Disease incidence rates are defined as the number of new cases of a given disease in a given period of time, per population. According to World Health Organisation (WHO), in 2012 Swaziland had the highest global incidence rate of Tuberculosis at an estimated 1349 people per 100,000 population. South Africa came in second at 1003/100,000. Rates plummet thereafter to country number 3, Sierra Leone, at 674/100,000. Cambodia’s TB incidence rate in 2012 was 411/100,000. To put these statistics into perspective, the equivalent rate in Australia is 6.5 per 100,000 and in America, 3.6 per 100,000. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317140584841
Another way TB is counted, is in absolute numbers and 22 of the world’s countries have been identified as containing 80% of all TB. Cambodia currently holds place as 22nd of these 22 highest burden countries.
Since 1982 World TB Day has been a global event held on March 24 each year. The significance of this date is that on March 24 1882, German microbiologist Robert Koch announced his discovery of Mycobacterium tuberculosis, the organism responsible for TB. Despite the bacteria’s relatively recent discovery in 1882, TB was known about since before Hippocrates, who in 460BC identified it as the most widespread disease of his time, almost always killing it’s victims. Through the ages many famous people have suffered from TB, including the Bronte sisters, George Orwell, Frederic Chopin, Napoleon Bonaparte and many others. It is recognised as the biggest killer of humankind throughout the ages, and today it is second only to HIV as the world’s biggest infectious killer.
World TB Day is used to promote awareness of the disease and spread messages about prevention, signs and symptoms, diagnosis and treatment, particularly to vulnerable populations such as the people of Cambodia. This year in Cambodia I had the privilege of being a part of a group of teams who dispersed across Kampong Cham Province, to spread the word on World TB Day.
My team traveled to a market place near the border with Prey Veng Province, the poorest of Cambodia’s 24 provinces. As 80% of Cambodia’s population are subsistence farmers, the agricultural market places scattered across the country in every town and city are packed with rural farmers, making them an ideal place to target the most vulnerable citizens who are graded by the World Bank as “poor” (living on <$2 per day) and “near poor” (living on <$2.30 per day). http://www.worldbank.org/en/news/press-release/2014/02/20/poverty-has-fallen-yet-many-cambodians-are-still-at-risk-of-slipping-back-into-poverty
We drove for about an hour towards Prey Veng, arriving at the market around 8am just as things were livening up. Horse drawn carriages and a variety of overloaded vehicles were flowing into the market getting ready for a day of sales. The rented loudspeaker was waiting for us on an old motorbike driven by it’s owner who had a crippled arm. When we located a place to situate ourselves he joined us, connecting the loudspeaker to two microphones and a radio to play music when we needed a break from speaking, and settled in to spend the day listening to us using his equipment.
We spent about an hour in one location near the entrance to the market, speaking into the microphone about tuberculosis and offering our time to anyone who wanted to interact with us. Once we felt this location had served it’s purpose, we wandered to the nearby stalls and spent some time mingling with the sellers, who were all very happy to speak with us, many of them telling us about their personal experiences with Tuberculosis. We had a lucky draw game in which anyone willing to answer three of our questions related to the basics of Tuberculosis could pick a piece of paper out of a box, with one of three possible prizes written on it (coloured pen, sweet or a World TB Day t-shirt).
From there we relocated to an intersection further into the market, where we hoped to reach a bigger audience. Our whole day was spent taking turns (between four of us) with the microphone, speaking about Tuberculosis, wandering to and through the stalls speaking with people, and running our Lucky Draw via a quiz over the microphone with willing audience participants. It was a very hot day, but we were furnished with a shady umbrella and the fun we had eclipsed any physical discomfort.
Some photographs from our day:
A few market scenes worth sharing: