The Ministry of Health, along with NGO partners, has begun to implement a six-month medical plan to respond to mounting concerns over the massive HIV outbreak in Battambang province’s Roka village in Sangke district.
The temporary measures will include the construction of a new social support service building in the area, a weekly rotation of four medical teams hailing from Phnom Penh and doorstep visits from a counselling group consisting of monks, nuns and persons living with HIV.
“We have been working on this plan for quite a while since the initial tests were delivered … and although this is just for the first six months of 2015, we are hoping that it will make it easier for patients to access services until we have something more permanent,” National Center for HIV/AIDS Dermatology and STDs (NCHADS) Deputy Director Dr Ly Penh Sun said yesterday.
The increased government response comes days after a joint release from NCHADS, the World Health Organization and UNAIDS, saying that preliminary findings show contaminated injections as the primary source of the widespread transmissions, which, by the end of December, reached a total of 212 HIV-positive patients.
The report ruled out other common modes of contamination, namely intravenous drug use, unprotected sex and mother-to-child transmission.
“We still need further testing, but at the moment, we are focusing on how to get patients proper treatment when they are so far from the provincial hospital,” Penh Sun said.
Four medical teams – affiliated with organisations such as FHI360, ARV User Association, AIDS Healthcare Foundation, Khmer-Soviet Friendship Hospital and the Sihanouk Hospital Centre of Hope – have started alternating weekly in administering treatments at Roka’s health centre, said Dr Laurent Serradini, FHI360’s associate director for care and treatment, and focal point for the USAID-funded HIV Flagship Project.
The teams, which are made up of one physician and three counsellors each, will be in place until the end of June, while the government trains two physicians who will take up residence in the village.
“We started at the end of December at the request of NCHADS, and we’re happy to support, because it’s a big challenge for all these people to go to the Battambang Referral Hospital and it’s a really specific situation,” Serradini said.
According to Penh Sun, Health Ministry staff are also assessing land near the local health centre to build a 2-storey social support service building that will serve as housing for the rotating medical teams and also as another hub where patients can receive treatment for HIV and other critical diseases.
Counselling groups will also visit every household in the area – regardless of their HIV status – to further promote preventative measures, encourage increased blood tests and minimise discrimination of HIV-positive patients.
“This incident has had a major impact on the community, so it’s important to have this kind of response and encourage people to volunteer for more testing since we don’t have the capacity to make it mandatory,” said WHO HIV team leader Dr Masami Fujita.
Since the end of December, Fujita said that the number of HIV-positive patients has risen over the current count, but they have yet to verify the exact number.
In the joint statement, 82 per cent of the 212 infected patients were reported to be Roka village residents.
Eighteen per cent, on the other hand, are from five other villages in Roka commune, primarily Ambaeng Thngae, where about 10 per cent of patients have tested positive, according to Penh Sun.
He added that residents from Ambaeng Thngae, which is the closest to Roka village, have been progressively volunteering to undergo blood tests due to suspicion that they have been tainted during consultations with local unlicensed medical practitioner Yem Chroeum.
Several villagers are holding Chroeum and his purportedly admitted reuse of needles liable for infecting them. Charged in late December with murder, Chroeum faces life imprisonment if found guilty.
“Although there have been similar outbreaks in the past in China and Pakistan, the situation is Battambang is very unique in the sense that it’s centred on this one doctor . . . but further testing is needed when we don’t necessarily understand everything that has happened in the area,” Fujita said.