Cambodia urges media to help raise public awareness on HIV/AIDS

05/24/2006

The Cambodian government on Monday launched a Media Guide on HIV/AIDS, asking journalists to help enhance publicity and awareness of the epidemic in the country.

“Media plays significant role in the HIV/AIDS program and is also a key player in disseminating true information about HIV/AIDS and changing attitude of the community toward the most vulnerable victims,” Hong Sun Huot, president of the National AIDS Authority (NAA), said at the launching ceremony.

The 186-page Guide has 21 sections, including facts and data about HIV/AIDS in Cambodia and in the world; HIV/AIDS and the media; the impact on children and young people; exploring the role of men and older people in the epidemic; HIV testing and counseling; treatment and care as well as the targets of the next 10 years.

“We need to expand media coverage rather than to cause restrain to the effort,” he added.

A formal survey in 2003 indicated that Cambodia has 123,000 HIV carriers, which is equivalent to 1.9 percent of all adult aged between 15 and 49.

An Ministry of Health’s estimate shows an increase rate of transmission from husband to wife among new cases.

“The rising scale and pace of AIDS epidemic in the rural areas throughout the country sparks an increasing concern, particularly the spread of AIDS to housewives and its transmission to their children, which remains the most prevalent in Cambodia against the overall trend in Southeast Asia,” said Hong Sun Huot.

He called on national and international journalists to help enhance people’s awareness in order to protect their families, society and the whole nation from HIV epidemic.

Cambodia diagnosed the first case of HIV in 1993, and HIV prevalence once rose to as high as 3.7 percent of the adult population in 1997.

The country has made much effort in response to the epidemic. UN Secretary General Kofi Annan underlined in last June that “The world has witnessed successes of preventive and prophylaxis program such as in Brazil, Cambodia and Thailand.”

Source: Xinhua

Deaths ’show malaria drug need’

05/18/2006

http://news.bbc.co.uk/1/hi/health/4771773.stm

A mosquito biting

Malaria is carried by mosquitoes

Britons travelling to exotic locations are being warned of the risks of contracting potentially fatal malaria by health experts. The number of travellers to malarial areas has soared by around 150% over the last decade.

But people are not taking anti-malaria tablets, putting themselves at risk, the Health Protection Agency said.

Last year, three people died after 26 travellers to The Gambia contracted the most serious type of the condition.

The HPA is warning that nine out of 10 Britons who contract malaria are carrying this form of the disease - plasmodium falciparum.

Latest figures show that of the 1,722 Britons with malaria in 2003, 1,339 had plasmodium falciparum - 78% of cases, up from 17% if cases in 1977.

That year saw 16 people die from malaria, up from nine the year before.

With the number of people being killed, it is so important to remember to take the treatment prescribed by the doctors
HPA spokeswoman

The increasing trend of taking a break in a far-flung destination or heading of for a last-minute holiday is leading to people not thinking about malaria tablets, or forgetting to complete the whole course, the HPA said.

Travel to India has more than doubled over the last decade, and more holidaymakers are heading for destinations such as Cambodia, Thailand, the Middle East and Vietnam, according to the Association of British Travel Agents.

An HPA spokeswoman said: “It’s not so much complacency, it’s people thinking they won’t need malaria tablets for what they see as a normal holiday.

“The indication is that, the number of cases is decreasing but the fatality rate is increasing.

“The message would be that, with the number of people being killed, it is so important to remember to take the treatment prescribed by the doctors.”

She added: “A lot of people forget once they come back that they need to continue to go through the whole dose.

“In addition, people visiting friends and family who may originate from an area where malaria is present may wrongly think they are immune.”

Travellers visiting malarial areas are being advised to visit their doctor or travel clinic before they go abroad to get advice on the best anti-malarial measures.

Once abroad they should use insect repellent, keep arms feet and legs covered and sleep under mosquito netting if outside.

Early signs of malarial infection include fever, a flu-like illness, shaking, muscle ache and tiredness.

Child and Maternal Mortality High in Developing Countries of Asia

05/16/2006

By Claudia Blume
Hong Kong
14 May 2006 (VOA)
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Families around the world celebrate Mother’s Day Sunday. But being a mother can be difficult in the developing countries of Asia, where many children die soon after their birth, or before they reach the age of five.

In developing countries, childbirth is often a life and death struggle for both mothers and children.

The charity, Save the Children, says more than four million infants worldwide die in their first month of life each year, mostly due to infections. A third of the deaths occur in Southeast Asia. South Asia has the highest rates of newborn deaths in the world, next to Africa. In Afghanistan and Pakistan, for example, up to six percent of infants die in their first month.

Many women also do not survive complications during pregnancy and childbirth.

Amy Weissman, a health expert for Save the Children in Vietnam, says the mothers most at risk are young, uneducated women who give birth at home, without the help of skilled professionals.

“The things that really make a difference around a woman’s survival are her level of education, her access to quality health care and her use of modern family planning,” said Weissman. “So, those things really need to be in place for a woman and her child to survive and thrive.”

Children who survive the first few weeks are still at risk in many developing countries of Asia.

The World Health Organization says about 3,000 children under the age of five die each day in the western Pacific region. Most of the countries with a high child mortality rate spend less than five percent of their gross domestic product on health.

Marianna Trias, advisor on child health at the WHO regional office in Manila, says common diseases, such as pneumonia and diarrhea, cause most childhood deaths. In some countries, Laos and Cambodia, for instance, malaria is a major killer.

She says tools that can save children’s lives, such as immunizations, nutritional supplements and insecticide-treated bed nets, are well known and inexpensive.

“But what is needed is the infrastructure, the human resources and financial resources to put this all in place and deliver the life-saving interventions through the health system,” explained Trias.

Trias says some countries in the region have made good progress in recent years on reducing the number of childhood deaths. They include China, Mongolia, Vietnam and the Philippines, where governments have implemented plans to improve child and maternal health.

UN Says World Falling Behind in Child Nutrition Goal

05/05/2006



02 May 2006
 

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U.N. officials say the world must do a great deal more to meet the goal of halving the rate of undernourishment among children. Nevertheless, a report by the U.N. Children’s Fund, says some countries, particularly China, are succeeding.

Healthy Chinese baby munches on apple
Healthy Chinese baby munches on apple

The regional nutrition representative of the U.N. Children Fund, Karen Codling, says UNICEF’s report shows the world has made little progress toward reducing undernutrition among young children.

“It (the report) shows that overall in the world, we have only reduced child underweight by five percentage points since 1990,” she explained. “It means that the world is not on track to achieve the World Millennium Development Goals for hunger and poverty.”

The 1990 goals seek to improve significantly the lives of the world’s poor by 2015. One of those goals is to cut in half the rate of poor nutrition among children younger than five years of age.

Codling says Asia on average is on track to meet the goal on child nutrition - but this is largely due to the performance of China, which has halved its proportion of malnourished children, from 19 percent to eight percent.

She attributes China’s success to its growing economy, government efforts to reduce poverty, and generalized access to education.

But she notes that seven million Chinese children are still undernourished, and she says China’s overall success hides high malnutrition rates among children in its rural areas and among its ethnic minorities.

Studies show that inadequate nutrition causes more than half of the world’s deaths in children under five. Experts say because nutrition is related to many different aspects of poverty, it is a significant barometer for the Millennium Development Goals.

Codling of UNICEF says China’s success notwithstanding, many Asian nations will fail to meet their child nutrition goals.

The UNICEF report says are most of the nations of Southeast Asia are not on track to halve their rates in the next nine years. Cambodia and East Timor report that nearly one-half of the children under five years are undernourished. Laos, Burma and the Philippines have shown some progress, but they, too, will have a difficult time meeting the goal.

The report says Vietnam and Indonesia are on course to meet the goals, but that certain groups in these large countries lag far behind the national averages.

The nations of South Asia, which are home to more than half the world’s undernourished children, are not on course to meet the nutrition goals.

Codling says governments emphasize economic growth and some social services. But they place less emphasis on areas that are known to improve child nutrition levels, such as preventive health care and woman’s education.

“The lack of progress is related to the fact that nutrition very often falls through the cracks,” she said. “Many people will say that nutrition is an issue for everybody, but the responsibility of nobody.”

UNICEF advocates raising nutrition issues on government agendas, using success stories like China’s as models, and focusing nutrition efforts on mothers-to-be and children under two-years old.

 

 

Cambodia Treatment Programme enrols over 1000 HIV/AIDS patients

05/04/2006

Roche collaboration achieves milestone in country with highest HIV/AIDS prevalence rate in Asia

Basel, 3 May 2006, The Cambodia Treatment Access Programme (CTAP) has successfully enrolled more than 1000 men, women and children infected with HIV/AIDS to receive care and treatment free of charge. The aim of the collaboration, which was established in 2003 as a three-way partnership between the Cambodian Ministry of Health, the National Centre in HIV Epidemiology and Clinical Research at the University of New South Wales, Australia and Roche, is to help tackle HIV/AIDS in Cambodia, the country with the highest prevalence rate in Asia.

William Burns, CEO Division Roche Pharmaceuticals, commented, “The achievement of CTAP demonstrates what can be achieved through collaboration. Roche, as a company, believes that to tackle diseases such as HIV/AIDS, it is vital that we use our skills and resources, together with those of other expert organisations. CTAP would not have been possible without the work of all three partners, who have created a programme that we hope will continue to be successful and treat many more people with HIV/AIDS in the future.”

“HIV/AIDS is now being addressed through programmes such as CTAP, which not only provides vital treatment and care, but also ensures that the healthcare professionals who provide HIV/AIDS care receive the necessary training”, explains Dr. Mean Chhi Vun, Director of the National Center for HIV/AIDS, Dermatology and STDS. “CTAP has helped many people affected, directly and indirectly, by HIV/AIDS in Cambodia. We are extremely proud to have achieved this first milestone. With global funding now reaching Cambodia, we expect to provide treatment to increasing numbers of people at the CTAP social health clinic.”

David Cooper, CTAP Steering Committee Member and Director and Professor of Medicine at the National Centre in HIV Epidemiology and Clinical Research in Australia commented, “Reaching the 1000 patient milestone is a great achievement and demonstrates the positive impact CTAP is having on the people of Cambodia. It is a real testament to the commitment and hard work of everyone involved and demonstrates the benefits of adopting a collaborative approach.”

About the Cambodia Treatment Access Programme (CTAP)

Initially, the partners’ efforts were concentrated on successfully establishing the Social Health Clinic, a new outpatient HIV medical service in Phnom Penh, but going forward an increased emphasis is being placed upon creating sustainable HIV/AIDS resource to help ensure its success long-term. Whilst the financial support initially provided by Roche enabled drugs, diagnostics and training to be secured, and allowed CTAP to initiate patients on treatment, additional sources of funding and resources are now being secured from other organizations, who, having seen the impact of the programme, have committed additional support. As part of CTAP, a training programme has been established to help enhance local HIV/AIDS knowledge and skills, and facilitate the national expansion of quality HIV care. CTAP staff has been involved with the delivery of the Cambodia’s National Training Curriculum for Clinicians, the development of the Training Curriculums for Counselors and Pharmacists, and delivery of in-house training.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world’s leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people’s health and quality of life. Roche is a world leader in diagnostics, the leading supplier of drugs for cancer and transplantation and a market leader in virology. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet at www.roche.com.

All trademarks used or mentioned in this release are protected by law.

Baschi Dürr
Media Spokesman
Roche Group
+41-61-688 8888

Paediatric health care in Cambodia takes a turn for the better

05/01/2006

http://www.bangkokpost.com/en/Outlook/13Dec2005_out41.php

Six-year-old Ieap Leap has been hospitalised for a week.
“She came in looking very pale and anaemic,'’ explains Dr
Samuthea, the head of station CII at Jayavarman Hospital in
Siem Reap. “She had a high fever and was shaking.'’ The
cause? Malaria. But a routine X-ray revealed additional
symptoms associated with tuberculosis. A CT scan ordered to
examine the child’s lungs later confirmed the presence of a
lung calcification, a surefire sign of TB, her doctor says.

After seven days of treatment, Leap has tested negative for
malaria. Outwardly she shows few signs of illness. A bit
lethargic from fighting off the tuberculosis, she sits in
bed and surveys the room with large, inquisitive eyes. Her
two-year-old sister, Ieap Lang, climbs around her while
their mother watches on with a weary but contented smile.
Leap has been released and can now return to her village _
though she will need to come back to the hospital every
eight weeks for the next nine months to receive the
remainder of her tuberculosis treatments.

Despite the cost of the rough two-hour journey from Leap’s
village to the city, this is the fourth visit her mother, Bo
Reap, has made to Jayavarman, each time with a different one
of her children.

Like Leap, most of the children at Jayavarman live in
poverty and come from distant towns or provinces. The
hospital tries to ease the burden placed on their health by
providing free treatment and subsidising the price of
transportation to Siem Reap. Before discovering this, Leap’s
mother sought care for her children locally. But at 10,000
riel (103 baht) for one vial of medicine, the costs began to
mount. Bo Reap was eventually forced to sell the family’s
modest home and their cattle to pay off the debt resulting
from these treatments.

With no home Leap’s father and two oldest brothers took up
residence near a rice field where the family is cultivating
a small crop. Her mother, sister Lang and 12-year-old
brother moved into her grandmother’s hut in a neighbouring
village.

This is the place to which she returns. The village is
composed mostly of her relatives _ aunts, uncles and
cousins; families with five, seven, even 10 children _ many
of who gather outside as Leap arrives.

It’s only been a week, but she shyly scoots about before
warming up to her surroundings. The homecoming is happy, but
Bo Reap worries it may be premature. This is malaria country
and access to clean water is scarce. Despite her best
efforts and those of the doctors at Jayavarman, diseases
like tuberculosis are still prevalent here.

“Money or blood?'’

That’s a question Dr Beat Richner has grown accustomed to
asking. As founder and director of the three Kantha Bopha
Paediatric Hospitals in Cambodia, he holds solo cello
concerts every Saturday to generate the money needed to keep
the hospitals up and running _ a task that has become
increasingly difficult.

At exactly 7:15pm, Dr Richner enters Jayavarman’s polished
hospital auditorium with crisp, clacking steps, takes up his
cello and with a brisk nod of the head _ an acknowledgement
of his welcoming applause _ he begins.

“So now, not so many tourists, not so many guests,'’ he
says. “But two years ago, maybe you remember, there were no
tourists.'’

That was during the Sars scare. Not long after 10,000
children were hospitalised in Cambodia due to dengue fever.
The country is still fighting that epidemic, along with a
host of other diseases, such as malaria, encephalitis and
tuberculosis _ an infection that, according to Dr Richner,
affects 65 per cent of Khmers.

A long-time entertainer, Dr Richner began performing for
children at the beginning of his medical career, creating a
musical clown character he dubbed “Beatocello'’ in the
early 1980s. He has since hung up his costume but continues
to use the character to draw attention to, and support for
Jayavarman.

His passion for what he’s doing is evident in the gusto and
verve with which he flavours each performance. Given the
weight of the topic and the starkness of the situation he
faces, Dr Richner is surprisingly good humoured.

“We ask young people for blood, older people for money and
people in between for both,'’ he explains, drawing laughter
from the crowd.

The newest of the three Kantha Bopha centres, Jayavarman
Hospital, sees an average of 900 outpatients each day, with
up to 170 hospitalised as a result. That number has doubled
since last year, a fact Dr Richner attributes to road
improvements that allow children from far away provinces
such as Anlong Veng _ the former Khmer Rouge stronghold _ to
make the trip to Siem Reap. The peak of the dengue season
usually occurs in July and this year was no exception. In
that month alone Jayavarman saw a record-setting 28,967
people, 4,528 of whom were hospitalised.

Between the two hospitals in Phnom Penh and Jayavarman,
Kantha Bopha can accommodate around 1,000 patients at one
time, and a new wing will be opened in the capital at the
end of December, providing the hospital system with an
additional 600 beds. While that is a positive step, it still
may not entirely reduce overcrowding that at times is so
acute that children are often forced to share mattresses.

Jayavarman is by far the largest, most high-tech hospital in
town, but other smaller operations are also going to great
lengths to care for local Cambodians. Angkor Hospital for
Children (AHC), operated by Friends Without a Border, sees
anywhere from 200 to 400 children per day and offers free
treatment to all children up to the age of 16.

Some say its size makes it more intimate, appealing and
accessible to Khmers intimidated by the formalities at
Jayavarman. AHC welcomes all a child’s immediate family
members and allows them to bring their own food for cooking.
It also has an outreach programme through which volunteers
go out into the community to deliver food and medicine,
conduct basic check-ups and provide education.

Jayavarman offers education as well, but Dr Richner is
adamant that curative medicine, the type of treatment Kantha
Bopha offers, is the only way to curb infectious illnesses.
Despite its successes, however, such treatment can be
costly, and the hospital system faces problems when it comes
to funding.

Annual operating costs amount to $17 million (701 million
baht), most of which is funded through donations. “That’s
why I talk about the money,'’ Dr Richner says, “because
it’s a brutal reality without it.'’

Until 2005 the Swiss government was the only authority
providing Kantha Bopha with funds, $2 million (82.6 million
baht) per year. Dr Richner’s Saturday evening concerts
currently bring in around $4 million (165 million baht) and
donations still make up the bulk of the hospital’s financial
support. But on January 1 of this year the Cambodian
government agreed to provide the hospital with $1.6 million
(66 million baht) annually and Prime Minister Hun Sen has
called the hospital system a model for the country.

Cambodians feel safe here, Dr Richner says, and that feeling
of confidence is very important for the healing process.

With that as his focus, Dr Richer is trying to awaken the
sensitivity of a new demographic: Wealthy Cambodians. In
late June, Dr Richner implemented a programme called the
Kantha Bopha Club. Members must contribute $100 (4,100 baht)
a year to the hospital, and they must be Khmer. There are
already more than 200 members, including the prime minister,
and Dr Richner aims for an eventual 12,000.

His hope is that Cambodians will take a greater role in
supporting their own health-care system. He already takes
pride in the fact that Jayavarman is what he calls a
Cambodian hospital, with 1,600 Khmer staff and only two
foreigners.

Of course, there are still many miles of rough and rocky
road to go. Improvements in infrastructure are needed in
order to provide safe drinking water to the 70 per cent of
the population without it. The work of NGOs and grassroots
organisations like AHC is equally important.

While Jayavarman aims to create a global impact through its
services, smaller facilities that provide home-care
programmes and medical education are also doing their best
to improve the health-care situation in Cambodia. Apart from
infectious diseases, many children are afflicted by
preventable illnesses such as diarrhoea and acute
respiratory infections. Thus, long-term improvements in
child health cannot be achieved through hospital-based work
alone.

“It’s a success that it works,'’ explains Dr Richner when
talking about the Kantha Bopha centres. In the early 1960s
the health-care system in Cambodia was on a par with that in
Singapore, he says. Yet the long civil war and years spent
under the Khmer Rouge regime destroyed the country’s
infrastructure and depleted the number of trained
physicians. His efforts and those of NGOs and personal
donors have gone far, but still more needs to be done.

“I never thought the needs would be so strong. Day by day
you must fight again.

‘’ Despite the difficulties at hand, Dr Richner remains
positive. In his mind, the solution lies in making people
aware that change is possible.

“It’s very important that people can see change exists,
because it does.'’

Funds for Kantha Bopha and Angkor Hospital for Children are
raised through grants, annual events and the generosity of
donors. For further information, visit www.beatocello.com
and www.fwab.org.

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