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MSF in Cambodia, 2008
Field Staff: 334
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The main health problems in Cambodia include HIV/AIDS, diabetes, and tuberculosis (TB ). A substantial increase in funding by international donors has helped strengthen efforts by the government of Cambodia and its partners to tackle such prevalent diseases. As a result, Doctors Without Borders/Médecins Sans Frontières (MSF) has begun reducing its activities in the country.
In the provinces of Siem Reap and Takeo, MSF is running two clinics that use an innovative approach to treat HIV/AIDS as a chronic disease alongside diabetes and hypertension. The approach aims to de-stigmatize HIV/AIDS by treating it as another chronic disease. Another aim is to increase the focus on diabetes—a disease that is rarely treated in Cambodia and yet affects 5 to 10 percent of the population.
"In Cambodia, care for people with HIV/AIDS is expanding and attracts a lot of attention from the international donor community. However, care for people with diabetes, arterial hypertension, and other treatable chronic diseases remains limited and the level of government spending on drugs is insufficient," says Philippe Berneau, MSF head of mission. "Some sufferers even say that they wish they had AIDS, since the HIV/AIDS care provision is much better. MSF’s approach of integrating care for HIV/ AIDS with care for hypertension and diabetes has resulted in satisfactory outcomes for patients and efficiency gains for the services."
At the end of the year, the two clinics were treating more than 3,000 HIV/AIDS patients, more than 1,700 diabetes patients, and 390 patients suffering from hypertension. MSF was also treating a small number of patients with TB and multi-drug-resistant tuberculosis (MDR-TB). Preparations have now started for the handover of these activities to local health authorities and partner NGOs.
In Phnom Penh, MSF is treating HIV/AIDS patients in the Khmer-Soviet Friendship Hospital, where 3,650 patients were given antiretroviral (ARV) therapy. In June, MSF began integrating the treatment into the public health system. The handover was achieved by transferring patients from other provinces to local centers providing ARV therapy. Now, the remaining MSF activity in the hospital is the treatment of patients who are co-infected with MDR-TB.
Since 2006 MSF has been providing HIV/AIDS care to prison inmates in Phnom Penh. In June, access to care and treatment in two of the city’s main prisons was increased.
In Kampong Cham, the handover process of HIV/AIDS care to local health authorities was in its final stages by the end of the year. The Cambodian health authorities were then managing the adult caseload, while the pediatric consultations were still carried out by MSF. A project dealing with HIV patients co-infected with TB as well as patients with drug-resistant strains of TB was set up in June.
MSF has long pushed to create a working group on drug-resistant TB, which would involve Cambodia’s health authorities and other interested parties. Such a group was finally created at the end of 2007. Throughout 2008 a series of meetings were held, focusing on establishing national guidelines and long-term plans to tackle MDR-TB.
MSF has worked in Cambodia since 1979.