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While some members of the at-risk migrant population
live in settlements, others are highly mobile, moving back and forth across
the border. This raises increased concerns over the transmission
of disease, such as multi-drug resistant tuberculosis and drug-resistant
malaria. Malaria is a particular concern in the border
provinces. While the border provinces account for about 11% of the
population, they report nearly 70% of the malaria cases in Thailand.
A number of humanitarian organizations are working along
the border. The key health-related international organizations
working in the border area include MSF France, ARC International, Aide Medicale Internationale, Malteser Germany, World Vision, Border Action Against
Malaria, CARE Raks Thai, The International Organization for Migration (IOM),
The International Committee of the Red Cross (ICRC), The International
Federation of Red Cross & Red Crescent Society (IFRC), The International
Rescue Committee (IRC), UNICEF, UNFPA, UNHCR and WHO.
The Border Health Programme focuses its
activities on improving the health of the population by improving
coordination, strengthening data collection, building capacity and sharing
information. Particular emphasis is placed on the health of
the vulnerable population groups such as undocumented migrants living outside
the camps.
Improving Coordination
The
Border Health Programme (BHP) strengthens
coordination between government, NGOs, UN agencies, researchers, donors and
others committed to improving the health of the population in the
Thai-Myanmar border area. A Border Health Meeting, where
information is exchanged and targeted issues discussed, is held
annually. This border-wide meeting also includes an exhibition on
border health activities and organizations. The first meeting was held in Mae
Sot in 2002. The second was in Ranong in 2003. The
2004 meeting was held in Chiang Mai, and the 2005 meeting was held in Kanchanaburi on March 17 and 18, preceded by site visits
on March 15 and 16.
The BHP supports ongoing Provincial Health Coordination Meetings
between Provincial Health Offices and NGOs in border
provinces. During the past two years, provincial health
coordination meetings have been held in Kanchanaburi,
Tak, Ranong, Prachuab Khiri Khan, Chumphon, Mae Hong Son, Chiang Rai and Chiang Mai Provinces.
Working with Policy and Strategy at the MOPH, an effort has been made to
identify appropriate capacity building skills needed to strengthen
Provincial Health Coordination Meetings. A Field
studies from this initiative contributed to the development of the MOPH’s Master Plan for Border Health.
The BHP and UNICEF co-host a UN Border Health Coordination
Meeting with the Ministry of Public Health every other month.
The BHP supports cross-border meetings between Thailand and Myanmar public health officials at the
local level. The first meeting was
held June 24, 2005 in Mae Sot, Tak.
Strengthening Health
Information System
The BHP supports the strengthening of the health information system in the
border areas to better identify public health problems, placing special emphasis
on the data collection of undocumented migrants living outside the
camps. NGOs and the MOPH have developed a standard data collection
form, common case definitions and an agreed-upon communicable disease
reporting system for the border camps, and the BHP continues to support this effort. A current copy of report of cases
and deaths of selected notifiable diseases in
border camps is available.
The BHP is supporting a related data collection effort outside the
camps. In cooperation with the Bureau of Epidemiology, a migrant
health data technical officer has been hired. The migrant
health data officer has, in coordination with partners, developed a data
collection tool for use outside the camps, field
tested the tool, and organized data coordination meetings.
A Border Health Joint Assessment Committee has begun meeting
regularly and provides input and direction to the migrant health data
technical officer. A border-wide health assessment will be conducted in 2005.
Building Capacity
The BHP
distributes technical publications and
information to health workers in the border areas.
In cooperation with the Bureau of Health Service System Development of
the MOPH, the BHP has supported the design and development of a standardized
maternal/child multi-lingual medical records book for use in the border
areas. This booklet is currently being distributed.
The BHP regularly hosts technical meetings to address specific
public health problems in the border areas. A meeting
on the national malaria drug policy was held in May
2004. A TB Border Health Meeting was held in October 2004 and the
Malaria Border Health Meeting was held in November 2004. These meetings have
been attended by health professionals from both Thailand and Myanmar. An HIV/AIDS, Nutrition,
Maternal and Child Health and Reproductive Health Border Health Meeting is planned for November 2005.
The BHP supports outreach activities to vulnerable populations
living in Thailand. The BHP is
collaborating with the Ministry of Public Health and the International Organization for Migration for
improving primary health care services to migrants in the border areas. The
BHP has supported the preparation of two Thai/Myanmar cross-border Global
Fund proposals. The BHP is facilitating cross-border training activities
between Chiang Rai Provincial Health Offices and Myanmar (Yong Kha).
The BHP serves in an advisory capacity to AMI’s
Health Messenger, a distance learning magazine for ground-level health
workers in the border area and supported the publication of the June 2004 Health
Messenger issue devoted to water and sanitation and the June 2003
issue on emergency preparedness and response.
WHO and IOM have collaborated to develop a desk review, HIV
vulnerability assessment, and survey of labour
migration patterns among priority Myanmar migrant populations in Thailand. Supported with UNAIDS funding, the project begins in
2005.
Sharing Information
The BHP
maintains banks of information on multi-lingual health education materials
available in the border area and health
studies and assessments conducted in the border area.
A Border Health Report, “Overview of
Thai/Myanmar Border Health Situation 2005”has been produced.
It contains health statistics, information on provinces, organizations, and
list of health educational materials. It is also available on CD.
Links
Data Sources
Mekong Basin
Disease Surveillance
Bordercamps
Studies and
Assessments
Health Access
Meeting
at the Crossroads: Myanmar Migrants and Their Use of Thai Health Care Services
Malaria
Cultural and
Behavioral Factors Related to Malaria Transmission and Control
Current Situation of Malaria
along Myanmar Border
Current
Situation of Malaria along Thailand Border
Malaria
epidemiology and control in refugee camps and complex emergencies
Combination
therapy for malaria
Effects
of malaria during pregnancy on infant mortality in an area of low malaria
transmission
Effects
of artesunate-mefloquine combination on incidence
of Plasmodium falciparum malaria and mefloquine
resistance in western Thailand: a prospective study?
Adverse
effects in patients with acute falciparum malaria
treated with artemisinin derivatives
Mental
Health
Karenni refugees living in Thai
Burmese border camps: traumatic experiences, mental health outcomes, and social
functioning
Nutrition
Beri-beri: the major cause of infant mortality in Karen
refugees
Iron Deficiency
Is Unacceptably High in Refugee Children from Burma
Postpartum
thiamine deficiency in a Karen displaced population
Dietary assessment of refugees living in camps: A case study
of Mae La Camp, Thailand
Reproductive
Health/Family Health
Fertility
and abortion: Burmese women’s health on the Thai-Burma border
TB
Report
on the Thai/Myanmar border TB situation
Organizations
Aide Medicale
Internationale (AMI)
ARC International (ARC)
Border
Actions Against Malaria (BAAM)
CARE Raks
Thai Foundation
International Committee of the
Red Cross (ICRC)
International Federation of the
Red Cross & Red Crescent Societies (IFRC)
International Organization for
Migration (IOM)
International Rescue Committee
(IRC)
Medecins
Sans Frontieres (MSF)
Malteser
Germany (MHD)
Shoklo
Malaria Research Unit (SMRU) TB/HIV Research Project Thailand
UNHCR
UNESCO
UNICEF
WHO Health Action in
Crises
The Four Official Border Crossings Along Thai/Myanmar Border
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Tachilek-Mae Sai
Border crossing
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Mae Sot-Myawaddy
Border Crossing
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Three Pagodas Pass-Payathonsu Border Crossing
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Ranong-Kawthong
Border Crossing
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The BHP is part of the Emergency
Humanitarian Action/Health Action in Crises
technical unit of WHO
and is funded by
For more information, please contact emerson@whothai.org
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