-
- Poor
medicine for poor people in poor
countries.
- A
policy which amounts to passive
genocide.
-
- The
policy and strategy of the WHO and many of its
subordinate organizations concerning medicine in poor
countries, in our case Cambodia, results in thousands
of deaths, thousands of invalids, and thousands of
brain-damaged victims. This policy, which we
characterize as poor medicine for poor people in poor
countries, is not only ineffective, it actually
actively endangers, damages, and destroys thousands of
lives. This policy amounts to passive genocide. These
organizations and their proponents are called upon to
assume their responsibility and change their policies
and strategies.
- To
a great extent the WHO determines the policy of the
Cambodian health ministry. Thus, for example, in the
health sector the projects and money from the World
Bank are directed by WHO policy, as are UNICEF
activities in the health area (the UNICEF central
pharmacy in Copenhagen for all UN organizations'
campaigns the "basic care" vaccination program at
district level, etc.). The WHO, the World Bank, and
other organizations have their offices on the first
floor of the Cambodian health ministry, in other words
at ministerial level. They have a permanent, central
presence in the Cambodian health ministry. Numerous
organizations, large and small, as well as numerous
governments of industrialized, wealthy nations follow
the WHO's policies and strategies.
- We
also call upon the WHO and other organizations to stop
defaming and endangering those institutions which are
effective and have the equipment and know-how at their
disposal to uncover and successfully combat the actual
horrible situation of suffering and death.
- There
is little point 30 years from now in complaining about
the tragedy of today and the past 20 years caused by
the mistaken policy of the WHO. We challenge the
international community to have the courage to
recognize the cruelty and horror of the situation and
act appropriately.
-
- Violation
of Children's Rights
- Every
child has the right to health (UN Charter of
Children's Rights). Every child has the right to the
best medical treatment possible (UNESCO Charter). The
best possible treatment for infectious diseases (90%
of children's diseases in Cambodia) is correct,
monitored, and corruption-free treatment.
Corruption-free means that medical criteria determine
treatment, not social class, ability to pay, or
patient connections. Correct means that an accurate
diagnosis must be made, a treatment's efficiency must
be evaluated, and the medication's effectiveness
monitored. The medications must be efficacious and not
deadly.
- Anything
else violates the fundamental rights of children.
Nevertheless, correct medicine is being hindered by
the international organizations, and the rights of
children are being abused.
- The
philosophy of basic medicine, peasant medicine, or
grass-roots medicine continues to be given as a
pretext and justification. However, there is much
confusion associated with these concepts. What is
really meant is just cheap medicine. If it were
correct and efficient, there would be nothing wrong
with basic, grass-roots, or peasant medicine. But in
fact it has never existed. It was always propaganda
and lies to justify a two-tiered medical system that
abandoned the poor. The claim is that little is done
for the masses of poor in order that there is enough
for everyone. In other words, nothing is done
efficiently. The powerful, the ruling classes, the
nomenclature, the party elite, and the wealthy are
exempt from the strategy of poor medicine; there are
other rules for them. The same holds for the
international organizations, especially the WHO and
UNICEF, which impose poor medicine on poor people in
poor countries. Their officials have other rights:
they assume the right to better medicine, a privilege
they would never grant to the poor masses they plan
for. There are other rules for them.
-
- Basic
medicine for poor countries: a propaganda lie with
lasting reverberations and grave consequences . . .
almost a parable.
-
- Liuk
Shaoqi, Mao's challenger and possible successor,
contracted tuberculosis in 1965. Mao ordered the
physicians in the area not to get involved in the
treatment of his opponent. However, he could not
prevent his opponent from getting medical care in a
good hospital. Consequently, all good hospitals had to
be paralyzed or destroyed. All physicians were sent to
the countryside. The pretext was the implementation of
a basic medicine strategy: "Doctors rush to the
countryside to be peasant physicians for the good of
the poor masses" (June 26 Directive of the Cultural
Revolution, 1965). This peasant or basic medicine
remained propaganda. It was never shown to be
effective for public health, which of course would not
have been in the interest of the manipulator Mao
anyway at the time of the Cultural
Revolution.
- The
propaganda lies of basic medicine were taken over by,
among others, the new left in Western Europe (basic
medicine basic groups) as a result of the '68
movement. Those lies still linger in the minds of the
former '68 heroes as a hazy mirage, those same heroes
who have been able to secure a comfortable existence
for themselves in international organizations, aid
organizations, and the media.
- The
propaganda of basic medicine was also embraced by Pol
Pot, Mao's star pupil. Of course, after he sent all
the physicians to the countryside he had them murdered
(900 out of 953). Basic medicine was celebrated with
little in Pol Pot's regime, so that there would be
enough for everyone. For all medical complaints, an
orange syrup was distributed by semi-skilled
teenagers, the young officers of the Khmer Rouge. The
Khmer Rouge officers themselves received medical care
from good Chinese physicians in Phnom Penh, and after
1979 from other foreign colleagues as well. (Just as
this was always taken for granted by Mao, it is taken
for granted by all the experts and officials of
international organizations.)
- The
third-world ideologists now set up programs of poor
medicine for poor people in poor countries, cheap
medicine that they distribute as basic medicine. The
efficiency of this practice has not been proven
anywhere. There has been no effectiveness shown since
the "memorable" Alma Ata conference in 1978, when the
principles and goals of basic public health care for
poor countries were established by the WHO, UNICEF,
and many nations, including Switzerland. It was and
remains just dossiers, bogus balance sheets, and
humanitarian long-haul tourism.
- The
only place that basic medicine did function and was
not simply propaganda was in Cuba. Che Guevara was a
physician, an allergist. He was an asthmatic himself
and one of the first patients to inhale with Ventolin.
Without Ventolin the Cuban Revolution could never have
taken place, because he suffered a severe asthma
attack on the legendary crossing to Cuba. Che Guevara
always insisted on the best possible medicine for
everyone. Even on the high plateau, a poor farmer
could have a free operation for a perforated appendix,
with no consideration as to whether that was too
expensive compared to "meeting the needs of the
masses". Thus for many years, Cuba enjoyed the fairest
and best medical system in Latin America. Che Guevara,
because he was honest, eventually become intolerable
for Castro, who was recently (May 1998) celebrated in
Geneva by the WHO. Che Guevara's lot is well-known. In
the meantime, the public health system in Cuba has
deteriorated.
-
- Man
is not made to think and fantasize for the masses; he
should act for individuals, and act fairly to all. And
he should not exempt himself from the rules that he
makes for others. In this way the mistakes of the
basic medicine propaganda over the past 30 years can
be rectified, mistakes which for the poor masses and
poor individuals have brought nothing but suffering,
misery, and death.
-
- Recently
a Chinese delegation from the first and best Peking
hospital visited Kantha Bopha. All of them were deeply
touched by Kantha Bopha. They said that where they
came from everything was also free for everyone, but
not everyone had access, only the party officials.
They were moved when they saw that we (even) did a CT
scan on a poor 12-year old girl: a year earlier in the
province of Takeo the girl had been treated for
pneumonia with chloramphenicol after a three week long
fever. Now she had arrived at Kantha Bopha with a
severe headache. The scanner showed a mandarin-sized
tuberculous brain abscess and calcification in the
lungs (a 100% indication for tuberculosis) that was
too small to be detected in an x-ray. Conclusion:
thanks to cheap medicine, which is backed by the Swiss
Red Cross and practiced on children in Takeo
provincial hospital, tuberculosis was not diagnosed
and the wrong treatment was carried out with a
dangerous cheap medication. The tragic result was then
an inoperable brain abscess. This is one of thousands
of cases similar to Mao's opponent, Liu Shaoqi,
although these are not manipulated by Mao but by third
world ideologists who implement the enduring lie of
basic medicine in the form of cheap medicine for the
poor masses in the poor areas of the
world.
-
- There
is little point 30 years from now in complaining about
the passive genocide that the world bestowed on the
children of the poor countries; 30 years from now is
when history will assess how the West handled this
problem 30 years ago, that is, today. It would be more
useful to be honest now and act.
-
- The origin
of this appeal
- This
appeal originates from the Kantha Bopha children's
hospitals in Phnom Penh, the capital of Cambodia.
Kantha Bopha is an active permanent stronghold of
dramatic daily combat against the passive genocide
practiced on the Cambodian children. In the words of a
leading Cambodian newspaper (August 1998), the Kantha
Bopha I and II children's hospitals hold the promise
of the Cambodian people. They are the only
institutions in the health system which function. Why?
Here corruption-free correct medicine is practiced for
every child, whether rich or poor. They are the only
correct and corruption-free functioning hospitals in
the country, with large preventative and medical
education centers and large medical and surgical
departments. Opened six years ago, children now come
from all over. The statistics for June, July, and
August 1998 show not only the desperate situation in
the country, but also the efficiency of the Kantha
Bopha hospitals.
-
- June
1998 41,143 out-patients 2,283 in-patients
- July
1998 39,170 out-patients 4,514 in-patients
- August
1998 38,613 out-patients 3,664 in-patients
-
- Today,
as this article is being written (29 August 1998) we
hospitalized 523 seriously ill children. Of these, 65
children were sick with Japanese encephalitis, 212
with hemorrhagic Dengue fever (HDF), nine with tetanus
(six of them newborns), and seven with cholera. A
total of 1,740 sick children were treated in the
clinic. A further 430 healthy children were
vaccinated.
- All
of the 65 serious and at times distorted encephalitis
(JEV) cases and all of the tetanus cases could have
been prevented with correct vaccinations. In addition,
the virulence of the Dengue fever virus can be
lessened with the JEV vaccination (cross-immunity
between the Dengue virus and JEV)! The WHO has been
hindering JEV vaccinations in Cambodia (for the past
four years!!!) in line with its strategy of "poor
medicine for poor people in poor countries". "Too
expensive for this poor nation" say the experts. At
the sight of these seriously ill children, I cannot
deny that today I am emotional. And why not? The noble
West despises emotions. So do the distinguished
experts, officials of international organizations, and
their partners in third world ministries. Despite
being invited, they never come to the hospital to see
the terrible reality. Money and unfortunately bogus
manipulated statistics are debated coolly in cooled
offices. I am not ashamed of my emotions, my anger, my
passion. In the final analysis, it is a matter of
humanity and feeling whether the children's right to
health is recognized. It is a matter of justice and,
consequently, a matter of peace.
-
- Each
month 2,000 children more would die if it were not for
Kantha Bopha. During the present Dengue epidemic in
the last three months, it would have been more like
3,000. The WHO is against Kantha Bopha. They say: "The
principle itself is wrong, it is too expensive for
this poor country." "Kantha Bopha has created needs
that did not exist before" !!!
-
- Tuberculosis:
the largest hidden minefield
- Tuberculosis
can be compared to personnel mines set in children
that will explode eventually. In contrast to land
mines, its explosion is programmed, short- or
long-term, its target in sight: as sure as death,
children. Tuberculosis in children can be declared the
largest mine field of the world, concealed and
preserved by the international
organizations.
- Tuberculosis
can only be fought when every actual and potential
center of infection is neutralized, meaning when every
child sick or infected with tuberculosis is given
correct, effective, and controlled treatment.
Unfortunately, there is no known effective vaccine
yet.
- Tuberculosis,
the deadly "minefield for Cambodia's children" is the
biggest health problem of Cambodia's children and
Cambodia's population in general. Every year we
discover 5,000 new cases just among the hospitalized
children. The WHO long with numerous experts and
officials still claims that tuberculosis is irrelevant
for children in the third world; it is not a problem.
Accordingly, it is not to be noticed or
treated.
-
- There
are two reasons given for this:
- 1
Tuberculosis in children is not contagious so it is
not a epidemiological problem.
- 2
Families are not disciplined enough to complete the
course of therapy (six to 12 months). (Incomplete drug
therapy is known to result in drug
resistance.)
-
- We
have been able to refute both:
- 1
Contagions have been detected in lab tests on
one-third of the children sick with
tuberculosis.
- 2
In our tuberculosis center, only 5% of the patients
fail to complete the full course of treatment. Parents
are informed about tuberculosis during their child's
hospitalization and receive instruction in our medical
education center. Even patients from far away come for
check-ups every three weeks, bringing back the empty
medication vials and picking up fresh medication for
the next three weeks. They receive the medication for
free, the check-ups are corruption-free. The pretext
of families' lacking discipline is an outrageous
indication of experts' arrogance. The failure of many
TB programs has resulted from corruption and lack of
professionalism, and can be blamed on the experts and
officials.
-
- Tuberculosis
is not listed as a disease in the WHO program of
respiratory infections, one of the biggest classes of
infections in the third world (IRA). However, 80% of
respiratory infections in children which are not viral
are tuberculosis cases. Thus, the most common type of
tuberculosis, pulmonary tuberculosis in children, does
not exist for the WHO!!
-
- Kantha
Bopha remains the only institution in the country that
can diagnose and correctly treat tuberculosis in
children. And the only one that does so.
- Laboratory
and diagnostic equipment cost money. The WHO's
response: "Much too expensive and too sophisticated
for such a poor country." "Not appropriate to the
standard of the country".
-
- The mines
hidden in children
- Calcification
in the lungs, a sure indication of tuberculosis in
children, is only visible if it is larger than 2 mm
across. With computed tomography (CT), we are now
finding countless children with calcification: mines
that with time explode and destroy lives. The dormant
tuberculosis also weakens the children's resistance to
disease. For example, numerous glomerulonephritis
cases (kidney disease) can be explained as the result
of an imbalance in the child's immune system. In the
CT scans of almost all of these children, we discover
calcification, the 100% proof of tuberculosis. We
discover tuberculosis as the cause of kidney
disease.
- The
numerous serious skin abscesses, muscle abscesses, and
fatty tissue abscesses are all directly and indirectly
related to tuberculosis.
- The
virulence of viral diseases such as Dengue fever (of
40 serious cases in a small study at the beginning of
August 1998, 60% had calcification in the pulmonary
hili), Japanese encephalitis, and hepatitis B and C is
much higher because the children are already infected
or ill with tuberculosis. The same is true for typhoid
fever, malaria, and normally trivial infections.
Children free of tuberculosis have much stronger
immune systems.
- But
tuberculosis can kill children on its own. If
mistreated, the many tuberculous meningitis cases, the
many tuberculous brain abscesses clearly identifiable
in CT scans, the serious lung defects, the severe
cases of miliary tuberculosis, the severe bone
inflammation, and the serious cases of tuberculous
pericarditis (clearly identifiable in ultrasound
scans) result in death or serious
disabilities.
-
- Computed
tomography is an enormous help in detecting
tuberculosis.
Typically enough, the acquisition of a CT scanner for
Kantha Bopha II was refused and fiercely criticized by
all the experts. "Foolish to have such a luxury for
such a poor country as Cambodia" "Top medicine and
prestigious medicine is ridiculous for such a poor
country"!! The TB minefield is to be preserved, the
truth not recognized. Thanks to the CT scanner we were
able to confirm many of our suspicions, including the
fact that thin "undernourished" children's condition
was due to dormant tuberculous and not lack of
food.
-
- The
Director of SDC (Swiss agency for Development and
Cooperation in Bern) commented on the news of the
upcoming acquisition of a CT scanner with: "If I were
to finance a CT scanner, I would be torn apart by
criticism from all my own staff, all the experts, and
officials." (July, 1996). At the official opening of
Kantha Bopha II on October 12, 1996, J. P. Delamuraz,
then President of Switzerland, exclaimed in the
presence of the King of Cambodia Norodom Sihanouk:
"Anyone who thinks that this machine is too
sophisticated for Cambodia is a
neocolonialist."
- The
policies and strategies of the WHO and many of its
experts and officials are the epitome of
neocolonialism.
- Ask
one of the officials whether a TB child has to die of
TB because treatment is not relevant for
epidemiological reasons (the experts believe that TB
in children is not contagious) and the answer is "Oh
well, yes" (November 1997).
- A
population infected with tuberculosis can never
achieve vitality; a population infected with
tuberculosis remains repressed. It can never apply the
rules of democracy, never determine its own path. It
remains trapped by the powerful, exploited by the
rich.
- The
WHO's inadequate TB policy in Cambodia has
accomplished nothing in the past six years. First
there was the IRA protocol, which declared that
tuberculosis did not exist in children. Then the
protocol prevented hospitals from treating
tuberculosis in children. According to the protocol,
this can only be done in the so-called tuberculosis
centers (and then with inadequate diagnostic
criteria). But medication never even makes it to these
centers in the provinces; it disappears in corruption
and never gets farther than Phnom Penh. The statistics
and accounts are faked.
- The
policies and strategies concerning TB in Cambodia
amount to passive genocide on Cambodian children and a
weakening of the Cambodian people in
general.
-
- Japanese
encephalitis
- We
first serologically established the endemic and at
times epidemic incidence of Japanese encephalitis in
Cambodia four years ago. For the last two years the
definite proof from CT has been available: cerebral
infarctions - terrible, irreversible destruction of
children's brains. Even if the patient survives,
normal life with normal intelligence is over. In the
month of June 1998 alone, 85 children in Kantha Bopha
died of this disease. The fatality rate is given as
34%. We have found a fatality rate of 20% here. Sadly,
many of the surviving children suffer from light to
severe neurological, motor, and intellectual deficits
for the rest of their lives. There is an efficient
vaccine available. The WHO turned a deaf ear to our
appeal three years ago for a mass vaccination program:
it was unnecessary and too expensive for such a poor
country.
- We
have now been vaccinating against encephalitis in
Kantha Bopha for more than a year. For free. The
Cambodian minister of health has repeatedly
authorized, approved, and welcomed our campaign. The
rich and the foreigners can get vaccinated at the
commercial Pasteur Institute for US$60. None of the
other 90% of the poverty-stricken population can
afford to pay that. The vaccine, which we import
directly from Osaka, costs us US$4. Employees and
families of the UN and embassies are strongly
recommended to have the vaccination. The policy of the
WHO, a UN organization, is to abandon the poor masses
to the deadly disease. Thousands are left to suffer
and die a wretched death.
- The
WHO's inactivity and denial of the epidemic leads to
passive genocide of thousands and the destruction of
brain tissue in thousands more.
-
- Encephalocardiopathy
- Hundreds
of seriously ill children under 9 months of age arrive
at Kantha Bopha with signs of dyspnea, difficulty in
breathing. According to the WHO protocol (IRA), rapid
breathing indicates bronchial pneumonia. For serious
dyspnea the protocol specifies that chloramphenicol be
given. We have now determined that none of these
children were suffering from lung disease, but from
encephalocardiopathy. Pulmonary hypertension could be
definitively proven with cardiac Doppler
ultrasonography. The dyspnea is also cardial. Cerebral
infarctions were revealed with the scanner too. In all
probability, the encephalocardiopathy is evoked by the
same virus that causes Japanese encephalitis (JEV).
The serology is sometimes JEV positive. Children under
nine months old react with different symptoms that
children over a year old since the immunological
situations of the two age levels are
different.
- Treating
these dyspneic children with chloramphenicol, as
stipulated in the protocol, is therefore absolutely
senseless. The treatment is random and the drugs used
can be fatal, as described in the next section.
Chloramphenicol is deadly.
-
- Prescribing
useless and dangerous medications
- There
are still antibiotics on the WHO's essential drug list
that are ineffective because of existing resistance
and produce such lethal side effects that they were
taken out of circulation in the West as early as
1970.
-
- Chloramphenicol:
Resistance
- Four
years ago we had already determined that 95% of the
Salmonella typhi bacteria were resistant to
chloramphenicol. Nevertheless the medication, in the
form of Typhomycin, is used by numerous organizations
to treated the widespread typhoid fever. The
resistance to Bactrim and Ampicillin is 94% each.
Augmentin is not effective; blood cultures remain
positive. We have continually observed this situation
in thousands of blood cultures.
- The
only medication to consider in treating typhoid fever
in children is Rocephin (which is, unlike
chloramphenicol, Bactrim, and Ampicillin, a very
expensive drug). The WHO defends the use of
chloramphenicol: "Chloramphenicol is a good
medication. Moreover, it is inexpensive. We cannot
afford to use Rolls Royce medication, expensive
medication like Rocephin, in the third
world."
-
- Chloramphenicol
produces the most adverse side effects
- As
early as 1970 chloramphenicol was withdrawn from
circulation for children in Europe and the USA. The
side effects of transitional bone marrow aplasia,
irreversible bone marrow aplasia, and isolated anemia
are well-known. We have watched hundreds of children
bleed to death in Kantha Bopha as a result of the
"medical" complications from other clinics. The
chances of a Cambodian child dying from this
medication is many times greater because many diseases
here affect the liver's functions. (Dengue fever,
malaria, tuberculosis, and hepatitis A, B, and C all
diminish the liver's ability to metabolize
chloramphenicol.)
- It
is therefore also outrageous that the WHO protocol
continues to specify chloramphenicol as the treatment
for meningitis and severe infections, in
general.
- The
most common cause of meningitis is tuberculosis. Here,
chloramphenicol is ineffective anyway. The second most
common form of purulent meningitis is Haemophilus
meningitis. However, 55% of the Haemophilus germs are
resistant to chloramphenicol. Because of this
resistance and especially because of this dangerous
medication's deadly side effects, chloramphenicol
should not be prescribed randomly.
- Use
of chloramphenicol actually amounts to active genocide
knowingly risked on the Cambodian
children.
- Proper
clinical pathology can and must only be done with the
proper equipment and laboratories, which permit the
correct diagnosis, and correct and controlled
treatment. That has nothing to do with luxury
medicine, as the WHO, UNICEF, and other organizations,
experts, and officials notoriously and consciously
would like to suggest in numerous media. It only has
to do with a medical duty to care for children, with
the correct treatment that every child has a right
to.
-
- The
tragedy of AIDS. A deliberately missed
opportunity.
- Until
1991 (starting in April 1975), Cambodia was more or
less a closed society. It had always been the custom
that a young man's first sexual experience was in a
brothel. It was considered good form. AIDS was not
known. In 1992, 14,000 UN troops and 8,000 UN
administrative personnel arrived in the country to run
the elections (UNTAC).
- Up
to 5% of the individual troop units were infected with
HIV before arriving. Despite much intervention and
many proposals for intervention programs and measures
by the commander of the UN medical corps, all measures
were rejected by the leadership of the UN (UNTAC under
Mr. Akashi) and the WHO. People should not be
discriminated against; everyone should enjoy the girls
(as Mr. Akashi said). The WHO did nothing. AIDS spread
like wildfire. Over the past five years the WHO has
still not done anything effective. Of the children
under five hospitalized in Kantha Bopha, 4% are
already HIV positive!!! The number is growing. The
children are vertically infected, from their mothers.
This shows for one that with the UNTAC campaign an
AIDS explosion broke out in Cambodia which should and
could have been avoided by the WHO, a UN organization.
For another, the steady rise in HIV positive mothers
shows that too little is being done against AIDS at
the moment. Among the older children, we only find HIV
positive results sporadically, caused by contaminated
transfusions in other hospitals.
-
- Tetanus
- Today,
August 29, 1998, nine cases of tetanus! Six of these
are new-borns. Their mothers were not vaccinated as
children. UNICEF, which has been responsible for the
Cambodian vaccination program for years, said in 1992
that Kantha Bopha should not worry about vaccinations
because the vaccination program was working. But
severe tetanus cases in older children and new-borns
reveal the truth: thousands of children and thousands
of their mothers were never vaccinated. In fact, the
vaccine hardly ever gets to the provinces. The
statistics were falsified (there are numerous
witnesses), the UNICEF officials were happy (it does
not affect their exorbitant salaries).
-
- Afraid of
the truth
- UNICEF,
like other organizations, is opposed to the hospital
under construction in the north of the country, Kantha
Bopha III, which will also have a large vaccination
and disease prevention center, adequate diagnostic
facililties, and 180 beds. The project is being
discredited in the media to make contributors
uncertain and thereby hinder the project. At the
district level, UNICEF has been pursuing inefficient
"grass-roots medicine" activities in the north for
five years. Nine inadequate facilities are available
to the poor there. "We don't need antibiotics. People
should wash their hands to prevent disease." say the
UNICEF officials. The insufficient relief services
even have to be paid for. The policy of sustainability
(a favorite word of third world ideologists from the
West) demands that the inadequate facilities pay for
-
- themselves.
Now the concern is that the normal medical diagnostic
equipment foreseen for Kantha Bopha III will reveal
the truth about the terrible health condition of the
children. If this happens, UNICEF's "grass-roots
activities" in the north of the country will lose
credibility. The WHO has joined the opposition. The
Swiss agency for development and cooperation (SDC) in
Bern has, as well. The claim now made about the Kantha
Bopha III construction project is that it is:
"undermining Cambodia's health system" (November
1997)!!
-
- For
any believers, the obvious collapse of the policy of
poor medicine for poor people in poor countries has
been the 1998 Dengue epidemic.
-
- In
the last six years, the WHO has run a Dengue fever
project for Cambodia. It is totally inefficient. This
year Cambodia has experienced the worst epidemic ever
in the world. Nothing was anticipated, nothing was
arranged. Between January and August 1998, the WHO
registered 10,000 cases of hemorrhagic Dengue fever
(HDF). Of those, 7,500 were hospitalized in the Kantha
Bopha hospitals! They came to us from all the
provinces. The fatality rate of the 7,500 seriously
ill children we hospitalized, most in shock, would be
60% without treatment. Treatment and monitoring is
costly; in many cases, plasma and blood transfusions
are the therapy of choice. Furthermore, the frequent
secondary infections such as typhoid fever and malaria
must be recognized quickly and treated efficiently. We
were able to reduce the fatality rate to
1.8%.
-
- The
WHO, although responsible for the past six years, has
not accomplished anything with respect to Dengue
fever. At the same time, the WHO has condemned Kantha
Bopha as being subversive to the health system (1995).
The only answer for the Dengue catastrophe is correct
and controlled medicine. This cannot be cheap and
poor, as the third world believers and the WHO assume.
A properly functioning blood bank on location is
crucial. Kantha Bopha I and II are the only
institutions in the country with proper blood banks
functioning without corruption. Kantha Bopha III under
construction in the north will also have a blood bank
and the appropriate lab facilities.
- Of
blood donors, 7% are HIV, 12% hepatitis B, and 4%
hepatitis C positive. In the month of August alone, we
had to perform 1,400 life-saving transfusions. Without
the time-consuming and costly checks and tests to
ensure that the blood and plasma were uncontaminated,
we could have infected 100 children with AIDS in July
alone and 220 children with hepatitis! This work, this
equipment, these reagents and tests cost money. The
tests alone are US$50 per bottle! The handling of the
Dengue fever has again exposed the collapse of the
WHO's policy of poor medicine for poor people in poor
countries.
- In
many hospitals today transfusions are performed
without any tests. Some of these children have been
admitted afterwards to Kantha Bopha seriously ill with
AIDS, suffering miserably, hopelessly.
- This
problem has been purposely concealed by the WHO. The
fantasy of poor basic medicine at the provincial or
district level can no longer be maintained here. This
medicine lets people die, or even actively kills
them.
-
-
- Introduction
of a payment system
- The
new WHO policy for the poor third world countries of
patients carrying the cost themselves is disastrous.
This policy is also supported by SDC, "that is the
global trend" and therefore correct, obviously. This
professes to "encourage the patient to take
responsibility for his health". (A principle that
might make sense in the wealthy West, where cosmetic
surgery and other luxuries are at issue, is
transferred to poor countries without regard to the
consequences under the modern preamble:
globalization!) This modern alibi releases officials,
experts, and their partner officials in ministries
from their true responsibilities.
-
- Kantha
Bopha is free for everyone. This has been criticized
by the WHO and also by the Swiss government as being
"inconsistent with the global trend". Sustainability
is the supreme principle. In order to hold to this,
the system must cover its own costs, including
hospitals. For a poverty-stricken child who needs to
be healed and saved, the theoretical and ideological
question of sustainability that the experts in their
offices are concerned about is absolutely
meaningless.
-
- The
Cambodian minister of health has admitted in the
meantime that all forms of payment system in Cambodian
hospitals have merely led to an increase in the
corruption that already exists.
-
- Terrible
things happen. Farmers are forced to sell their oxen
and all of their possessions; between US$50 and US$100
must be produced to even be admitted into hospital!!!
The livelihoods of hundreds of farm families, the
heart of Cambodian society, have been ruined in order
for one member to receive improper treatment and die
anyway. Hundreds, even thousands, of such tragedies
happen every day.
-
- In
order to avoid any kind of corruption, we have always
paid all of our Cambodian employees at Kantha Bopha a
salary which they can live on. No one can live on the
government monthly salary of US$14. This has led to
staff at hospitals working only two hours, taking
money from patients under the table, and stealing
medications to survive. Kantha Bopha does not have any
of the corruption encountered in all these hospitals.
Every patient is provided proper care free of charge.
The staff work all day and have duty every fourth or
fifth day.
-
- We
challenge the WHO, as a responsible body, to abandon
its inadequate payment policy, which they have imposed
on the government and which deprives the poor (90% of
the population), thus precipitating
genocide.
-
- There
is enough money on this supposedly global earth. With
just the WHO budget of US$800 million, 200 Kantha
Bopha centers could be built and operated forever.
That would be 200 centers where all patients could be
properly treated for free, without economic ruin. But
85% of the WHO's budget goes to administration. The
same is true for other organizations. The total annual
budget of Kantha Bopha I and II is US$7.5 million.
Only 3% of this goes to administration (including
PR).
-
- Urgent
appeal to the WHO and its subordinate organizations
and institutions
- The
policy of poor medicine for poor people in poor
countries amounts to passive genocide of the Cambodian
children.
- Four
years ago, in September 1994, I first raised my
criticisms concerning this issue. The WHO reaction in
March and August of 1995 was to send the entire
Cambodian government two ominous letters in which they
incited the Cambodian ministry of health to defame and
obstruct Kantha Bopha. The following was written:
"subversion of the state", "subversion of the health
system", "non-observance of the protocol" (the wrong
one!!), "forming a state within a state",
"blackmailing Cambodian employees with wages",
"baiting patients with money"!! (we give the poorest
families from the provinces money for food and the
frequently long, distant journeys). It did not work!
The government did not respond! Kantha Bopha remains
the only hope for the Cambodian children. All of the
Cambodian political parties agree. It is for all
children, whether rich or poor. The minister of health
has also repeatedly expressed his clear approval and
appreciation and thereby distanced himself from the
regrettable ideas of the WHO and other
experts.
- Increasingly,
I have been receiving letters and messages from
doctors who work in other poor countries. They say
that there are similar conditions where they are in
the handling of tuberculosis and other infectious
diseases, leading to passive genocide of
children.
- More
and more visits to Kantha Bopha from health ministers
and physicians from neighboring regions clearly imply
that in their experience the WHO's neocolonial policy
has also been unproductive. They would like to have
centers like Kantha Bopha for their
children.
- We
appeal to all experts and officials responsible to
change the policy and strategy of poor medicine for
poor people in poor countries immediately and
unequivocally, and to realize and ensure every child's
right to proper treatment.
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