Gov’t Rallies Officials at Frontline of Cholera Fight

The Health Ministry yesterday summoned nationwide rapid responses teams to prepare for the continuing fight against cholera. A workshop held in Phnom Penh updated more than 100 provincial health officials on the increase in cholera cases this year.

More than half of the health ministry’s operating areas nationwide had, as of June 22, recorded confirmed cholera cases since November. Across 20 provinces there were 449 positive test results for cholera, 4,000 suspected cholera cases, and 50 to 60 deaths.

“There has been an increase not only in cholera but other kinds of diarrhea,” said Sok Touch, director of communicable disease control.

The workshop aimed to improve the technical abilities of some the nation’s 1,200 rapid response team members and allow them to voice difficulties encountered in the field, Dr Touch said.

“As the minister said, if we cannot control cholera…it would be incredible. We must do whatever we can.”

A scarcity of water in the dry season meant people used contaminated sources, increasing the number of cases, while most deaths were due to late treatment, Dr Touch said. The main symptom of cholera is acute watery diarrhea, which can cause severe dehydration and death if left untreated.

Kratie, Kompong Thom, Pursat, Kompong Chhnang, Preah Sihanouk, Ratanakkiri, Phnom Penh, Kampot, Prey Veng, Koh Kong and Pailin provinces are all currently experiencing increases in acute watery diarrhea.

Ly Sovann, deputy director of communicable disease control, said that over the past ten years, intervention had contained sporadic cases of cholera but that this year had been different.

“Why does the trend keep increasing?” Dr Sovann asked, noting that the spread of the disease was being tracked to answer this question.

Action is needed to stop the transmission of cholera from feces that enter water sources and are consumed, said Chhorn Veasna, program manager for the National Cholera Control Program.

“We have slept for a while but now we must wake up,” Dr Veasna said, noting that the previous serious cholera outbreak was in Ratanakkiri in 1999.

Health Unlimited–one of the few NGOs at the workshop–currently pays for transport, communication and staff living costs, which the Ratanakkiri provincial health department cannot afford.

“It is not just a lack of willingness but a need for financial resources” at the provincial level, Ratanakkiri project manager Ginney Liu said, asking whether these would be provided.

Dr Sovann said that he recognized delays in making money available for operational costs, which are partly subsidized by the World Health Organization.

The Rural Development Ministry cooperates with the Health Ministry to provide clean water sources and toilets and to ensure these are used, said Chea Samnang, director of rural healthcare.

“It is a burden of my ministry in relation to clean water supply and sanitation,” Mr Samnang said.

Maria Concepcion Roces, a WHO medical officer, said her organization appreciated the teams’ response to cholera that had spread to most provinces.

“It is not just Cambodia, but your neighbors Thailand and Vietnam are experiencing increasing numbers of cholera outbreaks,” Ms Roces said.

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