Lang Sopheap's hand is permanently clenched from the terrible petrol burns he suffered to much of his body in 2004. After 10 operations, the 26-year-old has recovered, but the family will suffer forever from the accident, which happened while he was repairing his motorcycle. To raise the US$3,000 demanded by the Kossomak Hospital in Phnom Penh for treatment, his family had to sell their rice field and everything of value, including the family motorcycle. Now they have nothing and must eke out a living labouring in a rented field. And the treatment offered by the hospital? Despite the relative fortune handed over, doctors dressed the wounds and gave him medicine until the family's money ran out. He was then sent to the Children's Surgical Centre run by Jim Gollogly, where he has since had 10 operations free of charge and is now recovering, but is still without a job. For Dr Gollogly, or Jim as the no-nonsense orthopaedic surgeon prefers, Mr Sopheap's story is all too familiar. In Cambodia, according to the World Health Organisation, 40 per cent of the landless poor can trace their plights directly back to family medical bills. 'Something happens, and you will do whatever you can to get health care,' Dr Gollogly says while guiding three local surgeons through an operation on a 14-year-old girl's leg. 'If you have to sell your block of land to the guy next door who will give you half the value but cash now, that is what you are going to do. And chances are, they will pay their money and not get the treatment. Then they come to us.' Dr Gollogly runs the Children's Surgical Centre in Phnom Penh's Kien Khleang National Rehabilitation Centre. It was set up in a rambling old government building on the outskirts of the capital. Next door is a leprosy treatment centre, and across the road is a Japanese-sponsored rehabilitation centre for the disabled. At 8am on Thursday there were at least 100 prospective patients waiting quietly in the shade outside the hospital. Many had come from remote corners of this impoverished nation and had only a couple of days to spare from their duties back in the village to seek treatment for themselves or a family member. The wards were full of patients - from babies to the elderly - with a variety of conditions they hope they would be free from once they have visited the centre. Dr Gollogly set up the centre in 1998. Bored with western medicine, and with a grown family and his marriage over, he initially intended to operate on those with injuries from landmines. As Dr Gollogly puts it, there were plenty of surgeons prepared to saw off a leg, but no one to deal with the horrific injuries to other parts of the body. However, following an earlier visit with the Red Cross in 1992, he knew demands for surgery stretched much further than just landmine victims and the organisation was started with the intention they would 'do anything we thought we could do'. Dr Gollogly initially threw himself into small, cheap operations - such as fixing cataracts and cleft lips. But as the years went by and the word spread, the operations have grown more complicated. He now trains many Cambodian doctors in advanced surgical techniques, using equipment largely donated from hospitals in the west. Dr Gollogly estimates that in the past 10 years, the hospital has performed about 30,000 operations. Last year, the cost of running their operation was US$360,000, but six months into 2007, and they have already spent that amount and expect to spend about US$500,000 by the end of the year as the number and variety of procedures grows. As well as orthopaedics, the centre specialises in facial reconstructive surgery, eye surgery, plastic and burn surgery and training for Cambodian and international doctors and medical students. A particularly brutal area which they have begun treating is acid burns, a common form of attack by jealous wives or angry husbands. Dr Gollogly is determined to show that surgery can be done as cheaply in the developing world as treating infectious diseases. Recently they received a number of Ilizarov devices, designed by a Russian doctor in 1938, which allows a patient's leg which is shorter than the other to be slowly increased to its normal size. The pins which are drilled into the bone are acquired locally for just a few dollars and each day the patient tightens the bolts. They also have some outside help. Last week, a team of doctors from the US performed eye surgery in the southern city of Kampot. There is also an eye surgeon from Texas who visits every year to perform operations. Last week the Igor's Group in Hong Kong handed over a cheque for more than HK$2.3 million, which will provide funding for nearly a year's operations at the centre. Igor's, which has 26 restaurants, funds the charity with a HK$1 per meal subsidy on the end of each bill as well as regular auctions and events led by the company's charismatic founder, Chris Lenz. While not all the operations performed at the centre are essential, the improvements they make to the lives of not only the patients but the families are immense. On a tour of the facility there is the grandmother blinded by with cataracts - once they are removed, her grandchild would be free to go to school rather than spending the day guiding her around. There is the 16-year-old girl with her leg bent at 90 degrees; once fixed she will become a much more attractive marriage proposition. And then there is the elderly woman who has just had a treatment for the hip she dislocated six months ago when she fell off a buffalo. Once it heals, she will be able to return to the rice field and help her family with the harvest. Many of these patients share similar stories of horrendous bills accumulated at local hospitals before arriving at Dr Gollogly's surgical centre. Dr Gollogly says the problem will continue as long as the government refuses to properly fund health care. He is pragmatic about the solution - the costs are largely going to have to be borne by the west for the immediate future. 'People need health care. So you have to have some level of health care, and the government doesn't want to pay for it,' he says. 'We're essentially paying, and we have to. It's a question of social justice. But have you ever seen so many Lexuses in a country? Probably more than there are in Hong Kong. Maybe the generals should stop having Lexuses and put some money into health care. But this is just not going to happen.' Dr Gollogly was born in Britain but has practised in Australia, South Africa, Canada and the US. His passion is medicine, and Cambodia allows him to pursue this and see the results. 'Everybody here needs an operation,' he says. 'In the US or Hong Kong, a lot of the surgery is done for money - you could get by some other way. If you don't fix it in the US, there is someone else next to you who can fix it. Here I'm the only certified orthopaedic surgeon in the country. On a day-to-day basis, I can fix those people waiting down there. If I don't do it, it isn't going to get done. 'I don't need to be there for surgery, but I need to make a decision as to what is going to happen and who is going to do it.' His red complexion and snow-white hair and beard belie his age of 63. His energy, as he bounds through the centre asking questions and demanding answers about whether treatment procedures are being correctly followed, suggests he has no intention of retiring. 'I don't particularly intend to retire. I'll die with my boots on. Maybe if I get too old to run around, someone will point me to an office somewhere,' he says. But he is making plans to ensure the centre can continue even if he is not around to check up on everyone. There are plans for a regular rotation of US Army medics who can explain to the locals what needs to be done without Dr Gollogly, making sure everything is going correctly. 'I need to go around and make sure that everything is going on properly. Turn around and make sure what you want done, gets done without me getting too mad. There will always be someone here who can take over.'
