In December 2010, OpASHA opened its first center in Cambodia, where Tuberculosis (TB) is a pertinent issue. The country’s TB burden is one of the highest in the world with 690 cases of active TB per 100,000 people at any given time. According to the World Bank, Cambodia’s per capita income is just $2.59 a day. Affordable and accessible public health care is essential in Cambodia, and OpASHA’s model is well-suited to fill the dire need found in Cambodia’s most impoverished and isolated communities.

Since beginning its operations in Cambodia, OpASHA has grown to serve 15% of the Cambodian population, operating in 15 Operational Districts across 8 provinces and working with a total of 180 Health Centers. As of 1Q2016, we have enrolled more than 12,000 TB patients in Cambodia for treatment under the National TB Control Program. (Official website for Cambodia: www.opashacambodia.org)

Last-Mile Delivery: TB Treatment & Prevention

Pechmony, 7, takes his daily dose of medicine with the help of his mother. He is supervised by a Field Supervisor (not pictured) who ensures that he takes his medicine regularly
Pechmony, 7, takes his daily dose of medicine with the help of his mother. He is supervised by a Field Supervisor (not pictured) who ensures that he takes his medicine regularly

OpASHA works closely with the local government, provincial health departments and health centers to detect TB cases and deliver treatment to the local communities.

TB is a fully curable disease but it requires strict adherence to a treatment regimen where infected patients are required to take the right medication daily for up to 8 months. Most of our patients come from disadvantaged communities and do not have the means to make daily visits to the health clinics. To ensure all patients complete the full-course of TB treatment, we make use of our TB Technology to bring treatment right to the patients’ doorsteps.

Our model brings together Field Supervisors and Village Health Support Groups (VHSG) daily to bring care to patients’ doorsteps. They care for patients in three main ways: 1) screening, 2) diagnosis, and 3) treatment.

What sets us apart from other TB providers is our innovative use of technology. For each stage of care, we employ a different technological solution.

  • Screening: contact tracing app used to identify and diagnose individuals who may have come into contact with an infected person
  • Diagnosis: Lab Alert software with SMS abilities to notify field staff and patient of their TB test results in a timely manner
  • Treatment: biometrics system to track each dose taken by each patient to ensure adherence to the treatment regimen

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Patient Support: Food Program

Grandma Samnang taking her daily TB medication. To help her stay strong during her TB treatment process, OpASHA provides her with monthly rations of rice, salt, fish, and cooking oil.
Grandma Samnang taking her daily TB medication. To help her stay strong during her TB treatment process, OpASHA provides her with monthly rations of rice, salt, fish, and cooking oil.

TB is a disease of poverty. It is widely recognized that the more vulnerable the community, the higher the chance of TB outbreak. Inadequate diet and nutrition both lead to a weakened immune system, which causes the people in disadvantaged communities to be more susceptible to outbreak of TB diseases. Poor living conditions also provide a thriving space for TB bacteria to spread.

In 2014, Operation ASHA discovered that a substantial group of TB patients from disadvantaged communities were malnourished and unable to receive treatment due to their condition. In response, we began our Food Program to provide patients who qualify with monthly food allowances for the duration of their treatment. This program is particularly crucial as TB treatment can begin only when patients are no longer afflicted by malnutrition.

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Training Young TB Ambassadors – Schools Program

Students from a primary school in Phnom Penh welcoming OpASHA staff to their school
Students from a primary school in Phnom Penh welcoming OpASHA staff to their school

The Young TB Ambassadors Program was developed in partnership with the Child Health Foundation and covers 33 local schools in Phnom Penh, along with their surrounding communities.

Children are particularly at risk of developing TB. The purpose of the program is to conduct mass TB screenings for the students and raise awareness about TB by educating them to become young ambassadors for the disease. We empower the students to take charge of spreading TB awareness throughout the community by teaching them how to identify signs and symptoms of TB and encouraging them to pass on the information to their families and other individuals in their villages.

To ensure the program is sustainable, we involve the school community in taking charge of active TB detection by conducting TB awareness training with school teachers and setting up referral networks for them to easily refer students with TB symptoms to our field team. We have put in place an incentive program, where teachers get paid for each positive referral to encourage their efforts.

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Community Transport: The TB x Tuk Tuk Drivers Program

Srey Mom (left), 24, lives with her young daughter and is delivered her daily dose of medicine by trained Tuk Tuk drivers such as Rachana (back)
Srey Mom (left), 24, lives with her young daughter and is delivered her daily dose of medicine by trained Tuk Tuk drivers such as Rachana (back)

OpASHA continues to explore new delivery models to cater to the diverse needs of communities in different provinces.

Tuk Tuks are popularly used as a method of transportation in Cambodia. The TB x Tuk Tuk Drivers project is a new addition to our operations in Kampong Thom province, where we train and engage Tuk Tuk drivers in the community as health volunteers to carry out DOTS administration and TB awareness programs for their communities.

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Indigenous People Project

Sreyleak, 3, a sleepy young TB patient in Mondulkiri province.
Sreyleak, 3, a sleepy young TB patient in Mondulkiri province.

Indigenous peoples remain one of the most vulnerable populations in the Cambodian society, with little or no access to quality healthcare services. Cambodia is home to 24 such groups, spread across 15 provinces.

In collaboration with the Indigenous People Health Improvement Association (IPHIA), OpASHA Cambodia developed a series of TB treatment and education programs for the indigenous population in Mondulkiri province. We have also been working to build the capacity of local health centers and conduct trainings for the Village Health Support Groups who speak the local dialects. In this way, we hope to empower local villagers to carry out TB screening and detection within their own communities.

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Enhanced Case Finding

Two Field Coordinators from Kampot Province educate a gathering at a local village pagoda.
Two Field Coordinators from Kampot Province educate a gathering at a local village pagoda.

Enhanced Case Finding is carried out in selected provinces by our Field Coordinators, who travel to local gathering points of different villages, such as pagodas or community halls. Here, they conduct mass TB screening and training sessions to raise awareness about TB symptoms and to educate the community members about resources they can go to if their families or neighbors begin to show symptoms of TB.

The majority of participants are elderly villagers, who gather at the pagoda often. Elderly individuals are more at risk for developing TB than the average individual. At these sessions, individuals in the audience who have experienced TB symptoms are asked to stay behind after the talk to have their sputum collected for testing and enrollment into the TB program if the results are positive.

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OpASHA in the News


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