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Logo of Phnom Penh Post newspaper Phnom Penh Post - Rural health services in critical condition

Rural health services in critical condition

Australian doctor Frances Daily has been fighting to save people from malaria,

TB, AIDS, childbirth complications and other deadly threats in the remote

northern province of Oddar Meanchey.

But now she is fighting to simply

be able to continue the job of delivering health care to one of Cambodia's most

blighted provinces.

Malteser Germany, the NGO which employs Daily and her

small staff, has been providing affordable health care and supporting the

government's provincial health department in the western half of the province

since 1999, but funding for the Cambodian project has dried up.

Daily has

only one-third of the budget she needs to run her programs for 2001, and though

she has spent most of the past six months looking for funding, she currently has

no budget for 2002.

"I'm running against the clock. If we can't find any

funding we'll close by the end of the year and it will leave an enormous

population with a lot of serious health problems with little access to health

care," Daily said. "If we have to leave, then I feel like we should never have

come - the worst thing is to drive by and throw medicine out the window and

drive on."

Limited access to health care in Oddar Meanchey has larger

implications; Malteser's research found that half of the people they interviewed

had been forced to sell land or belongings in order to pay for care at private

clinics - a serious blow to the province's poverty-stricken

families.

Malteser's Cambodia operations were previously largely funded

by the European Commission Humanitarian Organization (ECHO), but the

organization decided it would stop funding for humanitarian projects in Cambodia

as it was deemed unnecessary. Instead, ECHO plans to support development

projects here.

Malteser has a staff of about 20 in Oddar Meanchey. The

program lost one expatriate doctor, one expatriate nurse and five local staff

last year due to funding cuts, leaving Daily and a Thai nurse as the only staff

with significant medical training to wage the battle against illness in Oddar

Meanchey.

The province is plagued with a number of serious health

problems, such as malaria, TB, leprosy, HIV/AIDS and B1 deficiency, as well as

more basic threats from diarrhea, respiratory infections, malnutrition and lack

of drinking water.

Complications in childbirth are also a major killer of

women in Oddar Meanchey, where about 99 per cent of babies are born in the

villages. There is only a temporary surgical facility available in the province

for women who encounter complications or who are need a ceasarean section.

Without that they must travel at least three hours on treacherous roads to

Thailand or Siem Reap. Malteser provides referrals to those

hospitals.

"It's not uncommon to see people carrying a woman in a hammock

along the road who has already been in labor for three days and has ruptured her

uterus," said Daily, 36, who previously worked in Africa, Thailand and East

Timor.

In addition, Malteser operates mobile vaccination clinics to

prevent children and women of child-bearing age from dying of preventable

diseases. Malteser hopes to start another mobile clinic program to visit

prostitutes in the border town of O'Smach in order to treat STDs and provide HIV

education.

Education is a crucial part of Malteser's work. A Malteser

survey revealed that about 70 per cent of people in the province did not know

that malaria was spread by mosquitoes, Daily said. Malteser has a health

promotion officer who conducts surveys in villages to learn about the villagers'

health-related knowledge and practices and then tailors programs to meet the

identified needs.

Three of the health centers that Malteser supports are

government centers (in Kon Kriel, Kok Mon and Ampil) and the fourth is a

temporary center in O'Pork that Malteser built because there was no government

health care for more than 25 kilometers. The O'Pork clinic is critical because

of a huge malaria problem and a soaring number of HIV infections in the area.

One of Malteser's other endeavors has been equipping and assisting the

Samrong Hospital, which was converted from a military hospital and opened in

May, 2000 with about $100,000 of donated equipment.

The government

hospital is run by a 28-year-old doctor and has a staff of only 12 people - many

of whom have little medical training and are stretched between several jobs. For

example, Eng Sak, the hospital's lab technician, also serves as the dentist,

hospital accountant and TB lab supervisor.

Despite the realities of life

in Oddar Meanchey and the uncertain future of a project for which there is dire

need, Daily remains optimistic.

"We can see the progress we've made and

people clearly have more health knowledge in areas where we've been working

compared to the untouched areas," Daily said. "But there is still so much more

we could do."

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