DURING July 1995, Kantha Bopha hospital made 36,409 consultations of sick
children and hospitalized 1,927 very sick children.
Seven hundred and
seventy seven children had dengue. Most of them travelled from afar, often in
desperate states, suffering from shock which is more difficult to treat the
longer it has been pre-existing.
This is why the dengue mortality rate is
so high: more than three percent. Without our laboratory and bloodbank, we would
lose many more children. Sometimes more than 30 transfusions are done each day.
Two big rooms have been temporarily set up as long as this dengue epidemic
continues. Instead of beds, we use mattresses on the floor so as not to waste
space.
Two hundred and fourteen children of those admitted had
tuberculosis (TB) - this is unique in the world. Their mortality rate last month
was twice as much as those with dengue (seven percent). Dengue epidemics are
expected every three to five years; the TB epidmic is permanent, and it is far
more difficult to diagnose in children than is dengue.
Kantha Bopha is
the only place in Cambodia with the skilled staff and facilities to diagnose TB.
That is why we are worried that the real figures for TB are much higher than can
be guessed.
TB children often arrive with different diseases at the same
time (dysentry, malaria, thyphus). They suffer from from TB-meningitis,
TB-osteitis (affecting the bones) and of the lungs and
intestine.
Sixty-five percent of all children suffering from bacterial
infections of the respiratory tract have TB; 70 percent of those with
malnutrition symptoms have TB.
We think that the recommendations of
international health organizations how to manage child health have to be
immediately changed, improved and corrected. The protocol on how to manage
infections of the respiratory tract does not even mention TB. The same goes with
the protocols of how to handle diarrhea and malnutrition.
There is no
effective prevention for TB. The vaccination is not good enough, one never knows
for how long it will remain active. Even children suffering from the most severe
TB are being vaccinated.
All sick and infected people must be treated to
stop this contagious epidemic from spreading even further.
As soon as
hospitalized children are stabilized they are sent home.
Follow up is
done in the following nine months in our new, small TB
center.
Ninety-five percent of families keep their appointments. They
follow the treatments and controls because they have been informed about TB, and
they get free medication from the center - even the poorest families keep their
appointments and observe the follow up treatments.
The drug treatment we
use, Rifater, is the same used in Switzerland and the United States. Treatment
for all children of the world should be the best possible.
Beat Richner, director fo the Kantha Bopha Children's Hospitals
