Koh Sdach

"If you are planning on visiting the southern regions of Cambodia, it is worthwhile taking a trip to the island of Koh S’Dach. Koh S’Dach translates as “King’s Island” and is certainly fit for a king! The island is located approximately halfway between Koh Kong and Sihanoukville in the Gulf of Siam. The island is small in size but is deemed to be the fishing capital of Cambodia.
The island, like many places in Cambodia, takes its name from a legend. The story goes that in ancient times there was a travelling monarch who rested on the island with his troops. During their exploration of the island, they came across a bubbling spring coming up through the rocks.
This spring can still be seen and is called the Royal Spring (it is located near to the boat passenger port)."

Koh Sdach is a small fishing village island sit at the half way mark between Koh Kong and Sihanoukville and is a daily stop of the bullet-boat. The trip to Koh Sdach is attractive, passing the deserted islands, rocky coastline, and jungle-covered hills of Koh Kong province.
Accommodation is available on the island, and for those interested in experiencing a totally unadulterated stay in a Cambodian fishing village, then this isn't a bad choice.

Located just a twenty minute boat-ride off the Cambodian coast, Koh Sdach is dominated by a sizeable fishing village that stretches along the side of the island that faces the mainland. While fishing is the mainstay of the local economy, the village also has a large ice-making plant, where you can watch it being made and ferried off by boat to the surrounding islands.

On the far side of the island lies the island's main beach, a somewhat rocky affair that sits beside the island's premiere karaoke bar. You can swim here if you wish and the water is crystal clear, as an added bonus, while you're underwater you can't hear the karaoke. The island of Koh Sdach is surrounded by a bunch of other islands and the mainland, many of which have spectacular and totally deserted beaches - all of which can be visited on daytrips by longtail from Koh Sdach. In Koh Sdach are very few speaking English so if you speak even basic Khmer (or Thai) you'll be fine.

Koh Sdach has a hospital but it seems to be used more as a venue for volleyball practice than for medical treatment. According to information from one local resident, the doctors in the hospital have set up private practice and all patients are forced to visit them in this capacity. However, another resident claims that the medical services in the hospital are inexpensive and of reasonable standard. Access to clean water is marginal as the water was supplied to the houses was not particularly clean. Sanitary facilities do not exist in many houses and where they do, the sewage seems to be directly released into the sea. Spotting fecal matter in the sea around the island was hardly unusual.

Most of the houses are made of wood and have tiled roofs. A few concrete houses also exist and seem to be owned by the wealthier members of the community. Interestingly, Mr. Panya, one of the most prominent locals, lives in a wooden house (though one which is large and adjoins the jetty). The land for a wooden house costs US$8,000 to US$10,000 with the materials and workmanship costing another US$1,000 and represents a very significant investment for a local family.

The chief entertainment seems to consist of watching videos, eating out, singing karaoke and playing pool. Several eateries and roadside stalls can be found from morning to night. Many of the eateries double as video houses during the night. Food costs are moderate with a meal costing around US$0.50. Many karaoke joints are to be found on the side of the island opposite to the main area of habitation. Many pool houses are there on the main street and charge around US$0.70 per hour. Most of the locals seem to combine playing cards and pool.

There's a ferry going from Sihanoukville to Koh Kong. The halfway point is Koh Sdach, and its possible to pay half price just to get to Koh Sdach. The cost of the trip is $15. It takes around two hours.

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From a Travel Blog:

"The Koh Sdach Meanchey Guest House (the signs mostly just read Mean Chey Guesthouse) is one of two Cambodian-run guesthouses on the island. It has two sets of bungalows -- small, windowless wooden affairs by the karaoke bar and water, and baby blue concrete cinderblocks up on the hill, almost out of earshot of the karaoke.
We strongly recommend the blue houses on the hill over the wooden beachfront affairs -- unless you have industrial strength earplugs. The concrete rooms are very clean with mosquito nets, private bathrooms with squat toilets and cold water showers.
There's a Cambodian restaurant at the foot of the property and next door the restaurant Yvonne -- still mainly Cambodian, with a foreigner working there and a Cambodian staff member who knows a handful of words in English.
Duong Chai Guesthouse trumps Meanchey for its accommodation, though if being somewhere where there's at least a chance you can communicate in a European language with someone nearby is important and you want a restaurant on site, then pick Meanchey".