Girl May Be Cambodia’s Last Polio Victim

Mum Chanthy is like so many Cambodian children, born to a poor family scraping by in the countryside. But until last week, she was probably the most sought after 5-year-old in the country.

World Health Organization officials had combed through provincial villages, asking about a little girl who cannot move her left arm and leg. Ads with Mum Chanty’s photo and the names of her parents were placed in Khmer-language newspapers and on television. Ads were played on radio as well.

Last week her family, now living in Svay Rieng province, saw one of the television ads and were brought to the capital to meet with Ministry of Health and WHO officials. Today, she is scheduled to share a stage with Prime Minister Hun Sen, the ambassadors from Australia and Japan and the regional directors of Unicef and WHO.

The search began in 1998, the year after Mum Chanthy left a Phnom Penh hospital after doctors told her family that she had polio. Health officials realized that the little girl, from a village along the Mekong River in Kandal province, wasn’t just the eighth recorded case of polio in Cambo­dia for 1997.

Mum Chanthy is now regarded as perhaps the last person ever to contract polio in Cambodia and the other 36 nations that make up the WHO’s Western Pacific re­gion. She is scheduled this morning to take part in a ceremony that will declare the wild polio virus officially extinct from Cambodia.

Polio is a viral infection that affects the spinal cord and brain. The disease mainly strikes children younger than 5 years old, attacking the nervous system and resulting in partial paralysis. It is spread by unsanitary conditions, such as contact with the bodily fluids of an infected child.

Monks will give a blessing this morning, a traditional dance will be performed and the national anthem will be sung. Finally, an official certification of polio eradication in Cambodia will be presented by the WHO.

This certification has been seven years in the making. Cambodia began its eradication program in 1994, a year that saw 300 new cases of polio. At the time, Cambodia was one of the most heavily endemic countries for polio in the world.

In 1995, the first of about 20 National Immunization Days began. More than 40,000 health workers and volunteers spread out across the country to spoon feed the sugary oral vaccine, which costs less than $1. Eventu­ally, the vaccine was given to about 2 million children in all of Cambodia’s more than 1,600 communes, according to Keith Feldon, a technical officer with WHO’s Cambodia immunization program.

Feldon estimates that about 80 percent to 90 percent of Cambo­dia’s children were given the vaccine. That was enough to stop the spread of the disease, he said.

The campaign was part of a global effort to eradicate polio. According to a WHO report, 100 million children were immunized between 1994 and 1998.

The disease now exists only in parts of India and Africa and could be eliminated from there by 2005.

According to WHO standards, health officials can declare a country safe from polio if it has gone three years without a new discovery. Fifteen month-old Mum Chanthy contracted the disease in March 1997. So officials tentatively were able to announce last year that polio in Cambodia was dead.

The long process of reviewing and verifying Cambodia’s immunization and investigation practices wasn’t completed by WHO officials in Japan until a few months ago. Stool samples have been sent to a laboratory in Japan, but no one in Cambodia has tested positive for the wild polio virus since 1997.

“They don’t do the declaration until after documentation has been looked at by regional and national certification committees,” Feldon said. “It’s just like a court case. They ask every question you can think of.”

But not everyone is convinced polio has been eliminated as a threat to Cambodia’s fragile public health system. While he admits that a 80 to 90 percent vaccination rate is a big success, Dr Beat Richner of Kantha Bopha Children’s Hospital said his hospitals in Phnom Penh and Siem Reap are still seeing sporadic cases of polio.

Staff from the Ministry of Health and WHO have come to the hospital and taken stool samples, he said. But Richner is skeptical that the tests in Japan can determine whether or not the samples contain the virus.

“The samples are very fragile. If the temperature is off, then you cannot find the virus,” Richner said. “As a medical doctor, I would not have the courage to join this ceremony. It is the third time they have made this an­nouncement. I think it is propaganda.”

Meanwhile, when Mum Chan­thy leaves the stage after today’s ceremony, she could benefit from a new campaign to help Cam­bodia’s estimated 70,000 polio victims.

Rotary International, which had helped to pay for the vaccination campaign, will now shift its focus to caring for victims through rehabilitation, surgery, education and job placement, Rotary President Anthony Sanford said. To begin, Rotary’s Cambodia organization decided Wednesday to fund Mum Chanty’s education.

“This is a long-term commitment that should remind us that she is the last victim,” Sanford said. “But we won’t just concentrate on one person. This will be a bigger program.”



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