tourism impact in cambodia

‘Just surviving’: For Cambodian tourism, recovery out of sight

Siem Reap is welcoming few foreign tourists weeks after Cambodia opened its borders to vaccinated travellers.

Siem Reap, Cambodia – Chheut Dina was only a few days into her reduced shift cleaning Siem Reap International Airport when she was told not to come back to work.

After 10 months with practically no tourism, the airport dropped its contract with Dina’s employer in December 2020, forcing her to cut spending on her family of seven and refinance an $11,000 loan she took out before the pandemic. HCC Angkor, the cleaning company contracted by the airport, had earlier reduced Dina and her colleagues’ employment to just one month out of the year due to COVID-19 restrictions.

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“Sometimes my kids, when they don’t have to study, they go to the pond or creek or lake to catch fish or snails and vegetables, so we spend less than [before] but we eat less proper food than before,” Dina told Al Jazeera.

With support from her union, Dina and the other HCC employees complained to the company, frustrated that management refused to confirm if they had been fired or just suspended.

The uncertainty around their future has been especially frustrating since the airport started to receive international flights following the country’s reopening of its borders to vaccinated tourists last month.

“If they want to dismiss us from the contract, they need to pay us proper compensation according to the law, then we can look for other job opportunities or get compensation,” Dina said. “This creates a blurred picture, we don’t really know what is going on.”

Although Cambodia has reopened to international travellers, its tourism centre of Siem Reap, home to UNESCO World Heritage site Angkor Wat, is still reckoning with its reliance on foreigners and the long and unpredictable path towards recovery from the pandemic.

Cambodia’s Prime Minister Hun Sen lifted quarantine measures for all vaccinated travellers on November 15 – a step beyond Thailand’s reopening, which this week reintroduced seven to 10 days of quarantine for foreign arrivals, except those visiting the Phuket “sandbox,” in response to the Omicron variant.

Arrivals, however, have been few and far between. Before Singapore Airlines resumed its service last week, the city’s airport had not seen a single international flight for 20 months.

Even before the pandemic, Siem Reap, which relied heavily on Chinese tour groups that have since disappeared, had been showing signs of fatigue, with Angkor Archaeological Park ticket sales down 8.3 percent in 2019 compared with the previous year, according to the World Bank.

Khek Norinda, communications director for Cambodia Airports, told Al Jazeera visitors fell 12.4 percent in 2019 compared with 2018, before plummeting further during the pandemic. Before Singapore Airlines resumed its service last week, the city’s airport had not seen a single international flight for 20 months.

While predicting a gradual recovery, Norinda said the return of the airline showed there was still an “appetite” for visiting Siem Reap.

“Also, the experience of visiting the temples without crowds and the hustle and bustle could play in its favour,” he said.

Thourn Sinan, the Cambodian representative for the Pacific Asia Travel Association, told Al Jazeera the government did not clearly communicate its pandemic policies, making it hard for his industry to respond.

“They have very good planning” for the industry in general, he said. “But on the other side with the pandemic era [continuing], they cannot decide what to do.”

During the pandemic, the provincial government has sought to beautify the city, widening roads and creating gardens and walking paths in front of Angkor Wat, the impressive tiered temple that is stamped on Cambodia’s currency.

Many businesses in the vicinity of the famous attraction – which is surrounded by family-run restaurants, clothing stalls, and artists displaying paintings and other souvenirs – complain the renovations have cost them customers.

A drink vendor outside Angkor Wat told Al Jazeera that small businesses were struggling, despite a spirit of collaboration among vendors who had decided to stay in the park.

She said felt guilty charging a lodger at her property $150 per month: “I want to get all the money [I can] but I’m not happy, because for them it’s not easier than it is for us.”

Sinan, the Pacific Asia Travel Association representative, said he doubted tourism in Cambodia would return to pre-pandemic levels for five to seven years, despite knowing tour operators who had invested in their business due to the border reopening.

“The new investments they [businesses] put in, this is probably the last investment [possible] for them, but if there’s no international tourists’ investment for them, they’ll keep losing,” he said.

Near the start of the pandemic, the Ministry of Labour and Vocational Training promised to provide furloughed workers in the tourism and garment industries $40 per month and compel employers to pay a further $30 per month. Apart from criticism the support was not enough, union leaders complained many workers were excluded from the assistance.

Dina, the airport cleaner, said she was not able to receive COVID-19 support payments nor healthcare through the national social security fund, making it hard to pay for her elderly parents’ medical expenses.

“Sometimes we don’t have money for that so we borrow around to put it together to make it,” she said.

Norinda said Cambodia Airports sought to prioritise the welfare of its staff during the pandemic, but “unfortunately” had to cut its relationship with HCC in Siem Reap.

With Cambodia reporting few COVID-19 cases – there have been no more than 25 daily infections since the start of December – domestic tourism, especially to ecotourism sites , has provided some light relief for the industry.

Chhay Sivlin, president of the Cambodian Association of Travel Agents, told Al Jazeera more domestic visitors visited Siem Reap’s temples, but they tended to spend less than foreign tourists.

“The travel culture of Cambodians [is that they] do not feel the need to hire tour guides nor do they require the assistance of local travel agents,” she said.

Sinan said he did not believe the city could count on the return of Chinese tourists, who were more interested in a COVID-free life in China than the “new normal” elsewhere.

He said Southeast Asian countries could fill the vacuum if they learned from Europe, where many residents holidayed during the summer on vaccine passports.

“I think ASEAN should be able to have a fast recovery in terms of tourism if ASEAN [members] can trust each other,” he said.

‘Waiting for the tourists’

For now, Siem Reap’s residents must make the best of difficult circumstances.

Before the pandemic, Doung Visith used to earn a comfortable $50 every time he led a tour of Angkor Wat. These days, Visith, who has a part-time job with a hospitality company, spends his mornings trying to convince locals to hire him for a short sunrise tour priced at $20, before spending the afternoon beckoning visitors to the newly renovated restaurants and shops in front of the temple.

Although he appreciates the manicured facade of the park, he wishes there were foreign tourists there to see it.

“We’re just surviving, waiting for the tourists to come again,” he said.

Take advantage of the search to browse through the World Heritage Centre information.

Improving visitor infrastructure in Angkor, Cambodia

The Angkor World Heritage site has long attracted visitors to Cambodia, providing a major driver for the country’s economy with a steady year-on year increase in visitor numbers. 

The dramatic drop in visitor numbers (to below 200,000 in 2021 from roughly 6.6 million pre-pandemic) had severe impacts on local communities. In the previously thriving city of Siem Reap, local people resorted to growing or foraging for their own food to survive. At least 100 hotels and guest houses are estimated to have closed, with many more announcing long-term suspensions. However, local authorities decided to use the sudden opportunity of reduced pressure from visitor numbers to carry out a range of conservation and restoration works, improve access and also make important archaeological discoveries.

During 2022 UNESCO’s support for sustainable tourism initiatives was put to work, employing local people and carrying out improvements which will make the Angkor World Heritage site safer and more enjoyable for visitors, while protecting the integrity and values of the complex’s precious built heritage. It has also helped to support local artisan entrepreneurs – particularly women – and tourist guides to build stronger and more resilient businesses, based on the lessons learned from COVID-19.

© UNESCO office, Phnom Penh, Cambodia UNESCO’s support is helping to improve the economic sustainability of tourism too, with training workshops held for vulnerable groups in local communities – particularly women artisans who specialise in local craft techniques such as lacquerware, ceramics, silk weaving and silver plating. The aim has been to provide artisans and craft professionals with the necessary skills to enhance the quality of their work, prepare products for exhibition and market them more effectively to local and international markets. Participants are also able to improve their business planning and branding skills, with the aim of being able to grow their businesses, become more profitable and improve living standards among family and colleagues in the local community.

“This training comes at the right time because we had nothing to do during COVID. It is the right moment to gain more knowledge” Artisans: Ms Pheakdey Samin, local designer and founder of Seungkhmer Design. Ms Pheakdey Samin uses traditional textiles to design modern clothes ( https://www.facebook.com/SeungKhmerCambodia/ ).

“During COVID, I took a job as a construction worker because there were no tourists to take on tours”. “One of the most interesting topics I learned about in this training is the part on storytelling and learning how to inspire visitors about the history of the site.” Tourist guides : Mr Tola Leav has been a tourist guide for 10 years in Angkor Wat

About Angkor

Angkor is one of the most important archaeological sites in South-East Asia. Stretching over some 400 km2, including forested area, Angkor Archaeological Park contains the magnificent remains of the different capitals of the Khmer Empire, from the 9th to the 15th century.

Project background

The ‘Promoting sustainable tourism and private sector engagement for inclusive community development in response to the COVID-19 crisis’ project was developed by UNESCO thanks to support provided by the German Federal Ministry for Economic Cooperation and Development (BMZ) and the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ). The project aimed to address some of the immediate socio-economic impacts of COVID-19 on tourism and heritage and was implemented across seven countries and ten World Heritage communities.

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Navigating uncertainty: Cambodian tourism businesses and the pandemic

Streets crowded with tuk-tuks carrying visitors to Angkor Wat; bustling restaurants and bars; hotels and guesthouses pre-booked for the Water Festival – these scenes vanished when the COVID-19 pandemic stopped international and domestic tourists from visiting Cambodia’s sights.

Although the country’s public health situation was comparably unscathed throughout 2020 – Cambodia recorded only 331 active cases and no deaths by November 2020 – movement restrictions decreased household incomes by 30 to 60%. The situation escalated in 2021 when Cambodia went from a few cases to more than 60,000 by mid-July 2021.

Contributing over 70% of jobs and 58% of GDP in 2018, Cambodia’s micro-, small and medium-size enterprises (MSMEs) have been profoundly affected by the pandemic. The tourism industry, Cambodia’s second-largest driver of economic growth and where many MSMEs work, is especially in crisis. In 2019, tourism generated about US$4.9 billion, nearly 20% of the country’s GDP , while COVID-affected 2020 saw international tourism revenue plummet nearly 80%, to US$1.023 billion.

In 2020 and 2021, to understand the impact of COVID-19 on small businesses in the region, The Asia Foundation collaborated with local partners in carrying out multiple surveys of MSMEs in tourism, handicrafts, manufacturing and other industries across Cambodia, Lao People’s Democratic Republic, Malaysia, Myanmar, Thailand, and Timor-Leste.

In July and November 2020 and in April 2021, we also surveyed registered and unregistered businesses in Cambodia’s tourism sector. The surveys indicated that 99% had been affected by the pandemic and lockdowns, with over 50% severely affected in April 2021. As COVID-19 restrictions were extended, the situation worsened: 54% of respondents reported cash flow problems in November 2020, increasing to 83% by April 2021.

The surveys revealed a link between national COVID-19 caseloads, perceptions around business survivability, and adaptation efforts. In Cambodia, a slight majority of surveyed businesses considered COVID-19 a threat to their operations in July and November 2020, when caseloads were low, but by April 2021 more than three-quarters of businesses viewed the pandemic as a serious threat.

In July 2020, 40% of Cambodian tourism businesses reported pandemic-related layoffs, while 60% had held steady. Only 16% reported letting staff go between July and November. Instead, many had decreased employee hours or were rotating hours to keep workers. However, by April 2021, facing greater restrictions and a worsening public health crisis, 33% of Cambodian tourism businesses reported having laid off employees – twice as many as in November.

Idled tourism workers sought any short-term work opportunities to make ends meet. In Siem Reap, the gateway to Angkor Wat and other attractions, many women – who were disproportionately affected by layoffs – left the city, hoping to find jobs in the garment industry in Phnom Penh. Unfortunately, COVID-19 containment measures caused the garment factories to close.

After the first lockdown in April 2020, street vendors, taxi drivers, and tuk-tuk drivers felt less affected by the pandemic because domestic tourism and daily life continued. However, as pandemic restrictions grew and activity declined, many male tuk-tuk drivers turned to construction work – only to see worksites close in April 2021 lockdowns, leaving some with only half that month’s salary in hand.

Many Cambodian tourism MSMEs were unable to adapt their business models to digital methods. Only 8% reported doing increased business online by April 2021. Some food-related businesses, such as restaurants and street vendors in Phnom Penh, generated income through online delivery platforms. However, online is not an option for tourism businesses that cannot offer takeout food or virtual services.

Since the crisis began, Southeast Asian governments have provided a range of packages to support businesses in weathering the pandemic. However, communication about assistance and how to access it has often been inadequate.

Cambodia has provided direct support, such as cash for laid-off workers, and indirect support, such as debt restructuring. Unregistered businesses do not currently qualify for support, yet they make up a large share of employers and workers.

Although Cambodia was relatively successful in disseminating information to registered businesses compared to other countries in the region, only about 50% of MSMEs surveyed had enrolled and received needed assistance. Some said they lacked information on the programs, especially process and eligibility details, while others found the application procedures difficult to navigate.

The initial optimism of many Southeast Asian MSMEs for a 2021 economic recovery has been dampened by the latest wave of COVID-19. Despite this, Cambodia may see a quicker return to normal due to one of the highest vaccination rates in the region.

Governments must prioritise vaccine rollout, and plan for an uncertain future, in order to mitigate the economic fallout of COVID-19 containment strategies. Financial assistance for MSMEs can help negate the worst of the effects and prolong business survival. But to be effective, coverage needs to include both registered and unregistered businesses.

Beyond existing support mechanisms, governments must provide targeted and tailored assistance for women, young people, and contract and informal workers – those most adversely affected by the economic fallout. A strong and inclusive economic recovery will require more than online access and minor business adaptations – it will demand greater attention to these differential dynamics, better communication and outreach to MSMEs, and larger safety nets while scaling up vaccination.

Read the Cambodia surveys .  Read the latest GovAsia issue 1.3 about the impact of COVID-19 on MSMEs across Southeast Asia . Find individual country survey reports .

This post is part of a collaborative series with  The Asia Foundation .

This article draws on research exploring the impacts of COVID-19 on Cambodian MSMEs in the tourism sector and households in Cambodia. The research was completed in partnership with Angkor Research and Consulting, Centre for Policy Studies, and Future Forum, and was funded under a partnership between The Asia Foundation’s United States Congressional Appropriation; Department of Foreign Affairs and Trade (DFAT), Australia; and Ministry of Foreign Affairs and Trade (MFAT), New Zealand through the Ambassador Fund. The views expressed are those of the authors only.

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Men Pechet is a Program Manager in The Asia Foundation’s Cambodia Office.

Marly Augustine

Marly Augustine is a consultant with The Asia Foundation’s Governance, and Evaluation and Learning Units.

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Asian Tourism Sustainability pp 163–175 Cite as

Scenarios of Sustainable Tourism Development in Cambodia

• Heidi Dahles 5 , 6  
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Part of the book series: Perspectives on Asian Tourism ((PAT))

The aim of this chapter is to provide a critical assessment of the current tourism development in Cambodia from the perspective of the ‘sustainable tourism development’ narrative. As one of Cambodia’s core industries, second only after the garment industry, tourism is a major source of income and an engine of economic growth. Despite the pivotal role of tourism in Cambodia’s economy, the dimension of sustainability is largely absent from the country’s current Tourism Development Strategic Plan. Outside the scope of this plan and largely ignored by the Cambodian government, myriad of pioneering initiatives are undertaken that have the potential to provide economic benefits to local communities. Commonly led by non-governmental organizations (NGO), such initiatives encourage the establishment of social enterprises that employ tourism as an instrument for creating sustainable livelihoods. But rarely are such enterprises developed and operated by local people. In this vein, this chapter will compare and contrast two scenarios that feature in Cambodia’s tourism development: the government-driven growth scenario and the diversification scenario led by local initiatives that evolve under the banner of sustainable tourism. It will critically assess the extent to which local people are engaged in the development and management of such initiatives in order to achieve sustainable outcomes.

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Dahles, H. (2022). Scenarios of Sustainable Tourism Development in Cambodia. In: Selvaranee Balasingam, A., Ma, Y. (eds) Asian Tourism Sustainability. Perspectives on Asian Tourism. Springer, Singapore. https://doi.org/10.1007/978-981-16-5264-6_9

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Enabling ecotourism development in Cambodia

Maurice andres rawlins, elisabeth steinmayr, werner kornexl.

Iconic Cambodian landscapes, such as the Cardamom Mountains have a wealth of natural assets that allow for new and exciting multi-day tourism itineraries for domestic and international markets. In addition, the remoteness of Cambodia’s picturesque forested landscapes also entices the mid to high-end tourist market, who are looking to unwind and unplug.

Cambodia’s tourism industry is a key contributor to its economic growth. It provides a sizable contribution to Cambodia’s economy (21 percent of GDP in 2019) , which has been on the rise for the past ten years. The ecotourism sector was a notable part of this and, in recent years, was showing signs of even greater growth than the rest of the tourism industry.

A recent slowdown in the growth of tourism in Cambodia , however, points to a need to diversify the sector. Angkor Wat in Siem Reap has been the main attraction to Cambodia, and while the iconic temples still draw crowds, statistics show that growth in arrivals to Angkor sites is slowing. Experts suggest that the decelerated growth of tourist arrivals is due to fewer Chinese tourists visiting Siem Reap.  Instead, these tourists are increasingly drawn to Cambodia’s coastal areas. Another reason is that higher competition from neighboring countries, especially Vietnam, is drawing Chinese and South Korean tourists away from Siem Reap.

Trends of increased visitors to ecotourism sites in Cambodia indicate that ecotourism is a product that could be further developed to harness its potential, and the Cambodian government wants to capitalize on this potential. Developing tourism can also create much-needed revenues to help manage Cambodia’s extensive protected area (PA) network and protect important economic services provided by forests in the PAs.

“Invest now in ecotourism development to: DIVERSIFY Cambodia’s tourism product with ecotourism offerings; CREATE jobs and STIMULATE rural economies; and PROTECT the forest assets that underpin ecotourism” is one of the main key messages that has been formulated in a newly released World Bank advisory report on Enabling Ecotourism Development in Cambodia ; a report which has been developed to support the Royal Government of Cambodia in the sustainable development of ecotourism. One of the main tenets promoted in the report is around investing and diversifying the country’s tourism, which is part of the Bank’s broader strategy for sustainable management of the country’s natural capital and strengthening its links to the economy. 

COVID-19 is an additional reason for diversifying the country’s tourism offerings. “BUILD BACK BETTER after COVID-19 in the tourism sector by investing in ECOTOURISM” is another key message being promoted in the World Bank’s advisory report. As more people become unemployed due to the fallout of COVID-19, they are more likely to turn to illegal activities to supplement incomes, such as illegal wildlife trafficking and logging, and clearing forests for agriculture. The promotion of ecotourism development in Cambodia is, therefore, an essential element of Cambodia’s post-COVID-19 recovery strategy. It is also an essential ingredient that can pave the way towards the building back of a more resilient economy, which in turn can boost sustainable livelihoods and rural job creation for the Cambodian people.

In response to the need to diversify Cambodia’s tourism product and respond to the COVID-19 through the development of ecotourism, this new World Bank report provides five key recommendations each with strategic actions for:

• Mitigating the impacts of COVID-19 on the ecotourism industry.
• Strengthening regulatory frameworks for ecotourism.
• Strengthening key institutions and partnerships for ecotourism development.
• Strengthening ecotourism destination planning, management, and marketing.
• Enabling and supporting the private sector in tourism. 

The World Bank will support the Royal Government of Cambodia on implementing these recommendations and developing its ecotourism sector through the Cambodia Sustainable Landscape and Ecotourism Project (CSLE) . The analytical work on ecotourism will also be expanded to Cambodia’s coastal areas with funding from the PROBLUE trust fund and will inform a regional approach for ecotourism development with funding from the PROGREEN trust fund .

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Tourism in Cambodia is big business. But why is tourism so important here and how should it be managed? Read on to find out…

Cambodia, with its profound history and enigmatic landscapes, is a magnet for travellers seeking both heritage and nature. From the awe-inspiring temples of Angkor Wat to the untouched beaches of Sihanoukville, the country showcases a rich tapestry of experiences. In this article, I will explore the myriad facets of Cambodia’s tourism sector, illuminating its diverse attractions and cultural depth.

Geography of Cambodia

Cambodia is a Southeast Asian country located in the southern part of the Indochinese Peninsula. It shares borders with Thailand to the northwest, Laos to the northeast, Vietnam to the east, and the Gulf of Thailand to the southwest. Here is a brief overview of Cambodia’s geography :

• Landforms: Cambodia’s terrain is characterized by low-lying plains, river valleys, and a central plain known as the Cambodian Plain or the Central Lowlands. The Mekong River, one of Southeast Asia’s major waterways, flows through the eastern part of the country, providing fertile soil and playing a crucial role in Cambodia’s agriculture.
• Cardamom Mountains: In the southwestern part of Cambodia lies the Cardamom Mountains, a range that stretches parallel to the Gulf of Thailand. These mountains are covered with dense forests and are home to various wildlife species, including endangered ones like tigers and Asian elephants.
• Densely Forested Areas: Large parts of Cambodia are covered by forests, particularly in the northern and eastern regions. These forests are rich in biodiversity, with diverse flora and fauna, including rare species like the giant ibis and the Asian black bear.
• Tonle Sap Lake: In the central part of the country, there is the Tonle Sap, which is Southeast Asia’s largest freshwater lake. It is unique because its flow changes direction depending on the season. During the rainy season, the lake expands significantly, while during the dry season, it drains into the Mekong River.
• Coastal Areas: Along Cambodia’s southern coastline, there are sandy beaches and several offshore islands in the Gulf of Thailand. Popular tourist destinations like Sihanoukville and Kep are located in this region, attracting visitors with their beautiful beaches and tropical landscapes.
• Climate: Cambodia has a tropical monsoon climate with two distinct seasons. The rainy season usually lasts from May to October, characterized by high humidity and frequent rainfall. The dry season runs from November to April and brings drier and cooler weather.

Overall, Cambodia’s geography offers a diverse landscape, ranging from fertile plains to mountainous regions and coastal areas. This diversity contributes to the country’s natural beauty, rich biodiversity, and varied agricultural resources.

Tourism Industry in Cambodia: 

Cambodia, a vibrant nation nestled in the heart of Southeast Asia, has witnessed a remarkable growth in its tourism industry over the past few decades. This paper aims to examine the country’s tourism sector, exploring its historical significance, popular tourist destinations, policy framework, and economic impacts. By doing so, a comprehensive understanding of Cambodia’s tourism industry can be gained.

Cambodia’s rich historical legacy, prominently exemplified by the majestic temples of Angkor Wat, has been instrumental in shaping its tourism landscape. Angkor Wat, a UNESCO World Heritage site, stands as a testament to the once-mighty Khmer Empire and attracts tourists from across the globe. Furthermore, Cambodia’s tumultuous past, including the tragic era of the Khmer Rouge regime, has generated interest among history enthusiasts and visitors seeking a deeper understanding of the nation’s complex history.

Beyond Angkor Wat, Cambodia offers an array of captivating destinations that contribute to its allure as a tourist hotspot. The bustling capital city of Phnom Penh showcases a blend of French colonial architecture and traditional Khmer heritage. The coastal city of Sihanoukville entices beach lovers with its pristine beaches and lively atmosphere, while the tranquil riverside town of Battambang offers an authentic glimpse into rural Cambodian life. Other notable attractions include the ancient temple complex of Preah Vihear, the wildlife-rich Cardamom Mountains, and the picturesque islands of Koh Rong and Koh Rong Samloem.

Recognizing the importance of the tourism sector, the Cambodian government has implemented various policies and initiatives to foster its growth. These include infrastructure development, visa facilitation measures, and the preservation of cultural and natural heritage sites. The Ministry of Tourism plays a pivotal role in promoting Cambodia as a tourist destination and has been actively engaging in partnerships and collaborations with international organizations and tour operators to enhance the industry’s sustainability and competitiveness.

The tourism industry has emerged as a vital contributor to Cambodia’s economy. Its rapid growth has led to the creation of employment opportunities, particularly in the service sector, thereby improving livelihoods and reducing poverty. Additionally, tourism revenues have supported the development of infrastructure, healthcare, and education systems, indirectly benefiting local communities. However, challenges such as seasonal fluctuations, environmental sustainability, and equitable distribution of tourism benefits persist and necessitate continued efforts for inclusive growth.

The tourism industry in Cambodia showcases the country’s rich cultural heritage, breathtaking landscapes, and hospitable communities. With its historical significance, diverse tourist destinations, proactive policies, and positive economic impacts, Cambodia has positioned itself as a prominent player in the Southeast Asian tourism landscape. While ongoing challenges persist, the sustained growth of the tourism sector holds immense potential for further socioeconomic development and the preservation of Cambodia’s unique identity.

Statistics about Tourism in Cambodia: 

Now lets highlight a few ket statistics about tourism in Cambodia:

• Tourist Arrivals: In 2019, Cambodia welcomed approximately 6.61 million international tourist arrivals.
• Tourism Revenue: The tourism sector contributed around $4.92 billion in revenue to Cambodia’s economy in 2019.
• Economic Impact: Tourism accounted for about 12.1% of Cambodia’s GDP in 2019.
• Employment: The tourism industry provided employment for around 630,000 people in Cambodia in 2019, representing approximately 12.7% of total employment.
• Main Source Markets: The top five source markets for international tourists visiting Cambodia in 2019 were China, Vietnam, Thailand, South Korea, and the United States. 
•  Angkor Wat Visitors: Angkor Wat, the famous UNESCO World Heritage site, attracted more than 2.2 million visitors in 2019.
• Tourism Growth: Between 2010 and 2019, Cambodia experienced an average annual growth rate of approximately 10.3% in international tourist arrivals.
• Average Length of Stay: The average length of stay for international tourists in Cambodia was around 6.7 days in 2019.
• Accommodation Capacity: Cambodia had a total of around 1,067 registered hotels and guesthouses with over 64,000 rooms available in 2019.
• Eco-Tourism Potential: Cambodia has a significant potential for eco-tourism with its diverse natural landscapes, including national parks, wildlife sanctuaries, and ecotourism sites.

Most Popular Tourist Attractions in Cambodia

Here are some of the major tourist attractions in Cambodia:

Angkor Archaeological Park:

• The Angkor Archaeological Park is an unparalleled treasure trove of ancient ruins and religious structures that testify to Cambodia’s glorious past. Nestled amidst lush jungles near the city of Siem Reap, this UNESCO World Heritage site encompasses over 400 square kilometers. Its centerpiece, Angkor Wat, is the world’s largest religious monument and an iconic symbol of Cambodia. Built during the Khmer Empire’s zenith in the 12th century, Angkor Wat displays intricate bas-reliefs, towering spires, and an awe-inspiring architectural design. Other notable temples within the park include Bayon, Ta Prohm, and Preah Khan, each exhibiting distinct architectural styles and historical significance.

Royal Palace in Phnom Penh:

• Situated in the capital city of Phnom Penh, the Royal Palace represents the pinnacle of Cambodia’s royal heritage. Serving as the official residence of the King since the mid-19th century, this magnificent complex showcases a fusion of traditional Khmer architecture and European influences. Its centerpiece, the Silver Pagoda (Wat Preah Keo Morokat), houses a renowned collection of Buddhist artifacts, including the Emerald Buddha. Visitors can explore the opulent Throne Hall, the Moonlight Pavilion, and the manicured gardens, gaining insights into Cambodia’s royal legacy and contemporary monarchy.

Killing Fields Memorial:

• While Cambodia’s cultural attractions evoke admiration, it is vital to acknowledge the country’s tragic history as well. The Killing Fields Memorial, located in Choeung Ek, stands as a poignant reminder of the Khmer Rouge regime’s atrocities during the late 1970s. This somber site encompasses mass graves and a memorial stupa containing the remains of victims. A visit to the memorial provides visitors with a solemn opportunity to reflect upon the past, pay tribute to the lives lost, and gain a deeper understanding of Cambodia’s journey toward healing and reconciliation.

Beaches of Sihanoukville:

• Nestled along Cambodia’s southwestern coast, the pristine beaches of Sihanoukville offer a serene retreat for tourists seeking relaxation and natural beauty. Renowned for its white sandy shores, azure waters, and vibrant marine life, this coastal paradise is an emerging tourist destination. Koh Rong and Koh Rong Samloem islands, located near Sihanoukville, boast idyllic beachfronts and provide opportunities for diving, snorkeling, and island hopping. Visitors can also indulge in local seafood cuisine and immerse themselves in the laid-back atmosphere that characterizes this coastal gem.

Cambodia’s popular tourist attractions encompass a wide array of cultural, historical, and natural wonders that captivate travelers. From the awe-inspiring ancient temples of the Angkor Archaeological Park to the poignant reminders of the country’s turbulent past at the Killing Fields Memorial, visitors are invited to explore the profound layers of Cambodia’s identity. Additionally, the Royal Palace in Phnom Penh showcases the nation’s regal heritage, while the beaches of Sihanoukville offer an oasis of tranquility along the country’s picturesque coastline. By experiencing these diverse attractions, tourists can gain a deeper appreciation of Cambodia’s rich tapestry of traditions, resilience, and natural beauty.

Most Popular Types of Tourism in Cambodia: 

There are many different types of tourism in Cambodia, here are the most common:

• Cultural Tourism: Cultural tourism serves as the cornerstone of Cambodia’s tourism industry. The world-famous Angkor Archaeological Park, home to the magnificent Angkor Wat temple complex, is a UNESCO World Heritage site and a key attraction for cultural enthusiasts. Visitors are captivated by Cambodia’s rich Khmer heritage, traditional dance performances, and local arts and crafts. Cultural tourism not only promotes national identity but also contributes to community development and cultural preservation.
• Historical Tourism: Cambodia’s turbulent history, including the Khmer Empire, the tragic era of the Khmer Rouge, and subsequent rebuilding efforts, attracts history enthusiasts seeking to understand the nation’s past. The Killing Fields of Choeung Ek and the Tuol Sleng Genocide Museum in Phnom Penh are poignant reminders of the Khmer Rouge regime and provide visitors with a solemn and educational experience. Historical tourism plays a vital role in Cambodia’s reconciliation process, preserving collective memory and fostering empathy.
• Ecotourism: The abundant natural resources and diverse ecosystems of Cambodia have nurtured the growth of ecotourism. Visitors are drawn to the country’s pristine national parks, such as Virachey and Bokor, where they can engage in activities like trekking, wildlife spotting, and exploring indigenous communities. Ecotourism initiatives prioritize environmental conservation, sustainable livelihoods for local communities, and the protection of endangered species, reinforcing Cambodia’s commitment to ecological preservation.
• Adventure Tourism: Adventure tourism in Cambodia is gaining popularity, particularly among thrill-seekers looking for adrenaline-pumping experiences. The country offers activities such as zip-lining, off-road cycling, and jungle trekking, allowing visitors to immerse themselves in Cambodia’s natural wonders while enjoying adventurous pursuits. Adventure tourism contributes to diversifying Cambodia’s tourism offerings and attracting a younger demographic of travelers seeking unique and exhilarating experiences.
• Religious Tourism: Religious tourism in Cambodia revolves around the spiritual significance of Buddhist temples and religious sites. Besides the iconic Angkor Wat, the country boasts numerous other ancient temples, such as Bayon and Preah Vihear, which attract pilgrims and spiritual seekers alike. Visitors can participate in meditation retreats, engage with Buddhist monks, and witness religious ceremonies, fostering cultural exchange and spiritual exploration.
• Beach Tourism: Cambodia’s coastline, notably the seaside town of Sihanoukville and the islands of Koh Rong and Koh Rong Samloem, draws beach enthusiasts seeking relaxation and tropical beauty. Beach tourism complements Cambodia’s cultural and historical offerings by providing visitors with a chance to unwind, enjoy water sports, and experience the laid-back coastal lifestyle. Development in this sector aims to balance tourism infrastructure expansion with environmental protection.
• Conclusion: Cambodia’s tourism industry encompasses a diverse range of popular tourism types, each contributing to the country’s economic growth, cultural preservation, and environmental sustainability. By leveraging its cultural heritage, historical significance, natural beauty, and adventurous opportunities, Cambodia continues to attract visitors from around the globe. The promotion of sustainable tourism practices is crucial to ensuring the long-term viability of Cambodia’s tourism industry, as it strives to preserve its unique attractions for future generations.

Impacts of Tourism in Cambodia

Tourism in Cambodia has emerged as a significant economic sector in the country, contributing to the country’s development and providing numerous employment opportunities. However, like any tourism destination, Cambodia experiences a range of impacts associated with the industry. This paper delves into the social, environmental, and economic consequences of tourism in Cambodia, shedding light on the overall effects on the nation.

Social Impacts of tourism in Cambodia

Positive Impacts: 

Cultural Exchange and Preservation: Tourism in Cambodia facilitates cultural exchange between visitors and local communities, fostering an appreciation for Cambodia’s rich heritage. This interaction often leads to the preservation and promotion of traditional arts, crafts, and cultural practices. 

Employment Opportunities: Tourism in Cambodia generates employment opportunities, particularly in the hospitality and service sectors, offering local residents income and improved livelihoods.

Negative Impacts: 

Social Disruption: Rapid tourism growth can cause social disruption by altering the dynamics and values of local communities. The influx of tourists may lead to changes in traditional lifestyles, increased competition for resources, and social inequalities.

Exploitation and Cultural Appropriation: Unregulated tourism in Cambodia can lead to the commodification of culture and exploitation of local communities. Cultural appropriation and misrepresentation may occur, diluting authentic cultural experiences.

Environmental Impacts of tourism in Cambodia

Positive Impacts:

Conservation Efforts: Tourism in Cambodia can provide incentives for the conservation of natural resources and protected areas. Revenue generated from ecotourism initiatives can be reinvested in environmental preservation efforts, contributing to biodiversity conservation and sustainable development.

Environmental Awareness: Visitors to Cambodia often gain a deeper understanding of environmental challenges, leading to increased awareness and support for conservation initiatives.

Negative Impacts:

Overexploitation of Resources: Uncontrolled tourism in Cambodia can strain local ecosystems, resulting in habitat destruction, deforestation, and pollution. Overconsumption of water, energy, and waste generation can degrade natural resources and disrupt fragile ecosystems. 

Carbon Footprint: The transportation and accommodation infrastructure required to support tourism in Cambodia can contribute to increased carbon emissions and climate change.

Economic Impacts of tourism in Cambodia

 Positive Impacts: 

Employment and Income Generation: Tourism in Cambodia is a significant source of employment, particularly for the local workforce. Jobs in the tourism sector provide income opportunities, alleviate poverty, and contribute to the overall economic growth of the country. 

Foreign Exchange Earnings: Tourism generates foreign exchange through visitor expenditures, which contributes to the balance of payments and helps strengthen the national economy.

Leakages and Dependency: Leakage occurs when a significant portion of tourism revenue leaves the host country, benefiting foreign investors rather than the local economy. Overdependence on tourism can make the economy vulnerable to fluctuations in the industry. 

Seasonal Employment: The tourism industry often exhibits seasonality, leading to fluctuations in employment opportunities. This can result in instability and unemployment during the off-peak season.

Tourism in Cambodia has brought about numerous social, environmental, and economic impacts, both positive and negative. While the industry has contributed to cultural preservation, employment generation, and economic growth, it has also posed challenges such as social disruption, environmental degradation, and economic vulnerabilities.

To maximize the benefits and minimize the negative consequences, sustainable tourism development strategies, including responsible tourism practices, community involvement, and environmental conservation efforts, are crucial. These measures can help ensure that tourism in Cambodia continues to play a positive role in the country’s development while preserving its unique cultural and natural heritage.

Crime and Safety in Cambodia

Cambodia has made significant progress in terms of safety and security in recent years, but tourism in Cambodia still faces some challenges related to crime. Here is an overview of crime and safety in Cambodia:

• Petty Crime: Like many tourist destinations, Cambodia experiences incidents of petty crime such as pickpocketing, bag snatching, and theft in crowded areas, markets, and tourist sites. Visitors are advised to remain cautious and take necessary precautions to safeguard their belongings.
• Scams: Some common scams in Cambodia involve overcharging for services, counterfeit goods, and fake charity organizations targeting tourists. Exercise caution when dealing with unfamiliar vendors or individuals asking for money.
• Violent Crime: While violent crime is relatively low in Cambodia, there have been instances of armed robberies, assaults, and burglaries, especially in urban areas. These crimes often occur in dimly lit streets or remote locations. It is advisable to avoid traveling alone at night and remain aware of your surroundings.
• Drug-related Crime: Cambodia has been used as a transit route for drug trafficking, primarily involving illicit substances like methamphetamine. Engaging in drug-related activities can lead to severe penalties, including lengthy prison sentences or even the death penalty.
• Terrorism: Cambodia is not considered a high-risk country for terrorism. However, global threats can affect any nation, so it’s always prudent to stay updated on travel advisories and follow any security instructions provided by local authorities.
• Traffic Safety: Road accidents are a significant concern in Cambodia due to factors like poor infrastructure, reckless driving, and inadequate enforcement of traffic laws. Exercise caution when crossing roads, consider hiring experienced drivers, and use reliable transportation services.
• Landmines: Cambodia still has areas affected by landmines and unexploded ordnance from past conflicts. It is crucial to stay on well-traveled paths and avoid venturing into unknown or unmarked areas.
• Keep your valuables secure and be vigilant in crowded places.
• Use reliable transportation services and licensed taxis.
• Respect local customs, laws, and regulations.
• Avoid excessive displays of wealth or valuable jewelry.
• Stay updated on travel advisories from your government or embassy.

FAQs about Tourism in Cambodia

Now that we know a bit more about tourism in Cambodia, lets answer some of the most common questions on this topic:

Q: Is Cambodia a safe country for tourists?

A: Yes, Cambodia is generally a safe country for tourists. However, like in any other destination, it’s important to exercise common sense and take necessary precautions, such as avoiding isolated areas at night and keeping an eye on your belongings.

Q: What is the best time to visit Cambodia?

A: The best time to visit Cambodia is during the dry season, which runs from November to April. This period offers pleasant temperatures and lower chances of rainfall, making it ideal for exploring the famous temples of Angkor and enjoying outdoor activities.

Q: Do I need a visa to visit Cambodia?

A: Yes, most visitors to Cambodia need a visa. However, citizens from certain countries are exempt from obtaining a visa or can obtain one on arrival. It’s recommended to check with the Cambodian embassy or consulate in your country for the most up-to-date visa requirements.

Q: What currency is used in Cambodia?

A: The official currency of Cambodia is the Cambodian Riel (KHR). However, US dollars are widely accepted and often preferred for larger transactions, especially in popular tourist areas. It’s advisable to carry a mix of both currencies when traveling in Cambodia.

Q: What are the must-visit destinations in Cambodia?

A: Cambodia offers a wealth of attractions, but some must-visit destinations include the ancient temples of Angkor in Siem Reap, the capital city of Phnom Penh with its rich history, and the beautiful coastal areas like Sihanoukville and Koh Rong.

Q: Is it necessary to take malaria medication when visiting Cambodia?

A: Malaria is present in certain parts of Cambodia, especially in rural areas. It’s advisable to consult with a healthcare professional or travel medicine clinic before your trip to determine if malaria medication is necessary and to take appropriate precautions against mosquito bites.

Q: What is the local cuisine like in Cambodia?

A: Cambodian cuisine is known for its blend of flavors and influences from neighboring countries. Some popular dishes include fish amok (steamed fish in coconut curry), lok lak (marinated beef stir-fry), and num banh chok (rice noodles with fish-based curry). Don’t miss trying the delicious fruit shakes and fresh tropical fruits too!

Q: Can I use credit cards in Cambodia?

A: Credit cards are widely accepted in major hotels, restaurants, and larger establishments in Cambodia, particularly in popular tourist areas. However, it’s advisable to carry some cash, especially in more remote locations and smaller establishments where cash transactions are more common.

Q: What should I wear when visiting religious sites in Cambodia?

A: When visiting religious sites, such as temples or pagodas, it’s important to dress modestly and respectfully. Both men and women should cover their shoulders and wear clothing that covers their knees. Carrying a scarf or shawl to cover up when necessary is also recommended.

Q: Are there any cultural customs or practices I should be aware of in Cambodia?

A: Yes, there are a few cultural customs to keep in mind. It’s polite to remove your shoes before entering someone’s home or a place of worship. Additionally, it’s considered respectful to avoid touching someone’s head, as it is considered sacred in Cambodian culture. Showing respect to elders and monks is also appreciated.

To Conclude: Tourism in Cambodia

Cambodia, where history whispers through ancient temples and untouched nature flourishes, reaffirms its stature as a Southeast Asian marvel. As our exploration draws to a close, spanning its archaeological wonders to verdant landscapes, the magnetic appeal of Cambodian tourism is undeniable. For those seeking a voyage anchored in cultural depth and scenic splendour, Cambodia stands as an evocative testament to the region’s rich heritage.

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• 2 February 2023

The Royal Government of Cambodia has acknowledged the potential of the tourism industry as a source of Cambodia’s socio-economy growth, including job creation and poverty reduction. Tourism has been considered one of Cambodia’s key economic pillars, both international and domestic. In the early 2000s , the top foreign tourists to Cambodia were westerners from the United States, United Kingdom, and France. 1 Chinese tourists have topped the 2019 Cambodia arrival list accounting for 2.36 million visitors. 2 It shows an 18 percent increase from 2018. Chinese tourists remain at the top for 2020, followed by Thailand and Vietnam . 3 Other tourist arrivals are from the United States, the Republic of Korea, Japan, France, and Chinese Taipei. 4 For outbound departure, Cambodia has traveled the most to Thailand (42 percent), Vietnam (30 percent), Taiwan (12 percent), China (5 percent), Malaysia (4 percent), and the rest of the world (7 percent) in 2019. 5

In 20 19, there were approximately 11.3 million domestic and 6.61 million international tourists. 6 In 2022, Cambodia recorded 2.2 million international visitors, an 11 percent increase from the previous year. 7 International tourist revenue shared of Cambodia’s GDP was 9.44 percent in 2000 . 8 The number increased to 19.61 percent in 2019. 9 International tourist receipts are equivalent to 228 million USD in 2000 and 4,919 million USD in 2019. 10 However, the number dropped significantly in 2020 as the world was hit with COVID-19’s quarantine and travel restrictions. In 2020, international tourist receipts dropped threefold from the previous year to around 1,023 million USD. 11

Tourism directly employed 630,000 workers , of which 60 percent were women in 2019. 12 The sector is only second to the garment sector with the largest number of women employed. In terms of hotels and accommodation, a s of 2020 , a total of 1,028 hotels provide 44,428 rooms residing in 25 provinces across Cambodia. 13 Another accommodation type is the guesthouse, in which 2,755 units are divided into 35,791 rooms are available for tourists. 14 As the tourism industry grows and demand for accommodation spike over the year, the number of hotels and guesthouses also increase. In 1998, there were only 216 hotels and 147 guesthouses. It shows a growth rate of 386 percent and 1.740 percent for hotels and guesthouses, respectively. 15

Cambodia’s top tourist destination is the Angkor Archaeological Park in Siem Reap. The park covers 400 square kilometers and consists of forest areas and many ancient temples. It is home to Angkor Wat temple, the largest religious temple in the world. The temple was listed as UNESCO World Heritage in 1992. 16 Angkor Wat and other temples in the Angkor Archaeological Park have generated millions of dollars and attracted millions of local and international travelers each year. In 2019 , Angkor Wat attracted approximately 2.2 million international tourists generating 99 million USD in revenue through ticket sales. 17 Other tourist’s popular destinations are coastal areas (Preah Sihanouk, Koh Rong, Kep, Koh Kong, and Kampot), mountain areas (Battambang, Rattanakiri, Mondulkiri, Pursat), and ecotourism that spread out across the countries .

Ecotourism and Communities-Based Ecotourism (CBET) in Cambodia

The United Nations World Tourism Organization defines ecotourism as “all nature-based forms of tourism in which the main motivation of visitors is the observation and appreciation of nature as well as the traditional cultures prevailing in natural areas.” 18   While communities based ecotourism involves the local communities’ participation and natural resource management, who will gain direct benefits through ecotourism activities in their areas. 19 As communities-based ecotourism generate profit for the local, it also preserves the natural resources and environments. For a country with rich natural landscapes and attractions, Cambodia has the potential for ecotourism development. 20  

In the last decades, ecotourism has experienced rapid growth. The main reason for the change is the government’s prioritization of diversifying the sector and the need for sustainable tourism. I n 2017 , the interministerial ecotourism task force was formed to manage and develop potential communities based tourism in Cambodia. 21 In addition, i n 2021 , based on the success of the interministerial task force, the National Committee for Management and Development of Community-Based Tourism and Ecotourism (NCDCBE) was established. 22  

Virachey National Park, Ratanakiri, Cambodia. Photo taken from Ministry of Tourism’s Facebook page on 05 October 2017.

As of 2019, the Ministry of Tourism stated that there are around 266 ecotourism sites, 13 of which are community base ecotourism operating across Cambodia. 23  In 2019 , ecotourism shared 16 percent of the total tourist visit in Cambodia. 24 The number has accelerated during the COVID-19 pandemic as the demand for domestic tourism increased due to international travel restrictions. In 2022, The Ministry of Environment approved 307 small-scale ecotourism projects, which shows a hike in ecotourism demand in the past few years. 25 Also, the Ministry of Agriculture has identified 131 agricultural communitie s that have the potential to convert into communities-based ecotourism that can improve the local’s living standard. 26

In collaborating with the World Bank, the Ministry of Environment implemented the Sustainable Landscape and Ecotourism Project (CSLEP) in 2019. The 50.66 million USD project aims to promote ecotourism and non-timber forest products in the Cardonmon mountain and Tonel Sap landscape, which they identified as potential areas for communities-based ecotourism development; namely, the Koh Kong province, Siem Reap province, and Phnom Aural protected area. 27 Under the CLSEP project, various frameworks are published including the Process Framework of the Cambodia Sustainable Landscape and Ecotourism , Indigenous People Planning Framework of the Cambodia Sustainable Landscape and Ecotourism and Resettlement Policy Framework of the Cambodia Sustainable Landscape and Ecotourism.

Tourism in the context of the COVID-19 pandemic

Having tourism as one of their main source of revenue, Cambodia felt the impact of COVID-19 . At the beginning of the pandemic, the tourism sector was drastically affected. The reason is mainly due to the travel restriction that prevents foreign tourists from traveling. 28 Foreigners visiting Cambodia dropped significantly from 6.61 million in 2019 to 1.3 million visitors in 2020. 29   It is estimated that Cambodia has lost 3 billion USD of tourism revenue to the COVID-19 pandemic. 30

I n 2020 , Tourism-related employment decreased by 21.7 percent from the previous year. 31 It was equivalent to 2.33 million in employment in 2019 to 1.82 million in 2020. 32 As of September 2020 , the Ministry of Tourism reported that about 3000 tourism-related businesses were closed or suspended. 33 About 62 percent o f the affected business were based in Siem reap, forcing nearly 15,000 workers out of jobs. 34 Most suspended or laid-off workers turn to the agricultural sector to support their daily incomes.

The government has initiated various long and short-term recovery responses to retrieve the tourism industry. Those measures include tax/fee exemptions and cash support/loans for tourism-related businesses and enterprises, vaccination campaigns and capacity development for employees in the tourism sector, and infrastructure development. For instance, on February 2020 , a policy on monthly tax exemption for all hotels and guesthouses in Siem Reap was issued. This tax exemption policy for tourism-related accommodation has been extended until March 2023 . In addition, on May 2022, the government launched 150 million USD of the Tourism Recovery Co-financing Scheme (TRCS), which comes from the RGC’s contribution of 75 million USD through the Small and Medium Enterprise Bank of Cambodia (SME Bank) and Participating Financial Institutions (PFIs) contribution of 75 million USD. The enterprises in the tourism sector affected by the COVID-19 crisis can apply for loans from participating financial institutions that are partners of SME Bank at a concessional interest rate. 

The government has implemented the Roadmap for Recovery of Cambodia tourism during and post COVID-19 . The roadmap is a comprehensive guideline that aims to strengthen the tourism sector during the post-COVID-19, mitigate the negative impact of the pandemic, and promote Cambodia’s prestige and tourism as a safe destination for post-pandemic. The roadmap consists of three phases of recovery such as: 

• Phase 1: Crisis management in the new normal phase and planning for recovery (2020-2021)
• Phase 2: Recovery of the tourism sector in Cambodia in the post-COVID (2022-2023)
• Phase 3: Preparation for the new future of the tourism sector in Cambodia (2024-2025).

Challenge and way forward

Despite gaining a large number of international tourists each year, Cambodia’s tourism sector still has room for improvement and to capitalize on the potential. The kingdom heavily depends on Angkor Wat as the main tourist attraction has made the country’s tourism sector vulnerable to external shock. For instance, the COVID-19 pandemic has presented a reality test for Cambodia’s tourism sector. The travel restrictions and border closure negatively affect all tourism-related businesses, especially in tourism-driven provinces such as Siem Reap and Preah Sihanouk.

A limited selection of destinations is also a problem. Cambodia needs to diversify the tourism sector in order to keep the average length of tourists’ stay high. In 2018, the average length of stay of international tourists was seven days, one day shorter than in 1995. 35 The longer stay usually means more spending, thus generating more revenue for the sector. Diversifying the tourism sector to more than just temple tours will attract tourists to stay longer as it offers more options for tourists to explore. The government has recognized ecotourism as a solution to diversify the tourism industry. In addition, the Strategic framework and programs for economic recovery and to promote Cambodia’s economic growth in living with COVID-19 in the new normal for 2021-2023 has identify areas for tourism diversification such as the coastal areas, northeastern regions, and natural landscapes such as Tonle sap, Mekong, and Bassac river.

Another issue associated with Cambodia’s tourism is poor infrastructure and limited transportation . 36 Infrastructure and transportation in other areas besides popular international destinations are often poor quality and underdeveloped.  Roads, network connectivity, electricity, clean water, and sanitation in remote tourist sites can be unsatisfactory. 37 The establishment of the Master Plan for Siem Reap Tourism Development 2021-2035 , Master Plan for Mondulkiri Tourism Development 2021-2035 , the Phnom Penh-Sihanouk expressway, the new Siem Reap international airport are the government’s attempts to enhance and diversify the sector through infrastructure and connectivity development.

For 2023, Cambodia’s government has projected to receive four million international tourists, providing a positive aspect for a post-COVID-19 recovery in the tourism sector. 38 This could generate 4 billion USD in revenue for the country. 39

Related to Tourism

• Economy and commerce
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• 2 . Khmer Times Staff, “ Chinese top tourist arrivals in 2019, ” Khmer Times, February 2020, accessed January 2023.
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• 5 . World Travel Tourism Council, “ 2022 Annual Research: key highlights, ” 2022, accessed January 2023.
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• 8 . Global Economy, “ Compare countries with annual data from official sources ,” accessed January 2023.
• 10 . Ministry of Tourism, “ Tourism Statistic Report February  2022 ,” February 2022, accessed January 2023.
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• 18 . United Nations World Tourism Organization, “ Ecotourism and protect areas, ” accessed January 2023.
• 19 . Phe Siphannara, “ Overview of community-based ecotourism for sustainable development in Cambodia ,” September 2019, accessed January 2023.
• 20 . OECD, “ Structural policy country note: Cambodia ,” Economic outlook for Southeast Asia, China India 2019: Towards smart urban transportation, December 2019, accessed January 2023.
• 21 . Post Staff, “ Hun Sen gives nod to creation of ecotourism task force ,” November 2017, accessed January 2023.
• 22 . Tin Sokhavuth, “ Gov’t orders formation of NCDCBE to boost tourism sector ,” October 2021, accessed January 2023.
• 23 . Phe Siphannara, “ Overview of community-based ecotourism for sustainable development in Cambodia ,” September 2019, accessed January 2023.
• 24 . Rawlins, et al, “ Enabling ecotourism development in Cambodia, ” World Bank, 2020, accessed January 2023.
• 25 . Sok Sithika, “ 307 small nature tourism projects approved in September, ” Khmer Times, October 2022, accessed January 2023.
• 26 . Khmer Times Staff, “Ministry identifies 131 potential ecotourism communities, ” Khmer Times, July 2022, accessed January 2023.
• 27 . Ministry of Environment, “ Cambodia Sustainable Landscape and Ecotourism Project, ” February 2020, accessed January 2023.
• 28 . Ngin Chanrith, “ COVID-19 and the Tourism sector in Cambodia: impact, response and the road to recovery, ” 2022, accessed January 2023.
• 30 . Ministry of Tourism, “ Roadmap for Recovery of Cambodia tourism during and post COVID-19,” 2021, accessed January 2023.
• 31 . World Travel Tourism Council, “ 2022 Annual Research: key highlights, ” 2022, accessed January 2023.
• 33 . Khmer Times Staff, “ 51,000 tourism-based jobs in Cambodia vapourised because of COVID-19 pandemic ,” Khmer Times, November 2020, accessed January 2023.
• 35 . Perter Varga, “ Angkor Wat: The Impact of Mass Tourism, ” EHL insight, accessed January 2023.
• 36 . George Styllis, “ Tourism slowdown threatens Cambodian model ,” July 2016, accessed January 2023.
• 38 . Khmer Times Staff, “ Four million international tourists expected by Cambodia this year after China’s pandemic strategy optimization ,” Khmer Times, January 2023, accessed January 2023.
• 39 . Chea Vanyuth, “ Cambodia expects tourism generating $4B in 2023 ,” Khmer Times, January 2023, accessed January 2023.

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Report Reveals COVID-19’s Deep Impact on Cambodian Tourism Economy

First the industry was devastated by the collapse of international visitors. Then the virus began its rapid spread.

Nearly half of tourism-related businesses in Cambodia have been forced to close their doors due to the compounding impacts of the COVID-19 pandemic, according to a new survey report published by the Asia Foundation last week.

Based on surveys conducted with around 1,000 tourism-related small and medium enterprises in various parts of the country in April 2021, the report found that 47 percent of tourism-related enterprises had ceased their operations since the beginning of the pandemic. Just 22 percent of businesses said that their operations were unchanged from before the arrival of COVID-19.

The businesses included both officially registered business – such as hotels, restaurants, travel agents, and karaoke bars – and the host of informal enterprises clustered around Cambodia’s tourism economy, which include street vendors and tuk-tuk drivers.

In full: https://thediplomat.com/2021/08/report-reveals-covid-19s-deep-impact-on-cambodian-tourism-economy/

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How the Tourism Boom in Cambodia Has Impacted Urban Poverty

The Economic Impact

In the first seven months of 2023, Cambodia welcomed 409% more international visitors, a significant growth compared to the same period in 2022. The tourism boom in Cambodia has caused a significant economic boost in the urban centers, particularly in cities like Siem Reap and Phnom Penh. The rise in tourist arrivals has led to a surge in demand for services, creating employment opportunities in many sectors, such as hospitality, transportation and retail.

Employment Opportunities

One of the most visible impacts of the tourism boom in Cambodia is the increase in job opportunities. Specifically, the hospitality sector, including hotels, restaurants and tour guides, has experienced significant growth, providing jobs for a large portion of the urban workforce. Due to the growth of this sector, there was an increased demand for specialized training. In 2023, the Ministry of Tourism responded by providing hospitality training to approximately 4,106 young people from economically disadvantaged families. These trainings took place across 10 Cambodian provinces and helped to strengthen the hospitality sector.

Entrepreneurial Opportunities

Beyond traditional employment, the tourism boom in Cambodia has spurred entrepreneurial activities. Many individuals have taken the opportunity to establish small businesses catering to the needs and preferences of tourists. In fact, in the first 11 months of 2023, the Ministry of Commerce recorded 11,056 new businesses. This number showed an increase of about 15% in new businesses compared to the previous year.

Infrastructure Development

Recognizing the potential of tourism as a cause of economic growth, the Cambodian government has invested significantly in infrastructure development. Remote communities, previously isolated due to inefficient transportation networks, are now much better connected. As a result, economic development is fostered with new markets for local products and creating trade opportunities.

Community Development

The positive impact of the tourism boom in Cambodia goes far beyond the economic realm, benefitting community development and social welfare. As tourism revenue flows into the country, the Cambodian government and local authorities have increasingly directed these profits toward needed services, such as education and health care. 

Tourism revenue has been channeled into building schools, providing scholarships and improving educational infrastructure. Similarly, the health care sector has received much-needed attention. Medical facilities in regions with a high influx of tourists have been enhanced, ensuring that both local residents and visitors have access to quality health care services.

Overall, the boom in Cambodia tourism has generated a large profit. This revenue has helped create new job opportunities, enhance infrastructure and improve the quality of life for impoverished communities in the country.

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WHY CHOOSE TO SUPPORT SUSTAINABLE TOURISM IN CAMBODIA

Sustainable tourism in Cambodia matters!

Traveling is one of our favourite activities, but sometimes it can have a harmful effect on the environment. It may also put pressure on the environment, especially when there’s a huge number of visitors in regions where the resources are already inadequate, like in Cambodia.

Unrestrained traditional tourism can be a possible threat to lots of natural resources in South East Asia, including:

• Forests regularly endure the destructive effect of tourism due to deforestation created by land clearing for hotels, as well as being used as building material and fuel for the tourism industry.
• Loss of natural habitat and wildlife due to loss of natural environment and forest that leads to degradation of local biodiversity. As many as 23 endangered or critically endangered species can be found in just one corner of Cambodia, in the wilderness that gently bumps up to Vietnam’s boarders.
• Water shortage – It is very evident that the tourism industry overuses the water resources for the development of golf courses, swimming pools, hotels, and even the personal use of water by some tourists.
• Tourism may positively impact Cambodia and the large cities in terms of economic advantages, employment opportunities, foreign exchange earnings, and growth in the service sector, however very little of these benefits trickle down to remote areas and rural communities.

For these and many other reasons, sustainable tourism in Cambodia matters. We think, as many others do, that the impact of our travels on the environment, local community and local eco-systems should be minimal.

We know that your time is precious, your vacation time is short and the year is long, and that you might have many options for your gap year.

There are far too many options for where to go, what to see and what activities you should choose to do. If you choose to travel sustainably in Cambodia, it does not mean missing out on the many awe-inspiring, once in a lifetime experience that this diverse, beautiful, fascinating and complex country has to offer. On the contrary, sustainable tourism is your passport into an authentic experience in Cambodia and this part of Southeast Asia.

With so many places to choose from and with such a wide range of experiences on offer, it can be extremely confusing and difficult to make the most sustainable and “green” choice for your trip. WE HEAR YOU! You want to choose carefully where we go, where we stay and how we use our money… ensuring that your money is used wisely and that your spending meets your values and principles.

We understand how damaging it is: to visit children’s orphanages, to go to animal petting wildlife sanctuaries or to pay for riding the elephants… therefore the only way to be and to travel to SUPPORT SUSTAINABLE TOURISM IN CAMBODIA.

If we can get more people, like you, to  choose local community based  tourism experiences and visits to ecotourism sites, sustainable tourism  can become an effective tool for sustainable development in rural Cambodia. Here are just few examples of the power sustainable travel has:

• As a direct result of your visit,  local communities will be able to achieve an increase in their families income, leading to a reduction in poverty and more educational opportunities for their children.  This is possible due to the creation of  alternative livelihood options through community-based tourism businesses and employment opportunities.
• It helps to safeguard natural resources and it helps to protect endangered species such as gibbons, elephants, Giant Ibises etc.
• Empowered local communities – especially for women and young people.

CHARITY IS NOT THE SOLUTION, SUSTAINABLE EMPLOYMENT AND EDUCATION ACHIEVED THROUGH SUSTAINABLE TOURISM IN CAMBODIA CAN BE THE SOLUTION!

For you, sustainable travel not only offers you the chance to see a side of Cambodia that few do, but it also enables travelers to have “real” experiences while meeting local people, experiencing the richness of local culture and exploring the natural biodiversity.

Year 2017 was appointed as the International Year of Sustainable Tourism for Development by the United Nations with the campaign slogan of Travel.Enjoy.Respect. Since the start of the year, the  World Tourism Organization (UNWTO)  – the United Nations Specialized Agency for Tourism has been working tirelessly to raise awareness of the extensive role sustainable tourism plays in development, and its immense socio-economic opportunities while encouraging all stakeholders to work together to build a better, more sustainable future through tourism.

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Angkor Wat: The Impacts of Mass Tourism

October 18, 2019 •

6 min reading

Overtourism is now a term that is frequently used to describe the negative impacts of excessive tourism on a destination. The impacts of overtourism are numerous and even if the term is quite new, we can find traces of this concept already among scholars in the beginning of mass tourism . Plog, for example, related the evolution of the number of tourists in a destination to the type of tourists visiting that same destination.

Tourists are divided into 3 categories:

• Allocentric tourists with a preference for non-touristy areas and novel destinations
• Midcentric tourists , being less adventurous and preferring quasi mainstream attractions
• Psychocentric tourists , seeking familiarity and preferring tour packages.

What the figure below below illustrates is that the more touristic the destination is, the more psychocentric the tourists are. This modification in tourists’ segments has a direct impact on the destination.

Typically, psychocentric travelers can cause cultural change, because of their demand for standardized infrastructures and services, economic leakage because of their use of services provided by foreigners (e.g. tour packages) and loss of clients, because allocentric and mid-centric tourists will leave for other destinations.

Figure 1: Plog’s tourist model of destination preferences

Cambodia, and more specifically, Angkor Wat’s nearby city Siem Reap, is a great example of this phenomenon.

• In 1992, the archaeological site of Angkor is added to the UNESCO World Heritage list. With the political stabilization in the country, tourism explodes.
• While only 118,183 international tourists visited the country in 1993, Cambodia hosted 6,201,077 visitors in 2018 .
• To host the booming tourism, an airport is built in Siem Reap in 2006.
• In 2017, Angkor Wat is chosen as the World’s Top Tourism Landmark by TripAdvisor .
• In 2018, 2,590,815 foreign visitors arrived in Siem Reap, representing 38.3% of the country’s international tourism.

Tourism growth has impacted tourism segments throughout the years.

In the early 2000s, the main visitors to Cambodia were westerners (USA, France, UK). Now China, Vietnam, Laos, Thailand and Korea account for 67.1% of the tourism industry, with 32.6% for the Chinese market, which represents an increase of 67.2% between 2017 and 2018.

In 2011, Chheang studied tourists’ motivations to visit Angkor Wat. The study showed that the main interests to visit the region were learning new things, local culture and history and experience the local atmosphere. These interests, which could be attributed to allocentric travelers, were stronger among non-Asian tourists than among Asian tourists. The increase of Asian tourists in Angkor Wat could lead to the replacement of allocentric travelers by psychocentric travelers.

Cambodia and Angkor Wat are becoming increasingly attractive to Chinese tourists.

Cambodia’s Deputy Prime Minister declared wanting to target 20 million Chinese tourists in 2020 and he uses all the necessary means to achieve his objective.

There are currently 31 direct flights per week between Siem Reap and China, Chinese investments are encouraged by the government (e.g. a Chinese company obtained a concession to build a new airport near the Angkor Wat area, the construction is expected to be completed by 2022) and the government created an accreditation for “Chinese-friendly” tour operators, based on the criteria of the Ministry of Tourism’s China Ready Center.

But what are the impacts of these modifications of tourism segments?

First, Chinese tourists tend to frequent Chinese-owned businesses and usually book organized tours with them. These preferences, typical of psychocentric travelers, increase the economic leakage, already very high in Cambodia.

In 2008, although only 15% of the touristic infrastructure in Siem Reap was owned by foreigners, 28.3% of the benefits left the country. Moreover, Chinese tourists usually spend only a few days in the destination, therefore, they spend little. In 2018, the average length of stay was seven days, one day less than in 1995. Chinese tourists, and more generally, the Asian tourism market is booming, replacing slowly the decreasing old markets, like westerners.

On the other hand, with the great relations between Cambodia and China, many Chinese companies are investing in the development of the country, creating jobs, building bridges, roads and solar power plants. Moreover, Chinese tourists are also interested in nature, this is the second main attraction for them in Cambodia, after culture. To meet their demand for nature, the Cambodian government promotes and develops eco-tourism. For example, Kulen Revealed, has provided, since 2018, community-based ecotours in Kulen Mountain, near Siem Reap.

A Chinese-dominated tourism economy generates diverse impacts in a destination such as Siem Reap.

The tourism strategy needs to be managed carefully, focusing on the right segments to avoid irreversible impacts. In Thailand, Chinese tourists are also a major segment, representing 8.7 million visitors in 2016. The government had to take measures, like banning cheap tours bringing no benefits to the country or discouraging big tour groups.

These measures, combined with cultural differences between the level of education between tourists and the local population, can limit the conflicts and avoid tourism rejection seen elsewhere (e.g., Venice, Barcelona, etc.). Moreover, the new Chinese generation differs from its predecessors. They are mostly independent travelers, seeking unique experiences.

With 149.2 million Chinese tourists in the world in 2018, destinations need to understand how they can tap into this growing market, without compromising the interests of other markets.

References:

Aldama, Z. (2017). How Chinese tourists are changing the world. Post Magazine . Retrieved from: https://www.scmp.com/magazines/post-magazine/long-reads/article/2113116/how-chinese-tourists-are-changing-world

CAPA. (2018). Siem Reap new international airport. CAPA . Retrieved from: https://centreforaviation.com/data/profiles/newairports/siem-reap-new-international-airport

Chheang, V. (2011). Angkor heritage tourism and tourist perceptions. Tourismos: an international multidisciplinary journal of tourism, 6 (2), 213-240. Retrieved from: http://www.chios.aegean.gr/tourism/VOLUME_6_No2_art13.pdf

Construction & Property. (2019). Cambodia to see massive infrastructure investment from Chinese firms. Construction & Property . Retrieved from: https://www.construction-property.com/read-news-1612/

Connor, L. (2019). ‘They only go to Chinese shops’: why Cambodia’s influx of mainland tourists is causing tensions. This week in Asia . Retrieved from: https://www.scmp.com/week-asia/society/article/2180257/they-only-go-chinese-shops-why-cambodias-influx-mainland-tourists

Neth, B. (2011). Angkor as World Heritage Site and the Development of Tourism: A Study of Tourist Revenue in the Accommodation Sector in Siem Reap-Angkor. In: World Heritage Angkor and Beyond: Circumstances and Implications of UNESCO Listings in Cambodia (pp.147-176). Retrieved from: http://books.openedition.org/gup/313

Peltier, D. (2018). Independent Chinese travellers close gap with tour groups. Skift . Retrieved from: https://skift.com/2018/10/29/independent-chinese-travelers-close-gap-with-tour-groups/

Plog, S. C. (2001). Why destination areas rise and fall in popularity: An update of a Cornell Quarterly Classic. Cornell Hotel and Restaurant Administration Quarterly, 42 (3), 13-24

Southern, N. P. (2017). Cambodia’s tourism industry: A Kingdom for more tourists. Globe. Retrieved from: https://southeastasiaglobe.com/cambodia-future-tourism/

Sullivan, N. (2015). Siem Reap warned Chinese tourists pose challenge and opportunity. The Phnom Penh Post . Retrieved from: https://www.phnompenhpost.com/siem-reap-insider/siem-reap-warned-chinese-tourist-post-challenge-and-opportunity

Tourism Statistics Department, Ministry of tourism [MOT]. (2006). Cambodia tourist statistical report 2006. Ministry of tourism . Retrieved from: https://www.catacambodia.com/Cambodia%20Tourism%20Statistics%20-%202006.pdf

Tourism Statistics Department, Ministry of tourism [MOT]. (2018). Tourism Statistics Report - Year 2018. Ministry of tourism . Retrieved from: https://amchamcambodia.net/wp-content/uploads/2019/04/Year_2018.pdf

Vannak, C. & Manet, S. (2016). Cambodia-China tourism pact. Khmer Times . Retrieved from: https://www.khmertimeskh.com/7913/cambodia-china-tourism-pact/

Xinhua (2019). Chinese tourists make nearly 150 mln outbound trips in 2018. China Daily . Retrieved from: http://www.chinadaily.com.cn/a/201902/14/WS5c64e2fca3106c65c34e9528.html

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Lessons from COVID-19's impact on medical tourism in Cambodia

Makoto kosaka.

a Internship, Kitahara International Hospital, Hachioji City, Tokyo, Japan

b The University of Tokyo, Bunkyo City, Tokyo, Japan

Yurie Kobashi

c Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan

d Kitahara International Hospital, Hachioji City, Tokyo, Japan

Kensuke Kato

e Department of Neurosurgery, Sunrise Japan Hospital Pheon Penh, Pheon Penh, Cambodia

Manabu Okawada

f Department of Pediatrics, Sunrise Japan Hospital Pheon Penh, Pheon Penh, Cambodia

Masaharu Tsubokura

Making medical tourism a more valuable healthcare system is a significant public health issue. However, little discussion has been conducted on what lessons can be learned from the impact of COVID-19 on medical tourism. This study aimed to discuss the issues and barriers faced by patients unable to seek medical tourism, and the medical care experience at private general hospital in capital, Cambodia. First, when patients seeking medical tourism were unable to go abroad due to the pandemic or other reasons, some of them could not easily visit domestic health care facilities. Second, even if patients received medical care in the home country's hospitals due to the interruption of medical tourism, sharing the patient's medical information between domestic and overseas medical institutions was difficult. The third problem in medical tourism is that dependence on overseas medical resources might hinder the development of medical professionals, facilities, and other environments in the country of origin. This experience revealed the need to encourage patients who were unable to undertake medical tourism to visit domestic medical facilities, make efforts to share patient information across countries, and to invest in developing each department in domestic hospitals. Support for patients who are unable to undertake medical tourism is urgently needed.

1. Medical tourism in Cambodia

Medical tourism is the medical care that patients seek across national borders. Patients seek medical tourism for various purposes; however, medical tourism is mainly in two directions: patients from low-and middle-income countries (LMICs) seeking higher quality medical care and patients from high-income countries (HICs) seeking low-cost medical care [ 1 ]. The host countries consider medical tourism as a source of economic profits [ 1 ]. Previous research in Korea, a patient-accepting country, concluded that the benefits of medical tourism outweigh the negative impacts of universal health coverage and the constriction of medical supply [ 2 ]. Moreover, medical tourism might be a powerful tool for reducing inequalities in healthcare worldwide [ 3 ]. Therefore, making medical tourism a more valuable healthcare system is a significant public health issue.

However, medical tourism is greatly influenced by COVID-19. Many countries have closed national borders, imposed isolation rules for residents from abroad or foreigners, and have made negative polymerase chain reaction (PCR) results mandatory for entry into the country. For instance, Bumrungrad Hospital in central Thailand, catering to half of the overseas patients, reached a 32.9% of decrease in patients in 2020 compared to the previous year [ 4 ].

Further, the effects of COVID-19 on medical tourism have continued into 2021 [ 5 ], adversely affecting medical tourism. However, little discussion has been conducted on what lessons can be learned from the impact of COVID-19 on medical tourism and what improvements are required to make medical tourism a part of a more beneficial healthcare system.

Cambodia, located in Southeast Asia, is a country where many patients undertake medical tourism to seek high-quality medical care [ 6 ]. Cambodian people go to other countries for medical checkups, surgical treatment, and chronic disease treatment. Many people have sought medical tourism to date; for instance, 3,837 patients made more than 10,000 trips to Thailand for medical care in 2010 [ 7 ]. Medical tourism is not only meant for wealthy people, but also for people of middle economic status in Cambodia, due to the concern for their health and the ease of traveling across the border to neighboring countries. Thus, medical tourism is an essential part of Cambodia's healthcare. Moreover, patients have less trust in domestic medical care owing to the extremely sparse number of medical professionals who emerged under the Khmer Rouge regime of 1975–79; the number of doctors was estimated to be 6,550 in 2016, approximately 0.4 doctors per 1,000 people [ 8 ].

In Cambodia, the total number of people infected with COVID-19 surged in April 2021 and reached 13400 on April 30, 2021, in spite of measures such as quarantining of people entering the country, lockdowns, and community residents’ education to protect them from infection. Due to restrictions on travel as a countermeasure of infection prevention, some patients who sought medical tourism are now visiting public and private hospitals in Cambodia. One such private hospital is Sunrise Japan Hospital Phnom Penh (SJH), which was established by Sunrise Healthcare Service, a joint venture between Japanese private companies (JGC Japan Corporation, Innovation Network Corporation of Japan, Kitahara Medical Strategies International) in 2016. It currently has 50 beds and provides medical care in 14 departments, including neurosurgery, pediatrics, and emergency medicine. In SJH, the number of patients varies each month, and the patient characteristics have changed since the COVID-19 pandemic.

This study aimed to discuss the issues and barriers faced by patients unable to seek medical tourism, and the medical care experience at SJH. We discussed the improvements required to make medical tourism a part of a more beneficial healthcare system.

2. The issues and barriers to seek medical tourism under COVID-19 influence

First, when patients seeking medical tourism were unable to go abroad due to the pandemic or other reasons, some of them could not easily visit domestic health care facilities. In the case of Cambodia, during the pandemic of COVID-19, some patients whose medical tourism was interrupted due to COVID-19, did not visit a domestic medical institution for more than a year, some purchased over-the-counter medicines in Cambodia without visiting hospitals or clinics, worsening their pre-existing conditions. Besides, medical tourism will be discontinued, not only due to the risk of pandemics like COVID-19, but also because of the high price of medical tourism itself. A previous study showed that 43% of medical tourists in the Maldives, an LMIC patient sending country, were forced to bear destructive household burdens [ 9 ]. Considering that medical tourism from Cambodia has an aspect of flight from domestic healthcare, similar phenomena may occur in Cambodia. This indicates that even if the pandemic is over and things return to normal, there will be patients who will have to give up medical tourism midway. For such patients to be able to visit domestic hospitals and clinics smoothly, establishing a system that allows them to easily access information on suitable domestic medical institutions is required. Besides, it is necessary to educate people on the importance of treatment continuity and cooperation between foreign and domestic hospitals.

Second, even if patients received medical care in the home country's hospitals due to the interruption of medical tourism, sharing the patient's medical information between domestic and overseas medical institutions was difficult. Some patients who discontinued medical tourism and visited SJH did not have complete documentation of their medical information and did not provide exact details of their disease. Thus, they had to perform all the tests again. They were unable to seek the best treatment because the doctors could not access the patient's medical history. This problem might be partly caused due to patients' low literacy level, and language barriers, causing miscommunication between the doctor and patient. In a previous study, the necessity of sharing information between overseas treatment institutions and family physicians was discussed to ensure the continuity of treatment in medical tourism [ 10 ]. In the field of medical tourism, it is necessary to pay more attention to the sharing of medical information and provide explanation to patients to ensure continuity of medical care. Changes to policies and regulations might be required to accelerate the sharing of patient's medical information crossing border.

The third problem in medical tourism is that dependence on overseas medical resources might hinder the development of medical professionals, facilities, and other environments in the country of origin. Although there is a neurosurgery department at SJH, several brain tumor patients had gone abroad before the COVID-19 pandemic; however, the majority of the brain tumor patients came to the capital hospital after the pandemic. A previous study reported barriers in medical oncology, surgery, radiotherapy, imaging, pathology, and palliative care departments for cancer patients who discontinued medical tourism due to the COVID-19 pandemic and went back to their countries; cooperation between these departments is needed [ 11 ]. Thus, to provide high-quality medical care tailored to each individual, the development of various sectors and cooperation between departments is required. Investment in medical facilities and human resources to break the vicious cycle of distrust in the home country's medical care that promotes medical tourism is required.

3. Conclusion

In this COVID-19 era, many patients are affected due to the loss of medical tourism. In Cambodia, where the obvious problem of providing medical care to people in own country as part of lifeline has not yet been solved, medical tourism has become a tentative solution that has prevented fundamental solutions to the problem. The COVID-19 pandemic has forced Cambodia to confront this problem by making medical tourism unfeasible. This experience revealed the need to encourage patients who were unable to undertake medical tourism to visit domestic medical facilities, make efforts to share patient information across countries, and to invest in developing each department in domestic hospitals. Support for patients who are unable to undertake medical tourism is urgently needed. Furthermore, medical tourism for profitmaking purposes might have a negative impact on sustainable healthcare, which needs to be reconsidered.

This study did not receive any specific funding.

Ethical approval

Not required.

Authorship contributions

MK, YK, KK, MO and MT contributed to writing the papers. All authors reviewed the present paper and contributed to the discussion of this work.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

We would like to thank Yoshifumi Okada, Mihoko Nakayama, and Sunrise Japan Hospital Phnom Penh staff for helping with this research.