Healthcare Cambodia Health & Safety CamboGuide

Health & Safety

Your guide to keeping safe and well on the road in Cambodia.

Please see our separate page for regulations and measures regarding Covid-19 / coronavirus, always updated with the latest information.

Healthcare facilities are on the up in Cambodia, but access to effective medical-treatment facilities are limited to the major cities, outside of which prevalence of tropical diseases and poor sanitation make health a greater concern than in other parts of Southeast Asia.

If you find yourself outside major hubs feeling particularly unwell, consult a doctor at a private clinic before visiting hospital- state hospitals in rural areas are pretty primitive so diagnosis can be hit and miss. If in dire need of medical attention or in case of emergency, proceed to Phnom Penh or Siem Reap. Pharmaceuticals can be bought over the counter, with most pharmacies in the larger towns remarkably well stocked, though stick to reputable chains and only take antibiotics as prescribed, ideally by a qualified medical professional.

While the potential dangers can seem overwhelming, few travellers experience anything more than an upset stomach, so long as proper precautions to safeguard health are taken. Our guide is here to help you circumnavigate the risks.

Do I need travel/health insurance when travelling in Cambodia?

Do not visit Cambodia without health insurance. For a cost equivalent to a bottle of beer per day of your trip, an insurance policy will cover medical evacuation to international standard medical facilities elsewhere should the need arise.

  • As with travel to any country, taking out a travel insurance policy, which covers theft, loss, accidents and medical problems, is highly recommended.
  • Many travellers believe that medical care in Cambodia is cheap and are tempted not to get insurance and pay out of pocket if/when the need arises. Be aware that if you require surgery and overnight stays in certified healthcare facilities, costs can quickly mount up to thousands of dollars and if you need to leave the country for care, you may be expected to pay upwards of $20,000 for medical evacuation upfront. Therefore, having insurance that includes “medevac” coverage, which guarantees access to treatment relevant to your particular injury in your home country, or a suitable regional alternative (depending on the specific terms of your insurance) is highly recommended. Worth keeping in mind is that, in addition to covering medical costs, cancelled trips, delayed flights and lost baggage, travel insurance may cover flying a partner or parent out to Cambodia to be with you should you end up in hospital.
  • Phnom Penh hosts a number of representative offices of regional hospitals, including the Bumrungrad Hospital and Bangkok Hospital in Bangkok, the Franco-Vietnamese (FV) Hospital in Ho Chi Minh City, as well as Sime Darby and Mahkota Medical Center in Malaysia. These sister hospitals can arrange appointments as well as transport, including Medevac, from Cambodia.
  • Several regional specific plans are available – with much lower prices than worldwide coverage policies due to the relative costs of health care.
  • Note that travel insurance is not as comprehensive as health insurance.
  • If you plan to do any adventure sports, such as scuba diving, motorcycling, dirt biking, zip lining, or even trekking, check you are fully covered under your policy. If you succumb to Cambodia’s irresistible charm and decide to extend your stay- be sure that you can extend your policy while in the Kingdom- many plans do not allow for extension so do your research beforehand.
  • Be advised that payment for emergency care is required in advance so without a credit card, you are very unlikely to receive care without insurance.

What vaccinations should I get before travelling to Cambodia?

Please see our separate page for regulations and measures related to Covid-19 / coronavirus, always updated with the latest information.

Visitors should be up to date with primary courses and boosters of routine vaccines before coming to Cambodia. Plan ahead- some vaccinations require more than one shot spread over several weeks or months for complete coverage, while others cannot be administered at the same time. Discuss your needs with your doctor, record all vaccinations on an International Certificate of Vaccination and carry this with you when travelling in Cambodia.

Primary courses and routine vaccines include: measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and a yearly flu shot.

Besides these, the following are usually advised:

  • Hepatitis A and typhoid vaccines are prudent in Cambodia because the viruses are primarily contracted through contaminated food or water throughout the country, with elevated risk in rural areas and for those who like to sample local food products. A Hepatitis A vaccine provides long-term immunity after the first shot and a booster at six to 12 months. A combined Hepatitus A and B vaccine are also available, requiring three injections over a six-month period.

Other vaccines to consider:

  • Cholera: contracted through contaminated food or water, the disease is common during floods and following natural disasters in areas with poor sanitation and lack of clean drinking water. Travellers maintaining a good standard of hygiene and taking basic precautions with food and water they consume are unlikely to contract the disease.
  • Hepatitis B is contracted through sexual contact, contaminated needles, and infected blood products. Travellers staying in areas without proper sanitation- especially for extended periods of time- and children may be exposed to the virus, through for example, cuts and scrapes on the hands and feet. This vaccine is recommended if you might have sex with a new partner, get a tattoo or piercing, or have any medical procedure. For complete coverage, three injections are required, with a booster at 12 months.
  • Japanese encephalitis: spread through infected mosquitoes which breed in rice paddies and bite mainly between dusk and dawn. Risk is higher for long stay travellers to rural, especially agricultural and forested, areas- vaccines are worth considering if you plan to do any trekking.
  • Rabies: spread through the saliva of an infected animal, primarily through bites, scratches or licks on broken skin from rabid dogs. Even when pre-exposure vaccine has been received, urgent medical attention should be sought by anyone after any animal bite. Risk is elevated for: travellers going to remote areas who may be unable to access appropriate treatment in the event of a bite, those at higher risk of contact with animals, and children. Sihanoukville has seen a rise in the incidence of rabies cases in recent times. Beware of dogs acting strangely around beach areas and do not approach them. If you are bitten, see a doctor immediately.

Medical Kit

Although there are a growing number of effective medical treatment facilities in the country, these are concentrated in the major cities, so you may like to consider including the following items in your travel medical kit, especially if you will be travelling to areas outside Phnom Penh and Siem Reap.

  • aspirin or paracetamol – for pain and/or fever
  • ibuprofen- for inflammation
  • antihistamine – for allergies, or to lessen the itch from insect bites or stings
  • cold and flu tablets, throat lozenges and nasal decongestant to combat dusty, dry conditions
  • multivitamins – useful for long trips, when dietary vitamin intake may be inadequate
  • loperamide or diphenoxylate – ‘blockers’ for diarrhoea
  • rehydration salts – to prevent dehydration, which may arise during bouts of diarrhoea
  • insect repellent (with DEET 30%+), sunscreen (SPF 30+), lip balm and eye drops, especially for sensitive eyes
  • aloe vera gel – to ease irritation from sunburn
  • antifungal cream or powder – for fungal skin infections and thrush, which thrive in humid conditions
  • antiseptic (ie. povidone-iodine) – for cuts and scrapes
  • zinc oxide ointment- for minor skin irritations
  • bandages, plasters and other wound dressings (due to humidity and dust, these must be changed regularly and wounds thoroughly cleaned)
  • water-purification tablets or iodine
  • a sterile kit (sealed medical kit containing syringes and needles) is highly recommended, as Cambodia has potential medical-hygiene issues. Beware, you need to put these in your carry-on luggage.

Infectious diseases

Traveller’s diarrhoea
Simple dietary or atmospheric changes can bring on a mild bout of diarrhoea even but one or two rushed trips to the toilet are not necessarily a cause for concern in healthy individuals. Long-stay visitors can expect a bout at some point.

Dehydration is the main risk with diarrhoea, especially in children and the elderly. Fluid replacement is the golden rule in cases of diarrhoea, and rehydration salts are very useful; add them to boiled or bottled water. Stick to a bland low-fat diet of boiled foods, such as white rice.

Gut paralysing drugs like Loperamide may bring relief by treating the symptoms but are not curative and should be used only as a last resort if you have no access to toilets are must travel.

Typhoid
Caused by ingesting contaminated water and food, typhoid fever is a dangerous gut infection. Those presenting symptoms must seek medical attention.

Symptoms:

  • In its early stages, sufferers may feel they have a bad cold or flu coming on, with headaches, body aches and a fever that rises a little each day until it reaches or exceeds around 40°C (104°F). This be accompanied by vomiting, abdominal pain, diarrhoea or constipation.
  • High fever continues into the second week, possibly with a few pink spots appearing on the body, in addition to trembling, delirium, weakness, weight loss and dehydration.

HIV & AIDS
The prevalence of HIV/AIDS in Cambodia is amongst the highest in all of Asia. Transmitted through exposure to infected blood, blood products or body fluids, in Cambodia the virus is primarily spread through heterosexual transmission, most often in the sex trade.

The disease is often transmitted through sexual contact or dirty needles, so vaccinations, acupuncture, tattooing and body piercing can be potentially as dangerous as intravenous drug use.

Sexually Transmitted Infections (STIs)
Among these infections are gonorrhoea, herpes and syphilis, which can have adverse effects if left untreated, including infertility.

Symptoms

Be on the alert for sores, blisters or a rash around the genitals and discharges or pain when urinating, especially if engaging in high-risk behaviour. With some STIs, such as wart virus or chlamydia, symptoms may be less marked or not present at all, especially in women. Reliable condoms are widely available throughout urban areas of Cambodia, albeit in Asian sizes.

Hepatitis
Hepatitis has several types, with different routes of transmission, however all of them affect the liver.

Symptoms:
All forms of hepatitis exhibit:

  • fever
  • chills
  • headache
  • fatigue
  • feelings of weakness debilitation
  • aches and pains

followed by:

  • loss of appetite
  • nausea
  • vomiting
  • abdominal pain
  • dark urine
  • light-coloured faeces
  • jaundiced (yellow) skin
  • yellowing of the whites of the eyes

Hepatitis A and E are transmitted contaminated food or water. If you display symptoms, seek medical advice, but be aware that there is not much you can do besides resting, drinking lots of fluids, eating lightly and avoiding fatty foods.

Hepatitus B is universally widespread, having almost 300 million chronic carriers worldwide. Along with Hepatitus C and D, it is spread through contact with infected blood, blood products or body fluids, such as sexual contact, unsterilized needles and blood transfusions. Beware of hand-rolled cigarettes or ‘beedis’, often sealed using saliva.

Mosquito-borne diseases

Malaria
As in most tropical countries, Cambodia has a health burden when it comes to mosquito-borne diseases such as malaria and dengue fever. Transmission is most intense in areas with open water sources (especially stagnant freshwater) as mosquitoes lay their eggs in water, and depends upon climatic conditions such as rainfall patterns, temperature and humidity and as such rainy season (May-November) and the period which follows is high transmission season.

  • While malaria is not prevalent in Cambodia, it exists in some pockets and travellers are advised to take preventative measures throughout the country. Malaria is low risk in Phnom Penh and Siem Reap but there is a risk when in outlying rural, mountainous or jungle areas, with risk highest in the northeastern provinces of Preah Vihear, Kratie, Stung Treng, Mondulkiri, and Ratanakiri, with antimalarials (atovaquone/proguanil OR doxycycline OR mefloquine) usually advised for visiting travellers.
  • Drug-resistant malaria is prevalent around the Thai-Cambodia border so particular care should be taken by all visiting the area- see Prevention below. There is a quarantine enforced here if anyone shows a confirmed case of malaria. However, the Ministry of Health runs advanced malaria control programmes and across the rest of Cambodia, malaria can be vaccinated against.
  • For travellers, the World Health Organisation (WHO) recommends preventative treatment with chemoprophylaxis, which suppresses the blood stage of malaria infections. Not all doctors support use of antimalarial drugs if unnecessary due to their possible significant side effects – whatever your travel plans, take steps towards prevention.
  • Antimalarial drugs, are widely available in Cambodia but should always be purchased at certified pharmacies after consulting with a medical professional if to be used as a curative – different drugs treat different strains of the disease.

Dengue fever
Dengue fever is active across the country. There is only a small risk to travellers, except during epidemics, which normally occur during orafter the wet season (May-November). No vaccine currently exists for dengue fever, (recovery depends upon the health of the individual) which is carried by daytime mosquitoes, however most cases of dengue can be treated at clinics in Phnom Penh.

Symptoms:

  • sudden onset of high fever*
  • headaches
  • joint and muscle pains
  • nausea and vomiting

*A rash of small red spots appears three to four days after onset of fever.

  • Dengue-transmitting mosquitoes may also carry zika virus for which Cambodia is ranked as a moderate-risk country, and yellow fever, which is preventable via vaccinations.
  • According to the WHO, early diagnosis and treatment of malaria reduces disease, contributes to reduction of transmission, thus preventing deaths. The organisation recommends that “all cases of suspected malaria be confirmed using parasite-based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment.”
  • Dengue fever, malaria and influenza share many of the same signs, so if you are come down with a fever it’s worth getting a blood test to determine exactly what condition you have.
  • If you are presenting symptoms or are diagnosed with dengue fever, avoid aspirin- it is known to increase the risk of haemorrhaging.

Prevention

  • Doctors recommend covering up as much of the body as possible with long, light-coloured clothing (WHO), particulary at high risk times- between dusk and dawn for malaria and Japanese Encephalitis-transmitting mosquitoes and during the day for dengue, yellow-fever and zika-transmitting mosquitoes- and using mosquito repellents with 30%+ DEET content on exposed areas such as the feet and face.
  • Sleeping under intact mosquito nets is an effective way of preventing mosquito bites.

Intestinal Worms
Very common in rural Cambodia, the various worms have several transmission routes: tapeworms may be ingested in foods such as undercooked meat, whereas hooked worms enter through the skin- beware of freshwater in rivers, streams and lakes, particularly surrounding villages which have no access to sanitation. It is prudent to have a stool test when you return home to check for worms – if left untreated, parasites can cause the development of diseases such as schistosomiasis, also known as bilharzia.

Fungal Infections
Concentrated on the scalp, between the toes (athlete’s foot) or fingers, groin or on the body (ringworm), incidences of fungal infections are more common in hot and humid weather. To prevent such infections, wear loose comfortable comfortable clothes made from natural fibres like cotton, bamboo, linen or hemp, wash frequently and dry yourself thoroughly.

Environmental Hazards in Cambodia

Food
Those adventurous in their tastes while travelling should exercise caution in Cambodia due to poor sanitation and lack of refrigeration- better safe than sorry. Be especially careful when it comes to salads, vegetables and fruit- wash these with purified water and peel them wherever possible. Ice cream sold in the street (or elsewhere) may have melted and refrozen, thus harbouring bacteria. Avoid shellfish, such as mussels, oysters and clams, as well as undercooked meant, especially in the form of mince.

Tap water
Although declared safe for consumption after vigorous testing at water treatment plants, you can’t safely drink tap water due to potential contamination between plants and household taps.  Be especially caution of ice- usually produced in factories- reputable brands of bottled water, soft drinks, tea and coffee are usually fine but only drink from water containers with a serrated seal.

Heat exhaustion
Upon arrival: take time to adjust and adapt to high temperatures- increase your exposure to sun gradually, always avoiding midday heat where possible, drink sufficient hydrating liquids and refrain from activities which are excessively physically demanding. Prolonged periods of exposure to high tempeartures and insuffiencient fluids leaves you vulnerable to heat stroke- always carry plenty of water with you, especially if walking in exposed areas such as some of the temples. Symptoms of salt deficiency are: fatigue, lethargy, headaches, light-headedness and muscle cramps- rehydration salts are great on-the-spot but salt deficiency is best avoided by adding extra salt to your food.

Contact lenses
If you wear contact lenses, note that Cambodia is a very dusty country, which can be a great cause of irritation while travelling. Whilst normally bearable in cars, it might prove too much when travelling on motocycles or tuktuks, so pack a pair of glasses just in case.

Insect bites and stings
Bedbugs are found throughout the world but are fond of mattresses and bedding- be discerning about where you stay and look out for telltale signs- spots of blood on bedding or on nearby walls. Bedbugs leave itchy bites in neat rows, which may only present themselves 24 hours later. Aloe vera gel may help reduce itchiness.

Sandflies inhabit beaches across Southeast Asia and have been reported at sites within Cambodia. They inflict a nasty bite that is extremely itchy and is prone to infection. Use an antihistamine to bring down the irritation and, if you have to itch, do so with the palm of your hand not your nails  to reduce the chance of infection.

Leeches may be present in damp forest conditions, particularly following rainfall. If you plan to do any trekking, wear walking boots up to the ankle with full length trousers tucked into them, to avoid leeches latching on to exposed skin close to the ground. In general, when walking in any forested area, it is advisable to cover up as much as possible to reduce the incidence of mosquito bites (and so risk of malaria and dengue), skin irritation from contact with certain plants and sunburn.

Snakes
Cambodia is home to numerous snake species, some of them venomous. Forests are high-risk areas, especially following rainfall. Although it is rare to see snakes because they prefer to avoid humans, if disturbed whilst sleeping in the undergrowth, they may bite around the ankle or lower leg, and quickly slither away, making identification of the species extremely difficult. To minimise your risk of getting bitten, wear boots, socks and long trousers when walking through undergrowth.

Traditional Medicine
Thnam boran prevails in Cambodia, being especially popular in rural areas where it is practiced by kru Khmer (traditional medicine men) who often have more trust from locals than modern doctors and hospitals. Tree bark, roots, herbs and plants are boiled up and often administered as ‘cure alls.’ The selected botanicals may not be without merit, but are not a substitute for proven treatments of serious conditions like snake bites. Other “cures” or “tinctures” include the steeping of animal parts in wine or spirits for their supposed quasi-magical properties. These have yet to be proven by modern methods and drive the illegal trade in wildlife- be a responsible traveller and refuse bottles containing cobras, scorpions and the like.

Hospitals, clinics and pharmacies
For information on quality healthcare facilities in the country, see our Medical Care section. Be aware that there are and there are no ambulance services outside Phnom Penh.

Safety

Robbery and petty theft
In the run-up to major festivals such as P’chum Ben or Khmer New Year (Chaul Chnam Khmer), there is a marked increase in the number of robberies, particularly in urban centres such as Phnom Penh. 80% of the country’s  population is rural- Cambodians often move to the cities for work and return to their hometowns for festivities, in which they are expected to buy gifts for relatives, make offerings or pay off debts, and for some cash-strapped individuals, theft is a sure way to come by this money. Vigilance is advisable at all times, especially around roads and even more so at night. Take care not to flash your smartphone in public and do not take valuables out with you unnecessarily. If your lodgings have a safe, use it.

Crime & Violence
Hold-ups and drive-by theft by motorcycle are more common in Phnom Penh and Sihanoukville than anyone would like. Bag snatchings have been reported in these hubs- with handbags and shoulder bags a particularly target, as well as smartphones- do not use these when in transit. Walking or riding (especially alone) at night is less than ideal, especially in unlit areas or main urban arteries, where a quick getaway for thieves is ensured. When using tuk tuks and motocycles keep effects close – it is not unheard of for people to be dragged off motos after thieves grabbed their bags.

Don’t display valuables, especially in crowded places where pickpockets and bag snatchers operate. If accosted it’s best not to put up a fight – hand over valuables avoiding eye contact. There are worse things than losing your phone.

Should you have the misfortune to be robbed, be aware that police cannot always be relied upon for assistance as law enforcement is lacking. If you are the victim of a crime, contact your embassy or consulate right away. They can help you replace stolen passports, get medical attention and connect with the relevant police services.

Violence against foreigners happens very rare, but be aware of your surroundings, especially in crowded bars or nightclubs in Phnom Penh. If you cross wires with affluent young Khmers in such places, keep your cool and back down. Many carry guns and come with an entourage of bodyguards.

Road safety
The most dangerous place in Cambodia remains its highways. Reckless road use helps define the country as the “Wild East” of SE Asia for many and for good reason: the country’s roads are its biggest killer. Be wary of poor surface conditions (especially in wet season) and narrow streets; drivers of minivans and pickup trucks in a hurry often attempt risky overtaking.

At night, streets and vehicles are often unlit and traffic rules disregarded, helped no doubt by laissez faire drink driving and scarce police patrols. If you rent a motorcycle, be sure to wear a decent helmet (it’s the law after all). And use the lock provided or you can expect to cover the costs of a new model.

Cambodia has some of the best unspoilt forested areas in the region for trekking, but go with a guide and stick to well-worn trails – remote areas may still have landmines.

Western-style clinics are hard to come by, and there are no ambulance services outside Phnom Penh. Take extra care, and treat wounds immediately.

Mines, Mortars & Bombs
If you plan to go on any walks or treks in areas outside major cities, consider taking a guide and never stray from the marked path under any circumstances. Mines are concentrated along the Thai border but may also linger in northeastern regions, left over from American bombing campaign of the early 1970s and subsequent skirmishes. Never touch any unexploded ordnance you come across – keep your distance and contact the Cambodian Mine Action Centre (CMAC).

Scams
You may encounter a number of scams during your travels, especially in tourist hubs – most are fairly harmless, such as moto or tuktuk drivers taking commission on fares. The trick is to be firm, fair and calm with scammers at all costs – outbursts are seen as loss of face and can lead to an escalation of the situation.

Beware of invitations to gamble outside of licensed casinos, even if it is just a seemingly innocent game of blackjack.

Street beggars carrying wide-eyed infants may ask for milk powder – insisting on the most expensive available – which is then returned to the shop, which will split the proceeds thereafter.

Drugs
Be prepared to turn down drugs offered on the street- peddlers often single out foreigners tempted by the ‘lax’ enforcement in Cambodia- consider all narcotic substances illegal and be prepared to cough off early if found with substances on your person- whether via a set-ups or voluntarily.

Be prepared to turn down any offers of yaba, known as the ‘crazy’ drug in Thailand, and ominously as yama (the Hindu god of death) in Cambodia. Also called ‘ice’ or crystal meth, what’s on offer is not a diet pill as stocked in pharmacies, but homemade meta-amphetamines produced in ‘labs’ in Cambodia and elsewhere in the region, which are often cut with toxic substances like mercury, lithium or whatever else is to hand. The resulting concoction is dangerous and addictive; provoking powerful hallucinations, sleep deprivation and psychosis. Other pills which may be peddled by ‘friendly’ drivers and dealers may be tranquilisers, and you stand to wake up with a sore head and empty pockets.

Resist the urge to buy any ‘cocaine’ in Cambodia – this is often pure heroin and far stronger than what you might find elsewhere, making it potentially fatal.

NB. Travellers can be prosecuted under the law of their home country regarding age of consent, even when abroad.