Lens and Scalpel: Arkoun's Vital Mission in Kampong Cham

In Kampong Cham, photographer Grégory Herpe teams up with the Arkoun association to document and extend a vital surgical mission. In a public hospital where patients wait months for surgery, this encounter between lens and scalpel reveals the silences of a strained medical system, between forgotten emergencies and the transmission of expertise. 

In Kampong Cham, along the Mekong, days start early. The heat settles in quickly, like a constant presence. In the corridors of the public hospital, patients wait, sometimes for months. Some can no longer walk. Others have never been operated on. All carry the same reality: late or impossible access to surgery.

In this country of nearly 17 million inhabitants, where over 70% of the population still lives in rural areas, health remains a matter of distance, resources, and vital priorities.

The medical system has been slowly rebuilt after the near-total destruction of infrastructure under the Khmer Rouge. Today, certain surgical specialties remain understaffed: there are only a handful of specialists for millions of inhabitants in some fields. The result: conditions simple elsewhere become lasting disabilities here.

Fractures That Shape Destinies

In Western countries, a femoral neck fracture is operated on urgently, often within 48 hours. In Cambodia, some patients live with it for years. Surgeons from the Arkoun association observe this on every mission. On site, they encounter advanced cases rarely seen in Europe: poorly healed fractures, irreversible deformations, femoral head necroses linked to prolonged use of corticosteroids without medical follow-up.

These situations are partly explained by the cost of care, but also by a deeper reality: in Cambodia, getting treated often means giving up work. And for many, that's not an option. Globally, joint diseases like osteoarthritis affect over 528 million people and rank among the major causes of disability. In a country where physical jobs still dominate, these conditions take on an even more brutal dimension: they prevent people from living.

A Healthcare System Under Strain

Cambodia is making progress. The health budget reached nearly $550 million in 2025, a sign of structural efforts. But inequalities persist. Each year, between 200,000 and 250,000 Cambodians go abroad for treatment due to a lack of suitable options locally. At the same time, non-communicable diseases—diabetes, hypertension, chronic conditions—now account for nearly 64% of deaths. These pathologies worsen orthopedic complications, especially in joints. Access to surgery thus remains a major issue. Not just in terms of equipment. But in terms of training.

Learning for the Long Term

This is where Arkoun's action stands out. Founded in 2023 in La Rochelle by doctors Cédric Bouquet and Bertrand Millet-Barbé, along with surgical equipment specialist and logistician Éric Piou, the association stems from over ten years of missions; it doesn't just operate. It teaches. Around the founders, two other French surgeons—Julien Nebout and Paul Brossard—operate directly in the operating room alongside their Cambodian counterparts.

The goal is clear: make local teams autonomous. And results are starting to show. Some Cambodian surgeons, like Dr. Tem Ponlok, can now perform hip prosthesis insertions independently. Arkoun makes a point of training local surgeons and, once back in France, the skills learned, replicated, and passed on serve the community.

Seeing to Understand

At the heart of this mission, another presence has emerged. Photographer Grégory Herpe joined the team, not as an external observer, but as an engaged witness. He's a veteran of reporting with NGOs worldwide, often focused on children's and women's rights, but also an artist. His gaze lingers where medicine is silent: in the pauses before surgery, in the tension of bodies, in eyes wavering between fear and hope. His photographic report moves through spaces—from the operating room to waiting areas—and gives visibility to these invisible trajectories.

"I could never thank the Arkoun association enough for opening the doors of the operating rooms so I could take pictures there, of course, but also to understand what happens inside and the major stakes at play. For me, so curious about everything, it was a huge personal enrichment, and I'm happy to have met men with big hearts, full of empathy that's so important to me. They can count on me in the future; I'll always be there to contribute my stone to this magnificent and important human adventure," he tells us.

In parallel, he's producing his second video documentary. A work that goes beyond mere capture to question what it means to "intervene" in a country where everything is lacking except human energy. Because documenting here is not a neutral act. It's extending the mission. Giving it memory. And reach. Grégory Herpe brings all his artistic sensitivity to Arkoun's remarkable work.

Between Urgency and Transmission

In Kampong Cham, the mission ends as it began: without staging to stroke egos that have no place here. This time, 15 patients of all ages were operated on, and if there were occasional complications, doctors Bouquet, Millet-Barbé, Nebout, and Brossard spared no hours or effort to give their best. Patients leave, sometimes standing for the first time in years. Cambodian surgeons continue, strengthened by Arkoun's advice and expertise. And something has changed—almost imperceptibly.

In a country where health challenges remain immense, where history still weighs on infrastructure, every transmission matters. Because in Cambodia, treating isn't enough. You have to learn to do without. And above all, learn to pass it on.

PS: Arkoun needs help! You can support them by contacting: arkounassociation@gmail.com www.instagram.com/arkounassociation

See and follow Grégory Herpe's work: https://www.instagram.com/gregoryherpephotographe/ https://www.gregoryherpe.com/