Health sector professionals have called for urgent donor funding to prevent the
closure of a project that provides 24,000 of the city's poorest residents with
essential, affordable health and childbirth services.
Health Services for the Urban Poor project (HSUP) was established in April 1999
under the broader Urban Health Project. It was funded by the British
government's aid arm DfID until December 2001 and extended with funds from UN
Habitat until December last year. Now, though, it has now reached a funding
crisis and may be forced to close within weeks.
UN Habitat's advisor,
Peter Swan, said the health services project had proven both efficient and
effective in meeting the health needs of the poor. He described the project's
$120,000 total annual budget as "trivial" in aid terms.
"I really do
think that it is extremely short-sighted of the donor community to let this
project close," Swan said. "Over the last three years they have done some
excellent intervention to provide much-needed affordable health services for the
HSUP operates health rooms at the Anlong Kngann and Samaki
squatter relocation sites on the outskirts of Phnom Penh, and another at the
Boeung Kak slum area.
The rooms provide very low-cost or free prevention
and care services, including pre- and post-natal care, medicines and
vaccinations. An equity fund also provides free referral services to hospitals
for pregnant women and emergency patients who cannot afford to pay.
Sour Salan, HSUP project manager with the municipal health department, said that
without additional funding the health rooms would be forced to close by the end
of February, leaving thousands without access to vital care.
people will try to treat themselves and use illegal or unsafe services, or for
people who can pay they will come to national hospitals," Dr Salan
David Wilkinson, technical consultant to the HSUP project, said the
project was highly successful and "read like a donor's wishlist".
project is targeting the poorest and most vulnerable," Wilkinson said. "It is
efficient and cost effective, it is improving equity and it is building the
capacity of the municipal health department. It is saving the lives of mothers
Wilkinson said the lack of funds was due to a donor
reluctance to support urban health projects in the capital. That, he said, meant
there was a "great danger" the health needs of thousands of the city's poor
would not be met.
"Donors are quite right to put the bulk of their
support into rural areas, but there is a danger if some funds aren't devoted to
urban poor," he said. "The needs and vulnerabilities [of the urban poor] are in
some cases greater.
"Because of the high concentrations of people in the
relocation sites and slum areas, poor sanitation and poor hygiene, there is a
potential for major public health problems such as TB and cholera."
DfID's health advisor, Delna Ghandhi, said the HSUP project had been extended
twice since December 2000. She said that while DfID appreciated there are poor
people in Phnom Penh, it wanted to focus its "limited resources" on the poorest
in rural areas.
"DfID's country strategy, which was developed in
1999-2000 with government partners, is to focus resources on the poorest areas
of Cambodia - those with the worst health indicator and least access to
services," Ghandhi said. "If you look at the statistics, infant mortality rate
in Phnom Penh is 37 per thousand births, while in Ratanakkiri it is
Swan said UN Habitat was trying to locate short-term funding to
allow the project's survival until longer-term funding is obtained.