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On 21 November 2023, the handover ceremony of the project “Improvement in WASH sector in Kampong Chhnang Province, Cambodia” took place in Kampong Chhnang Province, Cambodia. This important project, funded by the Czech Development Agency and implemented by a consortium led by the Czech NGO Diakonia, is an important landmark in the history of the Czech-Cambodian partnership in the field of water and sanitation.

The project was implemented between 2020 and 2023 representing a significant milestone in Czech-Cambodian development cooperation. Against the backdrop of the Czech Republic’s commitment to support the Millennium Development Goals, specifically access to water and sanitation, this initiative is the biggest achievement in this effort so far. It also corresponds with Cambodia’s National Development Strategy and the government’s rural development strategy.

Carefully designed to address pressing issues in the region, the project has addressed problems ranging from inadequate water resources and sanitation issues to chemical pollution and lack of awareness of the consequences of improper water management. Eight communes in two districts of Kampong Chhnang province were identified and comprehensive sanitation system was designed using locally available resources and taking into account the unique geographical and agricultural conditions of the region.

Under the leadership of the Czech Diakonia and in collaboration with local partner Life with Dignity, the consortium included the Czech University of Life Sciences in Prague and Czech companies G-Servis and Ekomonitor. Their joint intervention focused on both physical infrastructure development and community engagement, with an emphasis on water management and disease prevention awareness.

In the initial stages of the project, hygiene kits, water filters were distributed and collaboration with the local private sector was established. Feasibility studies were carried out, schools and villages were linked and awareness campaigns were organised. In the following years, construction of boreholes, water testing and designing of a comprehensive water supply system were carried out.

In September 2023, the four-year project culminated with the installation of a modern drinking water treatment plant with Czech technological solutions by the Czech company Ekomonitor. This state-of-the-art facility, with deep boreholes, a water tank and an automatic pressure station, will provide clean drinking water for more than 1,500 inhabitants, and more are already signing up to be connected. The project has not only commissioned cutting-edge technology, representatives of the local community have received comprehensive training to ensure that they can manage the treatment plant independently and contribute to a better quality of life for local residents for generations.

The project was announced by the Czech Development Agency in 2021 as a follow-up project to the one that ended in 2019. The project was successfully obtained by the Vita et Futura Foundation, which oversaw the entire planning, preparation, and implementation, including the selection of experts who participated in the project. In the first half of January, a large team directly conducted an extensive multidisciplinary program for the education of obstetricians, anesthesiologists, neonatologists, midwives, and pediatric nurses in Cambodia. On March 21 Cambodian delegation visited Czech Republic including main office of the Czech Development Agency.

The main objectives of the project are to reduce maternal mortality during childbirth, reduce perinatal mortality, and reduce child mortality within the first 5 years of life. I talked about the project and especially the course of the January working trip to Cambodia with Petra Pařízková, a midwife and project coordinator.

What was the composition of your team?

The team composition was diverse. We had obstetricians, neonatologists, anesthesiologists, a diabetologist, a midwife, a pediatric nurse, and paramedics, mainly from the General University Hospital in Prague – VFN and the First Faculty of Medicine, Charles University. We also had representatives of bioengineering and modern IT technologies, as well as interpreters.

How did you start your rich program?

Right at the beginning of the first day of the symposium, the Cambodian national anthem was played, which demonstrated the importance that local doctors and midwives attached to our interdisciplinary educational congress as part of the help supported by the Czech Development Agency. Then there was lecture after lecture. Midwife Mgr. Alžběta Němcová introduced triage for low-risk and high-risk pregnant women in our country, followed by care for low-risk pregnant women and mothers by midwives. MUDr. Zuzana Kokrdová presented novelties in the field of preeclampsia. A lecture by MUDr. Hana Krejčí on diabetes in pregnancy was significantly impressive. The day ended in the late afternoon with presentations on premature delivery, with the audience particularly appreciating video presentations of interesting case studies from our clinical practice. It was nice to meet the director of the National Pediatric Hospital, Nhep Angkeabos, after a year, who highly appreciated our work in creating English-Khmer slides.

What else did you cover in your lectures?

On the second day, we began with an introduction to today’s recommended practices for Caesarean section deliveries (by MUDr. Kateřina Slabá, prof. MUDr. A. Pařízek, CSc.). This was followed by a presentation on extraction methods in obstetrics, such as vacuum extraction and obstetrical forceps. These are life-saving methods that every obstetrician should be able to handle, even though forceps are in decline worldwide. There are still situations where they cannot be avoided in order to save the life of the child or mother. Obstetric forceps were seen for the first time by some midwives and doctors. We then presented the latest developments in life-threatening bleeding during childbirth, from both the obstetrician’s and anesthesiologist’s perspectives.

Did you also have a practical demonstration of your procedures?

Yes, our colleagues from Cambodia prepared a mother who was undergoing a repeated Caesarean section for us to demonstrate our technique. Honestly, operating in a completely unfamiliar environment, when not all healthcare professionals speak English, with instruments that are identical yet different, did not add much calm. However, the spinal anesthesia, brilliantly introduced and performed by MUDr. Jan Bláha, and the Caesarean section performed by Prof. MUDr. A. Pařízek, CSc., with the assistance of MUDr. Zuzana Kokrdová, and with Mgr. Alžběta Němcová securing everything along with the Khmer instrumentation, went smoothly. We received applause, which someone called “applause,” because there were an unusually large number of spectators in the operating room.

What other important information did you focus on in your lecture program?

Everyone who works in the delivery room knows that in cases of acute problems, the anesthesiologist is an absolutely key person. This is known by every obstetrician, neonatologist/pediatrician, and every midwife. When a child is suffocating (technically, experiencing hypoxia) and an emergency cesarean section is necessary, or when a woman is losing consciousness due to unexpected rapid and massive bleeding during delivery (technically, peripartum life-threatening bleeding), everyone immediately calls for the anesthesiologist on duty. The anesthesiologist quickly takes care of ensuring breathing for the much-needed oxygenation of the blood and subsequently the tissues, especially the uterus. They secure intravenous access to administer the necessary fluids, including blood substitutes, while also administering medications that support blood coagulation. Therefore, one whole day of our educational congress was devoted to anesthesia and intensive care medicine. The Cambodians were enthusiastic and requested, beyond the program, to hold a workshop directly in their hospital.

Premature birth and associated complications, such as infections, are often a problem in Cambodian hospitals within neonatology. I assume that you also addressed this issue.

Of course. After the obstetric and anesthesiology sections, neonatology came next. Colleagues from the National Pediatric Maternity Hospital showed great interest in innovations in the care of not only children who were fortunate enough to be born on time but especially those who had the misfortune of complications at the start of their lives, namely premature birth. A lack of oxygen during childbirth can cause a serious catastrophe in a child, namely brain damage. And there are many such cases here. There isn’t even one cardiotocograph in the entire province (11,000 births). Therefore, as the first topic, our neonatologists, led by Dr. Jan Smíšek, presented this issue (technically, hypoxic-ischemic encephalopathy), its diagnosis, and treatment. He pointed out that timely neonatal/pediatric intervention and proper resuscitation can be key means of managing this serious pathology. This was followed by the issue of early and late infections in newborns, especially to prevent the promotion of antibiotic-resistant bacterial strains.

What else is crucial for the healthy development of a newborn?

For example, the stabilization of the newborn is crucial. Professor Richard Plavka demonstrated lung issues immediately after birth during his teaching on this topic, mentioning the importance of late umbilical cord clamping, including basic steps of resuscitation. He described the respiratory support of high-flow nasal cannulas and addressed bronchopulmonary dysplasia, its diagnosis, treatment, and mainly prevention. MSc. Zuzana Tomášková delivered practical lectures, emphasizing the importance of thermoregulation in both premature and immature newborns. Her lecture on the significance and technique of breastfeeding aroused interest not only in the attentive audience. Cambodian neonatologists and pediatric nurses attended in large numbers and had numerous questions. Modern “baby simulators” purchased by the Czech Development Agency were also put into operation for these purposes when our colleagues in Cambodia received detailed information on how to use these modern tools.

One of the Czech Development Agency’s projects in Cambodia is focused on the much-needed field of bioengineering. Have you also addressed this topic?

Yes, the last day of our visit was dedicated precisely to bioengineering, directly at the National Pediatric Hospital. During the conference preparation, there were heated discussions about whether it could be organized on Saturday when it is not customary to work much here. The reality? There was no place to sit during the presentations by Professor Petr Kudrna and engineer Lucie Novotná. An unprecedented number of healthcare workers also came from Kampong Chnang province. It turned out that bioengineering must be an integral part of our development cooperation to enable people to operate often highly specialized equipment, which is provided through the Czech Development Agency at considerable cost. By the way, Petr Kudrna put our gift into operation in practice before the interested parties’ eyes. A device for C-reactive protein (CRP) analysis for inflammation diagnosis.

Did your team’s work trip meet your expectations?

Absolutely. Our mission was fulfilled to 200%. Additionally, before our departure, we learned how our Cambodian patient, for whom we ended her pregnancy by cesarean section, was doing. The mother, as well as her daughter, whom the parents named Emília, are doing very well, so we flew home with a good feeling.

Dear partners, dear friends,

On behalf of the Czech Development Agency, let us wish you a Happy New Year 2023.

pf 2023

On November 22, 2022 in Tbilisi, there was a working presentation and discussion of the Georgian draft Code on chemical substances and mixtures, which was created as part of the development project “Capacity building for sound management of chemicals – Implementation of REACH and CLP regulations” funded by the Czech Development Agency (CzDA).

The workshop for representatives of the state administration, chemical industry and non-governmental organizations was prepared in cooperation with the Czech Embassy and the Georgian project partner – the Ministry of Environmental Protection and Agriculture.

The working meeting was opened by the Deputy Minister of Environmental Protection and Agriculture, Mr. Solomon Pavliashvili, who appreciated the cooperation with the Czech Republic in the implementation of environmental protection projects and the cooperation with the Czech team. The Czech ambassador to Georgia, Petr Mikyska, emphasized that the implementation of EU legislation is not only a formality, but a real benefit for the people of Georgia. He also valued the outputs of the project, which will support Georgian activities within the framework of the fulfilment of the obligations defined by the Association Agreement between Georgia and the European Union.

The Czech Republic, through its bilateral cooperation, supported the Georgian partner in transposition of EU requirements for management of chemical substances into national legislation. Namely the EU regulations CLP* and REACH*, which regulate the classification, labelling, packaging of chemical products and their placing on the market.

The project comprised mapping of the existing legislation and competences of individual authorities in management of chemical substances in Georgia, elaborating the concept for harmonizing existing legislation with the requirements of the European REACH and CLP regulations, drafting a new Code on chemical substances and mixtures incl. explanatory note, three implementing bylaws and methodology for ensuring effective control of obligations arising from the new chemical legislation.

Expert capacities of national institutions active in chemical management were strengthened through numerous trainings, workshops in Georgia and study tours to the Czech Republic.

The implementer of the project, Czech company DEKONTA, has extensive experience with environmental consultancy and development of international cooperation projects in Georgia and other countries of Eastern Europe and Asia. The Czech company Medistyl, which provides consultations in the legislation of chemical substances, also participates in the implementation of the project.

The project, which started in December 2017, was completed in November 2022 by handing over all outputs to the Georgian partner and to CzDA.

The Gambia is a country with little manufacturing capacity, where most goods are imported. At the same time, however, the smallest country in continental Africa is opening up to new technologies, especially in the field of education. The interest in innovations in healthcare and production is also on the rise. Therefore, Prusa Research, one of the world’s leading manufacturers of 3D printers, with the support of the B2B Program of the Czech Development Agency, started a project whose goal is the socially beneficial use of 3D printing in the Gambia, especially in the field of healthcare and education. With the support of CzDA, the third largest 3D printing farm in Africa is being created in the Gambia. 

Prusa Research currently distributes its 3D printers to customers in more than 160 countries around the world. Independent institutions such as the 3D Printing Industry Awards or the Make Magazine has repeatedly confirmed the quality of the printers. Due to the exceptional quality of the products and the high level of innovation, the company with its automated 3D printing farm was included in the exposition of the Czech national pavilion at the international exhibition EXPO 2020 in Dubai

In 2021, the company won the “Country For The Future” prize awarded by the Ministry of Industry and Trade of the Czech Republic for the development of a filament with antibacterial properties. The Make3D company is also participating in the testing of this filament, which is planned to be launched on the market in 2022 and plans to use it, for example, for the production of prosthetic aids. “The benefit of 3D printing technology for developing markets lies primarily in the possibility of local decentralized production, whether it is spare parts or individually manufactured medical and educational aid. Compared to competing manufacturers, Original Prusa printers offer a whole range of functionalities that can be very well used in developing markets. This is mainly about easy repairability, including affordable spare parts, the so-called upgradeability, thanks to which it is not necessary to buy the entire printer when launching a new model, but only selected parts,” says project manager Jiří Průša, who as a volunteer in the past participated in cooperation with organizations People in Need or the Caritas Czech Republic to build digital literacy centers in several African countries. 

Other indisputable advantages of Original Prusa 3D printers for developing markets include the function of resuming printing after a power failure, which reduces waste (in the form of failed prints) and saves energy. To develop specific applications of 3D printing and the local market, from a sustainability point of view, the key activity is the construction of a competence center and an open workshop, which will be equipped with 3D printers.

“As the majority of goods in The Gambia are imported, 3D printing presents the possibility of creating decentralized small-scale production capacities that have proven effective during the collapse of supply chains caused by a sharp increase in demand for a specific type of goods (e.g. shields at the beginning of the Covid-19 pandemic) where 3D printing brought a quick and effective solution. Furthermore, 3D printing enables production to be moved closer to customers or users (patients, pupils, etc.) and their easier involvement in the product development process. This brings advantages, especially in the field of healthcare, where the need to transport a patient across a country with poor infrastructure is eliminated. Not to mention that transport can be a financial barrier to access to products and services for many customers,” explains Jiří Průša about the specific advantages of 3D printing for developing markets.

Although the small size of the market is a disadvantage for many entrepreneurs, due to its location, The Gambia has the potential to distribute goods and services to the sub-region. At the same time, its size makes it easier in The Gambia to achieve a systematic impact across the entire country. According to Jiří Průša, the establishment of a Gambian sub-regional 3D printing center will bring the potential for the re-export of know-how and technology and thus further add value to the business sector in the target country.

“During a recent business trip to The Gambia, we held a workshop on assembling printers. As part of the workshop, six printers were assembled, with the fact that thanks to the B2B Program, participants now have the opportunity to get a printer for free for a week or for the duration of their projects. For me, it was a pleasant surprise how the young people took on the task of assembling the printer and how passionate they were. I think that especially for girls who never held a screwdriver or pliers in their hands, building a printer was a great motivation and a way to increase their self-confidence,” adds Jiří Průša.

As part of this work trip, it was also agreed that a seminar focused on the use of 3D printing in medicine will take place in September. As part of that seminar, we plan to connect Czech and Gambian doctors regarding the use of 3D printing. The institution that has effectively adapted 3D printing in medicine in the Gambia, the Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine (MRCG at LSHTM) has shown interest in sharing know-how in this area.

According to the founders of Make3D Silvestre Tkáč and Fatou Juka Darboe, one of the obstacles to the access of especially young people to 3D printing and other technologies is the price. To make 3D printing more accessible, as part of a project supported by the Czech Development Agency, the Make3D company launched the “3D printing for trial” program, which will allow schools, after-school activity clubs, as well as individual interested parties, to test this technology at affordable prices.

Among the key final beneficiaries of the project is the Make3D company, on whose premises the competence center and the open workshop will be built. Make3D has already achieved several successes in the field of 3D printing in The Gambia, including the development and certification of a humerus plate in collaboration with a leading local orthopedic surgeon (Dr. Kebba S. Marenah). Also thanks to this innovation, Make3D reached the finals of the Royal Academy of Engineering Africa Prize 2021. This company will also benefit from the new business opportunities that the socially beneficial use of 3D printing offers. The beneficiaries of the project will also be representatives of the healthcare sector, both local hospitals, and healthcare facilities, as well as relevant authorities (e.g. Medicines Control Agency), for whom targeted workshops and possibly consultations will be prepared. In the field of education, 3D printing is already part of the concept of development of primary, secondary, and higher education. The project will demonstrate the benefits of using 3D printing to representatives of educational institutions and responsible authorities, e.g. using the example of individualized teaching aids (map of the Gambia, etc.). Finally yet importantly, the beneficiaries of the project will also be young Gambians interested in technical education, who will be able to participate in workshops or use the open workshop. Make3D regularly opens up opportunities for young Gambian entrepreneurs and makers in collaboration with the International Trade Center and the United Nations Development Program Acceleration Lab.

The main long-term goal of the project and of Prusa Research a. s. is the development of the use of 3D printing for socially beneficial purposes. For this purpose, an educational video will be created as part of the project and is expected to be used significantly beyond the duration of the project. “We believe that specific examples of the use of 3D printing in developing countries will also become an inspiration for non-profit organizations that will incorporate decentralized production options into their activities and projects,” concludes Jiří Průša. A model of a keychain was prepared for potentially interested parties, especially from the ranks of development cooperation project implementers, which can be used, for example, to mark property acquired in the project instead of using stickers. Following the principles of Prusa Research, this model is freely available to other interested parties on this link.