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Monday, December 28, 2009

Cambodia holds Khmer traditional measurement exhibition

PHNOM PENH, Cambodia's Reyum Institute has documented more than 130 Khmer traditional measurements and will run a show-casing of the documentation for the public in Phnom Penh from Dec. 28, 2009 to Feb. 2010, official news agency AKP reported on Monday.

According to Research Manager of Reyum Institute Preap Chanmara, Cambodia has long been using a wide variety of measurements for length, height, weight, depth, size, substance and time. Some measurements have been standardized with human body, things, like coconut fruit and tree, and others have been adapted from French measurements; for instance, meter, kilometer, etc.

Chanmara said that sources of the documented measurements include interview with people, written documents, and observation of people's daily interaction.

Different locations may use and understand different measurements. Some locations may use the same measurements for different meanings. Read more!

Vietnam and Cambodia reach US$6 billion business deals

Vietnam and Cambodia signed investment agreements and contracts worth US$6 billion at a conference held in Ho Chi Minh City on December 26 to promote Vietnamese investment in Cambodia.

Under the documents, Vietnam will invest in power generation, food processing, fertiliser production, rubber plantation and bauxite mining in Cambodia.

Two-way trade between the two countries has increased significantly in recent years, reaching US$1.7 billion in 2008, up 40% against 2007.

Vietnamese businesses have invested in over 60 projects in Cambodia with a total capital of nearly US$900 million.

Vietnamese Prime Minister Nguyen Tan Dung and his Cambodian counterpart, Hun Sen, co-chairmen of the conference, welcomed a joint initiative to host the conference as a practical move to promote bilateral co-operation in investment and trade.

PM Hun Sen said Cambodia is calling for foreign investment in such areas as agro-forestry, industry, infrastructure, product processing for export, mining and tourism.

Cambodia will create a favourable investment environment for the Vietnamese businesses to operate in the country, PM Hun Sen assured PM Dung and nearly 600 officials and business people attending the event.

PM Dung appreciated the effectiveness of Vietnamese-invested projects in Cambodia. He said, however, that the results have not yet matched the potential of both countries and not lived up to their people’s expectations.

He recalled high-level talks and meetings between the two countries’ top leaders who had agreed to take additional measures to broaden co-operative ties. They expressed their determination to raise two-way trade to US$2 billion in 2010 and increase Vietnamese investment in Cambodia to US$6 billion in the coming years.

At the event, the Vietnamese Ministry of Planning and Investment and the Cambodian Development Council signed a memorandum of understanding on investment promotion.

The Vietnamese Minister of Industry and Trade and the Cambodian Minister of Industry, Mining and Energy signed the minutes of their meeting regarding bauxite exploration and exploitation in the Cambodian Mondulkiri province.

The Bank for Investment and Development of Vietnam (BIDV) signed deals to provide financial services to Vietnamese businesses investing in Cambodia.

Also during the event, a certificate of operation was granted to the association of Vietnamese investors in Cambodia, and investment licences were given to a number of Vietnamese businesses. (VNA
Read more!

New form of Malaria near cambodia

MARGIE MASON and MARTHA MENDOZA
PAILIN, Cambodia (AP) - O'treng village doesn't look like the epicenter of anything. Just off a muddy rutted-out road, it is nothing more than a handful of Khmer-style bamboo huts perched crookedly on stilts, tucked among a tangle of cornfields once littered with deadly land mines.

Yet this spot on the Thai-Cambodian border is home to a form of malaria that keeps rendering one powerful drug after another useless.

This time, scientists have confirmed the first signs of resistance to the only affordable treatment left in the global medicine cabinet for malaria: Artemisinin.

If this drug stops working, there's no good replacement to combat a disease that kills 1 million annually.

.
As a result, earlier this year international medical leaders declared resistant malaria here a health emergency.

"This is not business as usual. It's something really special and it needs a real concerted effort," said Dr. Nick White, a malaria expert at Mahidol University in Bangkok who has spent decades trying to eradicate the disease from Southeast Asia.

"We know that children have been dying in Africa, millions of children have died over the past three decades, and a lot of those deaths have been attributed to drug resistance. And we know that the drug resistance came from the same place."

Malaria is just one of the leading killer infectious diseases battling back in a new and more deadly form, the AP found in a six-month look at the soaring rates of drug resistance worldwide.

After decades of the overuse and misuse of antibiotics, diseases like malaria, tuberculosis and staph have started to mutate. The result: The drugs are slowly dying.

Already, The Associated Press found, resistance to malaria has spread faster and wider than previously documented. Dr. White said virtually every case of malaria he sees in western Cambodia is now resistant to drugs.

And in the Pailin area, patients given artemisinin take twice as long as those elsewhere to be clear of the parasite, 84 hours instead of the typical 48, and sometimes even 96.

Mosquitoes spread this resistant malaria quickly from shack to shack, village to village, and eventually, country to country.

And so O'treng, with its 45 poor families, naked kids, skinny dogs and boiling pots of rice, finds itself at the epicenter of an increasingly desperate worldwide effort to stop a dangerous new version of an old disease.

Bundled in a threadbare batik sarong, 51-year-old Chhien Rern, one of O'treng's sick residents, sweats and shivers as a 103-degree fever rages against the malaria parasites in her bloodstream.

Three days ago Chhien Rern started feeling ill while looking for work in a neighboring district.

So she did what most rural Cambodians do: She walked to a little shop and asked for malaria medicine.

With no prescription, she was handed a packet of pills, she's unsure what they were.

"After I took the drugs, I felt better for a while," she says. "Then I got sick again."

The headaches, chills and fever, classic symptoms of malaria, worsened. Chhien Rern's daughter persuaded her to take a motorbike taxi past washed out bridges and flooded culverts to the nearest hospital in Pailin, a dirty border town about 10 miles from O'treng.

Doctors say there's a good chance Chhien Rern was sold counterfeit drugs.
People generate drug resistant malaria when they take too little medicine, substandard medicine or, as is all too often the case around O'treng, counterfeit medicine with a pinch of the real stuff.

Once established, the drug-resistant malaria is spread by mosquitoes. So one person's counterfeit medicine can eventually spawn widespread resistant disease.

Yet in most parts of the world, people routinely buy antimalarials over the counter at local pharmacies and treat themselves.

A recent study out of neighboring Laos found 88 percent of stores selling artemisinin-based drugs, the same ones scientists are desperately trying to preserve, were actually peddling fakes.

Worse, nearly 15 percent of the counterfeits were laced with small hints of artemisinin, which could prompt resistance.

The researchers found indications that some were made in China, feeding smugglers' routes that snake through Myanmar and into Laos, Thailand, Cambodia and Vietnam.

The counterfeits, along with outdated drugs, are jumping continents. In Africa, where malaria is endemic in 45 countries, the fake drug industry is thriving.

A 2003 World Health Organization survey found between 20 percent and 90 percent of antimalarials randomly purchased in seven African countries failed quality testing, depending on the type of drug.

WHO and Interpol formed a task force three years ago to try to stop counterfeiters, seizing millions of fake malaria, tuberculosis, HIV and other pills in Southeast Asia and Africa.

But officials say the work is only as good as the countries' legal systems.

"One of the problems is that there's not really any enforcement, so what happens when they find a drug that's counterfeit or substandard?"

Says

David Sintasath, a regional epidemiologist at the nonprofit Malaria Consortium in Bangkok.

"The policy is to take it away from them. That's good until the next month when they get their next shipment, right?"

Countless unlicensed shops in Cambodia sell artesunate, a single-drug therapy that has been banned in the country.

Artesunate, a modified version of artemisinin derived from a Chinese herb, has been hailed as miracle treatment worldwide because it works so well with so few side effects.

But Cambodian surveys have shown that many patients take artesunate alone instead of mixing it with another antimalarial drug, making it easier for resistance to build.

"The drug has been around for a long time and misused for a long time and this is all encouraging the parasite to develop resistance," says Dr. Delia Bethell, of the U.S. Armed Forces Research Institute of Medical Science, whose research has been at the forefront of identifying emerging resistance on the border.

Back in western Cambodia a few miles from O'treng village, shopkeeper Nop Chen turns a flashlight on a glass case full of drugs he hawks from inside his cramped roadside house.

He digs through the many boxes and produces two different types of artemisinin-based antimalarials. Both lack the full amount of a second required medication, mefloquine, necessary to treat the strain of malaria in the area and ward off more resistance.

But Nop Chen, a former Khmer Rouge medic, points to a small Cambodian seal on the boxes and says he feels confident the drugs are the real deal.

Still, he acknowledges he is not licensed to sell the pills and he's unsure where they originated.

"I'm not concerned because it's got the sticker and the stamp," he says, squinting at the Khmer script on the labels. "Because of the logo, I trust it to not be fake, it was made in Cambodia."

Walk past O'treng's cluster of sagging huts, cross another cornfield and hike a twisted mile on a dirt track to a wooden shack where a string of smoke is curling through the wooden floor planks in a largely futile effort to keep mosquitoes away.

It's here that skinny 13-year-old Hoeun Hong Da wakes up on the floor nauseous and burning with fever.

Hong Da recovered from malaria two months ago, but now the dizziness and headaches are back.
He's been sickened by the disease six or seven times in his short life — too many to remember.

He knows that if he doesn't get to a hospital soon, he could die. With no new treatments in the pipeline, normally reserved scientists are quick to use words like "disaster" or "catastrophe" when asked what might happen if they don't contain the disease that's ravaging young Hong Da before it spreads to Africa.

There, malaria already kills an estimated 2,000 kids daily. For the past 50,000 years the malaria parasite has been evolving, and migrating, alongside humans.

It moves within the huts of O'treng, and into neighboring towns when men like Hong Da's father and older siblings float from job to job.

Some work is close enough for them to return home at night, but other jobs keep them away for stretches of time.

They sleep in tight rows, sweating and weary, in disintegrating bamboo huts with workers who are also traveling, and possibly infected with malaria.

The concept of containing drug resistance has never been tried before. Scientists wonder: How do you control the spread of a resistant parasite transmitted by mosquitoes that bite people who live and work in infested jungle areas, then scatter in all directions, all the time?

This area, the former stronghold of the murderous Khmer Rouge, has a notorious history.

Burmese migrant workers who once mined rubies and sapphires in these now deforested hills are believed to have helped transport strains resistant to the drug chloroquine back to Myanmar a half century ago.

From there it spread to India and later over to Africa until the drug was useless worldwide.

A decade later, history repeated itself when resistance to the drug sulfadoxine-pyrimethamine followed the same path.

Now, in western Cambodia, scientists are concerned because the artemisinin-based drugs are taking longer than usual to kill the parasites.

Earlier this year, an army of aid agencies and experts from the WHO began racing to this impoverished corner on the Thai-Cambodian border to divvy up a $22.5 million grant from the Bill & Melinda Gates Foundation, aimed at stopping this virulent new strain.

But grants haven't stopped lines of Cambodians, sick or not, from queuing up every morning at Thailand's border, charging past the checkpoints in search of work or goods. Some may carry resistant strains in, others may bring them home.

And grants haven't stopped the parasite from spreading in the O'treng area, despite widespread bednet distribution, awareness campaigns and enhanced surveillance systems.

Some scientists say the only sure way to fix the problem is to eradicate malaria entirely from western Cambodia.

"It's really dangerous," says Dr. Rupam Tripura,

who's conducting a study in Pailin for the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Program. "What will happen to the mosquitoes?
Can you kill those living in the jungle? No, so you cannot kill the strain."

If O'treng is the epicenter of this emerging disease, Phoun Sokha is the point man aimed at controlling it.

At 47, Phoun Sokha is the village malaria worker who lives at the mouth of the hamlet and proudly displays an orange plastic kit that resembles a tackle box.

Phoun Sokha is serious about his packets of medicine and his rapid tests to prick blood from sick villagers' fingers to determine if they have malaria and if so, what type.

He makes sure patients are taking their free medicines and checks to see if they're improving. If not, Phoun Sokha can even arrange transportation to the hospital.

But treating O'treng's malaria patients can be frustrating.

"Some of the patients, when they went to the hospital, after one month, maybe they get malaria again," he says.

Today Hong Da, the village boy who has fought malaria so many times before, heads home from the hospital after a few days of treatment.

He clutches a new mosquito net he hopes will prevent yet another infection. Together, the recovering boy and his weathered mom shuffle past sick neighbor Chhien Rern's shack before disappearing among the tassels of the cornfield toward their home.

But all is not well. Under a tattered quilt, Hong Da's 9-year-old sister Hoeun Chhay Meth is curled on a thin mattress atop the wooden floor inside the family's open-air home.

She had malaria alongside her brother two months ago. They share a mosquito net that she burned a hole in when she stayed up one night reading by the light of a makeshift candle.

Her brother thinks that's how the mosquitoes infected them.

"Very afraid of dying," says Chhay Meth, who has started taking medicine provided by the village malaria worker. "I feel worse than before. I cannot walk myself or stand up by myself and cannot eat well."

Hong Da understands. He gently lifts his little sister's limp body, scooping her up, his strength returning.

Chhay Meth reaches weakly for her mother. Like her big brother, this child doesn't know about counterfeit drugs or antimalarials.

She only knows she's sick. And the medicines don't seem to work as well any more in this little village she calls home.

David Sintasath, a regional epidemiologist at the nonprofit Malaria Consortium in Bangkok.

"The policy is to take it away from them. That's good until the next month when they get their next shipment, right?"

Countless unlicensed shops in Cambodia sell artesunate, a single-drug therapy that has been banned in the country.

Artesunate, a modified version of artemisinin derived from a Chinese herb, has been hailed as miracle treatment worldwide because it works so well with so few side effects.

But Cambodian surveys have shown that many patients take artesunate alone instead of mixing it with another antimalarial drug, making it easier for resistance to build.

"The drug has been around for a long time and misused for a long time and this is all encouraging the parasite to develop resistance," says Dr. Delia Bethell, of the U.S. Armed Forces Research Institute of Medical Science, whose research has been at the forefront of identifying emerging resistance on the border.

Back in western Cambodia a few miles from O'treng village, shopkeeper Nop Chen turns a flashlight on a glass case full of drugs he hawks from inside his cramped roadside house.

He digs through the many boxes and produces two different types of artemisinin-based antimalarials. Both lack the full amount of a second required medication, mefloquine, necessary to treat the strain of malaria in the area and ward off more resistance.

But Nop Chen, a former Khmer Rouge medic, points to a small Cambodian seal on the boxes and says he feels confident the drugs are the real deal.

Still, he acknowledges he is not licensed to sell the pills and he's unsure where they originated.

"I'm not concerned because it's got the sticker and the stamp," he says, squinting at the Khmer script on the labels. "Because of the logo, I trust it to not be fake, it was made in Cambodia."

Walk past O'treng's cluster of sagging huts, cross another cornfield and hike a twisted mile on a dirt track to a wooden shack where a string of smoke is curling through the wooden floor planks in a largely futile effort to keep mosquitoes away.

It's here that skinny 13-year-old Hoeun Hong Da wakes up on the floor nauseous and burning with fever.

Hong Da recovered from malaria two months ago, but now the dizziness and headaches are back.
He's been sickened by the disease six or seven times in his short life — too many to remember.

He knows that if he doesn't get to a hospital soon, he could die. With no new treatments in the pipeline, normally reserved scientists are quick to use words like "disaster" or "catastrophe" when asked what might happen if they don't contain the disease that's ravaging young Hong Da before it spreads to Africa.

There, malaria already kills an estimated 2,000 kids daily. For the past 50,000 years the malaria parasite has been evolving, and migrating, alongside humans.

It moves within the huts of O'treng, and into neighboring towns when men like Hong Da's father and older siblings float from job to job.

Some work is close enough for them to return home at night, but other jobs keep them away for stretches of time.

They sleep in tight rows, sweating and weary, in disintegrating bamboo huts with workers who are also traveling, and possibly infected with malaria.

The concept of containing drug resistance has never been tried before. Scientists wonder: How do you control the spread of a resistant parasite transmitted by mosquitoes that bite people who live and work in infested jungle areas, then scatter in all directions, all the time?

This area, the former stronghold of the murderous Khmer Rouge, has a notorious history.

Burmese migrant workers who once mined rubies and sapphires in these now deforested hills are believed to have helped transport strains resistant to the drug chloroquine back to Myanmar a half century ago.

From there it spread to India and later over to Africa until the drug was useless worldwide.

A decade later, history repeated itself when resistance to the drug sulfadoxine-pyrimethamine followed the same path.

Now, in western Cambodia, scientists are concerned because the artemisinin-based drugs are taking longer than usual to kill the parasites.

Earlier this year, an army of aid agencies and experts from the WHO began racing to this impoverished corner on the Thai-Cambodian border to divvy up a $22.5 million grant from the Bill & Melinda Gates Foundation, aimed at stopping this virulent new strain.

But grants haven't stopped lines of Cambodians, sick or not, from queuing up every morning at Thailand's border, charging past the checkpoints in search of work or goods. Some may carry resistant strains in, others may bring them home.

And grants haven't stopped the parasite from spreading in the O'treng area, despite widespread bednet distribution, awareness campaigns and enhanced surveillance systems.

Some scientists say the only sure way to fix the problem is to eradicate malaria entirely from western Cambodia.

"It's really dangerous," says Dr. Rupam Tripura,

who's conducting a study in Pailin for the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Program. "What will happen to the mosquitoes?
Can you kill those living in the jungle? No, so you cannot kill the strain."

If O'treng is the epicenter of this emerging disease, Phoun Sokha is the point man aimed at controlling it.

At 47, Phoun Sokha is the village malaria worker who lives at the mouth of the hamlet and proudly displays an orange plastic kit that resembles a tackle box.

Phoun Sokha is serious about his packets of medicine and his rapid tests to prick blood from sick villagers' fingers to determine if they have malaria and if so, what type.

He makes sure patients are taking their free medicines and checks to see if they're improving. If not, Phoun Sokha can even arrange transportation to the hospital.

But treating O'treng's malaria patients can be frustrating.

"Some of the patients, when they went to the hospital, after one month, maybe they get malaria again," he says.

Today Hong Da, the village boy who has fought malaria so many times before, heads home from the hospital after a few days of treatment.

He clutches a new mosquito net he hopes will prevent yet another infection. Together, the recovering boy and his weathered mom shuffle past sick neighbor Chhien Rern's shack before disappearing among the tassels of the cornfield toward their home.

But all is not well. Under a tattered quilt, Hong Da's 9-year-old sister Hoeun Chhay Meth is curled on a thin mattress atop the wooden floor inside the family's open-air home.

She had malaria alongside her brother two months ago. They share a mosquito net that she burned a hole in when she stayed up one night reading by the light of a makeshift candle.

Her brother thinks that's how the mosquitoes infected them.

"Very afraid of dying," says Chhay Meth, who has started taking medicine provided by the village malaria worker. "I feel worse than before. I cannot walk myself or stand up by myself and cannot eat well."

Hong Da understands. He gently lifts his little sister's limp body, scooping her up, his strength returning.

Chhay Meth reaches weakly for her mother. Like her big brother, this child doesn't know about counterfeit drugs or antimalarials.

She only knows she's sick. And the medicines don't seem to work as well any more in this little village she calls home.

David Sintasath, a regional epidemiologist at the nonprofit Malaria Consortium in Bangkok.

"The policy is to take it away from them. That's good until the next month when they get their next shipment, right?"

Countless unlicensed shops in Cambodia sell artesunate, a single-drug therapy that has been banned in the country.

Artesunate, a modified version of artemisinin derived from a Chinese herb, has been hailed as miracle treatment worldwide because it works so well with so few side effects.

But Cambodian surveys have shown that many patients take artesunate alone instead of mixing it with another antimalarial drug, making it easier for resistance to build.

"The drug has been around for a long time and misused for a long time and this is all encouraging the parasite to develop resistance," says Dr. Delia Bethell, of the U.S. Armed Forces Research Institute of Medical Science, whose research has been at the forefront of identifying emerging resistance on the border.

Back in western Cambodia a few miles from O'treng village, shopkeeper Nop Chen turns a flashlight on a glass case full of drugs he hawks from inside his cramped roadside house.

He digs through the many boxes and produces two different types of artemisinin-based antimalarials. Both lack the full amount of a second required medication, mefloquine, necessary to treat the strain of malaria in the area and ward off more resistance.

But Nop Chen, a former Khmer Rouge medic, points to a small Cambodian seal on the boxes and says he feels confident the drugs are the real deal.

Still, he acknowledges he is not licensed to sell the pills and he's unsure where they originated.

"I'm not concerned because it's got the sticker and the stamp," he says, squinting at the Khmer script on the labels. "Because of the logo, I trust it to not be fake, it was made in Cambodia."

Walk past O'treng's cluster of sagging huts, cross another cornfield and hike a twisted mile on a dirt track to a wooden shack where a string of smoke is curling through the wooden floor planks in a largely futile effort to keep mosquitoes away.

It's here that skinny 13-year-old Hoeun Hong Da wakes up on the floor nauseous and burning with fever.

Hong Da recovered from malaria two months ago, but now the dizziness and headaches are back.
He's been sickened by the disease six or seven times in his short life — too many to remember.

He knows that if he doesn't get to a hospital soon, he could die. With no new treatments in the pipeline, normally reserved scientists are quick to use words like "disaster" or "catastrophe" when asked what might happen if they don't contain the disease that's ravaging young Hong Da before it spreads to Africa.

There, malaria already kills an estimated 2,000 kids daily. For the past 50,000 years the malaria parasite has been evolving, and migrating, alongside humans.

It moves within the huts of O'treng, and into neighboring towns when men like Hong Da's father and older siblings float from job to job.

Some work is close enough for them to return home at night, but other jobs keep them away for stretches of time.

They sleep in tight rows, sweating and weary, in disintegrating bamboo huts with workers who are also traveling, and possibly infected with malaria.

The concept of containing drug resistance has never been tried before. Scientists wonder: How do you control the spread of a resistant parasite transmitted by mosquitoes that bite people who live and work in infested jungle areas, then scatter in all directions, all the time?

This area, the former stronghold of the murderous Khmer Rouge, has a notorious history.

Burmese migrant workers who once mined rubies and sapphires in these now deforested hills are believed to have helped transport strains resistant to the drug chloroquine back to Myanmar a half century ago.

From there it spread to India and later over to Africa until the drug was useless worldwide.

A decade later, history repeated itself when resistance to the drug sulfadoxine-pyrimethamine followed the same path.

Now, in western Cambodia, scientists are concerned because the artemisinin-based drugs are taking longer than usual to kill the parasites.

Earlier this year, an army of aid agencies and experts from the WHO began racing to this impoverished corner on the Thai-Cambodian border to divvy up a $22.5 million grant from the Bill & Melinda Gates Foundation, aimed at stopping this virulent new strain.

But grants haven't stopped lines of Cambodians, sick or not, from queuing up every morning at Thailand's border, charging past the checkpoints in search of work or goods. Some may carry resistant strains in, others may bring them home.

And grants haven't stopped the parasite from spreading in the O'treng area, despite widespread bednet distribution, awareness campaigns and enhanced surveillance systems.

Some scientists say the only sure way to fix the problem is to eradicate malaria entirely from western Cambodia.

"It's really dangerous," says Dr. Rupam Tripura,

who's conducting a study in Pailin for the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Program. "What will happen to the mosquitoes?
Can you kill those living in the jungle? No, so you cannot kill the strain."

If O'treng is the epicenter of this emerging disease, Phoun Sokha is the point man aimed at controlling it.

At 47, Phoun Sokha is the village malaria worker who lives at the mouth of the hamlet and proudly displays an orange plastic kit that resembles a tackle box.

Phoun Sokha is serious about his packets of medicine and his rapid tests to prick blood from sick villagers' fingers to determine if they have malaria and if so, what type.

He makes sure patients are taking their free medicines and checks to see if they're improving. If not, Phoun Sokha can even arrange transportation to the hospital.

But treating O'treng's malaria patients can be frustrating.

"Some of the patients, when they went to the hospital, after one month, maybe they get malaria again," he says.

Today Hong Da, the village boy who has fought malaria so many times before, heads home from the hospital after a few days of treatment.

He clutches a new mosquito net he hopes will prevent yet another infection. Together, the recovering boy and his weathered mom shuffle past sick neighbor Chhien Rern's shack before disappearing among the tassels of the cornfield toward their home.

But all is not well. Under a tattered quilt, Hong Da's 9-year-old sister Hoeun Chhay Meth is curled on a thin mattress atop the wooden floor inside the family's open-air home.

She had malaria alongside her brother two months ago. They share a mosquito net that she burned a hole in when she stayed up one night reading by the light of a makeshift candle.

Her brother thinks that's how the mosquitoes infected them.

"Very afraid of dying," says Chhay Meth, who has started taking medicine provided by the village malaria worker. "I feel worse than before. I cannot walk myself or stand up by myself and cannot eat well."

Hong Da understands. He gently lifts his little sister's limp body, scooping her up, his strength returning.

Chhay Meth reaches weakly for her mother. Like her big brother, this child doesn't know about counterfeit drugs or antimalarials.

She only knows she's sick. And the medicines don't seem to work as well any more in this little village she calls home.

David Sintasath, a regional epidemiologist at the nonprofit Malaria Consortium in Bangkok.

"The policy is to take it away from them. That's good until the next month when they get their next shipment, right?"

Countless unlicensed shops in Cambodia sell artesunate, a single-drug therapy that has been banned in the country.

Artesunate, a modified version of artemisinin derived from a Chinese herb, has been hailed as miracle treatment worldwide because it works so well with so few side effects.

But Cambodian surveys have shown that many patients take artesunate alone instead of mixing it with another antimalarial drug, making it easier for resistance to build.

"The drug has been around for a long time and misused for a long time and this is all encouraging the parasite to develop resistance," says Dr. Delia Bethell, of the U.S. Armed Forces Research Institute of Medical Science, whose research has been at the forefront of identifying emerging resistance on the border.

Back in western Cambodia a few miles from O'treng village, shopkeeper Nop Chen turns a flashlight on a glass case full of drugs he hawks from inside his cramped roadside house.

He digs through the many boxes and produces two different types of artemisinin-based antimalarials. Both lack the full amount of a second required medication, mefloquine, necessary to treat the strain of malaria in the area and ward off more resistance.

But Nop Chen, a former Khmer Rouge medic, points to a small Cambodian seal on the boxes and says he feels confident the drugs are the real deal.

Still, he acknowledges he is not licensed to sell the pills and he's unsure where they originated.

"I'm not concerned because it's got the sticker and the stamp," he says, squinting at the Khmer script on the labels. "Because of the logo, I trust it to not be fake, it was made in Cambodia."

Walk past O'treng's cluster of sagging huts, cross another cornfield and hike a twisted mile on a dirt track to a wooden shack where a string of smoke is curling through the wooden floor planks in a largely futile effort to keep mosquitoes away.

It's here that skinny 13-year-old Hoeun Hong Da wakes up on the floor nauseous and burning with fever.

Hong Da recovered from malaria two months ago, but now the dizziness and headaches are back.
He's been sickened by the disease six or seven times in his short life — too many to remember.

He knows that if he doesn't get to a hospital soon, he could die. With no new treatments in the pipeline, normally reserved scientists are quick to use words like "disaster" or "catastrophe" when asked what might happen if they don't contain the disease that's ravaging young Hong Da before it spreads to Africa.

There, malaria already kills an estimated 2,000 kids daily. For the past 50,000 years the malaria parasite has been evolving, and migrating, alongside humans.

It moves within the huts of O'treng, and into neighboring towns when men like Hong Da's father and older siblings float from job to job.

Some work is close enough for them to return home at night, but other jobs keep them away for stretches of time.

They sleep in tight rows, sweating and weary, in disintegrating bamboo huts with workers who are also traveling, and possibly infected with malaria.

The concept of containing drug resistance has never been tried before. Scientists wonder: How do you control the spread of a resistant parasite transmitted by mosquitoes that bite people who live and work in infested jungle areas, then scatter in all directions, all the time?

This area, the former stronghold of the murderous Khmer Rouge, has a notorious history.

Burmese migrant workers who once mined rubies and sapphires in these now deforested hills are believed to have helped transport strains resistant to the drug chloroquine back to Myanmar a half century ago.

From there it spread to India and later over to Africa until the drug was useless worldwide.

A decade later, history repeated itself when resistance to the drug sulfadoxine-pyrimethamine followed the same path.

Now, in western Cambodia, scientists are concerned because the artemisinin-based drugs are taking longer than usual to kill the parasites.

Earlier this year, an army of aid agencies and experts from the WHO began racing to this impoverished corner on the Thai-Cambodian border to divvy up a $22.5 million grant from the Bill & Melinda Gates Foundation, aimed at stopping this virulent new strain.

But grants haven't stopped lines of Cambodians, sick or not, from queuing up every morning at Thailand's border, charging past the checkpoints in search of work or goods. Some may carry resistant strains in, others may bring them home.

And grants haven't stopped the parasite from spreading in the O'treng area, despite widespread bednet distribution, awareness campaigns and enhanced surveillance systems.

Some scientists say the only sure way to fix the problem is to eradicate malaria entirely from western Cambodia.

"It's really dangerous," says Dr. Rupam Tripura,

who's conducting a study in Pailin for the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Program. "What will happen to the mosquitoes?
Can you kill those living in the jungle? No, so you cannot kill the strain."

If O'treng is the epicenter of this emerging disease, Phoun Sokha is the point man aimed at controlling it.

At 47, Phoun Sokha is the village malaria worker who lives at the mouth of the hamlet and proudly displays an orange plastic kit that resembles a tackle box.

Phoun Sokha is serious about his packets of medicine and his rapid tests to prick blood from sick villagers' fingers to determine if they have malaria and if so, what type.

He makes sure patients are taking their free medicines and checks to see if they're improving. If not, Phoun Sokha can even arrange transportation to the hospital.

But treating O'treng's malaria patients can be frustrating.

"Some of the patients, when they went to the hospital, after one month, maybe they get malaria again," he says.

Today Hong Da, the village boy who has fought malaria so many times before, heads home from the hospital after a few days of treatment.

He clutches a new mosquito net he hopes will prevent yet another infection. Together, the recovering boy and his weathered mom shuffle past sick neighbor Chhien Rern's shack before disappearing among the tassels of the cornfield toward their home.

But all is not well. Under a tattered quilt, Hong Da's 9-year-old sister Hoeun Chhay Meth is curled on a thin mattress atop the wooden floor inside the family's open-air home.

She had malaria alongside her brother two months ago. They share a mosquito net that she burned a hole in when she stayed up one night reading by the light of a makeshift candle.

Her brother thinks that's how the mosquitoes infected them.

"Very afraid of dying," says Chhay Meth, who has started taking medicine provided by the village malaria worker. "I feel worse than before. I cannot walk myself or stand up by myself and cannot eat well."

Hong Da understands. He gently lifts his little sister's limp body, scooping her up, his strength returning.

Chhay Meth reaches weakly for her mother. Like her big brother, this child doesn't know about counterfeit drugs or antimalarials.

She only knows she's sick. And the medicines don't seem to work as well any more in this little village she calls home.
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Asian Monetary Fund to Debut in March

By Yoon Ja-young
Staff Reporter



Korea will join in the creation of an Asian version of the International Monetary Fund (IMF) next March by teaming up with with ASEAN member countries and China and Japan, the Ministry of Strategy and Finance said Monday.

The fund based on the Chiang Mai Initiative is expected to enhance member countries' ability to cope with short-term foreign currency volatility triggered by external shocks..

Finance ministers and central bank governors of the ASEAN member states and Korea, China and Japan announced the signing of the Chiang Mai Initiative Multilateralization (CMIM) Agreement, Monday.

The multilateral financial support program, which will make an official debut on March 24, includes the 10 member countries of ASEAN - Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam - and three Northeast Asian countries of Korea, China and Japan.

It is based on the Chiang Mai Initiative (CMI), in which the countries in Asia agreed to support each other with dollar liquidity in times of crisis. The need for the safety net especially increased following the Asian financial crisis, which also hit Korea in 1997.

While the CMI was a Bilateral Swap Arrangement between Vietnam, Cambodia, Laos, Brunei, and Myanmar, and Korea, China and Japan, the agreement this time is a multilateral one between the 13 countries.

"At this time, we reiterate the importance of the CMIM in strengthening the region's capacity to safeguard against increased risks and challenges in the global economy," the ministers and central governors of the member countries said in a joint statement.

"The CMIM, with the total size of $120 billion, will provide financial support through currency swap transactions to CMIM parties facing balance of payments and short-term liquidity difficulties," they added in the announcement.

If a member country seeks support, central banks of other member countries will provide dollars, while the recipient country will give its domestic currency in exchange.

For the $120 billion fund, Korea contributed 16 percent or $19.2 billion, while China and Japan provided 32 percent, each. Indonesia, Malaysia, Thailand, Singapore gave 3.97 percent, while the Philippines gave 3.07 percent. Brunei, Cambodia, Laos, Myanmar, and Vietnam accounted for less than 1 percent of the fund.

When Korea suffers a dollar shortage, it can seek up to $19.2 billion in support from the fund.

"Korea took a bigger share in the fund compared to its economic size, setting up ground to expand its influence within the region," the ministry said.

Among ASEAN plus three, Korea accounts for 8 percent of total GDP, and 6.4 percent of the region's total foreign exchange reserves.

"The launch of the CMIM is an important accomplishment upgrading intraregional financial cooperation, including the capability to cope with a short-term liquidity crisis," the ministry added.

chizpizza@koreatimes.co.kr
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In Southeast Asia, Unease Over Free Trade Zone

By LIZ GOOCH



KUALA LUMPUR — When the clock strikes midnight on New Year’s Eve, China and 10 Southeast Asian nations will usher in the world’s third-largest free trade area. While many industries are eager for tariffs to fall on everything from textiles and rubber to vegetable oils and steel, a few are nervously waiting to see whether the agreement will mean boom or bust for their businesses.

Trade between China and the 10 states that make up the Association of Southeast Asian Nations has soared in recent years, to $192.5 billion in 2008, from $59.6 billion in 2003. The new free trade zone, which will remove tariffs on 90 percent of traded goods, is expected to increase that commerce still more.

The zone will rank behind only the European Economic Area and the North American Free Trade Area in trade volume. It will encompass 1.9 billion people. The free trade area is expected to help Asean countries increase exports, particularly those with commodities that resource-hungry China desperately wants.

The China-Asean free trade area has faced less vocal opposition than the European and North American zones, perhaps because existing tariffs were already low and because it is unlikely to alter commerce patterns radically, analysts say.

However, some manufacturers in Southeast Asia are concerned that cheap Chinese goods may flood their markets, once import taxes are removed, making it more difficult for them to retain or increase their local market shares. Indonesia is so worried that it plans to ask for a delay in removing tariffs from some items like steel products, textiles, petrochemicals and electronics.

“Not everyone in Asean sees this F.T.A. as a plus,” said Sothirak Pou, a visiting senior research fellow at the Institute of Southeast Asian Studies in Singapore.

Asean and China have gradually reduced many tariffs in recent years. However, under the free trade agreement — which was signed in 2002 — China, Indonesia, Thailand, the Philippines, Malaysia, Singapore and Brunei will have to remove almost all tariffs in 2010.

Asean’s newest members — Cambodia, Laos, Vietnam and Myanmar — will gradually reduce tariffs in coming years and must eliminate them entirely by 2015.

Most of the goods that will become tariff-free in January — including manufactured items — are currently subject to import taxes of about 5 percent. Some agricultural products and parts for motor vehicles and heavy machinery will still face tariffs in 2010, but those will gradually be phased out.

In recent years, China has overtaken the United States to become Asean’s third-largest trading partner after Japan and the European Union. The overall trade balance has shifted slightly in China’s favor, although there are significant differences among Southeast Asian countries’ trade balances, said Thomas Kaegi, head of macroeconomic research for the Asia-Pacific region at UBS Wealth Management Research.

Singapore, Malaysia and Thailand have only small trade deficits with China, while Vietnam’s has grown substantially in recent years. In 2008, Vietnam exported items worth $4.5 billion to China but imported about $15.7 billion worth of Chinese goods.

In Indonesia, the textile and steel industries are particularly nervous about the lifting of tariffs, prompting the government to say that it would ask for a delay on some provisions. No time frame for submitting the request was given, but the Asean secretariat said it had not yet received an official request.

While competing with more Chinese imports may pose new challenges for Asean manufacturers, analysts say increasing their access to the 1.3 billion people of China could produce significant benefits.

Rodolfo Severino, who was secretary general of Asean from 1998 to 2002, identified Malaysia — which already exports palm oil, rubber and natural gas to China — as one of the countries that might benefit most from the removal of tariffs.

But nations like Vietnam that focus on the production of cheap consumer goods are more likely to be hurt, said Mr. Severino, head of the Asean Studies Center at the Institute of Southeast Asian Studies in Singapore.

Those countries may need to look for new export products and identify new niche markets, he said: “This is the nature of competition.”

Song Hong, an economist, expects that China will import more agricultural goods, like tropical fruit, from countries like Thailand, Malaysia and Vietnam when the trade area takes effect. That could hurt Chinese farmers in southern provinces like Guangxi and Yunnan, said Mr. Song, director of the trade research division at the Institute of World Economics and Politics at the Chinese Academy of Social Sciences in Beijing.

Mr. Sothirak, who was Cambodia’s minister of industry, mines and energy from 1993 to 1998, said the removal of tariffs might help increase Cambodia’s agricultural exports to China. Cambodia needs to diversify its export markets because its exports to the United States and Europe have declined, he said.

While he does not hold much hope that Cambodian textile exports would be able to compete with China’s highly developed garment industry, he said he believed the free trade area might entice more Chinese garment factories to set up operations in Cambodia, where production costs and labor are cheaper.

Pushpanathan Sundram, deputy secretary general of Asean for Asean Economic Community, acknowledged that there would be “some costs involved” for some countries when the free trade area took effect, but he said he believed China and Asean would “mutually benefit.”

Despite the expectations for increasing trade, Mr. Severino predicted that the introduction of the trade zone would not be a “breakthrough event” setting off a dramatic surge in commerce come January.

“There are many factors that traders and investors consider, and the trend has been going this way anyway,” he said. “What this does is to send out good signals and show the determination of governments to make things easier.”


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