HEALTH CLUSTER BULLETIN June 2016

Daw Nan Sint Sint Khaing visits a patient at Waing Maw hospital, Kachin State. Photo: UNFPA Life-saving reproductive health services and gender-based violence care provided in Kachin State In hard-to-reach areas of Kachin State like Moe Guang address the reproductive health needs of women in and Waing Maw townships communities have very these communities. limited access to basic health care, and women of reproductive age are particularly affected. To ensure Prevention and response to the consequences of that life-saving reproductive health services are sexual violence is also an essential and life-saving accessible and available to both displaced and local component of reproductive health interventions. populations in these areas, Health Cluster partners From 25th to 27th May 2016, UNFPA held a ‘Clinical UNFPA and Myanmar Medical Association (MMA) have Management of Rape Treatment and Gender- joined forces on a project addressing these key health Based Violence Workshop’ in Myitkyina, for 30 needs. To date, 3,099 women and 495 men have Government Health Staff including doctors, nurses accessed reproductive health services, which include and midwives from surrounding townships, in close family planning, health education and emergency coordination with the Gender-Based Violence (GBV) referrals through mobile health clinics and health sub-sector. Topics covered included the management facilities. Of this total, 857 women have received of gender-based violence cases and the review of antenatal and postnatal care, and 400 Clean Delivery reproductive health kits, how to set-up clinics and kits have been distributed to pregnant women. provide support to GBV survivors, the administration of post-exposure prophylaxis (PEP) and how to treat Funded by the United Nations Central Emergency rape survivors at clinics. Response Fund (CERF), this project prioritizes strengthening the capacity of health staff to deliver Daw Nan Sint Sint Khaing, who attended the quality reproductive health care. Training and workshop, has worked as a nurse for four years and on-the-job orientation on the Minimum Initial is now at Waing Maw Township Hospital. “During the Service Package (a set of key activities needed to workshop, we learned how to treat and support rape respond to reproductive health needs during crises survivors. We were able to share our experiences and emergencies) and on the use of Emergency and learn from each other. Returning to work, I feel Reproductive Health kits have provided MMA confident to put what I have learned into practice.” health staff from Waing Maw and Moe Gaung For more information, please contact: Township Hospitals with the skills and tools to better Dr Ye Myint Oo at [email protected]

Health Cluster Bulletin, Issue 3 || Page 1 Improving nutrition services for conflict-affected communities in Rakhine State

Ensuring adequate nutrition for Patients’ stories the most vulnerable sectors of the population is at the basis of health “ My name is Arr Mi Nar Har Thu and I live in Pauk Taw Township, service provision in emergency Sin Tet Maw Camp. I am twenty-seven years old and I have five settings. Good nutrition and children. One of my children was often ill and much thinner than the others. One day, my friend told me about Myanmar Health food supply can go a long way Assistant Association: they have a clinic and provide nutrition in preventing the onset of many services in our camp every Thursday. After he told me, I brought diseases, and targeted nutrition my daughter to the clinic. MHAA’s staff registered and checked- interventions can ease the burden up my child - they told me she was suffering from moderate of acute and chronic malnutrition acute malnutrition. amongst the population. They gave me her registration card, some medicines and one Currently, Myanmar Health pack of wheat-soya blend (WSB) supply. They explained how to Assistant Association is the only prepare the WSB and provided other information on nutrition. non-governmental organisation Now, I feed my child regularly and she is getting better. I went regularly to MHAA clinic, and after nine weeks they measured her providing health and nutrition again and told me that she is now well nourished. services for conflict-affected ” people in remote areas of Kyauktaw, Mrauk U and Minbya teams also facilitate the emergency Through their health and nutrition townships, in Rakhine State. referral process for patients and interventions, they are able to reach Funded through the Emergency provide support for transportation out to underserved communities Response Fund (ERF), the MHAA fees. in remote areas of the state, and project provides mobile clinics with provide health education sessions doctors, community nurses and MHAA has been working in in addition to health services. Their community health workers, well- humanitarian health and nutrition interventions are often life-saving equipped with adequate medicine projects in all affected townships for the children living in those supplies and transportation in Rakhine State since 2012, with areas. vehicles. In addition to providing funding supports from UNICEF, health and nutrition services, the WFP, WHO and ERF (UNOCHA). Similarly to Arr Mi Nar Har Thu’s daughter, Yarzin Arafa’s 3-year- old son also received treatment at one of MHAA’s mobile clinic. The staff measured his son’s medium upper arm circumference and told Yarzin he was malnourished. They provided him with medicines and food supplies, and explained him how to properly feed him. “I always followed the instructions given by MHAA staff. For five weeks, I went to MHAA camp clinic regularly. And I noticed that my child was getting remarkably fatter and healthier”, Yarzin said.

For more information, please contact: Dr Thant Zin at [email protected].

MHAA staff visit patients in mobile clinics. Photo: MHAA

Page 2 || Health Cluster Bulletin, Issue 3 Health emergency preparedness and response: strengthening capacities and activities in Rakhine State

A child walks through the mud of his village in Rakhine State after Cyclone Komen in 2015. Photo: WHO

Reinforcing government capacities and preparedness Basic Health Staff on ‘Disaster Risk Reduction and for health emergencies and disasters was the focus Emergency Medical Responses’, to be completed of a high-level workshop held in Sittwe by the in coming months. The State Health Department Rakhine State Health Department in May 2016. The in collaboration with ICRC developed the training workshop was chaired by the Social Minister of the modules, and Township Medical Officers act as Rakhine State Government, Dr. Chan Thar, and saw facilitators for their respective townships. Health the participation of State Health Director Dr. Thaung Cluster partners are also facilitating the implementation Hlaing, key SHD officials, the Medical Superintendent of training activities: ICRC supports training in of Sittwe General Hospital and acting State Director Maungdaw, Buthidaung, Pauktaw, Kyauktaw, (Medical Services) Dr. Shwe Thein and other hospital Minbya, and Mrauk-U townships; IOM covers Sittwe officials, as well as Township Medical Officers or and Kyaukpyu townships, while Relief International their representatives from all seventeen townships supports training activities in Myebon township. in Rakhine State. It was organized and facilitated by the Deputy State Health Director Dr. Aung Thurein Lastly, an assessment of emergency medical and supported by the International Organization for response teams and resource mapping for Migration (IOM), the International Committee of the health (human resources and functionality of Red Cross (ICRC) and the World Health Organization. health facilities) was also conducted. Plans for a more comprehensive approach to the use of A review of Disaster Risk Reduction (DRR) medical teams – for instance, conducting rapid activities in light of global and national frameworks health needs assessment in addition to providing was a central part of the workshop, given the “critical health services, in order to coordinate more quickly importance” of these activities in a disaster-prone with Township or State health authorities – were area such as Rakhine State - as noted by Social discussed. Standard Operating Procedures defining Minister Dr Thar in his opening remarks. Myanmar- the activation of such teams and their roles and specific documents and tools like the National Disaster responsibilities with respect to other government first Management Law and the Myanmar Action Plan on responders such as search and rescue, fire brigade, DRR were discussed and reviewed, also considering coastal guard teams will be developed. The issues the lessons learnt from the health impact of Cyclone discussed during this workshop will contribute to Komen in August 2015. the development of State Health Plan, in line with the identified priorities of the Ministry of Health and Strengthening health workers capacities in Sports for the first 100 days of the new government. disaster response was also a prominent item on the agenda of the meeting. Participants agreed on For more information, please contact: Dr Allison Gocotano the need to conduct capacity building training for all at [email protected]

Health Cluster Bulletin, Issue 3 || Page 3 HEALTH NEWS Rakhine State Health Department responds to Gastroenteritis outbreak in collaboration with Health Cluster partners

Between 11th and 17th May A team led by State Health were conducted in the affected 2016 a localized outbreak of Department and TMO Ponnagyun communities by the Township Gastroenteritis virus affected joined by representatives from Medical Officer of Ponnagyun. residents of Ponnagyun Township, WHO, UNICEF and International WASH items (e.g. hygiene kits, Rakhine state. A total number of Rescue Committee (IRC) visited the sit-down toilets, water pipes) 18 cases were reported among affected villages, noting the health were provided by the State Health displaced and host populations of requirements of the population. Department with logistics support the township, out of which two from UNICEF, IOM, OCHA and deaths were recorded. In the following days, Médecins WFP. Sans Frontières (MSF), IRC, The response to the outbreak OCHA, UNICEF Health and Clinical tests proved negative was well coordinated between WASH, UNHCR and WHO met to for both cholera and rotavirus. government health authorities discuss immediate action plans: Thanks to the smooth collaboration and health cluster partners, as in coordination with the State between Rakhine State health well as OCHA and partners from Health Department, health cluster authorities and international and other clusters. The State Health partners supported the referrals of local health partners, the outbreak Department called for a joint patients to Ponnagyun Township was managed effectively and mission to the affected areas on Hospitals (MSF) and the provision quickly brought under control. May 13th, after receiving notification of health services through mobile of the outbreak by Ponnagyun clinics (IRC and MSF). In addition, For more information, please contact: Township Medical Officer (TMO). health education sessions on Dr Allison Gocotano at hygiene and diarrhoeal diseases [email protected]

Union Minister of Health and Sports Dr Myint Htwe illustrates priority areas during Rakhine visit On June 1st 2016 a public forum including upgrading Sittwe General and other respective specialised was held in Sittwe for the visit of Hospital (500 bed hospital) with societies) and improving channels a team of Union Ministers led by specialists and medical officers for public discussion and listening Lt General Ye Aung, Union Minister and reinforcing health facilities to the communities. of Border Affairs. The discussion in Myaung Bway (Mrauk-U) and was focused on socio-economic Maungdaw townships. Additionally, two other issues development activities in Rakhine were identified as a priority for State. Dr Myint Htwe, Union The four priority areas identified by the Ministry of Health and Sports: Minister of Health and Sports, was Dr Myint Htwe for the state focus health promotion in communities part of the team. on Health Systems Strengthening, and School Health programs Human Resources for Health (with focused on prevention and early Amongst the different issues a particular focus on incrementing intervention with adolescents discussed, Rakhine State Obstetric-Gynecological nurses against drinking, smoking, and Government officials presented and midwives), updating Standards other health risk factors, to be the plans to upgrade and of Practice including treatment implemented in collaboration with improve Hospitals and other guidelines (in collaboration with the Ministry of Education. health facilities in Rakhine State, Myanmar Medical Association

For more information on health cluster activities, please contact: Dr Jorge Luna, WHO Myanmar Representative Email: [email protected] Phone: (95-1) 650405-406 GPN: 24214 World Health Organization, n 2 Pyay Road, 7 Mile, Yangon Health Cluster Bulletin, Issue 3 || Page 4