Areas of Work - Border Health (Thailand-Myanmar)

Report of Cases and Deaths in CampsAreas of Work

Border Health (Thailand-Myanmar)

Border Health Meeting 2004

Border Health Meeting 2005

Overview of Thai/Myanmar Border Health Situation 2005

Border Health Information

The Border Health Programme of WHO Thailand was newly formed in 2001. Initially funded by DFID for a two-year period, the program has been extended for two more years. The targeted geographical areas are the ten provinces in Thailand which border Myanmar. This area is comprised of nearly 7 million Thais and approximately 117,379 persons registered in nine UNHCR-run camps. In 2004, 400,888 migrants were registered by the Ministry of Interior in the ten border provinces. This number includes workers, spouses and children. Of these, 208,613 migrants registered for work permits as of 15 December 2004. In addition, as many as 500,000 undocumented migrants have been estimated to live in these ten provinces. This latter group creates the largest public health concern, as many undocumented migrants do not have access to health services, have increased morbidity and present a number of public health risks, such as low immunization rates.

Map of Thailand

Population of the Provinces in Thailand Bordering Myanmar

Province	Province Population¹	Registered Migrants²	Registered Migrants who Have Work Permits³	Registered Camp Population⁴	Est. Non-reg. Migrants⁵
Chiang Rai	1,244,564	32,725	13,061	0	20,000 to 40,000
Chiang Mai	1,599,538	82,959	48,502	0	30,000 to 80,000
Mae Hong Son	239,128	8,818	2,080	47,920	10,000 to 30,000
Tak	503,042	124,618	50,961	57,024	50,000 to 100,000
Kanchanaburi	799,588	32,391	14,647	3,407	20,000 to 70,000
Ratchaburi	832,005	20,307	16,070	8,353	10,000 to 20,000
Phetchaburi	461,539	5,333	3,802	0	5,000 to 10,000
Prachuap Khiri Khan	490,479	14484	11,093	0	5,000 to 15,000
Chumphon	475,467	23,504	18,239	0	15,000 to 20,000
Ranong	163,298	55,749	30,158	0	20,000 to 70,000
Total for 10 provinces	6,808,648	400,888	208,613	116,704	300,000 to 500,000
Total for Thailand	62,936,819	1,280,053	814,247	119,109	> 1,000,000

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.

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