Friday, July 27, 2012

Cambodia - Doctor slams WHO for causing virus panic

“The WHO in Cambodia should be closed” is the emphatic sign-off to a lengthy and vivid analysis by Kantha Bopha Children’s Hospitals of the recent “mystery disease” scare.

While the World Health Organization and Ministry of Health have declared that a series of recent child deaths are linked to EV-71, causing severe hand, foot and mouth disease, Kantha Bopha founder Dr Beat Richner has slammed the conclusion as a “catastrophic declaration”.

Richner said 72 cases of the unexplained illness have appeared in his hospitals, and of those, 68 have died.

The WHO yesterday said the totals from the Ministry of Health stood at 61 cases and 56 deaths, including one new death over the weekend that fit the case definition of severe HFMD.

The “case definition” is the critical impasse between the MoH and WHO, and Kantha Bopha, which treat 85 per cent of all Cambodian children.

Kantha Bopha’s “case definition” is encephalitis and complete lung destruction leading to a rapid death.

Not one of these cases showed lesions associated with HFMD, Richner’s statement says.

However, WHO communications officer Sonny Inbaraj Krishnan told the Post yesterday that of the cases recorded by the UN agency and the MoH, rashes and blisters were present.

“Sometimes, with EV-71, either blister or rash appears and it could be one or the other,” he said. “The case definition [for WHO and MoH] is that the child has fever with neurological systems such as vomiting and prolonged stretches of sleepiness or convulsions and respiratory symptoms such as difficulty breathing.”

This conclusion is wrong and is still confusing the media and public, Richner rebuts in his statement.

The question that has still not been answered, Richner said, is “what is destroying the lungs in these 72 cases of encephalitis in the last 6 hours of their life, all treated in private clinics?”

Richner believes that the administration of incorrect drugs to these 72 children could be a factor in the astonishing destruction of the lungs present in the cases that have been recorded by his hospitals.

The most “catastrophic” press release by the MoH and WHO, according to the Swiss doctor, was the most recent, in which the joint investigation conclusion is that a mix of pathogens and a root affliction with EV-71 has been aggravated and worsened by the use of steroids.

The Post previously reported Richner decrying WHO’s criticism of the use of steroids as “absolute nonsense”.

The doctor emphasised that all patients arriving with the unknown illness at Kantha Bopha hospitals showed signs of encephalitis, which requires steroids to stem fatal swelling of the brain.

A high number of platelets during the final moments before death could be a sign that underlying tuberculosis is complicating treatment, Richner said in the statement.

Kantha Bopha Children’s Hospitals operate in parallel to the public health system in Cambodia and provide outpatient and emergency care free of charge at their five hospitals in Phnom Penh and Siem Reap.

However, a bitter relationship between Kantha Bopha and the WHO appears to be complicating investigations into and solutions to the child deaths.

MoH Secretary of State Heng Tay Kry said only the minister or WHO could respond about Richner’s allegations.

Minister Mam Bunheng, Communicable Disease Control Department director Sok Touch and his deputy, Ly Sovann, could not be contacted yesterday.

WHO country representative Pieter Van Maaren, told the Post he considered Richner’s statement “irrelevant”.

“We don’t communicate with Kantha Bopha through the media,” Van Maaren said. “And we don’t give comment [on press releases]. The Ministry of Health and WHO joint press releases state what is our position [on the child deaths]."

Bridget Di Certo
With assistance from Chhay Channyda

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