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Inquiry Submission By Trip751610

Process for Rabies vaccine in Phnom Penh?s Pasteur Institute

During my trip in Cambodia, early 2018, I got scratched by a monkey (in a temple close to Kampong Cham) and went to the Pasteur Institute in Phnom Penh the next day.

As it was for me quite difficult to go through the admin process (No English instructions, quite overwhelming with many patients, not understanding why people were queuing in different places), I hope that I can help other foreigners who will be seeking medical treatment.

I separated this article in 2 parts, first the actual and factual process and in the second part, my own experience as well as advices.

Part 1 – Admin process:

? Go to the rabies center/annex of the Pasteur institute (which is next to Calmette Hospital).

? When you arrive you will see: the main counter with a door on the right and a door on the left and 2 more doors on the other side of the room, facing the counter

? There are 5 places where people queue:

1. The main counter where people ask general questions and where you can ask for an English form to fill (see Part 2)

2. The door on the right (when facing the counter) where you have to queue to see the doctor, give your form and explain how you got injured, by which animal and if you had a pre vaccination already. Know in advance if you need a tetanos vaccine as well. The doctor will then proceed with the paperwork

3. The door on the left where you retrieve your paperwork (keep them safe as you will need them for the follow up injections) and where they might ask you more questions to fill their database and tell you how much you have to pay (I waited 50 min between step 2 and 3)

4. The main building where you need to go to pay for the vaccine. Walk out from the back to the main building and you will see on the left an entrance. Walk past the waiting hall, turn right and there is a small room there with a few nurses. 12 dollars for vaccine (for 4 shots at day 0, 3, 7, 30) and 37 dollars for the immunoglobulin at day 0, if you need it

5. When you have paid, go back to step 3 and wait for them to give you a plastic card to see the doctor for the injection

6. The doors facing the counter where those who have received the plastic card can queue to wait for the injections (door 2 or door 3)

I arrived at 11:30 and left at 15:30. Part 2 will explain why.

For the follow up injections at day 3, 7 and 30, the process is very quick. Go straight to the left door, give them your papers, wait in line (between 1min and 15min depending on how busy they are), go see the doctor.

Part 2 – Advices and personal experience:

? For my registration, I arrived at 11:30 and I have been told to come back at 2pm as the registration is closed during lunch time (no information on the website)

? If you do arrive around noon, do not come back at 2pm but at 1pm. In my case, the registration resumed at 1:15 and by 2 the place was crowded

? For the follow up injections, they do seem to process your papers during lunch time. The break time apparently only applies to first time registrations at day 0

? You need to fill a form before step 2. Dont start queuing without one. Do proactively ask a form in English if you don?t read Khmer. Don?t assume it?s normal that they didnt give you one at the reception. The sad thing is that in the end I went back to the same counter asking the same staff an English form, wasting their time and my time

? If you need it, make sure to ask for immunoglobulin during step 2, as I had to go through the process twice since they forgot about it, even if they asked me if I had a pre vaccination

? Know your hotel address, they insisted that I write one down to put in their database

? Have preferably a Cambodian cell phone as they wanted to write a Cambodian number in the database (pre paid sim cards available easily everywhere in the country)

? Be polite but firm when queuing as other patients will cut the line in front of you

? The syringes are pre-prepared. In my case the doctor had it in his hand with the cap removed already when I entered the room, ready to inject me. I know there are really many people there, so they must do things quickly. I was however a bit nervous as I couldn?t know if that was a sterilized needle. I thought the doctor would prepare the dose in front of the patient

? Be patient. The whole process was slow as there were only 2 staff after lunch doing the medical visit + managing the database/admin + answering random questions at the main counter+ issuing/printing your papers + dealing with accounting. A 3rd person came after a while but still, they are basically understaffed

? The doctor I saw for the injection took some time to ask me how I felt and if I had questions. If you do have medical-related questions, this is the moment during the whole process to ask them, don?t miss it

? Most importantly: If you have a question or any doubt during the process, don?t hesitate to ask and ask again. Don?t assume that the staff will anticipate problems and pro actively inform you.

I wish there would be big panels in Khmer and English at the waiting area explaining clearly each step. There would be already much less time wasted in answering random questions from patients and the staff could focus on their actual work

? They seem to sometimes close on weekdays in the afternoon

? I tried to call 10 times various numbers of the institute while still in the countryside. Only 1 time did someone answer, where a local person gave me the number of a foreign guy who in the end didn?t even understand why his number was given to me in the first place…

? The Pasteur institute is I believe, doing a job that is very important to the local society and to be fair, I was during my 4 visits the only foreigner, so tourists who get confused and don?t understand how the local system works are not exactly a priority, which is understandable

? And last but not least, regarding monkeys, DO NOT have anything that they might be curious about (shiny glasses, food, drinks or even your smartphone). In my case, the monkey was not aggressive and just hold my arm, but still I had some superficial wounds