The Kien Khleang Center (KKLRC)
The Kien Khleang Leprosy Rehabilitation Center (KKLRC) has a capacity of 50 beds and is located in Phnom Penh, Cambodia. KKLRC is at the heart of CIOMAL’s project and has been recognized as the main center of excellence for the treatment of leprosy in the whole country. In addition to free healthcare for people affected by leprosy and its complications, KKLRC offers physiotherapy, dermatology and reconstructive surgery services.
In its premises built on a land provided by the Ministry of Social Affairs on the outskirts of Phnom Penh, KKLRC carries out – in addition to hospital care – teaching and training activities for patients, university students and health professionals.
The center also has an operating room, a treatment room, a pharmacy and a small laboratory. It is located next to three other organizations supporting people with disabilities: Rose Charities Cambodia (ophthalmology), Children Surgical Centre, and most notably, the Veteran International Cambodia Foundation, which manufactures prostheses. CIOMAL funds 80% of the position of a prosthetist for the leprosy affected patients requiring one.
Free medical care
KKLRC provides medical care for leprosy as well as adverse reactions caused by the disease and its treatment. The medical team also makes sure that patients take the multi-drug therapy and ensure patient follow-up. All of the medical and rehabilitation services at KKLRC are free, including the costs of transportation and stay at the center.
The large majority of patients are from rural and poor social backgrounds. The costs of transportation to KKLRC and their stay at the center represent for them a significant loss of income. That is also the case of ambulatory consultations for the patients being followed up for leprosy treatment or for those coming for a dermatology consultation.
The medical-surgical rehabilitation of people affected by complications due to leprosy includes the following aspects: adverse reaction to antibiotics, infection of the peripheral nerves resulting in a loss of sensitivity and mobility of the extremities and an inability to close one’s eyelids, infected ulcers.
Since the start of the project, CIOMAL has received regular visits from a Vietnamese medical team led by Dr. Khoa, who comes to perform surgeries, and Dr. Ry Sina, a Cambodian surgeon trained in France. The latter performs surgeries in Phnom Penh hospitals – plastic and reconstructive surgery – and has also come to KKLRC to operate on patients affected by leprosy.
The ability to perform reconstructive surgery on site further strengthens the reputation of KKLRC as a center of excellence covering all the interventions necessary in the control and management of leprosy cases. The average hospital stay is about 50 days and the patients who received surgery enjoy at least 3 weeks of physiotherapy.
During their hospital stay, patients follow training on disability self-management as well as literacy and even IT classes. They take part in social activities, World Leprosy Day and the International Day of Persons with Disabilities and have the opportunity to build professional skills.
As each patient’s disability and needs are different, the KKLRC staff makes sure that every person receives personalized care. The center also distributes prostheses, adapted and protective footwear, gloves and sunglasses. Physiotherapy sessions are also provided to help patients recover limb mobility or to prepare them before and after surgery.
In 2017, KKLRC carried out 630 leprosy consultations for outpatients which is 10% more then in year 2016; 36 new leprosy cases were detected among leprosy consultation patients (leprosy types: PB=12, MB=24, DG I=5, DG II=15) and 5722 consultations for dermatology outpatients was carried out which is 30% more then in year 2016. In total, 6388 people received KKLRC consultation services which is 27% more than the year before, among these 2190 male & 2465 female & 1733 children below 15 years.
159 people affected with leprosy (PAL) were admitted and treated in KKLRC for different reasons (hospitalization services). We admitted and treated 23 PAL because of reaction, 125 PAL for ulcer, and 11 PAL that received reconstructive surgeries.
The Kien Khleang Center includes a dermatology specialist trained in Vietnam, Dr. Molyva. KKLRC is therefore able to offer all of Phnom Penh’s population a consultation for patients with dermatological issues unrelated to leprosy, i.e. 76% of consultations.
Generalizing such consultations for any skin problems allows for the detection of potential leprosy cases in the context of a non-stigmatizing consultation since it is not specific to leprosy. Facilitating access to a dermatology consultation is therefore an effective means to contribute to the detection of leprosy. Such consultations also offer the opportunity to disseminate information about the disease to the patients and their relatives.
Orthopedic Shoe and Sandal Technology Workshop
Kien Khleang Leprosy Rehabilitation Center (KKLRC) has a new orthopedic shoe and sandal workshop for disable persons affected by leprosy in Cambodia. The orthopedic shoe technologist has been trained at Vietcot Training Center for Orthopedic Technologists in Hanoi, Vietnam.
The goal of the orthopedic shoe and sandal workshop in KKLRC is to provide to people affected by leprosy orthopedic shoes and sandals in terms to prevent further foot deformity, to protect foot ulcer, and to correct the foot that has serious deformations. The orthopedic shoes and sandals are for different types of foot problems such as: post-polio, club foot, pes planus, pes calcaneus, hallux valgus, pes cava’s, pump bumb, plantar fasciitis, leg lenght discrepancy, drop foot, amputated foot, diabetic foot. Types of shoes that can be done in the workshop are: instep shoes, Oxford shoes, Derby shoes, temporary shoes, boots, and sandals. Insole shoes and special shoes are made for ulcer protection, modified market shoes, anti-drop foot shoes, and mild shoes are made for foot deformities.
The orthopedic shoe workshop is well equipped with machines such as sending, skiving, pillow pressure and vacuum machine to provide the quality product to persons affected by leprosy in need for orthopedic shoes and sandals.
The Battambang Foot Care Center
Located in a hospital complex in the province of Battambang, the center was created by the Order of Malta in 1994, and was renovated by CIOMAL in 2011, with an extension of the buildings funded by the Order of Malta-France in 2013. This center has become an independent clinic since 2013, a Foot Care Center that also treats diabetic patients.