Quarterly Review 3 – 2019

The always original independent anthropologist-endocrinologist, Dr Sudah Yehuda, referenced MoPoTsyo
https://medicoanthropologist.blogspot.com/2019/07/thinking-of-genomics-snp-and-mauritz.html in his blog. He
has kept in contact for more than a decade already, visiting regularly and even facilitating a visit by surviving
members of the Omaha tribe living in North America because they were interested to see with their own eyes how
MoPoTsyo’s peer educators work.

On 9 July a large group of 20 students from National University Singapore came to visit (Pochentong Referral Hospital and our office). The visit had been organized by Dr Siyan Yi of KHANA and lecturer at N.U.S.

On 12 July 2019 there was a meeting in Kampong Cham, organized by MoH to talk about medicine-supply (including
medical supplies) for Diabetes & Hypertension/NCD activities in OD’s to find solutions for logistics issues.

On 16 July 2019 Cambodian NCD Alliance organized a workshop on Conflict of Interest, with a speaker from
Philippines sharing experience and a discussion on how CNCDA may try to protect itself from being captured.

On 22 July 2019, I joined the 2nd workshop of the Technical Working Group Meeting for Environment and Health to
“review the progress of implementation of the national multisectoral Action Plan 2018-2027”. Several line ministries
were given opportunities to present their indicators and targets. It was chaired by H.E. Ung Phirun

On 25th of July MoPoTsyo presented at the Provincial technical working group at Provincial Health Department Svay Rieng on its activities and results in operational districts of Romeas Hek and Chiphou.

On August 8th, we were in Kampot at Provincial Health Department because MoH-Preventive Medicine Dpt had
called for a meeting there to talk about the need for Angkor Chey RH to adapt to the new Ministry of Health program, that is WDF-funded, the Cambodia Project for Early Detection and Management of Diabetes in Primary Care. It is a 3-year project with strengthening health services and development of the community component and creating a new MoH database, to be implemented in Battambang and Kampot. The MoH Preventive Medicine Department has been urging the OD Angkor Chey to open a normal Diabetes Clinic according to standard MoH policy, although MoPoTsyo already has a successful intervention there. The challenge then becomes how to harmonize the comprehensive chronic care system that we have in place there (which has a real community component that is effective, low cost to the patients and financially sustainable) with a clinically focused model without a proven community component but higher cost to the patients when you take into account transportation cost + opportunity cost. Opportunity costs is the income that is lost because time could not be spent in a productive way by the patient and by the accompanying person who is also not productive because he/she is accompanying their dependent relative. So far government diabetes clinics give 2 weeks of medicine. We try to work out a compromise. On 23 September we attended a stakeholder-meeting. We want to protect the peer Educator network in Angkor Chey OD from being pushed aside instead of being integrated with the MoH own plan to train 2 volunteers in each village with a 2-day training. I think both systems should be made to complement each other: they are not mutually exclusive.

On 23 July, using a big excavator, a contractor began to put a new sewage system in the road in front of our office
in Sorla area. On August 9th or office was flooded because the new sewage system had not yet been connected.

On August 5th, the official opening of special rooms inside an existing building ” at National Pediatric Hospital in
Phnom Penh which are going to serve as “Diabetes Clinic for Children”.

On August 6th, MoH had organized a workshop on a Training of Doctors and Nurses for diabetes, with presence of
stakeholders like MoPoTsyo. During the meeting we got general information about the new course given by Prof
Stuart Brink from Massachusetts (USA). He explained what he would be teaching in the following 2 weeks. He is
Senior Endocrinologist, New England Diabetes & Endocrinology Center (NEDEC), previous Chair of ISPAD, for more details and training materials you can find it on their website see https://www.ispad.org/

On August 19th and on August 23rd we had meetings with Prof Wim van Damme of Antwerp Tropical Institute and
NIPH to discuss about how we cooperate with NIPH and ITM on research topics such as SCUBY (see
https://www.scuby.eu/) . This has resulted in a first signed agreement between NIPH and MoPoTsyo (16-09-2019).

In August we began to re-organize our Peer Educator Training. It has a new schedule and revised materials, including more video material. So far 12 videos have been produced but many more are to follow. We make them ourselves. We are considering the idea to create an online course for peer educators so training becomes less costly and more suitable for scale-up. The training began on September 2nd. It lasts 5 to 6 weeks partly in Phnom Penh and partly in Kampong Speu. Pchum Ben is put as one week rest before the exam week in October. 3 Candidates came from Posenchey and Sen Sok OD’s in Phnom Penh, 2 from Phnom Sruoch OD, and 1 from Baray Santuk OD.

17 September: we got a surprise visit from Prof Laurent Pordie, a French anthropologist-pharmacist of the CNRS,
who set up a sort of revolving drug fund enterprise for Traditional Medicine in Tibetan mountains. You can see his
work in https://www.youtube.com/watch?v=0Q45AAQ8Ac4 .

18 September: MoH PMD organized a workshop in Takeo to review the national training materials for Diabetes,
firstly for Type 1 Diabetes, and then perhaps also add Type 2 DM in that workshop. I was there for day 1, and our
Head of Training Unit, the Nurse Mr SRY Kimkhun continued for one more day. It was also our opportunity to share
our own material and explain.

25 September: 1st consultation at HC Roka Khnong in Daunkeo OD in Takeo province. We had had our program since 2009 until 2014 when MoH asked us to hand-over but then the service at the provincial hospital did not meet the expectations. We were asked to restore as it was before except that now we use local doctors instead of hiring
doctor from Phnom Penh to travel to Roka Khnong HC.

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