Wednesday, June 28, 2017

The long journey toward health: Improving the lives of vulnerable children

By Khiev Pharin and Arnaud Laillou

Vutha and his neighbours; ©UNICEF Cambodia/2017Pharin Khiev

Phnom Penh, Cambodia, June 2017: Eng Vutha is a three-year-old boy who lives in the Cambodian capital of Phnom Penh. Due to a physical disability, Vutha spends much of his day on the floor of a simple wooden house his parents rent in a slum community in Russey Keo district. He shares the home with his four siblings and mother, Nhem Sophea, 32, a housewife, and father, Om Phala, 31, a motorbike taxi driver. The family income is about 3,000 to 5,000 Cambodian riels or about US$1 per day.

UNICEF Cambodia staff first encountered Vutha in 2016, for a study being conducted in three vulnerable districts to better understand why health and nutrition status of certain newborns, infants and young children are not improving. The study takes a longitudinal approach, referring children to necessary services and then evaluating them at specific intervals to monitor progress. It aims to address persistent inequities between rich and poor and urban and remote households through innovative programming that works cross-sectorally and improves referral systems among local health centres, provincial referral hospitals, and the National Pediatric Hospital and other health facilities.

Vutha was diagnosed as severely acutely malnourished and with disability—and the team wanted to ensure both situations would be addressed by the health system.

Vutha has spent much of his short life being sick. After screening him for nutritional status, UNICEF staff referred him to the National Paediatric Hospital as he was severely malnourished and had health complications. During his stay at the hospital, he received proper treatment and was cured thanks to support from UNICEF through the Ministry of Health. But treating for malnutrition was not enough. His physical disability deprived him of a decent life.

His mother explains, “I brought him to the hospital in Phnom Penh where the poor are treated for free, but no one ever took care of his handicap.”

Vutha’s quailty of life still needed significant improvement. After the malnutrition was addressed, UNICEF facilitated transfer to Chey Chumneas Hospital in Kandal Province, about 16 kilometres away, where he was diagnosed with severe cerebral palsy. “His incapacity to stand and sit up made Vutha weaker and weaker,” Dr. Keo Sambath, explains. “He was gradually losing his abilities, forcing him to stay on the floor with no one in the home to take care of him for most of the day.”

With this diagnosis, Vutha was referred to another facility in Phnom Penh, Veterans International Cambodia (VIC), a local NGO that provides rehabilitation services and prosthetics for free to those in need. “It was urgent to prevent any additional muscle and coordination losses and allow him to gain some of his strength back,” Choub Cheakta, a nurse at VIC says. The centre proposed specific therapies to the family and offered to build a trolley that would allow Vutha to move about on his own.

After several months of waiting, in February 2017 Vutha received his trolley from VIC. The organization has just eight workers and a small workshop with old tools, providing up to one trolley and 50 wheelchairs per month. VIC will also provide community-based rehabilitation services at Vutha’s home.

Now Vutha and his family are able to manage his disability much more easily than before.

His life has changed drastically. He can sit up and keep his head straight on his new chair. His mother says, “I am very happy to see Vutha. He can sit on the trolley chair with a big smile. He starts to play with the neighbours again and he is not isolated anymore.”

Vutha is now able to sit up in a trolley chair
©UNICEF Cambodia/2017/Pharin Khieu

Thanks to the support of several UNICEF National Committees (Australian, Canadian, Korean, and Hong Kong), Vutha is one of 13 children with disabilities now receiving the treatment they need to have better lives.

In 2017, UNICEF Cambodia’s Child Survival and Development programme will continue its commitment to these vulnerable children, screening those in target districts and bringing together various sectors (nutrition, health, water and sanitation, disabilities), critical for ensuring more children can access the services they need.

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