Cambodia's second chance

From the 1998-1999 MSF International Activity Report

National staff : 292
International staff : 55


MSF first started working in Cambodia only weeks after the Vietnamese withdrawal in September 1989. Medical teams are now based in many parts of the country and through their concerted efforts, MSF is contributing substantially to the reconstruction of the Cambodian health system. The development of these health services is slowed down by the extremely low salaries of medical personnel who earn US$10 a month, a fraction of what they need to live on.

In fact the Ministry of Finance keeps full control of the health budgets, as in the old days. The management of human resources also requires modernisation, with the introduction of evaluations and incentives. Pilot projects that address these issues are already showing promising results.

The needs in what were formerly khmer rouge areas are enormous, as their leaders had kept the people prisoners for more than twenty years. MSF started to work in Anlong Veng, their last head quarter to fall into government hands. The HIV epidemic is the fastest growing in south east Asia. An estimated 180,000 people are infected with the virus.

To reduce infection, MSF runs Sexual Transmitted Disease (STD) clinics. In public hospitals MSF introduces so called "Universal Precautions" that aim to reduce hospital based transmission of HIV by providing training in sterilisation techniques, etc. As the disease is new in Cambodia, AIDS patients face severe discrimination. MSF supports the Preah Bat Sihanouk Hospital in Phnom Penh, which functions as the national referral hospital for AIDS patients.

Tuberculosis is estimated at around 4.5 per 1,000 people, one of the highest rates in the world. MSF provides technical assistance to the national TB centre CENAT. Activities include support to the home-based Directly Observed Treatment Short course chemotherapy (DOTS) programme and assistance to provincial supervisors in several provinces.