In the midst of a very busy Intensive Care Unit at Kantha Bopha’s main campus in Phnom Penh on Wednesday afternoon, 11-month-old Chin Brospou was fighting for his life as doctors monitored him in their continued efforts to save him.

The infant lay in a hospital bed with a catheter hooked to his tiny body to drain air from the pleura of his lungs. Only his soft cries of agony could be heard as his small, motionless body rested on his right side, partly covered with a red blanket.

The boy was also hooked to oxygen to help him breathe, and was getting antibiotics through an intravenous infusion. His mother, Huy Sreymom, 33, from Svay Rieng province, sat on his bedside, comforting him before she began to breastfeed him.

The boy had been in the ICU for the past 10 days after being admitted with severe pneumonia. After doctors conducted a blood test, they discovered a bacterium called pseudomallei in the boy’s blood and lungs, Dr Chham Sary, head of the ICU 1, explained.

It’s possible to treat the disease with the right antibiotics, but only one is working for Brospou, and his case is severe. These kinds of cases are common at the hospital, with two fatal cases this year, so far, Sary said.

“The infection has spread over his lungs,” Sary said, holding up an X-ray, where even to the untrained eye it was apparent that the bacterium had wreaked havoc on the organs. “I hope the child will recover in two to three weeks.”

“Without treatment, this child would have passed away,” Dr Denis Laurent, Kantha Bopha’s deputy director, interrupted as doctors hovered over the boy’s bed.

The infant’s treatment is being provided free of cost, in part, thanks to numerous donations from people in Switzerland, which help run the Kantha Bopha Children’s Hospitals in Phnom Penh and Siem Reap.

Doctors treat an emergency case on Wednesday afternoon at Kantha Bopha hospital. The free of cost children's hospital faces an uncertain future as the comes under government administration.Sahiba Chawdhary

Since prominent Swiss-born Doctor Beat Richner founded the hospitals 25 years ago, the facilities have provided treatment to nearly 18 million sick children, according to the hospitals’ statistics. The hospitals raise 85 to 90 percent of their $42 million annual budget through private donations, mostly from Switzerland.

However, Richner stepped down in March after more than two decades of managing the hospitals due to a serious illness, and while donations haven’t dipped yet, there are concerns that without his presence, they could. Richner is now receiving treatment at his home in Switzerland, but his condition remains serious, Laurent added.

Recent comments from Prime Minister Hun Sen calling on the government to ensure Kantha Bopha’s continued operations came as some relief, but with the hospital now coming under the control of a government long criticised for its substandard health care system, some – including some mothers with children being treated at the hospitals – remained sceptical that Kantha Bopha can continue to operate at the same level.

During the first six months of this year, the hospitals recorded $7.7 million in private donations from Switzerland, compared to $7.4 million during the first six months in 2016, according to Laurent.

“If the donations stop, we’ll have enough [funding] for two years,” he added. “The only concern with the absence of Dr Beat Richner is that we don’t know if we will get the same donations in Switzerland.”

During a recent speech, Hun Sen asked the Ministry of Economy and Finance and the Ministry of Health to seek ways to keep the hospitals running, even if outside funding dries up.

“We have to ensure the sustainability of Kantha Bopha, with good quality, service and principles,” he said. “If we don’t have the funds from Switzerland or other partners, make sure the hospitals still operate as usual. We have the ability to do this and help our children.”

Laurent said the pledge was very important for the hospitals, adding that hospital officials also met with the relevant ministries in March to explain the situation.

“They assured everyone that Kantha Bopha will not shut down,” he said. “For the government, it is not easy to find $40 million for Kantha Bopha, but it’s not impossible.”

Several officials at the Ministry of Economy and Finance declined to comment and requested that an official letter request be submitted to the ministry for comment, while others referred questions to Secretary of State Nguon Sokha, who heads an inter-ministerial committee established last year to prepare for the government takeover of the hospitals.

When reached for comment on Thursday, Sokha also declined to comment. Health Minister Mam Bunheng, meanwhile, referred questions to spokeswoman Or Vannadine, who couldn’t be reached for comment.

But Laurent remained optimistic. He said the government has kept its promises of increasing its contributions for the hospitals in the past, most recently in the form of a $2 donation from every ticket sale at the Angkor Archaeological Park.

Laurent said those donations had already yielded $2 million this year, so far.

Cambodians are also stepping up their donations, he added, with some $4,200 coming in on Wednesday morning, alone, he said. A large part of that donation came from a businessman who chose to take his daughter to the Kantha Bopha hospital for treatment because he trusted the doctors.

The hospitals employ some 2,400 people, with doctors earning a monthly salary of $1,500, and nurses earning $600, Laurent said.

Doctors and nurses dressed in white on Wednesday afternoon walked back and forth in the ICU attending to other children, who just like 11-month-old Brospou, were seriously ill.

Dr Som Saman, who heads the Outpatient Department, said Kantha Bopha’s success was grounded in the trust it had earned over the years. “We try our best,” he said. “This is the way our hospitals can stand.”

But some mothers on Wednesday wondered whether that would change with the government takeover.

Hun Narin, 31, of Svay Rieng, brought her 6-month-old boy, Lim Sopheaksda, to be treated at Kantha Bopha. She was worried that if the government fully funded the hospitals, they wouldn’t run as smoothly and the quality of care would decline.

But, she said, “If they do [maintain the quality], I would be happy.” Srey Ream, 26, the mother of an 8-month-old, said she hoped the government would shoulder the funding burden. If it didn’t, she said, it would be a great loss for Cambodia.

“It will truly affect [people], especially the rural, poor Cambodians, like me, who cannot afford medication when my child is seriously sick,” she said.

Meanwhile, Sreymom, the 11-month-old’s mother, said she was relieved that her child’s long hospital stay at the ICU wouldn’t result in costly medical bills.

“I’m very happy when I can treat my child without any expenses,” she said, adding that she trusted the doctors attending to her child.

A Kantha Bopha Hospital staffer provides free medicines to mothers standing in queue with prescriptions for their children.Sahiba Chawdhary

But Chum Sopha, executive director of the NGO Health and Development Alliance, said he had several questions and concerns regarding Kantha’s Bopha’s situation, as did others he’d spoken to.

Sopha questioned whether the government could actually come up with the millions it takes to run the hospitals annually, and whether it would keep the same management, staff and structure.

If staff are replaced with those working at other public hospitals, he said, Kantha Bopha would become just like any other state hospital.

“When the government is involved, there will be corruption, and when there is corruption, the quality might go down,” he said. However, “if we keep the same people, the same management, maybe it will [maintain] the same quality”, he added.

Laurent said that while he can “understand the concerns” of Cambodians over the hospitals’ fate, he maintained that if the government was to increase its financial contributions, or if the hospitals became fully funded by the government, Kantha Bopha would maintain the same system and quality of care.

“They don’t want to take [Kantha Bopha], they want to keep Kantha Bopha,” he said. “I’m sure the government doesn’t want to change the system.”

Additional reporting by Touch Sokha