Amir Khasru from VOA Bangla Service contributed to this report.
KRAYEA COMMUNE, KAMPONG THOM PROVINCE, CAMBODIA – The babies cry and cough while vomiting. old twins. Her daughters were tested positive for potentially fatal and almost always painful dengue fever.
Lang Chanthoeun says she has not got any money yet to be treated for Pheak Sonisa and Pheak Somatha. "I tried to borrow money from relatives, but they did not have one," she said.
"Last night I could not sleep," said the 35-year-old mother of six children, who lives in a poor rural area of the Kampong Thom Cambodian province in the central lowlands of the Mekong. The local rubber plantations in the province of Santuk protect mosquitoes and make them a center of this year's dengue outbreak.
A regular cycle of dengue
Huy Rekol, director of the National Center for Parasitology, Entomology and Malaria control in Cambodia, which is part of the Ministry of Health, said that this year's severe outbreak is part of a "regular cycle of five to six years or 10 to 12 years" in tropical Asia.
In Cambodia, which was severely hit during the rainy season, which began in May and ends in October, treating dengue fever can be a huge burden on poor villagers. Like Lang Chanthoeun can not find the money for blood tests and, if necessary, treatment. Some get into debt rather than seeing family members suffer.
Money or health?
Meas Nee, a political analyst, said that poor villagers like Lang Chanthoeun should owe debts to avoid debt, travel to hospitals such as Kantha Bopha in the capital, Phnom Penh, and Siem Reap for free.
After spending $ 35 on her daughters' blood test and some medicine in a private clinic, Lang Chanthoeun said she could not afford to travel for free care. As a coconut shell vendor, Lang Chanthoeun's income has dried up due to the recent heavy rains, and a one-person taxi or bus costs $ 10 to $ 15.
What is dengue fever?
Southeast Asian countries report huge costs increase in dengue cases in the first half of 2019 compared to the same period of 2018
The government should consider setting up a treatment center in the province so that the villagers do not Meas Ne Ne, who holds a doctorate in sociology and international social work from the Australian La Trobe University, said.
According to an article from the 2008 International Journal of Equity in Health, "the high hospitalization and mortality rates of infants and children due to dengue fever reflect the difficulties that women continue to face with finding enough money in medical care Emergencies, resulting in delays in diagnosis and treatment. "
" Regardless of whether they used a public or private facility, on average, seniors spent $ 34.50 and up to $ 150 on a dengue episode, "write Sokrin Khun and Lenore Manderson her article "Poverty, user fees and solvency for health care of dengue-suspected children in rural Cambodia.
In the Krayea community in Kampong Thom province, many babies and toddlers in the province's local private clinics and state hospitals were treated with dengue fever. Some of them were treated at the prestigious Kantha Bopha Children's Hospital in Phnom Penh and Siem Reap.
Both cities are a long way from Lang Chanthoeun's rural village, where mothers are in a private clinic in front of the town hall. They suspect that their children have dengue fever and want their blood to be examined.
Hospital power was cut short due to nationwide bottlenecks due to the hot weather and increasing demand from fast-growing urban centers such as Sihanoukville.
Pin Roeun awaits the results of a blood test for her 8-year-old son Sok Kea. She said she could pay up to $ 50 for blood tests, which is usually between $ 15 and $ 25 and a short treatment time.
"I do not know the exact costs yet," said Pin Roeun, 38, a farmer who grows manioc while raising two boys and a girl.
If the cost exceeds $ 50, she will borrow more money, increasing her current debt of $ 1,000.
"If I can sell manioc, I can pay the client," said Pin Roeun, who had paid interest on the debt for nearly a year at $ 25 a month.
Chun Mom, another villager at the clinic, taking care of her 14-year-old son Vann Vat, who may be experiencing dengue fever.
Chun Morn, a manioc and cashew farmer, said there always seems to be someone in her family who
"They often get sick like the flu, stomach problems," said the 30-year-old, one-year-old who carries a debt of around $ 500.
Sun Kimroeun, the village chief of Sen Serey Mongkul, said 90% of the 277 families in his village had borrowed money from financial institutions and banks.
"Some borrowed money for health care," he said. "You can not go to work when someone is sick," he said, adding that most Me To work in his village on the rubber plantations.
According to the World Bank Group's Microfinance and Household Welfare report published in February 2019, around 4% of borrowers need money to cover their health and injury-related expenses.
On the verge of poverty
Although poverty in Cambodia has declined sharply in recent years, there were 4.5 million citizens According to the World Bank, it fluctuates just above the global poverty line.
"The loss of just 1,200 Riel ($ 0.30) a day in income would throw an estimated 3 million Cambodians back into poverty and double the poverty rate to 40 percent Neak Samsen, a bank analyst, wrote in 2014.  Cambodia's per capita GDP in 2017 was $ 1,384, as reported recently by two NGOs, the Cambodian League for the Promotion and Defense of Human Rights (Licadho) and Samakum, Teang Tnaut.
Since 2006, the Cambodian government has implemented a program that provides free health care in public facilities. The beneficiaries receive colloquially and predictably known as "poverty cards" known equity cards, which must be presented in order to use the benefits.
More than a decade after the program began, however, they were supported by the German and Australian governments. Many people are frustrated and confused about the criteria for allocating the cards and the benefits to their owners.
Neither Pin Roeun nor Chun Mom are in the program. That means they do not have the card for the poorest of the poor.
Lang Chanthoeun said she qualified for the program but has not received a card yet.
Srey Sin, head of Kampong Thom Provincial Health Ministry
"We treat her for free if she has the poverty certificate," he said, that more than three times as many people showed up in local hospitals in 2019 for dengue fever treatment are. "Our employees have tried their best to treat them, even though there are many people."
Lang Chanthoeun's husband took the twins to a state hospital in the province after being diagnosed with dengue at the local clinic. 19659003] 37-year-old Hak Sopheak claimed to spend $ 25 each on treating Pheak Sonisa and Pheak Somatha, but was not pleased.
"It has made my daughters worse and worse that the medical staff treated them," he said. "Before that, they did not receive good care."