Floating Tuberculosis Centers – A Step Deeper in Mobile Healthcare Delivery by Adapting to Local Conditions (Part I)
Author’s Note: This is the first post in series of two blog posts on floating centers of OpASHA in Cambodia
Long ago, Cambodia was under water, except for a small island with a tree on top, called Kok Thlok.
Today, Cambodia is growing and Kok Thlok is an area of stilted villages along the banks of a river channel and floating huts within the channel itself. With a population of 2775 near Vietnam border. Kok Thlok can’t be searched on google maps and distance to it from any place can’t be calculated because there is no paved road or road, least to say, which leads to Kok Thlok. There is just water, which also takes the villagers to nearby Vietnam for selling vegetables et al and earn them their living. Kok Thlok has thousands of acres of rice fields and flooded/barren land on one side and a small river channel flowing on the other side which is their gateway to rest of Cambodia and Vietnam as well. This part of the country is flooded at least five months of the year. Last month, Operation ASHA (OpASHA) moved one step deeper in mobile healthcare delivery when it opened its first floating center and enrolled a tuberculosis patient in Kok Thlok.
Khok Thlok is one of the centers started recently by OpASHA in Takeo province (rural Cambodia; South). After one year of operations in urban Phnom Penh, OpASHA begin the expansion in Takeo in Jan 2012. The population density of the province is 250 per sq. km as compared to the capital, Phnom Penh which is inhabited by 5400 people per sq. km.
Because of the dispersed population in most parts of Cambodia, OpASHA uses a mobile healthcare delivery model in the country. Mobile model encompasses a counselor traveling from village to village on a motorbike, carrying anti-TB drugs & other supplies. The counselor dispenses the medicines to patients at their homes, as per DOTS guidelines and spends substantial time everyday looking for suspects. He/She also collects sputum samples from each of the suspects and carries it to a pre-assigned location, where Sputum Collector, again on a motorbike, is waiting to take sputum samples to the government lab. As Kok Thlok can be accessed only by water, the counselor makes use of a boat to travel from village to village. That explains the name ‘floating center’.
With nearly a quarter of population living on (or near) water in Cambodia, Kok Thlok is set to test the mettle of our mobile model. Results have been encouraging so far. Kok Thlok had only one TB patient registered in the local government health center in entire 2011 whereas OpASHA has enrolled four patients in the first one and half months.