Medicines Sans Frontieres (MSF) France has withdrawn technical support and
will stop financial assistance for a homecare program that administers medicines
for tuberculosis (TB) patients.
"We did [this program] for five years and
now it is time for us to withdraw," said Catherine Quillet, MSF's head of
mission. "[The Ministry of Health] can do it on its own. It is a very
inexpensive strategy."
MSF was working in conjunction with the Ministry
of Health (MOH) for the Directly Observed Treatment Shortcourse (DOTS) program,
which started as a pilot project in 1997, said MSF's Dr Laura Pariente. By last
year the program had expanded to cover four operational districts in Phnom
Penh.
The eight-month DOTS program begins with a surveillance period.
During the first two months, nurses from MOH go to the patient's house to ensure
the medicine is taken, or the patient comes to a clinic.
Patients are
also educated about their medicine and the importance of taking it everyday. The
danger of quitting treatment midway is that the disease can develop resistance,
which breeds a serious form of drug resistant TB, said Dr Ikushi Onozaki, chief
advisor of the Japanese-funded National Tuberculosis Control Project.
For
the next six months, patients come to a clinic once a month to pick up their
medicine and check in with doctors.
"We do a sputum check in the second,
fifth and eighth months," said Dr Mao Tan Eang, director of the National Center
for Tuberculosis and Leprosy Control (CENAT). "We do this to see the results of
the treatment."
Most patients choose homecare since it cuts down on the
time they spend at the clinic and means they do not incur travel costs, said
MSF's Quillet.
"They can still go to work," she said. "[DOTS helped]
increase the quality of life for the patient."
Until it stopped its
support, MSF trained DOTS staff and paid transportation costs for home visits.
Although the organization will provide financial assistance until the end of the
year, Dr Eang said the program now needed to find another supporter.
"We
will be looking for financial as well as technical support from all the partners
- NGOs or bilateral organizations - to continue the project," he said. "I think
we will be able to get the support [because it] is a priority."
