Dengue toll in Cambodia rises above 300 this year

09/04/2007

PHNOM PENH: Dengue fever has killed at least 333 Cambodians this year, most of them children, and many more could die before the rainy season ends next month, senior health officials said on Wednesday. The disease, which killed 116 Cambodians in 2006, has spread across the impoverished nation and infected 31,136 people this year, most of them in the countryside where living conditions are poor and children are vulnerable, they said.

“Their parents do not have enough time to take care of them at home. They are poor, they are away from home to make a living,” said Ngan Chantha, head of the country’s anti-dengue programme.

More could die with the monsoon season, ideal breeding weather for the mosquitoes which carry the disease, not due to fade until the end of September, he said.

A publicity campaign against the disease, including admonitions to clean containers at home every 10 days to ensure mosquitoes cannot breed in them, has borne little fruit.

“The striking issue is villagers do not clean their containers frequently,” said Duong Socheat, director of the National Malaria Centre.

The country’s four-Swiss funded hospitals have appealed for $7 million to fight a disease that reached epidemic proportions in wealthy Singapore as well as striking hard in Thailand, Malaysia, Vietnam and Indonesia.

The World Bank, the World Health Organization and the Red Cross have provided pesticide to kill mosquitoes and the Asian Development Bank (ADB) gave $300,000.

Cambodia, whose health care system was devastated in 30 years of civil war, spends about $3 per person on health a year, according to the World Bank.

U.S. Cambodian Refugees’ Use of Complementary and Alternative Medicine for Mental Health Problems

http://psychservices.psychiatryonline.org/cgi/content/abstract/58/9/1212 

S. Megan Berthold, Ph.D., L.C.S.W., Eunice C. Wong, Ph.D., Terry L. Schell, Ph.D., Grant N. Marshall, Ph.D., Marc N. Elliott, Ph.D., David Takeuchi, Ph.D. and Katrin Hambarsoomians, M.S.

OBJECTIVE: This study examined U.S. Cambodian refugees’ use of complementary and alternative medicine and Western sources of care for psychiatric problems. Analyses assessed the extent to which complementary and alternative medicine was used in the absence of Western mental health treatment and whether use of complementary and alternative medicine was associated with decreased use of Western services. METHODS: Face-to-face interviews were conducted with a representative sample drawn from the largest Cambodian refugee community in the United States. The sample included 339 persons who met criteria in the past 12 months for posttraumatic stress disorder, major depression, or alcohol use disorder. Respondents described contact with complementary and alternative medicine and Western service providers for psychological problems in the preceding 12 months. Bivariate and multivariate logistic regression analyses were used. RESULTS: Seventy-two percent of the sample sought Western mental health services, and 34% relied on complementary and alternative medicine in the past year. Seeking complementary and alternative medicine was strongly and positively associated with seeking Western services, contrary to the hypothesis that use of complementary and alternative medicine inhibits seeking Western mental health treatment. CONCLUSIONS: Only a small percentage of Cambodian refugees used complementary and alternative medicine exclusively (5%), and utilization of complementary and alternative medicine was positively associated with seeking Western sources of care for mental health problems. Complementary and alternative medicine use does not appear to be a significant barrier to mental health treatment in this population, contrary to the Surgeon General’s conclusion that Asian Americans’ use of alternative resources may inhibit their utilization of Western mental health care.

Refugees Denying Charges of Fraud

01/21/2007

Investigators look into Social Security disability claims
By Michele R. Marcucci, STAFF WRITER
More than two dozen Cambodian refugees in Oakland and elsewhere in the East Bay are fighting allegations that they fraudulently applied for benefits from the Social Security Administration and say they were unfairly targeted.

The agency is questioning whether the refugees are truly disabled, and therefore eligible for benefits that generally top out at $836 a month, said Steve Weiss of Bay Area Legal Aid in Oakland, who is representing some of the Cambodians. Lisa Lunsford, an attorney with the Homeless Action Center in Berkeley, is also working with some of the refugees.

Many of the Cambodians are patients ofDr. Mona Afary, a licensed marriage and family therapist who specializes in working with Afghans and Cambodian refugees. She now works with the refugees at the Center for Empowerment of Refugees and Immigrants in Oakland.

Afary has diagnosed many of her patients with post-traumatic stress disorder, sometimes several people in the same family, Weiss and Lunsford said. That — combined with what Social Security may see as Afary’s lack of proper clinical training to make such diagnoses — could have triggered the investigations, Afary, her patients’ attorneys and spokespeople for Social Security said.

The attorneys accused investigators of lacking the clinical training to assess whether someone was truly faking mental illness, as well as cultural insensitivity toward people who were traumatized by the harsh privations suffered under the Khmer Rouge. Many of the refugees came here in the 1980s.

The attorneys said their clients are poor, rural Cambodians who speak little or no English and may not have been able to adequately describe their mental condition. And they said many were re-traumatized in their contacts with investigators.

“It seems like a lot of insensitivity was involved and just little thought about the impact. It’s causing harm to the community,” Weiss said.

He and Lunsford said their clients are waiting up to two years for Supplemental Security Income benefits they desperately need and are legally entitled to.

A spokesman for Social Security’s Office of the Inspector General said investigators for its Cooperative Disability Investigations program are doing their job, which is to seek out potential benefits fraud before the money is lost. But he said the agency can’t tailor its approach for different groups of people.

“If the way you investigate a case is altered due to the cultural background of a subject … it would lead to a different set of investigative policies and procedures for not only every cultural group, but all kinds of other groups,” spokesman Jonathan Lasher said. “You can’t tailor a process for a national law enforcement organization to every aspect of the individual subject’s person.”

There are no public records indicating Afary has been charged with any wrongdoing, Lasher said.

Lasher said investigators for the decade-old program do not have clinical training. He said they bring interpreters if their interview subjects do not speak English.

Weiss and Lunsford said the investigators in the cases they’re handling called a commercial translation service over the telephone.

Weiss said Afary’s clients go to her because she specializes in working with them and with their specific mental conditions, and some were diagnosed by other doctors before coming to her. She had previously worked with another agency under a grant that specifically paid for her work with this population. And Weiss said Afary’s clients have few other places to go.

But Leslie Walker, an Oakland-based spokeswoman for Social Security, said her agency supplies doctors who can make disability determinations, and the agency has one doctor in the Bay Area who speaks Cambodian.

Mary Scully, director of programs for Khmer Health in Connecticut, which focuses on the health needs of Cambodian refugees, said a post traumatic stress disorder diagnosis is not uncommon for Cambodian refugees. She said the majority of them suffer from that and depression. She said many suffered major head injuries, illness and starvation under the reign of the Khmer Rouge.

This is not the first time Cambodians and their health care providers have been the target of Social Security fraud investigations. Similar investigations have taken place in Southern California, Boston and Washington state over the last decade. In those cases, some parties involved with the Cambodians were accused of fraud and others cleared, Scully said.

Weiss and Lunsford said that of the 27 appeals they are handling, just one client has been denied benefits; 13 clients won their benefits, and 13 others are pending.

Shirley Washington, spokeswoman for the state’s Disability Determination Service, which processes Social Security applications filed in California, said her agency has made just 20 referrals of possible fraud cases statewide to Social Security investigators over the past year, none of them concerning refugees. Five were from the Oakland office.

But Lasher said Oakland’s Cooperative Disability Investigations unit had 301 allegations of fraud referred to them during the 2006 fiscal year, with 294 investigations that resulted in 223 findings of fraud.

He said his investigators could look at additional applications without a referral if they pertain to an ongoing case, such as a doctor or middleman accused of fraud.

 

Contact Michele R. Marcucci at mmarcucci@angnewspapers.com or (510) 208-6434.

TB death rate down to 0.5 pct in Cambodia

10/10/2006

The death rate of tuberculosis went down to 0.5 percent in Cambodia this year, compared to 1.9 percent in 2005, medical official told Xinhua by phone here on Monday.

Meanwhile, the infection rate of the disease decreased to 18 percent in 2006 from 36 percent in 2005, said Mao Tan-Eng, director of the National Center for Tuberculosis and Leprosy Control, while quoting a nationwide survey.

During the survey conducted by the kingdom’s over 1,000 health service centers, 94 died out of 17,700 infected people among 100, 000 samples in 2006, and 700 died out of 36,000 infected people among 100,000 samples in 2005.

“This year, the TB death and infection rates are reduced ( compared to last year), because we have provided better health services, popularized relevant information through media promotion and community education, and conducted more vaccination across the country,” said Tan-Eng.

The government’s new strategy is to educate people about TB in pagodas and at schools because monks, teachers and school children are believed to be able to spread the knowledge about TB efficiently to friends and other people among their communities, he added.

As to the TB victims, the director said that they usually didn’ t want to see doctor when they had preliminary symptoms, which therefore deprived them of the chances to survive.

The kingdom plans to eradicate TB in 2010, he added.

According to the World Health Organization’s report in 2006, Cambodia is the world’s 22nd burden in the field of TB spread.

Approximately two-thirds of the 13 million Cambodians carry TB bacterium, while some 13,000 die of it annually, the report said.

Source: Xinhua

The Red Sense - a view from ‘down under’

08/09/2006

The Red Sense - a view from ‘down under’

A new film, called The Red Sense, by first-time Khmer-Australian director Tim Pek, deals with the Khmer Rouge Regime, and the upcoming trials, from the perspective of younger Khmers living in a western country. Actress Sarina Luy (pictured), plays the role of Kong Jan Melear, a thirty-something Khmer woman living in Australia, who discovers that her father’s killer is living freely in a first world country - an opportunity her father was never given. The film deals with her personal struggle as she tries to decide what the correct course of action is. Sarina Luy arrived in Australia in 1995 from New Zealand, after having left a refugee camp in Thailand in 1991. 

Filmed in Australia, with real Khmer actors and actresses, Director Tim Pek elected to have 80% of the dialogue in Khmer (with English subtitles). His hope is that the film will motivate Cambodians to forget the past and to focus on the future. The film is scheduled for an independent release in Australia in November 2006, along with a public release in Phnom Penh. You can see the film trailer and photos here.

Cambodia Steps Up Bird-flu Precautions Along Thai Border

08/07/2006

Cambodia destroyed thousands of smuggled eggs and mounted a campaign to warn people against buying illegally imported poultry products, in the wake of new reported bird-flu cases in neighbouring Thailand and Laos, authorities said Sunday.

Meach Son, the Agriculture Ministry chief in the northwestern province of Banteay Meanchey, said his department had destroyed 5,000 chicken eggs Friday to try to prevent outbreaks of avian influenza along its borders.

Thailand and Laos both reported new cases of the deadly H5N1 strain of the virus in recent weeks.

“We have also made a proclamation to all the people not to eat eggs and chicken brought illegally from Thailand and have warned people engaged in this trade that we will close them down,” Son said by telephone.

The Cambodian crackdown on cross-border poultry trade and new efforts to educate people about the virus followed Thailand’s confirmation of the second human death this year. Laos reported it had detected the virus on a farm last month.

Cambodia has recorded six confirmed human cases of bird flu, all of them fatal. Most of those occurred near its border with Vietnam.

However Thailand, traditionally an important supplier of poultry to Cambodia, has also been hard hit by the disease and Son said authorities on the country’s Thai border were taking no chances.   
   
© 2006 DPA

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