Risk Communication Training in Cambodia: Meet the Trainers in Kampong Speu Province

By Cecile Lantican

July 23, 2012

This blog is the second part of the earlier post, MID-BCC in Cambodia: Training the Frontlines on Risk Communication.

Cecile Lantican, MID-BCC Country Coordinator Lao PDR, traveled to Phnom Penh, Cambodia to train eight members of the national rapid response team on risk communication from June 20-21. The participants of the national training will train provincial and district team members to enhance Cambodia's capacity to repond effectively to a H5N1 outbreak.

(Editor's note: minor edits have been made to the author's original report)

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With support from the USAID MID-BCC project, after the TOT in Phnom Penh, the eight national trainers from the Communicable Disease Control Department of Ministry of Health, National Veterinary Research Institute of the Ministry of Agriculture, Forestry and Fisheries, and Cambodian Red Cross planned the cascade training. The main purpose of the plan was to train provincial and district agricultural staff, veterinarians, hospital health staff, private clinicians, pharmacists and pharmacy clerks, and village volunteers from four provinces – Kampong Speu, Kampot, Battambang, and Bantay Mencheay. These provinces had history of bird flu outbreak and human fatalities.

On July 3, Khoukham Xaymounvong and I traveled from Lao PDR to Phnom Penh, Cambodia to provide technical oversight in the conduct of the cascade training in Kampong Speu. From the airport, we traveled about 48 kilometers, an hour drive, before we reached the Provincial Health Department where the training was held. The main road has an excellent transport infrastructure; before, it was dirt road in 2008, my first time to visit the place with the FAO team.

This is the Kampong Speu Provincial Health Department office.  The training was held on the second floor of the building.

Kampong Speu is home to a significant number of manufacturing and industrial bases. Along the road, we noticed about a thousand young laborers, mostly women, coming out with banners from a garment factory. The driver told us that these factory workers were leading a massive strike because they were demanding raises and benefits from the company.

The province recorded a poultry outbreak in 2006 and the fourth human fatality from H5N1 in the same year. In May of this year, the province also registered the 21st human case of H5N1.

Of the eight trainers trained in Phnom Penh, six joined the Kampong Speu team. They arrived at the province one day before the training to prepare themselves and discuss team work and how to manage group sessions. On top of the logistic support was our coordinator, Tongngy Kaing.

There were 38 participants – 17 veterinarians and 22 health staff. Of this total, there were four women (two veterinarians and two community organizers from the Cambodian Red Cross).

At the end of the day’s session, I seized the opportunity to ask the trainers about themselves. I asked them about their impressions of the training – what is feasible and what is difficult for them.

Ms. Dim Vantha is the Project Officer of the Cambodian Red Cross Community-based Health and First Aid Project in Kratie Province. Before her stint with the Cambodian Red Cross she worked in an orphanage managed by a local non-government organization. She manages project activities on diarrhea, dengue and malaria, acute respiratory infection, water and sanitation, and mother and child health. She facilitated the technical session on interpersonal communication.

“My academic background was accountancy. When I joined the Cambodian Red Cross, I received training on epidemic control. Our training on risk communication at Sunway was my first training on communication. After our training I did not have the confidence that I could be a trainer. My work in the community was more of coordination with local authorities and partners to implement our activities. I had some fears that I may not be able to meet the expectations of the team. Before I left for Kampong Speu, I received a lot of prodding and encouragement from my supervisor in the office.”

I asked her again, “How did you find handling the session on interpersonal communication skills or IPC?”   She replied, “It was not easy. I was fortunate to work with Mr. Chansana on this session. He guided me to deliver the session. I learned from him who was more experienced in this work. I received advice from other trainers, too.  I really appreciated the teamwork. After yesterday’s session, I felt better. From other trainers, I understood well about the disease and our key messages. I saw other trainers perform.  Now, I feel more confident to deliver my next session.”

Mr. Mak Chanthol has served as a project staff of FAO Cambodia. He was hired by FAO in 2006 and was deployed at NaVRI to support the communication needs of the institute. His academic background was animal health and production.  He is now a member of the Communication Task Force of the Department of Animal Health and Production. He leads the avian influenza community forum supported by FAO and NaVRI. He facilitated the sessions on:  (1) Avian Influenza situation in the country and Kampong Speu, symptoms of AI in birds, and prevention/protection of the disease in birds, and (2) Forming a Communication Task Force – Roles and responsibilities.

Mr. Chanthol shared, “From our TOT in Phnom Penh, I was amazed that we have moved the provincial training so fast. Early on, I had some doubts that we could get the team. We have different levels of understanding   the content areas of the training, and different experiences considering the offices we come from. Before the training, the team discussed slight changes on the agenda which we agreed on during the TOT. As a trainer, I believe we need to learn more in every training we do.  Each training that we conduct should serve as an opportunity for us to learn more. I personally believe that training in other provinces should continue, but there is a problem of lack of government funds to finance the activities.”

Mr. Hang Chansana is the head of the Emergency Health Unit of the Cambodian Red Cross and concurrently the Program Manger of the Community-based Health and First Aid Project in Karatie province. Mr. Chansana attended the AI-BCC interpersonal communication skills training that was conducted by AED in 2008. AED implemented the USAID’s AI-BCC project in Cambodia from 2006 to 2008. He facilitated the role play and scenario setting for interpersonal communication skills.

“I feel great about our training. This is the first time that district agriculture staff and health staff attended an avian influenza training together. We at the Red Cross have been advocating for more engagement of the government people to move into action the ‘One Health’ concept. This training is essentially a manifestation of promoting this concept.  I heard from the participants that this was their first time to be oriented on the importance of communication in their work. Indeed, it was the first time in this province that district staff from the animal and health centers talked about the issue of bird flu together.  As the IPC facilitator, I was happy to see participants catching up slowly with our communication content.  I was happy to see that the members of the training team, despite diversity of experiences, they shared their ideas and helped one another. The Cambodian Red Cross is always open to provide community mobilization support for emerging pandemic threat or any event of disaster. Since AED trained us on IPC in 2008, we have been training our own people in the field. However, sometimes we’re limited to do so because of the project donor priorities.”

On the venue of the training, Mr. Chansana noted, “I hope similar trainings like this should be conducted at the village level. We can observe participants’ reaction and performance better in an environment that is close to them.”

Dr. Sok Sary works at the Communicable Disease Control Department of MOH as a surveillance officer and investigator during outbreaks of avian influenza, diarrhea, H1N1, dengue and malaria. He provides oversight and supervision to Kampong Speu provincial health department. He served as the resource person for H5N1 situation in the Phnom Penh, symptoms of AI in humans, and how to protect oneself from contracting the infection.

 “I am amazed that we were able to put together in one meeting the agriculture and health staff of the province. It was our first time to train them like this and all districts of the province were represented. Today, we have stressed the importance for them to communicate, share information immediately once a suspected case of bird flu outbreak is probable. The attendance of the private clinicians and pharmacy operators and their clerks was also important. They too have a key role to play in reporting and referring probable cases of bird flu infection in humans.  However, I am not quite sure how much they can remember about the information we provided. Two-day training is too fast. Our people in the health department seldom get updated on technical know-how. I hope they better understand the course purpose. I am also concerned that after this training – how we can monitor them. This is an issue that we have not settled yet.”

Mr. Sem Tharin works in the Laboratory Inspection unit of NaVRI. During the bird flu outbreak he joined the surveillance team to collect samples of dead and dying birds in the community. The TOT on risk communication made him understand why people were reluctant to cooperate with them during outbreak.

“The TOT made me realize the importance of the manner we approach the people, how we communicate with them when we get their animals without giving compensation in return. I may have technical knowledge about the virus, but never got a chance to explain its danger to people in a manner that they could understand it and therefore would take the necessary action to protect themselves. The TOT called my attention how to be more organized in my field work and listen to people.  I learned from other trainers. But I learned more from the district people who shared their thoughts and experiences today.  Duration for the training is too short. Given the number of participants, we should have divided them in much bigger space to allow more interaction among them. It was their first time to experience this learning process. I think they have more ideas to share, especially those who came from villages with H5N1 outbreaks.”

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