2nd Quarterly Review 2018-April through June

Research University of Washington: On April 25th we had the Advisory Board meeting at the Phnom Penh Hotel with participation of NIPH, MoH-PMD and Researchers from UW (Seattle) to present preliminary findings and discuss general ideas about future research. The findings show signs of a little improvement in Blood Pressure and Blood sugar but not significant. We decided to continue to send messages for 3 more months to increase the available data for this pilot, so the voice messages stopped on 30 June 2018. Now we have to collect data for evaluating the trial and ask patients and peer educators what they think these new tools.

 

OD Bassac: We discussed standard agreement with OD and visited Niroth HC. But the Director informed us that he could not sign because we charge fees inside the walls of the public service. We postpone this with a few months. However the Peer Educator was trained and installed and is already screening so for the moment we refer to Pochentong Hospital. Hopefully later this year we can also provide the same service in Bassac Referral Hospital.

 

Importation of medicines:  Airfreight arrived on May 8 as our stocks were running dangerously low. A 20-feet sea-container is on its way by ship and has just arrived at the port.  This time MoH asked us to justify “why we need so many medicines” but we could show them our database with the invoices and names of patients who bought our medicines and then MoH approved our importation. We are busy with customs clearance. We already made a new order for small airfreight in October and a large bulk order with sea-freight that should arrive by very early in 2019.  We are preparing an order for another order for the end of this year to protect us from shortages till end of July 2019.

Hep C: Our laboratory staff and program staff and the peer educators were trained in the screening for Hep C. I made a video for our members explaining the screening process. When I showed to Kossamak Hospital, the Director of Diabetes clinic wants the same video for their diabetes patients so I am going to help him with that. Hep Screening has started on Friday 25th of May. It is 2 stage screening: first a rapid test which we do at our Laboratory. Then we send the blood of positive cases to Kossamak Hospital for testing of the viremic load (PCR/GeneXpert). Then we communicate the result to the patient and facilitate appointment for starting free Hep C treatment at MSF France supported Hepatitis Clinic at Kossamak. It is complicated to explain so the video is needed to play the messages again and again. Per end of June we have screened 318 diabetic patients, detected 23 Hep C cases who will get free Hep C treatment from MSF France at Kossamak. This means that +/- 7.2% of diabetic patients have Hep C. We have about 13,000 members with Diabetes, so we can perhaps help 936 Diabetes with Hep C in the same way.

New laboratory machine: Our new laboratory machine HUMASTAR 200 is working well. We began to use it in the last week of May and it helps reduce workload on our staff.

STEP Survey 2016 results were disseminated at Faculty of Medicine on May 8 in an event presided by H.E. Prof Mam Bun Heng.  The STEP Survey 2016 compares with STEP Survey 2010 following same methods. National sample of 2869 participants. Hypertension rate was almost 50% higher than in 2010. Raised Blood Glucose was also several times higher than in 2010, at 8.9% impaired fasting glycaemia and 9.6% raised Blood Sugar (≥110mg/dl).

The new Primary Care Guideline for Diabetes and Hypertension was discussed during MoH Workshop Siem Reap. Participants issued recommendations that Peer Educators become “Village Health Support Group” ( recognised by Ministry of Interior). This would qualify them for financial incentives from the government.

Center of Hope and MoPoTsyo signed a training contract: CoH will train-on-the-job 10 Medical Doctors in medical consultations for Diabetes and Hypertension. We chose government doctors from rural hospitals. Training is during 2 weeks starting in August in groups of 2. Last year, we paid for 17 doctors, same kind of training.

 

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