Quarterly Review 4 – 2022

Expansion: In Takeo province, Ang Roka Operational District (OD), the Peer Educators organized primary prevention to communicate about the relaunch of the peer educator network in the OD, including the medical services. Then, at Referral Hospital Ang Roka the first blood- and urine collections were organized, and after that the first medical consultation session took place on 28 October 2022 with 46 patients right away.  The hospital and staff and peer educators all worked together to deal with the patient-load, and it went very well. In this hospital, we experiment separating the payment location from the pharmacy dispensing location. This requires daily reconciliation between the hospital cashier and pharmacist who is dispensing. We will find out over time if it works well and can become a useful improvement for other hospitals. The relaunch has gone well but our peer educators are very old. We should not forget that they were already a bit old when they started in 2007.  In Kratie province, Chhlong OD there are enough patients to increase frequency of medical consultation sessions. We resumed talks with Krouch Chhmar OD and PHD Tboung Khmum province about our plan to start in early 2023, to fulfill the MoU with MoH.

Refresher Training Workshop: With permission from MoH-PMD, we organized a 2-day training Workshop with counterpart Doctors: On December 8 and 9 we had 70 doctors participate at Sunway Hotel. Invited experts shared experience with the audience on Diabetes Type 1, Type 2, with practical instruction on insulin therapy, Melioidosis and Depression. Both the diseases Melioidosis and Depression are linked with Diabetes. The participants received theoretical knowledge and were invited to consider case studies. The posttest and feedback showed good improvements. The workshop was organized at the request of our counterparts. It was the first time in 3 years that we organized it because 2020 and 2021 COVID19 prevented us from organizing this kind of large group gathering.

Good Storage Practice (GSP): We hired a consultant with experience in GSP to help us improve practice. She first made an assessment and then created new draft policies. After that our staff was trained in how to apply the new policies to comply with MoH regulation on GSP for pharmaceutical products and the SOP that we have adopted for our own organisation. Logistics: In December, the medicines that we had ordered (new packaging of 100 tablets per bottle) arrived by air and by sea by container. Now we must adapt our Khmer labels to small pots. To apply new (GSP) Good Storage Practice policies we will make some modifications to the building.

Meetings: MoPoTsyo joined in several meetings. The MoH Consultative Workshop 5-7 October on Finalization of the Training of Trainer’s Curriculum for NCD in Primary Care. Also, in the Technical Working Group on Tuberculosis and Diabetes that was launched officially on 13 October. And lastly, the workshop on preparation of Diabetes Treatment Guideline on 21 October 2022. Nutrition Workshop was held in Kampong Chhnang, with MoPoTsyo also among participants.

Accounting: A new chart of accounts has been prepared so we can split the accounts into a set of accounts for how we receive and use foreign financial donations and another set of accounts for the financial contributions from our own members which do not fall under the income tax exemption, unfortunately, as has recently become clear when the GDT decided specifically on this issue. Nor are the medicine contributions exempt from 10% VAT. Our accountants are now learning how to account in this new system that we implement from 2023 onward.

Per 01-01-2023 a price rise is unavoidable. We calculated at which price levels of the medicines we can continue to sustain the NGO while also paying VAT on medicines and income tax. However, we keep insulin at the same price level per vial including 15 syringes as before (33,000 Riel) but label it as 10% VAT included. It means that the VAT we must pay on insulin will have to be generated from revenue on tablets. We are not sure to what extent the planned price rise on 01-01-2023 will lead to a drop in demand for our medicines, nor do we know if such drop in demand will be permanent or only temporarily. We must have an adequate monitoring mechanism in place after 01-01-2023 to measure the trends.

Staff Retreat: During the last week of November the office employees joined the annual staff retreat, this year in Kampong Som. It rained a lot, which is unusual for this time of the year. The retreat was useful to prepare everyone for a challenging 2023 and how we can improve our activities and adapt.

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