singapore Parkway Pantai Group of Hospitals, such as Mt. Elizabeth Hospitals and Gleneagles Hospital in Singapore. This means, SSMC can offer the most direct fast-track access to more than 2,500 medical specialists in Singapore, when necessary and required by patients.

SSMC sees the importance of improving the medical excellence of Cambodian doctors, nurses, and allied health workers overtime. Together with local partners, SSMC wants to create opportunities for upskilling of the local medical workforce at all levels. This would include advanced training and fellowships for Cambodian allied professionals and specialists with reputable Singapore and other international medical institutions. Since the beginning of 2019, Parkway Hospitals Singapore and SSMC have been organizing Continuous Medical Education (CME) sessions for medical doctors in Cambodia to share knowledge and experience with fellow and overseas medical specialists.

Besides sharing medical professional knowledge, SSMC also organizes free public health talks regularly with medical experts from Singapore, educating the public more about preventive and pro-active health care. More importantly, SSMC wishes to empower patients with information about health and well-being, improving their quality of life and managing diseases better. With the vision of nurturing more healthcare professionals and being able to detect health issues for patients early through preventive actions and proactive healthcare, SSMC works hard to be the healthcare partner of choice for individuals and the community-enhancing better and healthier living.