Like all forms of government services—particularly health care—its the impoverished villagers in the remote areas who are too often ignored.
And that’s especially true for villagers who live in the mountainous, forested areas of Ratanakkiri province, where malaria is rampant and where access to prepackaged medicine therapy and “dipstick” tests—which can tell within minutes if someone has malaria—is limited.
This gap has prompted the National Malaria Center, with the support of the European Commission Malaria Control Program, to look into using health volunteers in remote villages.
A pilot project was launched in Ratanakkiri in June 2001, and a second one in Koh Kong province earlier this year.
In each case, the project involved one volunteer per village who received two days of training on how to recognize symptoms, reduce fever and keep records, according to Sean Hewitt, malaria control specialist for the EC Malaria Control Program.
Elders in each village were asked to recommend candidates, he said. Out of them, a volunteer was carefully selected, said Hoy Vannara, communicable disease chief for Ratanakkiri.
“They had to read and write Khmer; be popular and trusted by other villagers; live close enough to the village to be easily reachable; and to be used [to] and ready to work hard and long hours,” he said.
In Ratanakkiri, 36 ethnic Jarai and Tampoun minority villages participated in the project, and in Koh Kong province, 10 ethnic Khmer villages.
The preliminary report on Ratanakkiri shows that the formula meets a major goal of malaria control—early detection and treatment.
In villages with volunteers, 75 percent of the children sought treatment within three days of becoming ill, compared to 35 percent in villages without volunteers, Hewitt said.
One out of 10 sick children never came for treatment in villages with volunteers, while three out of 10 sick children did not seek treatment in villages that did not have volunteers, he said.
During the first 11 months of the Ratanakkiri project, nearly a third of the 15,000 people involved showed malaria symptoms. Among them, 2,271 tested positive—half of them being under 7 years old.
In Koh Kong, 787 of the 2,200 people showed malaria symptoms and 284 of them had the disease. A third of those who tested positive were under 15.
The volunteers receive a $2 per diem for attending meetings twice a month, said Duong Socheat, director of the National Malaria Center.
The cost of the program is estimated at $1.20 per year per person in participating communities, officials said.
Mam Bun Heng, secretary of state for the Ministry of Health, who visited participating Tampoun villages last weekend, said the results prove that the village volunteer formula might also work for other public health care efforts.