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Looking back 18 months, we can say that, fortunately for Cambodia, we found fewer diabetes patients among rural Cambodians than among the urban Cambodians. In the rural area, Ang Roka Operational District in Takeo province, the peer educators are finding only 1 in 110 adults with urine glucose, compared to 1 in 35 in the urban slums. What a difference lifestyle makes!

 

By the end of 2008, the Peer Educators have given a urine strip to almost every one of the 50.000 adults living in Ang Roka OD. As a result more than 460 diabetes patients were found and registered themselves with MoPoTsyo. More than 70% of them said they did not know that they were diabetic. Self-screening with urine strips is of course not perfect but it is affordable and harmless. We know that there must be more diabetics because based on the prevalence surveys done in other rural areas in Cambodia.

 

We have signed contracts with the remaining 4 other Operational Districts to copy the Ang Roka intervention to their areas as well. We are using funding that we have left over from Ang Roka to expand into the other 4 OD’s. But to do a whole province we will need a lot more.

 

Insulin For Life from Australia and MoPoTsyo signed a partnership agreement. Ron Raab came to visit our slum projects and we already received the first two batches of insulin for our patients.

In collaboration with scientists MoPoTsyo did a study to determine the Glycemic Index of Cambodian white rice to see if the GI varies according to different ways of preparation. The results showed GI values varying from 87 to 97 (on a scale of 100), so very high. Cambodians eat white rice in large quantities 3 times per day. Many diabetics do not know it raises their blood sugar. After all, rice does not taste sweet.

MoPoTsyo’s Food Pyramid is being revised for the third time. But this time it is with inputs from the National Advisory Committee on Diabetes. MoPoTsyo is also an active member of this committee.

MoPoTsyo has started a Revolving Drug Fund. It is not just for medicines but also for Blood Glucose Strips and Urine Glucose strips. The medicines are subjected to a quality test at the National Laboratory for Drug Quality Control of the Ministry of Health.

On a hardcover colored plastified flipchart that is suitable for the use in primary schools, MoPoTsyo produced a story about life in the city compared to life in the country side. The audience is children in primary schools in Ang Roka and Kirivong in Takeo province. The people who present the story are the primary school teachers. This 20 slides flipchart was approved by both the Ministry of Health and by the Ministry of Education. Its effectiveness will be tested during 2009. The production of this flipchart was financially supported by the Swiss Red Cross in Cambodia.

MoPoTsyo is preparing to start a new hypertension program in Anlong Kangan, funded by Het Maagdenhuis. After they evaluated our Diabetes intervention in that area, they funded this second, hypertension intervention in the same area. For hypertension we will use a slightly different strategy with regards to screening and public health services, but the local peer educator remains the backbone of the intervention. “We’ll have to feel the stones while crossing the river” and learn from this intervention lessons that we can later apply in other areas.

MoPoTsyo recently had the opportunity to present its intervention strategy at several international fora: In Bangladesh, Dhaka in 2008 August 24-26, during the workshop “Making Health-Related Markets Work Better for Poor People organized by the Future Health Systems Consortium,

In Cambodia, In Phnom Penh on May 30th,, 2008, in a presentation on the importance of chronic diseases in Cambodia and the disproportionately small attention they get from the aid community and policy makers. In Phnom Penh on 2008, October 7th during the 5th National Diabetology Day;

In Laos, Vientiane, 2008 Oct 9th and 10th during the workshop: “HEALTH AND SOCIAL PROTECTION, MEETING THE NEEDS OF THE POOR by the National Institute of Public Health, Vientiane, the China Health Development Forum and the POVILL Consortium;

In Belgium, Antwerp, in 2008 on Nov 24th and 25th during the conference called “Primary Health Care in the 21st Century, New Challenges and opportunities for the first line”.  [PowerPoint Presentation]