Quarterly Review 4th 2018

Expansion: Doctors from Health Centers Samaki and Kambol Posenchey OD and Anlong Kangan HC in Sen Sok OD came to visit locations where our program is running so they can see how it works and atalk with their colleagues. They want to copy the model. Also, in Kampot province where in Angkor Chey OD we visited Health Center Champey to talk with its Director. There, the director is a Doctor and he has visited our program elsewhere. He is interested to set up the service in his HC so we will pay a refresher course for him and then set up Medical Consultation and RDF in his Health Center so he can cooperate with the local peer educator, who is also a Village Health Worker Support Group member (VHSG) there. Also, we expanded in Svay Rieng province: The Director of PHD Svay Rieng asked us to expand to HC Mee Sar Thngok (in Chantrea district) close to the Vietnamese border. We have installed the automation system and RDF pharmacy there on 19 December 2018.

Two new Peer educators: On 19 november 2018 two new peer educators passed the exam, having completed their training at MoPoTsyo. They are both from Baseth district in Kampong Speu. One is a retired policeman, and the other one is a rice farmer.

Refresher training for Doctors: Center of Hope has trained 7 Doctors selected by us in rural hospitals where we work. They are 2 from Por Senchey OD. 1 from Angkor Chey OD (Kampot) and other 2 from Koh Andaet OD (Takeo). The Center of Hope still welcomes if we have more trainee during the rest months in this year. Two more Doctors were trained in December: one from Champey HC in Angkor Chey OD, and one from Anlong Kangan HC in Sen Sok OD. Cooperation with Center of Hope is good.

Annual Staff Retreat 2018: was held in Siem Reap from 26 till 30 November. It was very productive and pleasant. Two members of the Board were present this year: both our President Mr Men Cheanrithy and Dr Ky Kanary. 2 days of meetings was not enough so a 3rd day will be added next year.

Two Publications: On 13 November 2018, the Journal for Medical Internet Research Protocols accepted our article “Using Targeted mHealth Messages to Address Hypertension and Diabetes Self-Management in Cambodia: A Research Protocol” for publication in a few months time. MoPoTsyo’s intervention is mentioned favorably in article “Service Delivery Transformation for UHC in Asia and the Pacific” in the journal Health Systems and Reform, written by Prof Gerald Bloom of IDS Sussex, see https://www.tandfonline.com/doi/full/10.1080/23288604.2018.1541498

Dr Sudah Yehuda visited: He is a globetrotting endrocrinologist (you can read more about him as he often refers to MoPoTsyo https://medicoanthropologist.blogspot.com/2009/10/day-in-life-of-endocrinologist.html ). He is working for the Native American Health Service and works with several tribes. He came to visit us again in November, briefly, on his way to Siem Reap. Two years ago he brought two Native American Indians from an Omaha reserve in Nebraska to learn about our peer program. Since then they have replicated some elements of our model to their area in Nebraska.

Presentation at National Institute for Health-USA : 04-12-2018 UW researcher Lesley Steinman presented about our study “Can mHealth messages improve management of diabetes and hypertension through a peer educator model in Cambodia?” at the NIH Conference on the Science of Dissemination & Implementation in Washington DC.

Our Swiss Donor FSM visited MoPoTsyo office and projects in Phnom Penh and in Svay Rieng. They liked what they saw and continue to fund. They will visit again in 2 years from now.

2-Day Training of Doctors: With the funds left over from the revenue of consultations we organized a two day training of 30 doctors from rural hospitals and health centers, held in Tonle Bassac 2 in Phnom Penh. Trainer was Dr Em Savoeun, Associate Professor at the Faculty of Medicine.

TB & DM Workshop: I presented our program at Cambodiana on 25 December 2018, organized by Cambodian NGO HSD. They want to work with our peer educators in Kirivong OD to link between the Diabetes and the TB program there.

Revolving Drug Fund: Both the Airfreight and the Container arrived in December. Our stocks are full.

Pharmacy Rewards of 2017/2018: We distributed the 15% pharmacy reward to the stakeholders (based on adherence and patient satisfaction) in the OD’s of Angkor Chey, Chiphou, Romeas Hek, Chamkarleu, Baray Santuk, Stoong and in Thmar Pouk OD. This 15% is the share of the turnover in the public health facilities from the sales of the medicines of our Revolving Drug Fund. This sharing of revenue with the public service has been going on since 5 years and we see a rising trend in adherence and in patient satisfaction. It is a sort of public private partnership but then not-for-profit. Over the years the system has gained confidence of those who work in it. It is financially sustainable and the patients pay the full cost of their own routine medication including insulin and syringes. Feedback was positive and we felt good support for our program from our counterparts.

TV’s : We bought 10 LG TV’s (43 inch) to install in HC’s and Ref Hospitals for showing health promotion video’s.
Primary Care Guideline for Diabetes and Hypertension was finalized by official Ministry of Health working group on 20-12-2018 by the task force. MoPoTsyo is member. It describes the role of peer educators in this new guideline as volunteers who can help.

Office Rent contracts: One of our rent contracts would expire after 3 years on 30-06-2019 so we have re-signed as an extension for 3 years. During the retreat we decided to increase our office space.

Hep C: Since we began screening in June 2018 a total 1257 of our diabetic members were screened for Hep C. Among them 77 (=6%) cases positive and we sent their blood samples to MSF France in Phnom Penh at Preah Kossamak National Hospital to test the virus load. Among the 75, there were 49 (4%) who needed to be treated with the combination treatment, which they receive free of charge from MSF France at Kossamak National Hospital, with whom we partner for this nice intervention.

Cambodia, Phnom Penh 31 December 2018

Maurits van Pelt

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