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Cross Learning Field Visit Kanchanaburi Province, Thailand 14 - 15 September 2018

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Cross Learning Field Visit Kanchanaburi Province, Thailand 14 - 15 September 2018 Cross Learning Field Visit Kanchanaburi province, Thailand 14 - 15 September 2018 American Refugee Committee, host of the Malaria CSO platform with support from platform partner Raks Thai Foundation organized a learning visit last 14-15 September 2018 in Kanchanaburi Province, Thailand which is one of the RAI2E implementing areas along the Thailand-Myanmar border. The main objectives of the visit were to interact with community people malaria volunteers, community leaders, and malaria risk population and service providers and identify the success and challenges at the field level, and document evidence of success and challenges in RAI2E implementation and share to the RAI RSC .Meeting/discussion with project staffs, volunteers, public health officers, Village Malaria Worker (VMW), Mobile Malaria Worker (MMW) and community people were organized during the visit . This report was developed as part of a collaborative cross learning field visit activity coordinated by RAI RSC CSO platform in GMS. The activity enabled RAI RSC CSO representative and other CSOs to interact with and learn from each other, allowing them to view and share practical experience of best practice, challenges and success in malaria response. This report is based on observation in the RAI implementing districts of Kanchanaburi and cannot be generalized for other areas. ARC on behalf of Malaria CSO platform would like to thank you for the generosity of the individuals and partners for their support to this visit. About the platform The Regional Malaria CSO Platform in the Greater Mekong Sub-region (GMS) is a network of Civil Society Organizations (CSO) from the Global Fund RAI implementing countries: Myanmar, Thailand, Cambodia, Lao PDR, and Vietnam. The Platform serves as the CSO constituency engagement mechanism for the RAI RSC. ARC is the host of the platform for 2018-2020. For more details, please visit www.malariafreemekong.org Report: Cross learning field visit, Thailand, 14 – 15 September 2018 1 | P a g e Visit Summary ARC as a CSO platform host organized the cross learning field visit on 14th – 15th September in Sai Yok and Mueang district of Kanchanaburi, Thailand in partnership with Raks Thai Foundation (RTF). RAI RSC CSO Representative Louis Da Gama joined the visit together with representatives of Raks Thai, platform secretariat and ARC. Kanchanaburi Province, Thailand Kanchanaburi province is located 129 kilometers from Bangkok and covers a total area of approximately 19,483 km2, with a total population of 848,198 (2014). The province has mostly mountains and hilly terrains, shares borders in the west with Kayin State, Mon State, and the Tanintharyi Region of Myanmar. Kanchanaburi has large number of Mon ethnic community and host big number of migrants from Myanmar. Most of them are working in farm in Kanchanaburi. Phu Nam Ron crossing border, located in in Ban Kao sub-district, Mueang district, Kanchanaburi province is 1 of the 4 of Thai/Myanmar border official points. The Phu Nam Ron border crossing is the most direct route into Myanmar from Bangkok. Phu Nam Ron is a pass across the Tenassarim Hills on the border between Thailand and Myanmar to Htee Kee which is the town in the Tanintharyi Region on the Myanmar side. This crossing border is expected to gain in importance if the planned Dawei deep- sea port project goes ahead, which includes a highway and a railway line between Bangkok and that harbor. Meeting with ARC staff In order to get update on the malaria situation and challenges at the district level, a meeting with ARC field team was conducted. Based on the online information from January to September 2018, Kanchanaburi Province has 110 malaria active foci from 70 villages in 7 districts wherein Bong Ti sub district is one of those with 11 active foci in 3 villages. ARC is implementing RAI2E project in Kanchanaburi as a sub recipient under the management of Raks Thai Foundation. The project started in June 2018 due to delayed grant signing. ARC targeting risk population in the community and work site with community mobilization, awareness raising and referral activities. Report: Cross learning field visit, Thailand, 14 – 15 September 2018 2 | P a g e Bong Ti sub-district Approximately 474 families are living in Bong Ti, 60% of them are Thai and the rest are non-Thai. Bong Ti is 1 in 3 of the sub-districts in Sai Yok district which reported the most positive malaria cases this year according to ARC staff who have been working on the project. There were about 200 of malaria cases reported from January – September this year. ARC has its Border Malaria Corner (BMC) at Phu Nam Ron border point in Mueang district The BMC is managed by volunteer working closely with malaria clinic. The purpose of BMC is to provide malaria service information to mobile migrant population. Decreased budget for these specific activity from RAI phase to this RAI2E phase, the budget for 1,500THB/quarter, ARC managed to have the activity happened as much as possible to service to those target group. ARC volunteer screen people passing through this screening point and refer suspected malaria case to the nearest health facility for testing and treating. The NGOs in Thailand are not allowed to do malaria test and treatment due to set guidelines. Bong-Ti Bon village Majority of people in this village are Karen by ethnicity, half of the villagers are Thai nationality. Villager speak both Thai and Karen language. The village is in the condensed forest area near Myanmar border putting community at risk of malaria. ARC has volunteers who can speak Karen, Thai, and Burmese and they are providing health education to those community in their own language. Field visit team had a chance to observe one of the health education session which was conducted in Karen language. Report: Cross learning field visit, Thailand, 14 – 15 September 2018 3 | P a g e Health Promoting Hospital (HPH) -Bong Ti Team visited the Health promotion hospital in Bong Ti. This HPH covers 4 villages which composed around 6,000 people and 4,000 of them are non-Thai. Hospital service is free for those has legal document or ID card, but for those who do not have an ID required to pay 30 baht for the registration. The closest hospital from HPH-Bong Ti is 27 km away. The hospital provides malaria testing The field visit team met the leader of HPH-Bong Ti to discuss health issues services but not treating positive case at under the services areas the hospital. All the positive case is referred to the nearest Malaria Clinic for treatment, according to the HPH officer. Meeting with Malaria Post Worker (MPW) Meeting with malaria post volunteers was organized to understand malaria situation in the front-line level and knowing its challenges. Malaria Post is managed by the government and the volunteer working in the MP can test (by RDT) suspected malaria case. Malaria post worker provide service during the morning and the evening and most of people using this service are people living in the villages. The number of malaria positive case in Sai Yok district has increased compared to the same period last year according to the volunteers. One of MP volunteers who work in Wang Gra Jae sub-district reported that, since January to September this year, there were around 29 malaria positive cases had been tested (unofficially documented). Most of the cases are found among villagers who work in forest and farm. Most people in this district work in the forest and cross border to Myanmar regularly. Malaria post volunteers showed their concern on delayed LLIN distribution as the LLIN was not 6 lanes road from Bangkok, Thailand to Dawei, Myanmar to the deep-sea port project are under constructions distributed during high malaria season. Malaria Clinic (MC), Mueang district Field visit team had visited the Malaria Clinic near the Thai-Myanmar border in Phu Nam Ron village of Mueang district. The visit team met MC officer and also observe movement on the border Report: Cross learning field visit, Thailand, 14 – 15 September 2018 4 | P a g e and understand the malaria situation. The clinic is located 4-5 kilometers far from the border and provides malaria test and treatment services. According to the MC officer, malaria positive cases has increased compared to the same period last year. Most of the cases are migrants who cross the border on daily basis. From June until 15 September 2018 (saying as rainy season according to the officer), there were 10 positive malaria cases per month, only P.v cases were found in this clinic up to now. During the discussion with the MC officer, the team was informed that there was irregular drug supply in the past. The clinic had limited antimalarial drug when the visit team was there. It was mentioned that migrant case was higher than estimated having impact on increased commodity needs. The MC officer emphasized the need for increased health education, and frequent activities in the community for prevention and awareness raising. In addition, it was noted that construction work is ongoing in Kanchanaburi's special economic zone (SEZ), linking to Dawei deep-sea port project. Most of workers in SEZ construction area are migrant from Myanmar. The SEZ is strictly limited access, therefore, no health education session nor do specific health services reach this area. There is a cross-border collaboration between Myanmar and Thailand governments for information sharing and joint activities to response health issues. The local organization Pitakkarn Foundation is providing needed health assistance to mobile and migrant population on the border. In addition to job seeking opportunity, many people from Myanmar is coming to Kanchanaburi to meet their family, for trade, business and health services.
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