According to the Ministry of Health, one in eight Cambodian children dies before reaching the age of five. But many child deaths could be easily prevented through proper sanitation, better nutrition and immunization, health experts said.
“Every child has the right to being protected from diseases,” said Dr Chhorn Vesna of the Integrated Management of Childhood Illness. “The parent should provide their children basic rights—immunization.”
Children should receive seven standard vaccines; against polio, diphtheria, whooping cough or pertussis, tetanus, hepatitis B, tuberculosis and measles, doctors said.
Measles is one of the leading causes of death among children under five years old, along with acute respiratory infection, diarrhea and malaria, according to the World Health Organization.
Despite efforts by the Ministry of Health, immunization in Cambodia remains comparatively low. Only 40 percent of children are fully immunized against these diseases, according to the 2000 Cambodia Demographic and Health Survey.
“There is no guarantee that vaccinations can protect a child 100 percent from diseases and death, but it can help to protect a child nearly 90 percent from being exposed to illnesses,” said Kohei Toda, head of the WHO’s Expanded Program on Immunization.
In January 2003, the Cambodia government implemented a national immunization program aiming to fully immunize every infant under the age of one with all seven vaccines, free of charge.
Depending on the size of the town, trained health staff regularly give shots to 80 to 100 children at a time.
About 95 percent of Cambodians now understand the importance of immunization for their children, said Dr Svay Sarath, deputy manager of the National Immunization Program at the Ministry of Health.
That’s a big change from about 10 years ago, he said, when many mothers attending immunization sessions tried to cover their babies with kramas to hide them from doctors.
However, the very poor in remote regions still lack understanding of the importance of immunizations, Svay Sarath said.
While in the field, he said, some villagers have complained to him and his team, asking: “Why would I bring my kids to get shots when afterward they get sick?”
Within two to three hours after receiving vaccination shots, children may come down with fever, but that is a normal side effect, doctors explained.
One of the frustrations of working in the field is that health staff are unable to give shots if the parents are not present, which happens frequently, Svay Sarath said.
“When the mother and father go out to the field to fetch water or plant rice, they leave the children at home,” he said.
According to records from the Ministry of Health, more than 400,000 children under the age of one were fully immunized in 2003.
Svay Sarath said that it is too late for children older than two to get immunized because after that age, some vaccinations may not be as effective and may do more harm than good.
Mengly Quach, dean of the College of Public Health at University of Cambodia, disagreed.
There is no cut-off age for getting immunized, he said. Still, he added, it’s best for children to receive vaccines before age two.
“It is important that children should be immunized as soon as possible according to immunization schedule,” he said.
Mengly Quach stressed the importance of following up on immunization schedules, as some vaccines require more than one shot, which need to be administered within a certain time period. Children can contract diseases such as polio if they are not immunized according to the immunization schedule, he said.
Polio is an acute viral disease marked by inflammation of nerve cells of the brain stem and spinal cord.
Through immunization, Cambodia eradicated polio in 2000. Measles is next to be eradicated in the country, possibly as soon as next year, Svay Sarath said.
