© Tim Dirven/Panos Pictures


Between March and May 2020, we suspended our long-running hepatitis C programme in order to support the Cambodian Ministry of Health’s response to the COVID-19 pandemic

New, more effective diagnosis and treatment strategies for hepatitis C proved successful in Cambodia in 2019. 

Hepatitis C is endemic in Cambodia yet access to diagnosis and treatment is virtually non-existent. After three years of collaboration with Preah Kossamak hospital in the capital, Phnom Penh, and the introduction of simplified diagnosis and treatment, Médecins Sans Frontières (MSF) handed these activities over to the hospital’s hepatology department in June.

We continue to treat patients in the Municipal Referral Hospital with the aim of identifying barriers to hepatitis C care in this urban context.

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MSF’s work in Cambodia: 2020

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Médecins Sans Frontières (MSF) continued to provide hepatitis C diagnosis and treatment at the Municipal Referral Hospital (MRH) in the capital Phnom Penh. Our staff also work in the outpatient departments of three other hospitals, where we organise referrals to MRH for confirmatory testing and treatment. From March, patients already enrolled were given their remaining dose so they could continue treatment from home, while newly diagnosed patients were put on hold. 

We supported the health ministry’s response to COVID-19 by assisting with the tracing of contacts of patients who tested positive for the virus, and the drafting of guidelines on infection prevention and control and clinical care, which were previously unavailable in the country. We also improved triage in six hospitals close to the border with Thailand, where hospital staff treated many migrant workers who were returning home.

The fear of infection with COVID-19 prevented many people from seeking care, including for hepatitis C. Our teams adopted comprehensive personal protective equipment measures, which allowed the resumption of hepatitis C activities in Phnom Penh and Battambang province from May. 

Working with provincial health staff, the team in Battambang finalised the roll-out of hepatitis C screening and diagnosis in all rural health centres across the province. MSF has trained nurses to screen the patient history and check if they currently have symptoms of cirrhosis, a complication of the disease. If they do, they are referred to the district hospital. Otherwise, the nurses initiate treatment with direct-acting antivirals at the health centre. The success of this simplified model of care demonstrates that it could be adopted nationally. 

A mobile team was sent to Pursat and Kampong Chhnang provinces to investigate exceptionally high rates of hepatitis C (>30 per cent) among younger age groups and to provide treatment where necessary. Possible sources of the high infection rates include a traditional healer using the same needle and knife during consultations with patients from both provinces, and a dentist providing door-to-door care in Kampoing Chhnang.