The most basic measures to keep children healthy—such as vaccination and proper nutrition—are often neglected in the wake of higher-profile programs.
In 2000, the World Health Organization declared polio eradicated in Cambodia. The last reported cases of the disease, which can leave children paralyzed, had been in 1997.
But in spite of the children’s polio vaccination program, which has continued, cases of a rare type of polio were recently discovered in Kandal province and Phnom Penh, prompting an emergency vaccination campaign in January.
This shows how crucial it is to maintain disease-control programs even when progress is made, said Rasoka Thor, a doctor heading the child-survival promotion program at the UN Children’s Fund in Cambodia.
According to the 2006 Demographic Health Survey, 67 percent of Cambodian infants now are immunized for traditional diseases such as measles, diphtheria, polio and tuberculosis before they reach 23 months.
As a result, only 2 percent of Cambodia’s children die of measles nowadays, Rasoka Thor said at a recent conference on child health at the French Cultural Center. But vaccination must continue or progress will stop, he said.
Two factors threaten the program. The Japan International Cooperation Agency, which has been supporting the Ministry of Health’s National Immunization Program since 1992, has not decided whether it will keep on funding the program after March 2007, said Nhean Tola, JICA’s media relations officer.
Moreover, the government only pays expenses of about $2 per day when health workers travel more than 10 km from their health centers, Rasoka Thor said. Some health workers, especially in the countryside, pay petrol out of their own pockets to tour villages and vaccinate children, but they cannot really afford it, and this technicality is undermining the immunization program, he said.
Malnutrition—due to low-quality food—is another health issue which, like vaccination, receives limited attention despite its critical importance. It severely hampers children’s growth and plays a role in half of all child deaths in Cambodia, Rasoka Thor said.
The health survey indicates that nearly one Cambodian child out of four is underweight and shorter than the norm—conditions that can make a 6-year-old child appear barely 4 years old.
In addition, a third of the children and nearly half of all women in the country suffer from anemia due to iron deficiency. If not treated before a child reaches 2 years, anemia may cause irreversible brain damage, said Philippe Longfils, a doctor and adviser on a food security program supported by the GTZ-German Development Cooperation that ended in December.
As Ministry of Health data shows, handing out vitamins is not always the solution: Only 4 percent of pregnant women who get the prescribed 60 iron tablets actually take all of them, he said.
Looking for solutions that could fit into Cambodians’ lifestyle, Longfils’ program researchers worked with several organizations to experiment with an iron-fortified fish sauce in Kampot province in cooperation with fish sauce producers and the Cambodian government.
They concluded last year that, at an average price of $0.23 per liter, fish sauce is a promising way to give Cambodians the iron they need since a typical family eats fish sauce six days per week at the rate of 2.6 times per day, said Longfils.
Researchers have also studied a vitamin-and-mineral tablet to put in babies and children’s food, he said.
Rasoka Thor added that children often stay with their grandparents in the countryside while their parents work in Phnom Penh. Those older people often don’t have the energy—let alone the money—to serve children appropriate food, and need easy and inexpensive ways to supplement children’s diets.