Bay Area Youth Environmental Coalition

The Cambodian Health Committee (CHC) works for the improvement of the health and well-being of the Cambodian people. The agency focuses on those suffering from tuberculosis (TB) and AIDS, who are among the poorest in Cambodian society, regardless of race, sex, age, religion, or political affiliation. The CHC aims to help people to live with dignity and in good health and has done so by using novel approaches that engage family, community resources, and community health workers in these efforts. The CHC is a local Cambodian non-governmental organization (NGO) that works in both rural and urban settings.

Using this approach, as of December 2006, CHC has cured over 10,000 people of tuberculosis and has the largest rural AIDS program (2,000 patients) of any NGO in Cambodia. The operational approaches of CHC are now used widely in both the Cambodian National TB program and globally.

The Cambodian Health Committee (CHC) was established and the treatment program began and by capitalizing on the patients' desire to be cured, the abundant support network of family and friends, and by linking with the World Food Program to provide nutritional supplements to TB patients, the program was highly successful. By the end of 2006, approximately 10,000 patients will have been treated and cured in Svay Rieng and in Kampot, another impoverished Cambodian province where CHC began to work in 1998.

This was accomplished by several innovative approaches. The CHC developed the idea of a patient supporter and a treatment contract whereby the patient, patient supporter, and health worker enter into an agreement to complete the long and difficult treatment. CHC is the initiator of the DOT (Daily Observed Therapy) program in Cambodia and the model is now widely implemented by the Cambodian National TB program.

The CHC also developed a successful microcredit program that was linked to TB treatment and used profits of the program for the training of village health workers (see below). A TB home care program was established where TB medicines are delivered to patients by CHC health workers 5 days a week and family members or the patient supporter supervises treatment two days a week.

The CHC's efforts expanded beyond treatment to address an underlying cause of much of the illness in the country-- poverty. Poverty increases disease by creating obstacles to seeking diagnosis and treatment. Transportation costs, loss of income due to missed work, and poor road conditions are all barriers to care in Cambodia. By creating a series of village banks that provided loans to small groups of villagers (based on the Grameen bank model pioneered in Bangladesh by Muhammad Yunus, the 2006 Nobel Co-Laureate for Peace), the village bank program enabled particularly women to set up small businesses and increase their family's income. TB patient families and other particularly vulnerable individuals were particularly encouraged to be part of the village bank program, which became an independent Cambodian microfinance institution in 2005.

Realizing that advancing scientific knowledge about the causes of TB and AIDS would ultimately lead to better treatments for Cambodians and the millions worldwide infected with these diseases, a close research partnership was established between the clinical work taking place in Cambodia and the laboratory resources of Harvard Medical School and particularly the CBRI in Boston, Massachusetts. This work for example led to the discovery of the first gene associated with susceptibility to TB and improved understanding of basic aspects of the immune response to TB.

The access to medical care has improved, but there is still much work to do. With access to anti-retroviral therapy (ART) the health of the patients is getting better but they face other problems. The basic one is economic: many do not have resources and cannot respond to their or their children's essential daily needs. There is often not enough food, a lack of proper shelter, and limited schooling. Responding to these needs is a priority for CHC; through innovative projects for vulnerable children and income generating initiatives, CHC tries to break this circle of poverty to give these people a chance to improve their lives and open the window to a better future.