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Sector’s ‘backbone’ broken

A medical professional works at a lab in Preah Kossamak Hospital earlier this year. A recent WHO report says the Kingdom suffers from a severe shortage of public health field epidemiologists.
A medical professional works at a lab in Preah Kossamak Hospital earlier this year. A recent WHO report says the Kingdom suffers from a severe shortage of public health field epidemiologists. Sahiba Chawdhary

Sector’s ‘backbone’ broken

Cambodia currently has only one epidemiologist for every 430,000 people – or less than half the recommended amount – a shortage that an expert yesterday said was a troubling flaw in what he characterised as the “backbone of public health” when it comes to countering outbreaks.

The shortcoming was first highlighted late last month in a WHO report, which said the Kingdom only had 23 field epidemiologists, though a Health Ministry official said yesterday that 13 more had graduated since the evaluation for the report – for a total of 35.

Cambodia has a detailed health workforce development plan for 2016-2020. However, it doesn’t include epidemiologists, which WHO characterised as “major” oversight that “needed to be remedied if Cambodia is to develop a sustainable public health system”.

Dr Ly Sovann, spokesman for the Ministry of Health and director of the ministry’s Department of Communicable Diseases, said the WHO recommended that the country have at least one epidemiologist for every 200,000 people. “We plan to reach the goal in the next few years as recommended by WHO,” he said.

He added that the Kingdom has some 2,008 rapid response team members, with basic epidemiology training, to respond and investigate outbreaks nationwide.

Vicky Houssiere, a communications officer with WHO Cambodia, said the WHO is supporting a six-month program, run by the Ministry of Health, which aims to produce field epidemiologists. Every year, the program sends five public health workers to a six-month foundation course in epidemiology. Since the program was born in 2011, 30 have graduated.

However, even the WHO’s own report determined that the “course is unlikely to provide adequate opportunity to develop all core skills necessary to function as a field epidemiologist”.

The country’s other five epidemiologists were trained outside the country, Sovann said.

Heng Sopheab, deputy director of the National Institute of Public Health, said the shortage “is a concern because epidemiology is the backbone of public health, such as dealing with disease distribution, with outbreak of diseases, food poisoning, health hazards”.

But Sopheab said this field is not “popular” among students. The School of Public Health at the National Institute only has about five to six students pursuing their master’s degree in epidemiology. “The subject is hard [for] students since it is involved [with] research design and biostatistics course, [which] many students find hard to learn,” he said.

The school has graduated less than 10 epidemiologists since it first opened in 2007, he added.

Dr Hor Bun Leng, who teaches at the School of Public Health at the International University, believes students are not interested in this field because “there is no market in Cambodia”, as epidemiology involves substantial research.

“In Cambodia, we have no research,” he said.

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