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Battling malaria village by village

Pailin

Corn farmer and mother Chan Kolab, 42, has an important job to do: protecting people’s lives in Pailin province’s Ou Tavao district from the deadly disease malaria.

Her village, Ou Proes, lies 12 kilometres from Pailin town in one of Cambodia’s most remote provinces.

Now, the community forms part of the front line in the battle against malaria in Cambodia. In a joint effort between the provincial health department and non-government organisations, such as
Médecins Sans Frontières (MSF) and Family Health International (FHI), villagers are being harnessed to tackle the spread of the mosquito-borne disease.

Currently being paid an incentive of US$15 per month by FHI for her part-time job as a village malaria worker, Chan Kolab tests blood and gives medication to patients in her village. She was initially trained to help treat the disease by MSF in 2003 and was commissioned by the NGO on a case-by-case basis until 2006.

Phal Sareun, 28, is one of many patients who have visited a village malaria worker.

In late March, the farmer caught fever and had a headache. He immediately went to see Chan Kolab, who lives next door. Within only a few hours he had received medication after the blood test indicated that he’d been infected by malaria.

“I think I was bitten by a mosquito when I was at my farm working,” Phal Sareun recalled.

Although it remains a deadly disease if not treated, malaria is now curable. It took the farmer just a few days to fully recover after visiting Chan Kolab.

“It wasn’t until the third day after taking the prescribed medicine that I got back to normal, and was able to start working again,” he said.

“The VMW has not only treated people, but has helped us become aware of looking for treatment quickly.”

The farmer has been encouraged to bring a treated mosquito net with him when working away from home.

With effective treatment available in most villages in Pailin, educating people about the disease is a significant step towards ensuring declining rates of death from the disease in the Kingdom.

Awareness campaigns are being spread through popular entertainment. Produced by the BBC World Service Trust in Cambodia with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the National Center for Parasitology, Entomology and Malaria Control (CNM),
The Village Nurse's Charms is a 30-minute film drama that intends to raise rural people’s understanding of malaria risks and prevention measures.

Cambodia is one of 109 malaria-affected countries in the world. But it seems as if the Kingdom is fighting the disease effectively.

Nearly 10 years ago, Chan Kolab could earn almost US$100 a month from treating malaria patients during the rainy season, as the rate of infection was high due to a lack of awareness of basic prevention techniques such as sleeping with a mosquito net.

“In the early 2000s, there were more than 30 cases of malaria detected in a single month, while in recent months, there have been less than 10 cases,” she said.

“These days, people are more informed of malaria. They visit me whenever they catch fever and suspect they’re infected, rather seeking other traditional methods and believing in superstition to cure the disease.”

FHI has helped the province, which has a population of 70,482, by supporting the National Committee for Disaster Management’s efforts to fight malaria through education, diagnosis and the distribution of mosquito nets. FHI provides treatment in 23 villages, with at least one village malaria worker in each village. They are well-equipped with testing kits and anti-malarial drugs.

Sam Ossophea, FHI’s Malaria Program Coordinator in Pailin, said there were two crucial areas to ensure effective prevention.

“First and foremost, to continue to change people’s behaviour, as some people still look for traditional ways to treat their illness. The second thing I’m concerned with is the use of counterfeit anti-malarial drugs,” he said.

To reduce fatalities and maintain the decrease of malaria case, it’s vital for the programme to provide additional support to health centres in the community bases, he said.

“The coordination work we’re doing with local health centres provides a greater possibility to reach out to our targeted, vulnerable groups. People can get free-of-charge and proper treatment through the Village Malaria Worker Program,” said Sam Ossophea, who manages three staff based in Pailin to monitor the program.

When talking about challenges facing program activities, the 47-year-old said, “When it rains, it’s high time for malaria. It is a tough time for our program staff, as muddy roads can be damaged and stop our access to most villages, where medicine and other supplies are needed.”

The spread of malaria decreased by “about 60 or 70 percent” in the eight years from 2000 to 2008, according to CNM chief Tol Bunkea.

Even so, CNM recorded more than 80,000 malaria cases resulting in 300 deaths in the Kingdom last year. According to a World Health
Organisation report, there were nearly 500 recorded deaths from the disease, out of a total of 71,258 total cases.

At least 2 million people in Cambodia – particularly those in communities living within 1 to 2 kilometres of forest in malaria-endemic provinces – face the risk of being infected by malaria.

Though the use of mosquito nets increased by around 43 percent from 2004 to 2008, the current nets are not effective enough to protect people against malaria.

Health NGO Population Services International plans to assist mosquito net wholesalers throughout the country in providing insect repellant-treated nets to retailers as part of a new malaria-prevention strategy. The plan calls for retailers to sell the treated nets at the same price as untreated ones.

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