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MSF in Cambodia, 2006
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In Cambodia, where approximately 180,000 people are estimated to be HIV-positive, MSF is currently focusing its work on treating people with HIV/AIDS. Government and NGO efforts, including those of MSF, have increased treatment access and by the end of 2005, Cambodia had 30 treatment centers. Over half of the 12,335 patients receiving antiretroviral treatment (ART) were being treated at seven MSF-supported centers.
In the nation’s capital, Phnom Penh, MSF works in Norodom Sihanouk hospital, where over 2300 people are now following a regimen of ARVs. In 2005, an average of 63 patients per month was added to the program. Tuberculosis is the most common opportunistic infection for persons who are HIV-positive and MSF offers integrated treatment for those co-infected with TB and HIV at all its treatment centers.
On the grounds of Siem Reap Hospital, MSF runs a Chronic Diseases Clinic (CDC) where over 2500 HIV/AIDS consultations were provided per month in 2005. Consultations and care are also provided for people with other chronic illnesses such as diabetes and hypertension. MSF treated approximately 40 diabetics monthly in 2005.
MSF runs CDCs to the west of Siem Reap in Sotnikum, and at Takeo Provincial Hospital in the south of the country. Combined, these centers currently have over 1200 HIV/ AIDS patients on a regimen of ARVs, 176 of them children.
Together with the Ministry of Health (MOH) and other NGOs, MSF is supporting decentralisation of treatment from CDCs to provide more localised access to treatment. In the towns of Kampong Trach and Poipet, over 500 patients were receiving treatment in decentralised sites by July 2006.
An HIV/AIDS clinic at the provincial hospital in Kompong Cham is the only one available to see patients, not only from its own province, but also from the neighbouring provinces of Kompong Thom, Kratie and Stung Treng. By the end of 2006 it is expected that 1600 patients will be receiving treatment at this location.
MSF runs a tuberculosis (TB) project in Sotnikum and in 2005 introduced a community TB program in 180 remote villages, providing community-based TB treatment with the goal of increasing treatment access whilst ensuring adherence. Village volunteers are assigned patients and help ensure that medication is taken. This program is supported by bi-weekly visits from a medical home care team.
MSF has run a malaria project in the Sotnikum area over the past five years, which will be handed over to the MOH by the end of 2006.
MSF has also operated a malaria outreach project in the isolated Pailin area, utilising village malaria workers to screen people, and providing effective artemisinin-based combination therapy (ACT) for this increasingly drug-resistant illness. In 2005 over 7000 people were treated, and the activities will be handed over to the MOH at the end of 2006. MSF is currently assessing the effectiveness of a recently developed and effective antimalarial drug, Artekin, in this setting.
MSF has worked in Cambodia since 1989.