THE cholera epidemic raging in Rattanakiri is still claiming hundreds of victims,

but experts are hoping that a Ministry of Health/World Health Organisation initiative

will put a halt to the spread of the disease in the next few days.

At Post press time, the official figures were 1,184 sick and 87 dead, in what is

the worst outbreak of the disease since Cambodian records began.

Dr Jerry Pais of Health Unlimited, who is currently based in Rattanakiri, said that

four teams of specialists from the MOH and WHO were working round the clock to treat

the sick and dying, and that health education messages were being spread by loudspeaker

accross the province to try and educate the villagers on how to protect themselves.

"Some of the teams are concentrating on disinfecting the water points; others

are disinfecting the houses and areas of the sick people," he said Wednesday

evening by telephone.

"We are still finding new cases, but with our teams handing out drugs to treat

those affected, we are hoping the rate of infection will decrease in the next few

days."

However, he predicted that the actual number of people affected was already higher

than the current figures suggested.

The source of the outbreak has been traced to a remote village, Bakalan, where the

first case of cholera was recorded on April 16. Since then, the outbreak has spread

accross at least four provinces. Lack of provincial healthcare and the remote nature

of the area has added to the tragic death toll.

Dr Eng Kunvuth, Chief of the Technical Department of Rattanakiri Provincial Hospital

said the lack of hygiene amongst the villagers was the root cause of the problem.

"They relieve themselves in the open fields and use water wherever they are.

They don't care about sanitation."

He added that it was difficult to treat a lot of the villagers as they often travelled

long distances to work during the day, so a medical team might visit a village but

find a large proportion of the inhabitants away from home.

"We're playing a game of hide and seek" he said.

Dr Kunvuth was also concerned that help was not getting to the villagers fast enough,

and said that he wanted drugs to be given not only to those already suffering from

the disease, but also to those in close proximity to them.

He said he needed 1,000 liters of serums, and 10,000 tablets of doxycycline for the

first emergency treatment, but that the Ministry of Health had provided him with

only a third that amount.

As there has been no such outbreak of cholera in Rattanakiri before, officials were

not prepared for the scale of the epidemic, and according to Dr Pais, some of the

teams that were deployed this week were concentrating on training up staff to be

able to administer treatment.

"If the spread is not halted, we're going to be very short-staffed," he

said.

Vaccinations are available against cholera, but according to Dr Pais, would take

some time to have effect, and so are not suitable for an outbreak that is already

so advanced.

Dr Kunvuth said he felt that the government had forgotten his province.

"I would like to tell all the leaders of the Ministry of Health that they should

not. . . let people continue to die every day. Remember the lives of the people in

Rattanakiri are as valuable as the lives of those in Phnom Penh."