Screening and education
Improvements in sight
Patients in a local hospital in Cambodia.
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Maximum impact with minimum means

Swiss non-profit organization BASAID is fighting diabetes and hypertension in Cambodia. The volunteer-based organization strives to reach maximum impact in underserved rural regions.

Text by Mara Fornaro and Simon Stock, photos by Sean Sprague

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Rural populations in Cambodia have a hard time getting access to healthcare.

arrow-rightScreening and education
arrow-rightImprovements in sight

Published on 09/11/2020

Chronic, non-communicable diseases such as diabetes and hypertension are a leading cause of mortality worldwide. This is especially true in low-income countries such as Cambodia, where more than 80 percent of the country’s 14 million people live in rural areas with limited access to healthcare.

BASAID, a Switzerland-based non-profit organization that consists of volunteer workers, wants to change this situation. As part of its efforts, BASAID is currently supporting a diabetes and hypertension screening and community-based health education project in the Battambang district in Cambodia.

The project, which is designed to support government efforts in the country, is run by volunteers under the direction of Dr. Simon Stock, who oversees training and surgery operations at the Handa foundation medical and trauma center in Battambang.  

The Ministry of Health of the Royal Government of Cambodia is aware of the rise in chronic diseases but has a hard time to manage this major healthcare challenge, also in the area of diabetes, which kills some 8000 in the country every year.

While several community-based models of care are currently being used in Cambodia through non-governmental organizations, none of these organizations are working or planning to work in the Battambang region. This is where BASAID is jumping in with its project.

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Small but important – a makeshift pharmacy in Cambodia.

Scree­ning and edu­ca­ti­on

In the first phase of the program, BASAID screened high-risk individuals in the community for both diabetes and hypertension. The screening was conducted using the Epicollect+ application, designed by the Imperial College London specifically for community data collection. It is a web and mobile application that allows real-time data collection with GPS to provide geographical localization. It is ideally suited to Battambang because of its widely dispersed rural communities with no registered addresses. It does, however, require the use of smartphones for data collection. Part of the capital cost went towards the purchase of smartphones.

The second phase of the project entailed regular education sessions with patients to help them take control of their day-to-day health needs between regular clinic visits. There is an emphasis on risk factor management.

Creating a sustainable matrix

Sustainability is one of the problems that many community-based projects encounter. Although educating the community goes some way towards ensuring this, the provision of medicines, especially for the very poor, remains.

As part of BASAID’s project, medication is provided free of charge, although a sustainable long-term solution is the goal. A sustainable solution could entail a combination of revolving drug funds and savings schemes, but there will be some exceptions for the poorest, who will continue to receive free treatment.

The plan is to work alongside existing healthcare facilities so that in the long term it will be possible to hand over ongoing care to the government. This will not happen for a considerable time, as there is currently no provision for the care of non-communicable diseases in the more rural areas of Battambang.

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Medical care must be strengthened, especially in rural regions.

Im­pro­ve­ments in sight

BASAID’s first survey took place in February 2016 in the village of Peas. The survey identified 131 households – a total of 641 people – and focused on people aged over 40.

The survey identified diabetic patients giving a point prevalence of 2.2 percent. Within the 40+ age range there was a prevalence of 8.7 percent. Thirty-two people (21%) had high blood pressure. Of these, only 14 were aware that they had hypertension. There were a further 13 people who had controlled hypertension.

In conclusion, the prevalence of diabetes in this rural community is similar to that found in other studies and BASAID confirmed that diabetic patients have a higher body mass index and weight/waist-to-height ratio than non-diabetics. BASAID also found that a very high percentage of this population smokes (44%).

Currently, 40 diabetic patients receive treatment via BASAID in the region, which represents an increase of over 100 percent compared with the numbers of 2015.

The immediate goal is to increase the efforts to address patients’ lifestyles as part of the ongoing educational program for the diabetic patients and to improve the monitoring and control of blood glucose and blood pressure levels in hospitals and at home.

However, the long-term goal is to find a sustainable solution for the supply of essential medication for both diabetes and hypertension and to extend the screening to other rural communities within the Sangke health district.

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BASAID is a Swiss-based non-profit association of volunteers that supports small projects in underserved communities around the world. The current BASAID organization formed in 1996 by the merger of CIBAID and BASAID. BASAID is the association of employees formed after the Ciba-Geigy and Sandoz merger created Novartis. BASAID work is supported through membership fees and donations generously matched every year by Novartis. BASAID supports projects on education, water and sanitation, agriculture, and health.

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