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."
