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Dengue Deaths Sweeping Cambodia Highlight Healthcare Failures

, when we had five cases total for the whole year," he says.

Two children have died. Un Sam Ath says he wanted to send them to the provincial hospital in Kompong Cham city, about three hours down a dirt road pitted with deep muddy holes.

"But their families were too poor to afford the trip. We have no ambulance and transport is a problem," he explains.

"We are so worried about the coming months -- parents are always waiting too long to bring their children to our hospital. By the time they arrive they have already fallen in a coma," Un Sam Ath says.

Those who can afford transportation to Kompong Cham will be okay, "but what about the poor?" he says.

The outbreak, which has stretched several hospitals in the capital Phnom Penh to capacity, highlights the many failures of Cambodia's health system, which like all of its public institutions is struggling after years of civil war and neglect.

"The total level of public financing for health is simply too low," the World Bank said in its 2007 equality and development report, which found that rural Cambodians still lacked significant access to healthcare.

The government spent only four dollars per person on health expenditures in 2006, the World Bank said, while Cambodian health officials admit that paediatric care is especially thin.

"We have not enough health care services for children -- it is still at a limited level," says Mam Bun Heng, a secretary of state with the health ministry.

A lack of basic health knowledge is also particularly deadly for uneducated rural Cambodians like many of those seeking help in Krouch Chhmar.

This combination has left Cambodia woefully unprepared for the current dengue outbreak.

"People's understanding of sanitation is still very low," Mam Bun Heng says. "We are educating them," but about three million dollars will be needed to fight yea
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