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Cholera caused Kratie deaths

LABORATORY tests have confirmed that five people who died of severe vomiting and diarrhoea in Kratie province last month had contracted cholera, according to a health official who declined to provide further information on the number of cholera cases reported nationwide for fear it would impact tourism.

Ly Sovann, deputy director of the Communicable Diseases Control Department at the Ministry of Health, said Wednesday that the five deaths were the result of “acute watery diarrhoea caused by Vibrio cholerae”, a reference to the bacterium that causes cholera.

Asked if there were other reported cases of cholera in Kratie or elsewhere, Ly Sovann said, “I cannot make the data of the cholera cases public because we are afraid the data will hit profits in our country.” He went on to say that he was particularly concerned about how news of cholera cases might affect the Kingdom’s tourism sector.

Ly Sovann’s comments provided further evidence of the Health Ministry’s reluctance to acknowledge the recent presence of cholera in Cambodia.
Development partners and some health experts have in recent weeks said that it makes little difference whether cholera is diagnosed, and that the disease can be treated much like any case of acute watery diarrhoea.

We are doctors, not politicians or working in tourist offices.

However, not everyone has agreed.
In early February, health officials at a Phnom Penh paediatric hospital criticised the government for failing to announce an outbreak that they said had been reported to the Health Ministry last November, and suggested that economic considerations – in particular, the well-being of the tourism industry – were exerting undue influence over a matter of public health.

“We are doctors, not politicians or working in tourist offices,” Dr Beat Richner, director of the Kantha Bopha Children’s Hospital, said at the time. “For us as doctors, it is most important that the people are informed.”

In a series of open letters published in local media that month, Richner argued that, contrary to statements made by World Health Organisation officials, cholera was a particularly acute form of watery diarrhoea that could kill within hours, and that it should be treated with antibiotics.

Dr Pieter van Maaren, the WHO’s country representative, on Wednesday reiterated the WHO’s position that cholera should be treated in the same way as other cases of acute watery diarrhoea, and said it was not necessary for cholera test results to be made public.

“People have a very poor association with the word cholera, and this is really affecting the work that the [Health Ministry] and its partners do.

People get scared when they hear the word cholera,” he said.

He added: “From a WHO perspective, we are very much following the health situation in the country; whether or not there is tourism doesn’t make any difference to us.”

However, Ou Virak, president of the Cambodian Centre of Human Rights, said the government should be transparent about the number of cholera cases, and that past attempts by governments to de-emphasise reports of confirmed cases had contributed to the spread of the disease.

“No doubt it will have some impact on tourism,” he said, “but in the long run Cambodia will be a more trusted destination if we are transparent about this.”

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