Malaria Drop a Health-Care Success in Oddar Meanchey

April 24, 2002
By Matt Reed and Lor Chandara
The Cambodia Daily

O'smach commune, Oddar Meanchey province - Just a few years ago, malaria was rampant in this remote, hilly enclave along the Thai border.

About 400 people were contracting malaria every month in 1999 and 2000, according to Dr Frances Daily, project manager for Malteser Germany, a health care NGO that operates throughout Oddar Meanchey. Up to 30 villagers died every month, she said.

When CPP and Funcinpec forces ended their one year of fighting here in 1998, thousands of people returned to build homes and cut down the forest to create farmland. The commune's population is now estimated to be between 4,800 and 8,800.
Many of the malaria cases were returnees from Thai refugee camps who no longer carried a natural immunity to the local strain of malaria and were more likely to contract a severe case of the deadly disease, Daily said. Many people contracted malaria because they were spending their days cutting wood in the forest, where mosquitoes live and breed.

The most severe malaria problems in Cambodia occur in isolated villages surrounded by forests, according to the National Malaria Center.

Nationwide disease rates range from 15 percent to 40 percent in villages near forests. That compares to rates of less than three percent for people who live in the plains and near rice fields, according to the National Malaria Center.
The poverty and remoteness of O'Smach meant that most malaria cases went untreated. Even today, the commune does not have a health center.

About 1,000 villagers travel 11 km every month to neighboring O'Pok commune to get medical treatment for all types of illness, Daily said. Others cross into Thailand.

Several visits from National Malaria Center officials starting in May 2000 have helped to bring a large reduction in the number of malaria cases.

About 20,000 chemically treated bednets were handed out in Oddar Meanchey province in 2001, according to the National Malaria Center.

Thanks to bednet distributions, education and "early detection" blood testing, there are now just 10 to 20 people who come down with malaria each month in O'Smach, Daily said. Malaria is still a big problem, but the reduction is "one of the biggest health success stories" in the province, Daily said.

Deforestation is another reason for the drop in malaria cases, Daily said.

Just three years ago, much of Road 68 from O'Smach to the provincial capital of Samraong cut directly through forest. Today, there are hundreds of meters of bare farmland on either side of the road.
"This is good for malaria [prevention], but not so good for the ecology, of course," Daily said.