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| Villagers lined up for medical checks outside the Kuntha Bopha children's hospital in Phnom Penh |
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It must be
every parent's nightmare - reports of a mystery disease killing dozens of
children.
Sixty
undiagnosed deaths over a period of three months triggered a report from the
Cambodian authorities to the World Health Organisation (WHO). In such cases, there
is usually an internal investigation to discover the facts before anything is
made public.
This time,
however, the report was leaked to a news agency in the Philippines. It soon
made international headlines, perhaps understandably, bearing in mind that
diseases like SARS and bird flu had first been identified in this region.
But it
turned out that the unidentified illness was nothing remotely so serious.
'Needless
panic'
Working
together with Cambodia's Ministry of Health, the WHO found a virus known as
EV71. It was the first time it had been positively identified in Cambodia, but
it is common in nearby countries, including Vietnam and China.
It is one
of the triggers for hand, foot and mouth disease - a childhood illness that is
well-known around the world.
For most
children, it causes nothing more than a few days' discomfort. But for those
already weakened by malnutrition or diarrhoea, it can become more serious if
not properly diagnosed and treated.
 |
| Dr Pochenda Chhorn says poor living conditions trigger disease |
Most health
experts in Cambodia were bemused by all the fuss. One told the BBC that
treating the illness as a news story would be "like covering an outbreak
of chickenpox".
Dr Beat
Richner, the Swiss national director of Phnom Penh's Kantha Bopha Children's
Hospital, berated the WHO for causing "needless panic" in its
handling of the affair.
But
officials at the WHO are themselves privately seething that what should have
been an internal report ended up going viral, spreading alarm before all the
facts were known.
The fuss
over the affair will probably die down soon. But some health workers hope that
it will at least illuminate the challenges facing Cambodia, especially its
young children.
Toilet
access
Sixty
deaths over three months may seem a lot, until one realises that 50 children
under the age of five die in Cambodia every day.
Over a
year, that comes to almost 20,000. In all, one in 20 Cambodian children will
not live to see their fifth birthdays.
The reasons
are tragically simple. Dr Pochenda Chhorn sees them every day at the Cambodian
Children's Fund Clinic on the outskirts of Phnom Penh.
"They
live in very poor conditions. They have low hygiene - this is the biggest cause
of disease for them," she said.
It is a
staggering statistic, but true nonetheless: Cambodians are more likely to own a
mobile phone than have access to a toilet. In rural parts of the country, the
vast majority lack sanitation and the consequences are predictable.
 |
| Children in Cambodia are vulnerable to infections because of poor hygiene |
Diarrhoea
is one of the main causes of death for the under-fives. Even when it does not
kill, it leaves children vulnerable to other infections, including hand, foot
and mouth disease.
Simple
advice
The WHO's
advice for reducing the spread of EV71 and HFMD is simple: wash hands and
practise good hygiene. If children develop a fever, treat them with
paracetamol.
Despite the
recent scare, and the high under-five mortality rate, the WHO is keen to
emphasise the progress Cambodia has made. As recently as a decade ago, one in
eight children died before they reached five.
Dr Howard
Sobel, the WHO Maternal and Child Health Team Leader in Cambodia, says that
credit should be given to the government's promotion of breast-feeding.
"These
days, three out of four mothers practise exclusive breastfeeding. It used to be
one in 10," he says.
Mr Sobel
also praises the government's efforts to restrict the advertising of infant
formula milk and says the campaign and its results have been remarkable for
such a small, developing country.
If that
level of commitment could be applied to sanitation and child nutrition, then
further success may come. Cambodia's children would then be much less
vulnerable to the likes of EV71 and hand, foot and mouth disease.
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