The malarial deaths of two Cambodian wildlife officials in the past six months have caused concern among health officials that people working in malaria-infested areas may not be properly educated on how to prevent and treat the disease.
Sam Veasna, of the Wildlife Protection Office, contracted cerebral malaria in November while searching for a rare animal in Anlong Veng. He died a short time later. He is believed to have taken fake malaria drugs, though it was never proven.
Meas Chanda Mony, also of the WPO, died earlier this month while on an expedition sponsored by Fauna and Flora International searching for wildlife in the Cardamom mountains of southwestern Cambodia.
“No one knew he had malaria in the field,” said Hunter Weiler, Cambodia’s FFI liaison, who requested a meeting with malaria-control officials earlier this month to discuss the issue.
Meas Chanda Mony had joined the expedition at the first field site in Veal Veng district in Pursat. While traveling back to Phnom Penh on March 8, he complained of exhaustion.
Like the rest of the people on the expedition, he was supposed to be taking doxicyclene as a preventative medicine.
The next day, at his home in Kompong Chhnang, he felt sick enough to visit a doctor. The Cambodia physician diagnosed him with cerebral malaria and gave him a shot of quinine, which can take up to one week to take effect. The team had been using artisunate, which usually works within a couple days.
On March 11, Meas Chanda Mony’s brain hemorrhaged and he died.
Though Meas Chanda Mony’s case was the most severe, he was not the only person on the expedition to become sick. “We’ve had 20 people go into the field. Thirteen of them have contracted malaria,” Weiler said.
While several foreigners on the expedition became sick, Weiler said he was most concerned about the local staff. “We want to develop a mechanism for the Cambodians so they know what they should do before they’re in the field, when they’re in the field and when they get back,” he said.
Part of the problem is the language barrier. It is unclear, for example, if Meas Chanda Mony knew he should be taking doxicyclene as a prophylactic and artisunate as treatment.
Jan Rozendaal, malaria adviser for the European Commission Malaria Control office, suggested telling Cambodians to only go to a doctor experienced in treating malaria if they should get sick.
Stefan Hoyer, malaria control officer for the World Health Organization in Cambodia, said there are simple steps which can reduce the chances of contracting malaria. “You should beef up your self-protection with sprays, long sleeves and treated nets.”
He also suggested groups going into remote areas have better procedures for keeping staff safe and evacuating them in an emergency. “You should have a much better security backup,” he said. “You never know what is going to happen.”
In the wake of the most recent death, the National Malaria Center has reiterated its request that groups doing field work in malarial areas come to the center first to make sure they have the right prevention and the right treatments.