In 2010, Médecins Sans Frontières completed the handover of its activities in the infectious disease department of the Khmer-Soviet Friendship Hospital. More than 3,000 HIV patients were transferred to the care of the health authorities, and shifted our focus to tuberculosis (TB) care.

Cambodia is one of 22 countries listed by the World Health Organization as having a high burden of TB. In Kampong Cham, the most populous province in the country, staff worked to improve the diagnosis and care of people with TB and drug-resistant TB (DR-TB). Staff established a chest clinic within the TB ward of Kampong Cham provincial hospital, and began to actively seek patients with TB, visiting and offering TB testing to patients who had been admitted to hospital for other reasons.

By the end of 2010, the number of TB patients had increased by 25 per cent, and revealed a need for improved patient follow-up. Médecins Sans Frontières had carried out an assessment of facilities for TB care in four districts of Kampong Cham, and had begun providing TB care in local health centres. However, decentralised activities were temporarily suspended so that our staff could focus on its work in Kampong Cham hospital and ensure the follow-up of its patients. In the coming years, we will develop a comprehensive TB care approach throughout the province.

HIV and TB care for prisoners

Overcrowding, lack of ventilation and generally poor living conditions in prisons mean there tends to be a high risk of TB contamination. Médecins Sans Frontières extended HIV and TB services in Phnom Penh prisons to provide comprehensive testing, counselling and treatment for both diseases. Teams also provided general healthcare.

In Phnom Penh men’s prison, more than 80 per cent of inmates agreed to be tested, and preliminary results showed 3 per cent prevalence of HIV in comparison with 0.6 per cent among the general population, and 3.9 per cent prevalence of TB in comparison with 0.7 per cent among the general population. Prevalence was slightly lower in the city’s women’s and children’s prison, at 2.7 per cent and 2 per cent, respectively.

Cholera outbreak

Médecins Sans Frontières teams also assisted during cholera outbreaks across the country in 2010. Staff provided technical support and cholera kits that were adapted for use in national treatment centres. In collaboration with other organisations, our teams helped to strengthen the surveillance system for communicable diseases, especially cholera, dengue fever and measles.  Staff are working with health programmes at national and provincial levels, investigating suspect cases and analysing the performance and challenges of the care given. This should enable timely identification of a medical crisis and a more efficient and appropriate response.

Médecins Sans Frontières has worked in Cambodia since 1979.