AT long last, a different kind of dry season offensive is underway in the Northwest.
Children living in areas controlled by Khmer Rouge breakaway factions are being targeted
for the first time in a nationwide vaccination campaign against poliomyelitis.
Part of a three-year push by the Ministry of Health and the World Health Organization
to eradicate polio in Cambodia, they hope this year's National Immunization Days
(NIDs) - Feb and Mar 11 - will be the last.
"If Cambodia's 1997 NIDs are as successful as those of 1995 and 1996, and if
efforts to reach pockets of missed children are equally successful, the Ministry
of Health anticipates that there will be no more Cambodian children infected by poliomyelitis
after 1997," a Ministry of Health statement said.
According to health officials, because of the complicated logistics of reaching under-fives
in the former war zones, the first round of NIDs has already been launched in four
districts of Battambang province: Pailin (Jan 28), Kamreang (Jan 29), Phnom Prek
(Jan 30), and Sampov Lung (Jan 31).
At press time, Second Prime Minister Hun Sen was due to go to Phnom Malai for tomorrow's
launch of the NIDs.
NIDs will be launched in Samlot on Sunday, health officials said.
Government health workers, mobile teams, and trained volunteers have been deployed
to administer the oral polio vaccine to an estimated 13,975 children in the five
Battambang districts, and to 3,000 in the Malai district of Banteay Meanchay province,
said Ly Nareth, director of the Ministry of Health's poliomyelitis eradication unit.
The aim of the two Immunization Days which will occur at a monthly interval, according
to Dr David C Bassett of WHO, is to deny the polio virus a human host by providing
blanket coverage.
"The wild virus has only one known host and that is a human being," he
said.
"If the wild virus is circulating in the environment and cannot find a human
host then in two to three weeks it will die."
So far, the 1995 and 1996 NIDs achieved high coverage - at least 90 percent in both
years - helping to dramatically reduce the number of clinically diagnosed cases of
polio in Cambodia, but there is room for improvement, health officials said.
In 1994, according to Bassett, Cambodia was the most polio stricken country in WHO's
Western Pacific Region. In 1996, approximately 1.8m children were taken to vaccination
posts nationwide in both rounds.
As a result, the current number of 1996 confirmed cases of polio is down to 50.
Health officials, however, have come to identify the weakness in their strategy to
reach all susceptible populations, particularly those living in formerly insecure
areas and remote pockets, or those that move along Cambodia's intricate network of
waterways.
"In our work in 1994, '95, and '96 we have been learning a lot," said Bassett.
"We have learned, for instance, that even if you get 90 percent coverage, obviously
it means that you're still missing ten percent.
"We recognize now that there are populations of children who are being chronically
missed," he added. "We've got to reach those children if were going to
eradicate polio."
To close the gap, a new component is being added to this year's NIDs: 461 mobile
teams that will fan out across the country on-board boats and motorbikes.
Health officials also admit that if indeed the 1997 blitzkrieg against polio is to
be the last, they are going to have to beat the clock.
"If at the end of the month we have not eliminated all of the virus - and we
know that so far we have not - then that gives the virus 11 months to re-establish
itself," Bassett said.
