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Thursday, February 19, 2009

U of T Samaritans saving lives in Cambodia

Kunthy Ok, a midwife and assistant at the University of Toronto’s Centre for International Health in Cambodia, takes a photograph of Pich Thy and her children for their health card. The centre is funded by donations.


Bill Schiller
Asia Bureau


KEP, Cambodia–Word reached Dr. Rebecca Draisey's tiny office, tucked away in this remote corner of Cambodia, late last week.

A handful of water filters were not getting to families that needed them due to a bureaucratic glitch.

And so, on Saturday morning, Dr. Draisey, the director of the University of Toronto's Centre for International Health here, strapped on her helmet, jumped on the back of her assistant's 125cc motorcycle, and together they rode off into the bush on a series of broken bi-ways and rutted red trails to sort it out.

Forty minutes later they arrived in Angkoul Commune, 25 kilometres away, where a small group of families were waiting. They wanted what people in the West take utterly for granted: clean water.

The group delivers water filters and medical help to the Cambodians on a modest budget that relies a lot on fundraising – they hope to raise $35,000 this year – and includes staff salaries and a small stipend for Draisey. Almost every dollar goes directly into improving Cambodians' health.
"We kind of knit our budget out of thin air," Draisey says.

But funding is a challenge and the financial crisis hasn't helped.

Recently, a generous contribution of $10,000, from two health-care professionals Draisey knows, had to be suspended due to the financial meltdown. "You can't blame anyone," she says. "In times like these, you definitely understand."

Recently she scored big, landing $8,000 from a U of T student organization called Earthtones to continue distributing water filters.

Draisey and the staff believe, as the late, celebrated cultural anthropologist Margaret Mead did, that individuals actually can change the world – indeed, as Mead once said, it's the only thing that ever has.

"I'd like to think we are making a difference," says Draisey.

As anyone who has worked in the developing world knows, even small sums – wisely spent – can go a long way. The filters cost about $11 each, not much for a potentially life-saving device.

So far the program has distributed 200, but Draisey's dream is to deliver 800 more by year-end. Somehow.

In a country where many drink raw water from contaminated wells, where a toilet – of any kind – is a luxury, and just 17 per cent of people have access to electricity, a good water filter is like gold.

It can mean the difference between life and death, especially for infants. "These won't filter out everything," Draisey explained as the filters were being handed out to the families at Angkoul Commune. "But they will filter out parasites and bacteria – what causes gastroenteritis. And it's gastroenteritis that often kills infants."

The distribution of water filters is just one small, but valuable project in the U of T's multi-pronged effort here, the brainchild of David Zakus, director of the university's Centre for International Health.

The university also has projects in China and in Africa.

Zakus wanted to create small-scale projects in developing countries that could provide valuable field research to local health officials, bring health education to the poor – and provide U of T students with their first experience of health care in the developing world.

Since its start here in Cambodia's remote Kep district in 2002, it has done all of that and more – on a shoestring. It has tested more than 150 wells, finding half of them contaminated; it has trained 16 midwives; it has helped organize a system of free health care for the district's poorest; and it's now trying to bring clean running water to Kep's only hospital, a facility serving the district's 37,000 people.

The hospital currently uses untreated water.

All are significant accomplishments, but all the more surprising given how small the operation is.

Draisey, a U of T medical graduate who practised medicine in Windsor, Ont., for 21 years, operates from a 49 square-metre room equipped with a refrigerator, a bicycle, two desks, two computers, and enough money to afford Internet access for three months of the year.

The grand total of staff is two: Kunthy Ok, a gifted local woman who is not only a qualified midwife but – fortunately – owns her own motorcycle, and Bunthoeun Thon, driver and program manager.

Draisey credits the idea and fundraising efforts to two U of T students who interned here: Mary Cameron, now at the University of Ottawa, and Risako Shirane, who came as an undergraduate student in global health.

For most students who get involved in the program, this is their first experience with the developing world. Many find it shocking.

"Within a very short period they end up throwing away all of their preconceptions," says Draisey. "There's shock, frustration, even anger.

"Many say, `Why isn't the world doing more for these people? Why isn't the university, the Centre for International Health, the Canadian International Development Agency? How can this be happening?'"

Dr. Draisey notes that students come from a highly structured environment while the developing world often lacks basic structure.

Most students undergo a period of reflection after the initial shock, then find there really are specific contributions they can make.

Students have helped to test local wells, gathered research on maternal health care and participated in medical outreach clinics in small villages.

One of CIH's more ambitious programs is the Most Vulnerable Family project, a pilot project aimed at ensuring the poorest of the poor in Kep have access to health services they cannot afford on their own.

CIH photographed 196 families identified by local officials, issued them health cards validated by the government, and persuaded the Ministry of Health to render services upon presentation.

Other ministries have now agreed to provide their services for free on presentation of the card, Kunthy Ok explains.

"This card will even allow a child to enter school for free," she says.

She says these words in a way meant to convey excitement, even hope.

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