Muang Nan Municipality Safe Community Thailand

Application to the World Health Organization, Collaborating Center on Community Safety Promotion for the Designation of

As a Member of the International Safe Community Network

Contents

Congratulation messages 3

General Information

1. Introduction 6

2. About Nan Province 7

3. Background of Muang Nan Municipality Safe Community 8

4. The Commencement and process of Community 13

Indicators for International Safe Community

1. An infrastructure based on partnership and collaborations, 17 governed by a cross- sectional group that is responsible for safety promotion in their community

1.1 Working Group of Safe Community 17

1.2 Collaborations and Networks 19

1.3 Financial Support 19

1.4 Media and Communication 19

2. Long-term, sustainable programs covering both genders and all 22 ages, environments, and situations 2.1 Programs for different age groups 23

2.2 Road Safety 26

2.3 Drowning Prevention 30

2.4 Improvement of Emergency Response, Disaster Prevention 33 and First Aid Capacity

2.5 Safety and injury prevention during festivals 40

2.6 Safety in Sport and Recreation Safety 45

2.7 Violence and Abuse Prevention 46

2.8 Food and Product Safety 48

2.9 Home Safety 51

2.10 Occupational Safety 52

2.11 Others in associated with safety and health promotion 53

3. Programs that target high-risk groups and environments, and 55 programs that promote safety for vulnerable groups 3.1 Child Safety 55

3.2 Elderly Safety 71

3.3 Environmental risk 73

4. Programs that document the frequency and causes of injuries 76

4.1 Injury Record system 76

4.2 Safety Round system 87

4.3 Risk Behavior Record system 88

5. Evaluation measures to assess their programs, processes and 89 the effects of change 5.1 Evaluation by External Agencies 89

5.2 Internal Evaluation 90

6. Ongoing participation in national and international Safe 95 Communities networks 6.1 Participation in Domestic Conference 95

6.2 Participation in International Conference 98

6.3 Inspection and Field Trip 99

6.4 Award and outstanding performance 99

Future plan 101

Congratulation Message from Nan Governor

I feel love and appreciate the Nan Province as a city with full of fascinating and unique culture. Nan is a peaceful city where people have a simple lifestyle and are generous. Nan is a safe city where domestic and foreign tourists in an increased number can feel safe and secured wherever they visit. In order to ensure Nan is a safe city, it is greatly required the cooperation of local people. Members of communities should be able to participate in every step starting from planning, decision making, utilizing local valuable resources, implementing by local people to create a continual risk management system and preventive action plans. To achieve the extent of safe community, the communities must be empowerment, have a network integration, strong lateral collaboration, and decisive determination in achieving safe community in conformity with the World Health Organization (WHO) indicators. The management of safe community project in Nan province has been operated under the basis of cooperation and strong partnership networks from a variety networking teams. The operations have been appropriately adapted into the context of community and its needs. The operations also focus on creating long term safety awareness by providing knowledge, understanding, skills, and promoting safety culture and climate in community. For example, the persuasions of having local lifestyle and cultural traditions on a safety basis, the public promotion campaign to ban alcohol consumption and sales during festivals, regulations on the service hours of entertainment places and children disallowance, the uncompromising control measures of games/internet shops, promotion of public security, public mind, security volunteers in communities. I sincerely congratulate Muang Nan Municipality and people in the municipality that have been joining the safe community programs intensively and consistently; all which bring about a safe and peaceful city, and delightful people.

I sincerely wish that the people in Muang Nan municipality will remain the communities in a sustainable safe practice forever.

(Mr.Chumporn Sangmanee) The Governor of Nan Province

Congratulation Message from the Mayor of Nan Province

What I can concern as being received an opportunity to be a Mayor from people in Muang Nan municipality is that the members of Muang Nan municipality all desire for safety. Communities in Muang Nan municipality are centuries-old communities in which the members in communities have long been connected together. Each community has its own fascinating and unique culture but also maintains the simple and meaningful lifestyle with a strong social capital. The safety operations in Muang Nan municipality have been based on the collaboration from a variety networking teams. However, the major mobilizing team is Nan hospital, Muang Nan municipality and community organizations in Muang Nan municipal. In safe community programs, we have created public safety knowledge and awareness that safety should be responsible by everyone in the community to make their own life and communities secured. All members are required to participate from the vision setting, planning, operating and results of actions. We have created a safe playground for children; as well as, safe child care centers, safe schools. We have promoted safe awareness and disciplines among members, including setting surveillance volunteers. We also have uncompromising measures to ban alcohol consumption during festivals which include prohibiting advertising signs, sales, and consumption of alcohol - beer in Muang Nan municipal. An effective system of flood prevention in the municipality, emergency and call center service for public complaints, safe toilets for the elderly, and community nurses to care for the health of people in the community are also set up. I would like to express my sincere thanks to Child Safety Promotion and Injury Prevention Research Center (CSIP) that enlighten us in creating safe community activities. Special thank is extended to the representatives from World Health Organization (WHO) on their assessment and for their valuable advice. I would also like to thank all the related networking teams, including people in Muang Nan municipality who participated in safe community program so that all communities in Muang Nan municipality becomes a safe, livable and pleasant community.

I hope that communities in Muang Nan municipality will keep going on the safe community activities from generations to generations in order that our communities can continue the sustainable development and can be a safety learning center in demonstrating to other communities which can finally be extended to the safety in provincial and national level.

( Mr. Surapol Thiansuttra) Mayor of Nan Province

Congratulation Message from the Director of Nan Hospital

Injury is a major problem that occurs with people of all age groups and genders. But injury is preventable. With the concerns about a large amount of suffer and loss caused by injuries each year, Nan Hospital, the agency responsible for health care, has collaborated with Muang Nan municipality and communities in promoting safety to people of all age groups in order to reduce preventable injuries which will lead to reduced losses and damages from the injury. To participate in solving injury problem, it requires injury data and analysis for implementation planning and to raise safety awareness of the individual. Only safety awareness and no life negligence can reduce the injury risk and lead to safety culture of all people in society. On behalf of the Director of Nan Hospital, I would like to express my appreciation for the dedication of community volunteers and staff in all organizations who have tried to create a safe community. Although we have tried to prevent the injury and raised the safety promotion at some extent, there are also many activities that we all must work together to further enhance the safety in communities.

I hope that the efforts from all of us to reduce losses-related injuries and enhance the longevity of Nan people as stated in the Muang Nan Municipal Vision as ‘The Town of Longevity’ will remain a better quality of life to all community members.

(Pisanu Kantipong) Director of Nan Hospital

Introduction

Accident and violence is a major cause of death in Thailand. Thai people died from accidents and violence about 43,000 people per year or at the mortal rate of 69/100,000. The highest mortal rate related to accidents and violence found in teenagers and young adults. In addition, accidents and violence is also a leading cause of death in children as well. Each year, there were children aged 1-14 years died from accidents and violence about 3,400 cases, representing a death rate of 22/100. Based on the significant rationales, Muang Nan Municipality in cooperation with safety networking agencies such as Nan hospital, Nan provincial police, Nan provincial social development and human security office, Nan children’s shelter, Nan education service area office 1, Nan army officers, communities and schools in Muang Nan municipality, agreed to implement the "Muang Nan Municipality, the Safe Community" program to encourage communities, schools and child centers to have proper safety management based on the self-learning center approach, the injury surveillance system integrated from Nan hospital to communities, the collaborations between public networks and local organizations in safety works to promote safety in individual, group and community level.

Nan Province

Nan is located in the upper north of Thailand. The province is adjacent with Lao People's Democratic Republic to the northern and eastern part, Uttaradit province to the south, and Phayao and Phrae province to the west. Generally, its geography is bordered by mountains from north to south, especially along the north-eastern border which is adjacent to Lao. Doi Phu Kha in Pua district is the highest pinnacle at 1980 meters height. The central of Nan are plain basin situated on the riverside. The major river in the province is Nan River, which origins from the north of the province and flows down to the Sirikit Dam in Uttaradit province, then joins with Ping River in Nakhon Sawan, and ends at the Chao Phraya River. There are also other important rivers such as Sa canal, Wha canal, Samun canal, Pua canal, Yang canal, Haeng canal, and so on. The province is populated by multi-ethnic people. Therefore, Nan province can be considered as a province of diversity. Nan is divided into 15 districts (Amphur), 99 sub-districts (Tambon) and 848 villages. 1. Muang Nan district in the center of the province. It is a small town and not densely populated. 2. Mae Charim district in the east of the province. There are lots of natural attractions in this district. 3. Ban Luang district in the west is adjacent to Phayao. People are sparse. 4. Na Noi district in the south is adjacent to Phrae. The major tourist attractions are Si Nan National Park and Sao Din Na Noi. 5. Pua district, the economic hub in the upper area of the province where is surrounded by mountains and situated with oldest attraction places and Doi Phu Kha National Park. 6. Ta Wangpha district in the central of the province is famous for weaving by Thai Lue villagers. The most ancient temple is Wat Nong Bua. 7. Wiang Sa district, originally was called Sa district is a gateway to the province. The attraction places are Doisawan waterfall, Wat Doichai and Wat Boonyuen. 8. Thungchang district is the historic landmark where it was the location of of the Communist Party of Thailand. The heroic monument of Thungchang people is situated. 9. Chiangklang district, a small district in the north is located with beautiful resorts for tourists. 10. Namuen District, the southern border of the province is adjacent to Uttaradit. The fishing villages living above Sirikit dam is an attractive sightseeing place. 11. Satisuk district is a small peaceful district in the east of the province and surrounded by mountains. 12. Bokuea district is situated with historical saline and assumed to be the ancient Muang Phu Kha. It is a major sightseeing place and attractive for rafting at Namwa canal. 13. Songkwai district, in the northwest of the province is adjacent to Phayao where the Thai-Lao border checkpoint is situated. The ethnic hill tribal villagers called Khamu are inhabited in this hilly area. 14. Phupiang district, close to Muang Nan district, is situated with Wat Phrathatchaehaeng. 15. Chalerm Prakiat district, in the northern of Nan province is inhabited with Thai hill tribe villagers and famous with growing source of golden oranges and a major Nan River.

Background of Muang Nan Municipality Safe Community

1. History In 1936, Government announced a royal decree to upgrade all communities where situated the city hall to be municipality. Therefore, Muang Nan has been upgraded to be Muang Nan Municipality on 11 February 1936.

2. Geography Largely, Muang Nan municipality covers with plain areas with the Nan River flowing through. There is no steep area. The area is densely populated on the average of 3,759 people per square kilometers. Muang Nan municipality is the center of provincial government agencies and all levels of educational institutes.

Map of Muang Nan Municipality Safe Community

3. Climate Muang Nan municipality is located in the southwest monsoon region. There are 3 seasons as following: • Summer starts in mid-February till mid of May when the north-pole faces the sun causing the hot weather in general and especially in April. In this season, even if the weather is hot and dry, but sometimes there may be thunderstorms, hailstorms or hailstones due to the cold air mass from China.

• Rainy season starts in mid of May till mid of October. The most prevalence rate of rain is in July and August. • Winter starts from mid of October till mid of February. The weather is cold and dry. The coldest month is around December to January.

Source: Meteorology Office of March 31, 2010

4. Area size Muang Nan Municipality covers the area of 7.6 sq.km and comprises of 31 communities as followings:

1. Ban Chang Kam 2. Ban Ming Muang

3. Ban Sri Pan Ton 4. Ban Apai

5. Ban Puang Payom 6. Ban Monthian

7. Ban Pai Lueang 8. Ban Hua Khuang

9. Ban Mongkol 10. Ban Pumin-Ta Lee

11. Ban Prayaphu 12. Ban Don Sri Serm

13. Ban Suan Hom 14. Ban Hua Wiang Tai

15. Ban Suan Tan 16. Ban Don Kaew

17. Ban Aranyawas 18. Ban Muang Len

19. Ban Ta Chang 20. Ban Prakerd

21. Ban Pranet 22. Ban Chang Pueag

23. Ban Sataros 24. Ban Mahapho

25. Ban Chiang Khaeng 26. Ban Nam Lom

27. Ban Pratu Plong 28. Suriyapong

29. Ban Don Sawan 30. Ban Fa Mai

31. Ban Suan Hom Moo 3 (Ban = village)

5. Neighboring districts

• North - - connecting with Tambon Faikaew Administrative Organization. • West - - connecting with Tambon Pa Sing Administrative Organization. • South - - connecting with Ban Prayawat, Tambon Du Tai Administrative Organization. • East - - connecting with Nan River.

6. Transportation • Road: Distance from Nan province to Bangkok is about 668 kilometers by the State Highway No. 1 Phaholyothin (Bangkok-Nakornsawan) passing Phitsanulok, Uttraradit, Denchai, Phrae, Nan. It takes about 8 hours from Bangkok. • Airway - By Karn Air (Chiangmai-Nan) - By Nok Air (Bangkok-Nan)

7. Population • Inhabitants There are 19,722 inhabitants in Muang Nan Municipality. There are 9,773 males and 9,955 females. Unregistered people are 5,000. (Source from Muang Nan Register Office on 1 June 2010)

Table of population data by number and gender

Year Male Female Total

2003 10,823 10,827 21,650

2004 10,069 10,455 20,524

2005 10,000 10,413 20,413

2006 10,013 10,362 20,375

2007 9,982 10,315 20,297

2008 9,912 10,269 20,181

2009 9,761 10,117 19,878

2010 9,773 9,955 19,728

2011 9,774 9,824 19,598

2012 10,668 10,609 21,277

• Households There are 8,651 households. Populated density are 3,759 persons/sq. km. • Occupation such as public officers, farmers, merchandizers, state enterprise employees and general works. • Religion Majority are Buddhists. • Education All received the compulsory education in the communities.

8. Infrastructure • Telecommunication Land lines and public land lines by TT&T PCL. and TOT Co.,LTD. • Electricity Accessible to every village supplied by Nan Provincial Electricity Authority.

• Water supply Water supply is serviced by Provincial Waterworks Authority, Nan Province (water source is from Nan River) • Artificial water sources Waste water treatment along Nan riversides

9. Networking Groups • Public Health Volunteer • Civil Defense Volunteer • Community Safety Guardians • Community Patrol Police • Drug prevention networking • Women and housewife group • Community Elderly Group • Village Heads Group • Juvenile council of Muang Nan municipality

10. Main destinations in community a. Public schools under Muang Nan Municipality authority - Jumpee Wanidaporn school (Ban Pumin Municipality) - Samakkee Wittayakarn school (Ban Pranet Municipality) - Darunwittay school (Ban Suan Tan Municipality) b. Schools authorized under Education Service Area Office 1 - Ban Don school (Sri Serm Kasikorn) - Rachanuban Nan school - Sri Nan Girl school c. Schools authorized under Office of Vocational Education - Nan Technical College - Nan Polytechnic College d. Private schools - Sinjong school - Nan Christian school - Nuntaburi Wittaya school - Yuwittaya school e. Day Cares - 4 day cares under Muang Nan Municipality authority - 6 private day cares f. Public Health - 1 hospital namely Nan hospital - 2 Public Health Service Centers - - Nan Dental Service Center and Nan Public Health Service Center - 14 private clinics g. Main destinations in community - 11 banks - 11 hotels - 1 cinema

- 9 department stores - 394 stores - 5 Market (2 municipality markets and 3 private markets) - 5 Petrol stations - 1 Bus station - 1 pawn shop - 35 Industrial factories (1 medium factory, 34 small factories) - 45 Public offices - Park / Stadium at 10 different sites.

11. Traditions, cultures, and beliefs • Culture and life style People have simple life style and hospitality. Majority use local language which is the cultural identity. There are many religious ancient places that have been well conserved till now such as Wat Pumin. • Cultural traditions such as - water-pouring ceremony to ask a blessing from respected elderly in Muang Nan municipality - Loykrathong Yipeng (floating paper lantern-balloons) - give food offerings to a Buddhist monk on religious days. • Major traditional festivals such as - boat racing festival / long-tailed racing for the King Cup, Alcohol free in boat racing - candle procession festival in the Buddhist Lent Day - Loykrathong free from alcohol and fireworks - Offering food to the monks with name label at Wat Changkam Worawiharn - Songkarn without liquor / Songkarn with no sexy singlet dress.

12. Strength of Community Due to the relatives and close relationship in communities, it highly influences the collaboration and empowerment from community members to the safe community works

The Commencement and process of Community Safety promotion is one of the major tasks of Muang Nan Municipality to achieve the public well-being and security in life. Bicycle project is one of the example safety promotions. The project was held by the cooperation between Muang Nan Municipality and Nan Hospital to build bike tracks in community and persuade community members to use bicycles in order to reduce traffic accidents, promote better health, save energy. The project was implemented successfully and resulted in benefits to all age groups, especially the children group. From this successful project and the other safety projects that Muang Nan Municipality have been implemented, Child Safety Promotion and Injury Prevention Research Center (CSIP), Faculty of Medicine, Ramathibodi Hospital, considered that Muang Nan Municipality should be promoted as safe community and be model of safe community to other communities. Concerning the child safety, Muang Nan Municipality has launched ‘Muang Nan Municipality - - Safe City for Kids’ with the subsidization from CSIP and other networks such as Nan Hospital, Nan Provincial Social Development and Human Security Office. The project focused on child safety and extended to cover all age groups in the community. Apart from that based on medical record of Nan Hospital, it revealed that without good surveillance system and injury prevention system, the incidence of injury would be more serious. Therefore, to prevent and reduce injury rate, ‘Muang Nan Municipality - - the safe community’ program has been launched to educate community members the understanding, knowledge and participation in safety promotional activities on a basis of public participatory, network cooperation either in the procedure of program or the budget of safety program.

1. Conceptual Framework

Procedure of Safe Community Program in Muang Nan Municipality

Analysis of Injury record in every community

Safe School, Safe Safe Community Child care center

Return injury Community find Injury/risk records to out preventive inspection community solutions

2. Procedure of Safe Community Program in Muang Nan Municipality

2.1 Created common understanding and network • Meetings for the guidelines of safe community program in Muang Nan Municipality, presentation report on injury record of community members to community heads, and for setting working teams for safety works in each community which were appointed by community heads on monthly basis. • Informed the public health volunteers at approximately 200 persons about the safe community program, and set a community health volunteer team for safey works in each communities on monthly basis.

2.2 Organized a committee for safe community A committee for safe community comprises of delegates of Muang Nan Municipality, Nan Hospital, government delegates, community heads, health volunteers and children.

2.3 Organized meetings for problem analysis The 32 communities of Muang Nan Municipality called for its own internal community meeting in brainstorming for problem analysis, detecting injury cause and risk in community, finding the improvement or adjustment, decentralizing and implementing the program on a network collaboration basis.

2.4 Inspection and problem analysis Working teams for safe community program carried out a safety round in their own communities such as a safety round in Ban Pranet community.

• Picture showed that with the road condition at T- junction in Ban Pranet it may blind the drivers and cause road injury, community solved this danger by marking clear traffic line to avoid crashing

• Picture showed burning injury associated with hot oil during cooking. It found that the cook talked with a guest during cooking. With carelessness caused fire ignitable and she was burned from hot cooking oil

• Picture showed the inspection of falling injury with a member in Ban Apai. Ms. Chujit was slippery in front the toilet that had water drop on floor

2.5 Safe community activities carried out by the communities Community participated in safe community programs to reduce all kinds of injury.

2.6 Network with outside agencies and cooperation Cooperated with outside agencies, public and private organizations namely Tambon Administrative Organization, provincial public health office, district public health office, and community networks.

2.7 Conforming the “13 steps for safe community”, the community: 1) take the interest and awareness on the injury prevention and set up the “Cross Sectorial Group” for safety works in the community. 2) able to network with outside agencies to find out the preventive solutions of each specific risk factors. 3) implement the “Unintentional Injuries And Intentional Injury Prevention” program, together with the safety promotion program. 4) have a deep observation to the high risk groups. 5) carry out the “injury surveillance system” 6) participate in “safety round” and “risk behavior monitoring” 7) promote the “safety equipment” 8) turn down the “hazardous products” and “hazardous environment” 9) deny the “risk behavior” 10) train and educate on the injury prevention, first-aids and basic rescues. 11) able to maintain a long run implementation plan under the existing resources and budget. 12) determine and conform to the safety indicators. 13) able to accumulate all the knowledge and experience to educate others.

2.8 Child Participation in Safety Promotion To promote child participate in safety activities and to be representatives in sharing safety knowledge among children and extend to community level.

Safe community of Muang Nan Municipality compliance to 6 safe community indicators

1. An infrastructure based on partnership and collaborations, governed by a cross- sectional group that is responsible for safety promotion in their community

2. Long-term, sustainable programs covering both genders and all ages, environments, and situations

3. Programs that target high-risk groups and environments, and programs that promote safety for vulnerable groups

4. Programs that document the frequency and causes of injuries

5. Evaluation measures to assess their programs, processes and the effects of change

6. Ongoing participation in national and international Safe Communities networks

Indicator 1: An infrastructure based on partnership and collaborations, governed by a cross- sectional group that is responsible for safety promotion in their community

1. Working Group of Safe Community

1.1 Safe Community Committee of Muang Nan Municipality Responsible for investigating causes of injury of each patient in the community which led to the preventive solutions. The community was also responsible for support and promoting people empowerment to safety activities. The committee took parts in disseminating safety news and disaster in the local and nation level. Members included public health volunteers from 28 communities and village representatives selected by village head. Issues about community safety would be brought up for discussion on monthly basis.

1.2 Committee of Muang Nan Municipality on Safe City for Kids Responsible for the regulations promoting safe city for kids with focus on injury reduction, decrease of risk environment and behavior. Members of this committee were separated into:

1.2.1 Working group for child death deliberation Responsible for child death deliberation in case of injury related death happened in Nan Province. Data collection of child death at age of 0-14 years, field study and site inspection, depth interview with parents of dead child, witnesses, policemen were carried out. Child death deliberation led to primary information for community development and risk management. Members included pediatricians, nurses, social welfare officers, psychiatrists and lawyers.

1.2.2 Working group for Community Injury Surveillance Responsible for • Injury surveillance in children at age younger than 2-6 years from child care centers of Muang Nan Municipality such as Suan Tan Nursery, Pong Sri Nursery, Benjamas Nursery, Lukrak Nursery, Ta Lee Nursery, and Denpanya Nursery. • Injury surveillance in students in 10 schools namely Sri Nan Girl school, Nunthaburi Wittaya school, Yuwittaya school, Nan Christian school, Racha Nuban school, Sri Serm Kasikorn school, Sinjong school, Darunwittaya school, Samakkee Wittaya school, and Jum Pew Wanitaporn school. • Injury surveillance in community by Nan hospital.

1.2.3 Sub-committee on risk surveillance and safe products Responsible for risk surveillance, risk inspection, detecting risk behavior, surveying risk products, collecting information from hospitals and police stations. Data analysis for preparing preventive action plans in particular product improvement to reach TIS standard (Thailand Industry Standard) and consumer protection.

1.2.4 Sub-committee on death investigation and drowning prevention Responsible for death investigation and deliberation either from external cause or abnormal death cause which may involve the problems on socio-economic situation, environment, caring or behavior. The process should include detecting whether any agencies or laws related. Data analysis and report to Child Protection Committee or any agencies associated with child safety and child drowning prevention.Provided information to public and caregivers in order to improve risk behavior and environment. Also provided swimming skills to children at age younger than 7 years.

1.2.5 Sub-committee on educating safety providers on safe villages, safe road, safe playground, stray dogs control and physical impact prevention Responsible for educating safety providers and providing skills in child safety, first aid, basic rescue to community members, schools, child development, caregivers, government officers, private sectors, hospitals, public health officers, civil defense volunteer.

1.2.6 Sub-committee on safe school Responsible for risk inspection in schools, injury record, injury analysis and injury preventive action plans all which led to safe school 6 aspects that are physical safety of children, safe daily activities in child care center, safe route to/from school and home, child right violation, disaster, skill learning and safety awareness.

1.2.7 Sub-committee on child care center and development Responsible for risk inspection, safety round in child care centers, injury record, child injury analysis, injury preventive plans all which led to safe kids in 6 aspects that are physical safety of children, safe daily activities in child care center, safe route to/from school and home, child right violation, disaster, skill learning and safety awareness.

1.2.8 Sub-committee on disaster prevention Responsible for disaster preventive action plans and practicing the plan, action plans in assisting injured persons and victims.

1.3 Child and Youth Council of Nan Municipality To promote child participate in safety activities and to be representatives in sharing safety knowledge among children and extend to community level.

Figure: Integration of Safe Community and Injury Prevention Networking in Muang Nan Municipality

2. Collaborations and Networks

2.1 Community networks • Public Health Volunteer • Patrol Policeman • Community Safety Guardians • Civil Defense Volunteer

2.2 Outside collaborations • Nan Municipality • Nan Hospital • Nan provincial police • Nan Provincial Social Development and Human Security Office • Nan Children’s Shelter • Nan Education Service Area Office 1 • Nan Army Officers • Provincial Administrative Organization of Nan

3. Financial Support subsidized by • Muang Nan Municipality • Local Health Insurance Fund • Nan Provincial Disaster Prevention and Mitigation Office • Nan Provincial Social Development and Human Security Office • Child Safety Promotion and Injury Prevention Research Center, Ramathibodi Hospital • Thai Health Promotion Foundation

4. Media and Communication

4.1 Publications The column on safety-related issues in local daily newspaper by Doctor Pongthep Wongwacharapaiboon.

4.2 Radio broadcast, local cable TV and local radio channe To disseminate news, information, safety molibization, injury data and injury prevention of each festival. • Radio broadcast with victims from road accidents-related the drunken drivers to promote public awareness on the danger of drunk driving.

• Informed people on alcohol and beer prohibit via local cable TV. and local radio channel ; including informed about injury and death data.

• Loi Krathong festival. Informed people injury incidents in Nan and other provinces via local cable TV.and local radio channel.

4.3 Websites The column on safety-related issues in www.facebook.com

4.4 Others • Installation of warning signs in communities, playgrounds and roads. Bulletin board about the danger from drinking alcohol, a mobile exhibition to reduce alcohol consumption.

• Education about accident prevention, danger of drinking alcohol, and safe sexual behavior to 5,000 students from 12 schools in elementary, secondary and vocational level.

Indicator 2: Long-term, sustainable programs covering both genders and all ages, environments, and situations

Safe community action plans in Muang Nan comprise of 1. Road Safety 2. Drowning Prevention 3. Improvement of Emergency Response, Disaster Prevention and First Aid Capacity 4. Safety and injury prevention during Festival 5. Sport and Recreation Safety 6. Violence and abuse Prevention 7. Food and Product Safety 8. Home Safety 9. Occupational Safety 10. Others related safety and health promotion 11. High-Risk Groups Safety such as the elderly and handicapped persons (as in Indicator 3)

Programs for different age groups

Environment Strategies Ages 0-5 Ages 6-12 Ages 13-18 Ages 26-60 Ages 61 or Relevant older organizations Safety in on the basis of education to education on injury prevention and education on education about Nan Hospital House education parents and child dangers from drinking alcohol and safe injury prevention falling injury care givers on sexual behavior and dangers prevention home injury from drinking prevention alcohol safe environment safety and safe living in dormitories fire prevention bathrooms -Muang Nan setting improvement for -Municipality and elderly networks Safety in on the basis of Safe Day Cares Safe schools - - -Nan Hospital school education -Muang Nan Municipality Road Safety on the basis of - education to traffic education about ‘Don’t Drive Drunk” campaign -Nan Hospital education volunteers road accident -Muang Nan prevention and Municipality dangers from alcohol during driving 100% Safety by helmet campaign -Nan provincial police -Muang Nan Municipality safe environment bicycle tracks promotion -Muang Nan setting drainage improvement project Municipality

Environment Strategies Ages 0-5 Ages 6-12 Ages 13-18 Ages 26-60 Ages 61 or Relevant older organizations Safety in on the basis of drowning prevention -Muang Nan community education -Municipality Nan Hospital - basic rescuing skills falling injury Nan Hospital prevention - fire prevention Muang Nan Municipality - flood prevention Muang Nan Municipality - - accident drills Department of disaster mitigation and prevention safe environment safety rounds / injury investigation / traffic environment setting Safe community setting working group art zone for children - - -Muang Nan child protection system / call center service - - Municipality safe playground - - -Nan Children’s Shelter enforcement of the Alcohol Control Act in 2008 -Muang Nan Municipality -Nan Hospital, Excise Department -Patrol Policeman stray dogs prevention Muang Nan Municipality , Nan Hospital, villages in community

Environment Strategies Ages 0-5 Ages 6-12 Ages 13-18 Ages 26-60 Ages 61 or Relevant older organizations Muang Nan Safety and injury boat race festival with liquor free zone prevention during Municipality and Festival networks Muang Nan alcohol free in Loykrathong festival /no fire cracker in festivals Municipality and networks Safety in - - physical checkup - Nan Hospital workplace Others development of injury data and analysis for the communities Nan Hospital associated lead free cooking hardware -Muang Nan Municipality with safety -Nan Hospital issues

1. Road Safety

1.1 Bicycle tracks project

Background Muang Nan municipality is an urban community with a combination of all kinds of vehicles such as cars, truck, motorcycles, and bicycles. With the concerns of the increased number of vehicles, Nan provincial office in collaboration with both public and private related agencies agreed to promote the use of bicycle.

Objective To promote the use of bicycle for the purpose of road safety,energy saving, and better health.

Key Activities Therefore, a meeting to the common guidelines for bicycle track pilot project was conducted as followings: • Announcement from Nan governor about sharing the traffic routes with the bicycle riders dated 8 February 2006. • PR the bicycle tracks project in the village heads meeting. • Muang Nan municipality to install PR boards about bicycle route and speed control at 30 km. in appropriate sites. • Community coordination center, assistance requests from public agencies, educational institutes, and media. • Nan provincial police to educate traffic laws to increase safety awareness among children and people, requests for coordination in facilitating during rush hours. • The pilot project of bicycle tracks and riding started on 13 February 2006 which was the “Makha Bucha Day” to promote bicycles uses and making merit activities at Wat Phrathat Changkham Worawihan on this religious day.

Warning sign More bicyclists in the community

Result • Set up ‘Bike Lanes’ in Muang Nan Municipality

1.2 Road Safety Project

Background Muang Nan Municipality is a densely populated community where there are many inners streets in the communities. Data showed injured people associated with road accidents were about 1,600 per 100,000 people annually. This problem could lead to the loss and damage of people life and property.

Objective Muang Nan municipality organized the road safety to reduce traffic injury and accidents.

Key Activities • Improvement of drainages connecting the main roads and inner streets to prevent flooding. • Installment of road warning signs.

• Promotion of child safety related travelling such as driving skills, travelling by cars or motorcycles, helmet use, seat belt use, pedestrian skills, and improvement the risk sites on roads.

Results Installment of ‘Traffic Signs’ on roads.

Improvement of drainages connecting the main roads and inner streets to prevent flooding.

1.3 Traffic Education Program (to promote safe motorcycling and 100% use of helmets)

Background Road accident and mortal-related road accident in children in Nan province has been in a high rate. In 2011, Thai government has announced this current year as the year of promoting wearing helmet and has set out the road accident prevention as priority in the national agenda that every agency must collaborate integratively. Under the safe community project, Muang Nan municipality therefore has established safe motorcycling and 100% uses of helmets.

Objectives To educate children about road accident prevention and raise people awareness of the road accident.

Results Children and people had higher awareness about road accidents and were well educated about traffic laws and safety on roads. At the meantime, Muang Nan municipality has actively responded to the national agenda of road accident prevention and promotion of wearing helmets.

2. Drowning Prevention

2.1 Teaching swimming skills to children at age older than 7 years

Background Injuries in rivers or associated with flooding could bring about a large number in loss and damage of people life. If children are educated the basic skills of swimming and survival in water, it could help to prevent the drowning injury.

Objectives To educate their children the right swimming practice, to be able help themselves in water, to benefit their leisure time, to keep children far away from drugs, and to increase children’s interest in sports for better health.

Key Activities • ‘Basic swimming skills for students in Muang Nan during 2008’ at swimming pool of Nan stadium. Participated students were 130.

• ‘Basic swimming skills for students in Muang Nan during 2009 (1st batch)’ at swimming pool of Nan stadium. Participated students were 120.

• ‘Basic swimming skills for students in Muang Nan during 2009 (2nd batch)’ at swimming pool of Nan stadium. Participated students were 107.

• ‘Basic swimming skills for students in Muang Nan during 2010’ at swimming pool of Nan stadium. Participated students were 130.

Result Participants in this campaign had proper basic swimming skills enough to help themselves and others in the drowning incidence.

2.2 Drowning prevention in sightseeing places on Nan Riverside

Background Muang Nan municipality is partly bordered by the Nan River and beaches such as Hinkhao beach in Thachang village and Ruamjai beach in Pranet village. In summer, there were crowded with visiting people and children. There also were a lot of food and drink sellers on the beaches. As observed, it found last year alcohol was sold to children aged below 20 years which was considered to the violation of Alcohol Control Act in 2008. Once the children or teenagers got drunk, they might bring about the quarrel or any injuries, as well as the inappropriate sexual behavior. Therefore, Thachang and Pranet village with the support from Muang Nan municipality, Nan hospital, Alcohol abstain agency and Thai Health Promotion Foundation, agreed to set Hinkhao beach and Ruamjai beach as ‘alcohol free zone’ during the beach opening fair during 20 March till 20 April 2011. These two beaches would remain as the area for creativity, enjoyment, and safety for everyone at all aged groups.

Objective To created beach for fun, safe from injury for all ages group.

Key Activities In addition to the compliance of the Alcohol Control Act in 2008, communities also carried out some other safety measures for these two beaches such as installing a barrier along the deep water zone and warning sign of such dangers that may occur, setting security guards along the beach, having ropes and or any safety devices to prevent drowning, and including food shop inspection.

Result No drowning injury during the beach opening fair.

Warning signs for drowning prevention on Nan riverside

3. Improvement of Emergency Response, Disaster Prevention and First Aid Capacity

Table showed the number of safety staff and safety devices for emergency and disaster prevention in Muang Nan Municipality. No. Items Quantity Remarks 1 Safety manpower 32 persons With additional 176 manpower from Civil 2 Fire extinguisher engine 2 units Defense Volunteers 3 Water truck 3 units 4 Patrol car (199) 2 units 5 Fire extinguisher Crane 1 unit 6 Rescue ship 2 units 7 Water pump size 12” 4 units 8 Water pump size 4 “ 10 units 9 Small water pump 3 units 10 Chain saws 2 units 11 Fire extinguisher (dry chemical 18 units powder) 12 Fire extinguisher (Co2) 2 units 13 Fire-ball extinguisher (dry chemical 10 units powder)

3.1 Practice the emergency response and emergency medical services

Background Fire accident could be a greater serious problem in the densely populated community. Muang Nan municipality in collaboration with safety networking teams organized fire drills to the civil defense volunteers for the preparedness purpose to actively respond fire injury. The safety networking teams for community fire drills included Fire Prevention and Rescue Bangkok officials, department of disaster mitigation and prevention, Nan hospital, and Nan army officers.

Key Activities • Fire drill by Muang Nan Municipality

• Fire drills training to the civil defense volunteers

• Fire drill with Bangkok Officials

• Fire Prevention and Rescue with the Department of Disaster Mitigation and Prevention, Nan hospital and Nan army officers.

Results Rate of Fire accidents in Muang Nan Municipality reduced as shown in below table.

Year Fire accident Damages Fire accident Damages

(in Muang Nan (Baht) (outside Muang (Baht) Municipality) Nan Municipality) 2001 9 times 179,500 11 times 3,790,000 2002 13 times 860,500 43 times 412,500 2003 12 times 317,300 22 times 3,210,000 2004 8 times 110,000 32 times 162,000 2005 8 times 720,850 39 times 6,300,500 2006 6 times 126,500 - 126,500 2007 16 times 3,000,000 3 times 900,000 2008 18 times 1,240,300 53 times 2,891,500 2009 2 times 50,300 2 times 346,000

3.2 Safety Education

Background After conducting safe community project in Muang Nan municipality, community members had proposed to have ‘Safety Education’ program provided to all members to reduce and prevent injuries, as well as to promote safety in various aspects. Therefore, Nan hospital in cooperation with Muang Nan municipality conducted public education program covering 28 communities in Muang Nan municipality. The program involved basic rescue, injury prevention, and dangers from drinking alcohol, safety in communities, health promotion and rehabilitation.

Objective To educate community members about injury prevention knowledge and skills.

Activities Education and training programs as followings: • Training on first aid and basic rescue to all parties associated with safety works.

• Safety in communities education

• Training on health promotion and rehabilitation to Public Health Volunteer

3.3 Surveillance of Fire injury

Background In Thailand, fireworks are quite popular during festivals. However, fireworks could bring about fire injury especially in summer when it is very dry. Fire injury resulting from fireworks, any flammable materials or cable failures may extend seriously to wooden houses in community.

Objective To prevent fire injury in houses in Muang Nan Municipality.

Activity Under the surveillance of fire injury program, Muang Nan Municipality had set out a working team to inspect and guide the community members and fireworks traders about fire protection.

Result Community members more realized about and collaboratively cared for the danger of fire injury.

3.4 City flood protection

Background Muang Nan Municipality is located on low land area and easily prone to flooding from Nan River which adversary affects personal property, health and hygiene.

Objective To prevent city flooding in Muang Nan municipality.

Activities Under the flooding prevention program, Muang Nan Municipality had organized the ‘city flood protection’ by keeping record of rain quantity and conditions, water level record of Nan river, setting flooding prevention plans, having sufficient water pumps to drain floods out of communities.

• Water level watch to prevent a flood in Muang Nan

Picture: water level record of Nan River (flood)

Year Water level (metre) Date Remark N 1 Gardlang 2001 6.79 14 August 2001 Rescue, financial 2002 6.20 23 July 2002 support, food, 2003 5.98 12 September 2003 medicine for victims 2004 7.09 12 September 2004 of disaster 2005 7.22 14 August 2005 2006 8.42 19 August 2006 2007 4.77 12 September 2007 2008 7.19 8 August 2008 2009 5.60 13 July 2009 2010 7.25 31 August 2010

Results • Community setting flooding prevention plans

• Flood gate to prevent community flood

• The steps to keep raining condition and water level in Nan river in track

• Having sufficient water pumps to drain floods out of communities

4 Safety and injury prevention during festivals

Background The communities in Muang Nan Municipality regularly carried out cultural traditions such as Loykrathong, boat racing festival. Muang Nan Municipality and safety networks realized the safety issues associated with playing during festivals

Objective To prevent injury during festivals in Muang Nan Municipality.

Activities 4.1 Loi Krathong festival Injury and accident news occurred during Loi Krathong in Nan and other provinces were reported to community members through the local cable TV and local radio channel to alert public on the arising dangers such as drowning, fireworks, road accidents.

Example of injury news via local radio channel and local cable.

Example of injury incidents

4.2 Loi Krathong festival with the prohibit on alcohol, beer and fireworks

• Closed traffic during Loi Krathong festival with the prohibit on alcohol, beer and fireworks

• Notification from Muang Nan Municipality to ban selling of alcohol, beer and playing fireworks during Loi Krathong festival in 2010

4.3 Boat racing festival in Nan province

People were notified from Muang Nan Municipality to ban selling and drinking alcohol via local cable TV and local radio channel. Injury and death record from past 3 years during boat racing festival were also informed. Below were the injury information broadcasted on local cable. • In 2006 - a 49 years old man received car accident caused by drunken driver. He was sent to hospital and found unconsciousness, spleen damage, kidney damage and death finally. - a 20 years old man received physical impact and found he was unconscious, not breathing, skull and lung damage, unsuccessful CPR (Cardiopulmonary Resuscitation). • In 2010 - a 60 years old woman was injured caused by drunken driver. She was sent to hospital and found unconsciousness, no vital signs, head injury, knee and leg injury, iris not response, and death at final. - a 59 years old drunken motorcyclist received motorcycle accident and required operations. - a 25 years old drunken man was shot and required operations. - a 64 years old drunken man fell down from stairs

Picture: Doctor Pongthep Wongwacharapaiboon on local cable to talk about injury prevention

Achievements of alcohol banning campaign during boat racing festival: With the collaboration from networking groups, the successful performance of injury prevention from prohibit alcohol during boat racing festival were as followings:

Results • Number of injured persons from accidents and drunken decreased about 80%

• Number of hospitalization related injury decreased about 60%

• Number of injury related death in boat racing festival decreased 1-2 persons annually and found no death during 2008-2009

5. Safety in Sport and Recreation Safety

5.1 Safe playground project

Background The first safe playground in Muang Nan Municipality was built at Srimuang Park in 2002, and following with other safe playgrounds in schools in the communities of Muang Nan municipality in 2004.

Objectives The purpose of having safe playground was to provide children a good learning center, to promote child development, to reduce child injury associated with playing, and to be a model for other communities.

Activities • 3 playgrounds in schools. • 5 playgrounds in parks. • Playgrounds in communities namely Ban Don Kaew, Nam Lom, Tha Chang, Mahapho. • Public park for local cultural shows, sports, music, and other performances. • A committee to inspect the quality and safety of playground and its equipment was nominated. • The safe playgrounds were responsible by a committee team cooperating with school building teams to inspect and maintain the playgrounds in good and safe conditions for child playing.

Result The figure below showed numbers of 6-12 years old-injured children resulting from playground falling during 2006-2010.

6. Violence and Abuse Prevention

6.1 Social harm prevention

Background Muang Nan municipality incorporates with all educational levels covering at all aged groups. There are 66 student dormitories in Muang Nan municipality and 35 buildings for rented rooms. The gather of students may bring about bad purposes liked drinking alcohol, sexual problems, gambling. Muang Nan municipality in collaboration with Nan Provincial Social Development and Human Security Office, Nan Education Service Area Office 1, school representatives, Nan provincial police, and Nan cultural office had carried out the monthly inspection of dormitory, internet café, and child gather on Nan riverside.

Objective To prevent child risk groups vulnerable to the abuse and violence both in physically and emotionally, sexual abuse and child neglect.

Activities and results • the inspection of dormitory in Muang Nan municipality

• the inspection of a child gather on Nan riverside

• the inspection of internet café

6.2 Safe community and surveillance

Background Nan Municipality is the most urbanized community in Nan province, comprises of 31 sub communities. The municipality itself could not take the whole responsibility for safety management,therefore multi-sectoral collaboration has been developed as a community security watch team. Nan municipality set up the civil defense volunteer while the police department set up the community cop and the community therefore set up the community security watch team.

Objective This program was aimed to empower the community to establish community security system joining the formal system of the police department.

Activitie • The village security teams regular safety round in the community

Result Safe community and surveillance teams were set up in 31 communities.

7. Food and Product Safety

7.1 Safety in food consumption

Background Muang Nan Municipality is considered as ‘the reception hall’ of Nan province. It is important that local people should accommodate visitors with good place and good food. To promote food safety, it is needed to educate food shop and food stall sellers about food sanitation, conduct regular inspection of food shops and food stalls, increase their awareness about food safety and cleanliness both in normal and high season period.

Objectives 1. To educate food shop and food stall sellers about food sanitation standards. 2. To give advice, examine, and evaluate food shops and food stalls in order to have them conformed to food sanitation standards. 3. To prevent transmitted disease from food and water.

Target group Food shop and food stall sellers, consumer protection volunteers.

Activities • Inspection of food stalls (street stand food shop) along Hinkhao beach on Nan riverside. After inspection, it found that there were 64 food stalls all which were approved by Food Sanitation Standards for Department of Health, Ministry of Public Health.

• Inspection of food shops and food stalls in Muang Nan municipality. There were 221 food shops and 154 (74.2%) were approved by the ‘Clean Food, Taste Good’ standards, while there were 147 food stalls and 136 (92.51%) were approved by the normal standards.

• ‘1 Tambon 1 Safe Food’ campaign to encourage a better standard of fresh market and promote ‘Golden Fresh Market Standards’

• ‘Big Cleaning Day’ campaign to promote a regular cleaning in fresh markets.

• ‘Fresh Food inspection’ campaign by inspecting fresh food, vegetables, fruits which may be added by toxic preservations from borax, sodium hydrosulfite, hazard preservation, formaldehyde, pesticides, and reuse oil. From 140 vegetable specimens, 107 (76.42%) did not show toxic preservations, and 33 specimens (23.57%) found safety for consumption. From 58 specimens for inspecting the contamination, 100% showed no contaminant agents.

• Training to young food and drug volunteers, public health volunteers for safe food and safe market

• ‘Outstanding noodle shops and 100% lead-free cook wares’ campaign. There were 135 noodle shops in Muang Nan municipality, 9 shops were approved for outstanding level (Taste good, clean, and economical), 92 shops or 68.14% that uses noodle pots free from lead contamination and 43 shops or 31.85% shops that participated in campaign giving noodle pots free from lead contamination.

Picture: a campaign on giving noodle pots free from lead contamination

8. Home Safety

Activities

8.1 Education • Education to the public health volunteers about the fire injury and home setting to prevent child injury. • ‘Parents school’ campaign to educate parents, grandparents, or care givers about child caring and child development.

Results showed that the public health volunteers and child care givers had more understanding about child caring and could build up as a networking team for child surveillance in a particular area.

8.2 Fire injury in home The Mayor of Muang Nan municipality inspected every family and residents in order to guide community members about fire injury.

Result showed that community members had a greater concern about fire hazard and participated in fire surveillance networking team.

9. Occupational Safety (Safety in Transmitted Diseases)

Background From the record of Nan provincial Control office of Sexually Transmitted Diseases (STD), it found that the numbers of Gonorrhea and Sexually Transmitted Diseases has increased consistently. Therefore, the STD Control Department of Nan hospital had carried out ‘STD and HIV control for call girls’.

Objectives The campaign aimed to survey the prevalence of STD and HIV infection among call girl groups, to promote safe sexual relations and distribution of condoms.

Activities • Meeting with people in restaurant, nightclubs, or any entertainment places to enhance understanding about STD and HIV prevention. • Proactively setting up a clinic for STD. • Creating networking in distributing condoms to call girls.

Results 1. People associated with nightclubs and entertainment services had better understanding and proper ways in preventing STD and HIV. 2. The service of STD clinic could effectively reduce STD and HIV dissemination in Muang Nan municipality. 3. A distributing condom network is accessible by everyone including the call girls. 4. From the risk screening test of 96 persons in 24 entertainment service such as hotels, restaurants, karaoke, Thai message in Muang Nan municipality, it found 1 person vulnerable to cervical cancer, 6 persons toward syphilis, 85 persons showed abnormal blood results who should receive treatment or service from Medical Social Work Clinic in Nan hospital.

10. Others in associated with safety and health promotion

10.1 Rabies and Stray dogs control Muang Nan Municipality is a densely populated urban community and considerable amount of stray dogs and cats or about 50-100 per a community. It is needed for Muang Nan Municipality to prevent rabies. Aimed to provide rabies vaccination to the public, and to create safety management skills in community.The veterinary division of Nan Environmental Public Health Department in collaboration with public health volunteers carried out the rabies vaccination for 1,440 dogs, 49 cats, and 1 monkey in every January-February annually.

10.2 Elimination the mosquito breeding sources and Dengue prevention Muang Nan municipality associated with Nan hospital, public health volunteers, elderly and children group regularly carried out the campaign on Dengue prevention by survey and eliminating mosquito breeding sources with using temephos in schools and communities once in a quarter of a year.

10.3 Health promotion and rehabilitation team Muang Nan municipality with the funding support from Provincial Health Insurance Fund set up health promotion and rehabilitation teams to cover all 28 communities and to service people in demand.

10.4 Depression Screening Program During 2007-2010, there was an increasing rate of depression patients in Nan province at 60.55, 79.19, 83.11 and 87.65 per hundred thousand people respectively. The unnatural death / suicide / homicide rates were 13.62, 16.97, 15.36 and 15.77, respectively. In Muang Nan Municipality, the rate of self-harm in different ways showed 39.26, 9.85, 9.91, 6.10 and 0.00 per 100,000 people during 2006 – 2010. Although it found no self-harm accidents in 2010, the concern about intentional injury had remained. Therefore, Nan hospital set up the depression screening program in 2010 to screen depression patients and have them treated appropriately. Patient questionnaire was used as depression screening tool by public health volunteers. In 2011, depression screening program was conducted with 8,560 people (or 40.12% of total population) in Muang Nan Municipality. By using 2Q-questions, it found 8.82% at risk depression and by using 8Q-questions it showed 4.48% at risk of suicide. Therefore, Nan Hospital had organized an interdisciplinary team including psychologists, nurses and social workers to visit patients. After visiting, it showed no risk rate of suicide.

Indicator 3: Programs that target high-risk groups and environments, and programs that promote safety for vulnerable groups

1. Child Safety • Aged 0-5 years • Aged 6-12 years • Aged 13-24 years

1.1 Safe School 10 schools in Muang Nan participated in safe school program namely Sri Nan Girl school, Nunthaburi Wittaya school, Yuwittaya school, Nan Christian school, Racha Nuban school, Sri Serm Kasikorn school, Sinjong school, Darunwittaya school, Samakkee Wittaya school, and Jum Pew Wanitaporn school. 1.1.1 Meetings among the groups of school administrators and teachers of safe school program 1.1.2 Child injury record, information about safety rounds in schools and child centers, guidelines about safe school operational plans were presented.

1.1.3 Working group of safe school program carried out the risk inspection in schools. 1.1.4 Schools implemented the safe school action programs and injury preventive action plans as meetings in order to reach the safety indicators, safety programs in schools were as followings:

School Activities Sri Nan Girl school Educated students about safety / board presentation about risk in school Nunthaburi Wittaya Educated students about safety / board presentation school about risk in school Nan Christian school Environmental risk inspection / teachers’ surveillance on risk behavior / educated safety knowledge board presentation about risk in school Sri Serm Kasikorn Improve risk environment / board presentation about risk school in school Racha Nuban Environmental risk inspection / teachers’ surveillance on school risk behavior / educated safety knowledge board presentation about risk in school Sinjong school Improve risk environment / board presentation about risk in school Darunwittaya school Educated students about safety / board presentation about risk in school

Samakkee Wittaya Educated students about safety / board presentation school about risk in school and Jum Pew Educated students about safety / board presentation Wanitaporn school about risk in school Yuwittaya school Educated inspector students / warning signs of risk / educated safety knowledge board presentation about risk in school

1.1.5 The continual safety program in schools in 2012 was as followings.

• Jum Pew Wanitaporn School: Promotion the use of helmet among children

Activities 1) Analyzed current conditions and problems on the way to-and-from schools. 2) Carried out the action plan for the promotion the use of helmet program. It focused on learning activities, encouraging students who traveled to school by bicycles or motorcycles using helmets, promote the use of helmet in young children before they can ride. 3) Conducted training programs on Safe Riding by traffic police, and the importance of using helmet by the Nan Hospital staff to the parents. 4) Supports helmet to the target children.

Results Children in community and schools were more aware of accidents and injuries. They possessed more safety behavior. Knowledge exchange among schools, community and relevant organizations brought about good cooperation to increase safety in school and community.

• Darunwittaya School: Fire Drill and Fire Prevention Plans / Earthquake evacuation plan

Activities 1) To educate teacher, students and school personnel in total of 350 people. 2) Morning session - about the prevention plan for fire and earthquake. 3) Afternoon session - fire drill and evacuation plan.

Results 1) Employees, teachers, students had a better understanding about fire prevention and earthquakes disaster. 2) The risk of fire and earthquakes decreased continually and sustainably.

• Samakkee Wittaya School : Safety in School and Day Care Center

Activities 1) Conducted safety round and observational tools to find out injury causes. Observational tools included injury record, observational checklist of school environment survey, students risk behavior record, survey of motorcycle use to-and- from school, and inspection checklist of playground safety. 2) Promotion the use of helmet program by having traffic police give information about traffic accidents and prevention, as well as encourage parents, teachers, students, and community members wearing helmets. 3) Training programs such as fire drills and first aid by firefighters and Nan hospital staff.

Results 1) Teachers, parents and students had more awareness on the importance of safety community projects. 2) Students knew how to solve the problem and prevent themselves and others from danger. 3) Injury rates in school and among students decreased.

• PHOTOVOICE Project

Activity 1) Introduction via recreational activities. 2) Learning activities as followings; - Game 1: Safety map - Game 2: Lucky board - Game 3: My way (Draw a map of the route from home to school. Identify the risks and hazards on the way) 3) Implementation session 2: Photography Training 4) Implementation session 3: Observational Research Field Trip in the Community 5) Implementation session 4: Discussion and photo selection 6) Implementation session 5: Final discussion and photo presentation 7) Implementation session 6: Set up a meeting / launch photo exhibit to children, parents, teachers, and relevant agencies prioritize the risks for improvement.

Results Photovoice program was carried out in all 14 districts in Nan province and responsible by staff of district hospital. All the interventions were the same.

It showed that number of injured students in primary classes was decreased.

1.2 Safe Child Care Center

Child care centers participated in the program included Suan Tan, Pong Sri, Benjamas, Lukrak, Ta Lee, Denpanya, Ban Suan Hom, Ban Pa Sing and Ban Pa Tub. • Meetings among school administrators and teachers to acknowledge about safe school action programs and teachers received form of safe round to carry out risk inspection.

• Child care centers implemented the safe child care center action programs as following:

Child care center Activities Suan Tan Installed non-slip materials in toilets / covered pillars with sponge Pong Sri Installed handrails in toilets / promoted the use of helmets in children Benjamas Board presentation of risk in school / promoted the use of helmets in children Lukrak Improve risk environment Ta Lee Installed non-slip materials in toilets / covered pillars with sponge Denpanya Have corner or wall cushion Ban Suan Hom Performed safe school activities according to safe school standards Ban Pa Sing Performed safe school activities according to safe school standards Ban Pa Tub Performed safe school activities according to safe school standards

1.3 Set up call center 199 for child protection in Muang Nan municipality

Call center for child protection was serviced by different safety networking groups such as Nan Provincial Social Development and Human Security Office, Nan Children’s Shelter, Nan Hospital, Nan Provincial Police, educational institutes and schools in Nan.

Picture: complaints box in every community

Performance of Muang Nan Emergency Center • Playing hooky from school (game addiction) 10 students • Quarrel in children or students 4 students

1.4 Art zone campaign to prevent drug problems

Muang Nan municipality in collaboration with Nan Provincial Social Development and Human Security Office, Community networks on drug prevention, and Children council in Nan has organized an art zone for children to benefit their free time and consequently to prevent drug problems. Children were trained on paintings and other kinds of art. Results showed that children had more creative activities in community area, spent their time more usefully, kept themselves away from drugs, and formed a network on drug surveillance.

1.5 Development of child protection by multi-professional teams

Funded by Nan Provincial Social Development and Human Security Office, Muang Nan municipality set up a call center 199 for child protection and cooperation site of child protection networks. Activities included: • Survey of risk areas in Muang Nan municipality by Children Council. • ‘Child Watch’ survey gathered from schools and communities. The survey would help about the current child incidents in Nan province. • Hotline 199 for child protection

1.6 Survey of risk areas in Muang Nan municipality by Children Council

The children council or called ‘Kam Plang Muang’ carried out a survey in communities to explore risk areas that may harm children such as road conditions, drainage, any potential gangster locations, construction sites in community. Survey form of risk area was originated by the ‘Medical Social Work Clinic’ of Nan hospital, and all the gather information was submitted to Muang Nan municipality management for improvement.

Picture : children survey risk area in community

Picture : some risk areas that children found

1.7 The enforcement of Alcohol Control Act in 2008

Nan province has gained the 1st rank of drinking alcohol. There were 86,811 drunken people on weekly basis from total 364,752 people. From Nan public health office, it found that the major leading death cause of Nan population was cancer at average 500 persons annually; following with liver cancer. The numbers of patients from liver cancer was doubled during the past 8 years. It found that liver cancer in male population was 2.5 times in female. Major cause of liver cancer was from drinking alcohol and beer regularly. Their drinking habit started from drinking after works and in festivals and finally in daily. Drinking did not cause only the liver cancer but also bring about accidents and injuries. With this concern, Nan province decided to enforce the Alcohol Control Act in 2008 strictly such as site inspection and requesting for participation in limiting every form of advertisements of liquor products, having volunteers for surveillance liquor selling in educational institutes, temples, or parks. If any violation to the law happened, the offenders would be seriously punished.

The results showed that most shops cooperated well in the campaign.

Before After

Picture: no advertisement on alcohol beverages

Picture : excise official notified the public on the ban of selling alcohol to children

1.8 Child Mortality Review

Muang Nan municipality carried out child mortality review team to investigate child death causes, gather data and analyze child mortality from external or abnormal death causes, report the death deliberation to child protection committee for improvement. From the child mortality review among children aged below 15 years in Nan province during April 2008 - May 2009, it found that: 1) There were 11 boys (55%) and 9 girls (45%) aged below 15 years (ranging from 8 days till 14 years old) died from external causes in Nan province during April 2008 to May 2009. If categorized by age group, school age group showed the highest proportion of child death (15 or 75%), following with pre-school age group at 10% and toddler group at 5%. Categorized by race, 80% of child death was local children, the other 20% were tribal village children. Considering the primary child care giver, 80% were mother and 15% were grandmother. 75% of main care givers were farmers and 70% were educated at primary level or below. 2) Concerning child death causes, it found 65% from road accidents, followed by 30% drowning accidents and 5% of unknown reasons. If categorized by age group, 75% were school age group in which 67% of that figure came from road accidents; followed by 10% in pre-school age children from road accidents, drowning and unknown reasons; and 5% of toddlers from road accidents. If categorized by location, Muang district and Wiangsa district showed the highest ratio of child death, 80% of child death in Muang district was from road accidents and the other from unknown reasons; while 80% of child death in Wiangsa district was also from road accidents and the other from drowning. 20% out of total child death found in Pua district in which 75% was from drowning and 25% from road accidents. Tawang district found 15% out of total in which 67% found in drowning and 33% from road accidents. Chiangklang district found 15% out of total in which half of that figure were from drowning and the other half from road accidents, and Tungchang found only 5% of child death and all from road accidents. Considering the injury time, child death most occurred in summer and winter. April was the month showing the highest number of child death representing 25% of total death (or 5 cases).

Picture: field investigation by Child Death Deliberation team

Picture : data analysis to find out death Picture : the Safe Sub-district for Children causes and report for problem solving inspection by provincial networks.

1.8.1 Child Death Deliberation in Nan hospital

Child Death Deliberation (CDD) is a strategy and tool to understand causes and factors of child deaths related accidents and violence in a systematic way. The results of this analysis will lead to child death prevention. CDD focus the process of careful consideration and identification about child death cause which may be either external or unnatural causes. This integrative process would lead to child death prevention and policy movement in local and national level.

Objectives 1. To watch rate of child death from external cause. 2. To find out risk behavior of children, environment and product-related child death, and responsibility of relevant agencies. 3. To mobilize in-charge agencies in deliberation process faster and more accurate. 4.To integrate safety works of all networking for proactive involvement and better coordination to achieve the environment improvement and ultimate injury prevention. 5. To improve child protection, social service and welfare for children. 6. To communicate with the public about cause of death and preventive method in order that they can be aware of the risks and know how to avoid any re- occurrence. 7. To move the local policy and legislation about child safety forward.

Figure shows child mortality from external causes in Nan province during April 2008 - July 2012.

Cause Amount (case) percentage drowning 25 43.86

Traffic injury 18 31.58

Suffocation 3 5.26

Suicide 2 3.51

Electrical shock 1 1.75

Head injury 1 1.75

Dyspnea respiration 1 1.75

Physical attacked 2 3.51

Burns 4 7.02

1.8.2 Injury Investigation

According the operation of Alcohol control committee and Nan hospital, the cases of injured children aged below 20 years and in association with drinking alcohol and hospitalized in Nan hospital would be forwarded to Nan Provincial Police to investigate and find out the offenders incompliance to the Alcohol control act 2008.

Picture : data collection form

Picture : Dr.Phongthep was asking a case of injured

1.8.3 Surveillance of risk behavior

Muang Nan municipality in association with Nan hospital, Nan Provincial Police, and the Excise Office inspected and authorized the restaurants and pubs in communities to be compliance with the Alcohol control act 2008.

1.9 Hospital to Home Injury Prevention and Safety Promotion (HIPS)

Objective • To educate injury prevention skills to child-care takers, families and community members. • To minimize the injury re-occurrence. • To have social mobilization on safe environment for children.

Activities Nan hospital and 8 district hospitals in Nan province gathered child injury with required hospitalization from March – August 2012. The total of child injury was 69 cases as below figure.

Injury cause Amount (case) Percentage Burns 4 5.80 Traffic injury 10 14.49 Drowning 1 1.45 Falling 33 47.83 Animal bites 10 14.49 Foreign objects 5 7.25 Weapon 2 2.90 Food/poison 4 5.80

Almost all of injury cases found at children's home when children were taken care by others not parents. Therefore, working group visited and explored the risk in house and provided guidance in setting safe environment for children.

1.10 Injury and violence prevention program for high risk student group

Objectives • To create and develop assessment tools about risk group and risk improvement. • To have home visit for the risk group. • To set up activities for the risk group and their parents.

Activities • Created and developed the assessment tool based on student group and type of risk in 5 schools. • Identified certain risk group and set up home visit and intervention programs.

Results • Obtained the assessment tool to identify risk group from injury and violence. • Be able to identify the risk group and followed up with home visit. • Carried out activities to reduce rate of accidents, injuries and violence in schools.

2. Elderly Safety

2.1 Bathroom improvement for the elderly in Nan municipality

Background From ICD 10 record of Nan hospital and investigation of elderly injury, it revealed that falling and slippery in bathroom came the first rank of injury in elderly group. This project return information about falling accident in elderly to Nan Municipalities, they did the project to renovate bathroom for poor elderly in the communities.

Objectives To reduce the rate of falls in the bathroom.

Activities Therefore, Muang Nan municipality carried out the bathroom improvement campaign. The selected 50 elderly participated in the campaign.

Results It found that there was no injury under this intervention and it showed satisfactory level of the campaign.

3. Environmental risk

3.1 Preparedness for flood prevention of Pumin and Talee village

Pumin and Talee villages are located on Nan riverside and usually affected with river flows and flooding. Therefore, the cooperation with different safety agencies for manpower and safety devices was carried out as followings:

Activities 1) meeting with household heads

2) setting flooding prevention and mitigation team

3) investigating river level and flooding level

4) setting relocation sites

5) setting a community learning center for disaster prevention

6) relocation drills

7) determination of key success factors such as high risk awareness, disaster prevention system, warning system, drills and relocation, assessment and plan development, funding for safety and survival devices.

Indicator 4: Programs that document the frequency and causes of injuries

1. Injury Record system

1.1 Injury record

a. Information source. Information was collected from International Disease Classification (ICD -10) on V01 – Y34 code of Nan hospital. b. Participants. Participants of the injury study were people in Muang Nan municipality and hospitalized in Nan hospital during 2006-2010.

Example of injury data analysis 1) Rate of injured persons per 100,000 people during 2006-2010 decreased.

2) Categorized by age group, it found the highest injury rate in every year was the adult group aging from 26-45 years.

3) Rate of injury associated with road accidents during 2006-2010 showed consistency.

4) Categorized by age group, it found the highest injury rate associated with road accidents was the adult group aging from 26-45 years.

5) According to the number of falling injury, it found the highest rate of falling injury was children group aged from 6-12 years and elderly group aged above 61 years.

6) Rate of falling injury during 2006-2010 decreased.

7) Categorized by falling cause in elderly group aged above 61 years, it found the major cause was slippery or stumble; followed with stair or chair falling.

8) Rate of injury associated with the exposure to inanimate mechanical forces showed a decreased tendency.

9) Rate of injury associated with the exposure to animate mechanical forces showed a decreased tendency.

10) Categorized by injury type, it found the highest injury rate in most age group involved exposure to inanimate / animate mechanical forces such as attacking by throwing, dropping, or falling objects, stabbing or piecing by an objects, pinch, cramp or compressed by objects, cutting, foreign objects into body. Concerning to gender, males had more injuries than females except dog bites.

Other injuries Fall Traffic accident Assault Self attack

รอยละของการบาดเจ็บแยกตามเพศInjury rate by gender and cause of injury

Female

Male

hurting - object injury Falling Dog Dog bit throwing cut by knife Transport Transport Be injured

Attack with Self A Other Other injuries

11) Categorized by injury cause during 2006-2010, the major cause of injury was injury exposure to inanimate mechanical forces; followed with road accidents and falling injury.

12) Categorized by age groups in pre-school, primary, and secondary level, pre- school age group showed the increased injury rate while primary and secondary age group showed the decreased injury rate.

13) Concerning the self-attack injury during 2006-2010, it showed non-significant number. In 2010, there was no injury related to self-attack.

14) There were 2 cases of drowning in 2008, but no drowning injury was found in other years.

15) Figures below show injury record categorized by community and cause of injury during January 2006 – May 2009

15.1 Concerning the injury associated with motorcycle accidents, Mahapho community revealed the highest rate of motorcycle accidents; followed with Muanglen and Chang Pueag community.

Top 10 village of injury by motorcycle

8 7.71 7.04 6.96 6.95 7 6.76 6.23 6.19

6 5.57 5.33 4.98 5

0 มหาโพธิ์ เมืองเล็น ชางเผือก อภัย สถารศ ศรีพันตน ทาชาง พวงพยอม มณเฑียร ดอนแกว

15.2 Concerning the injury associated with bicycle accidents, Sri Pan Ton community revealed the highest rate of bicycle accidents; followed with Sataros and Pranet community.

Top 10 village of injury by bicycle

2.5 2.24

2 1.66 1.58 1.53

1.5 1.19 1.14 1.12 1.09 1.07 0.99 1

0.5

0 ศรีพันตน สถารศ พระเนตร น้ําลอม ชางเผือก สวนตาล มิ่งเมือง ดอนแกว มหาโพธิ์ อภัย

15.3 Concerning the injury associated with inanimate mechanical forces, Chang Pueag community revealed the highest rate; followed with Nam Lom and Pranet community.

Top 10 village of injury by Exposure to inanimate mechanical forces

19.09 20 18.58

18 16.9

16 14.57

14 12.82 12.59 12.08 11.36 11.31 12 11.35

0 ชางเผือก น้ําลอม พระเนตร อภัย พญาภู เชียงแข็ง ชางค้ํา ทาชาง มหาโพธิ์ สวนหอม

15.4 Concerning the injury associated with animate mechanical forces, Nam Lom community revealed the highest rate; followed with Sri Pan Ton and Chang Pueag community.

Top 10 village of injury by Exposure to animate mechanical forces

3 2.68

2.5

2 1.99 2 1.78 1.66 1.65 1.58 1.4 1.38 1.5 1.3

0.5

0 น้ําลอม ศรีพันตน ชางเผือก พระเนตร อภัย พญาภู ดอนแกว ชางค้ํา พระเกิด หัวขวง

15.5 Concerning the falling injury, Apai community revealed the highest rate of falling injury; followed with Chang Pueag and Pranet community.

Top 10 village of injury by fall

12 10.26 10 9.15 8.3 8 7.23 6.98 6.93 6.9 6.8 6.76 6.41 6

0 อภัย ชางเผือก พระเนตร พระเกิด ศรีพันตน ทาชาง น้ําลอม เชียงแข็ง สถารศ พญาภู

After collecting all the data of injury, safety working team carried out the death deliberation and presented in community meetings to find out improvement solutions.

Picture: community meeting to find out solutions

Picture: injury data collection form

2. Safety Round system

2.1 Safe community working team carried out safety round in their communities.

Picture showed that with the road condition at T-junction in Ban Pranet it may blind the drivers and cause road injury, community solved this danger by marking clear traffic line to avoid crashing.

2.2 Community participated in safe community programs to reduce all kinds of injury as followings:

Community Activities

01 – Puang Payom Risk surveillance/ install warning signs/ visit injured patients

Hygienic promotion / install warning signs / install light 02 – Hua Khuang streets 03 – Mon Thian Risk surveillance/ install warning signs Injury prevention from insect bite / surveillance teenagers 04 – Prayaphu fighting on Nan riverside. 05 – Chang Kam Build speed reducers in community 06 – Sri Pan Ton Risk surveillance/ install warning signs 07 – Apai Install warning signs 08 – Chieng Khaeng Risk & injury surveillance / Install warning signs 09 – Ming Muang Risk surveillance / Periodical risk inspection 10 – Mongkol Install reflectors 11 – Ta Lee-Pumin Install warning signs 12 – Sataros Install warning signs / Install convex mirror 13 – Chang Pueag Traffic safety training to children / Install warning signs 14 - Mahapho Install risk alarms 15 – Nam Lom Injury warning sign / other warning signs 16 – Ta Chang Injury warning sign / install street lights Build speed reducers in community / Injury warning sign / 17 – Muang Len marking traffic lines 18 – Suan Tan Install warning signs / Install convex mirror 19 – Suan Hom Injury warning sign Build speed reducers in community / Install warning signs / 20 - Prakerd Install convex mirror 21 - Pranet Injury warning sign / marking traffic lines 22 – Don Kaew Fence surrounding Nan River 23 – Don Sri Serm Injury warning sign Install warning signs / Traffic lining / traffic marks / Build 24 - Arunyawas speed reducers in community 25 – Hua Wieng Tai Safety promotion campaign at Wat Hua Wieng Tai 26 – Pai Luang Install warning signs 27 – Pratu Plong Risk surveillance/ install warning signs 28 - Suriyapong Install warning signs

3. Risk Behavior Record system

3.1 Child Fatality Review Carried out death investigation and deliberation either from external cause or abnormal death cause and report to Child Protection Committee.

Indicator 5: Evaluation measures to assess their programs, processes and the effects of change

1. Evaluation by External Agencies

1.1 The 1st Community inspection by WHO CC in order to be certified as International Safe Community Professor Shumei Wang from School of Public Health, Fudan University, Shanghai, China and Dr.Yoko Shiraishi from Ristumeikan University, Deputy Director, Mature Life Institute, Japan were the delegates from the WHO Collaborating Centre for Community Safety Promotion (WHO CC) to inspect Safe Community in Muang Nan Mulnicipality on 18-22 January 2010. This inspection was collaborated with “Board of Community Empowerment for Injury and Disaster Prevention” under the authorization of National Safety Council.

Results 1. The injury record and all data collection were satisfied. Data collection was a major part of safe community project representing self-learning approach on identifying and analyzing the problems. 2. Team works in safety between public and community members showed more efficiency. 3. The campaign on “alcohol-free in community’ was satisfactory and awareness about drinking alcohol increased as could be observed even in the pre-school age group. 4. Reports required more statistic data. 5. Reports needed to focus on 3E guidelines which are Environment, Education and Enforcement perspectives. In addition, Engineering and Economic perspectives are suggested. 6. Data collection should be compliance to International Disease Classification (ICD -10).

1.2 The 2nd Community inspection by WHO CC in order to be certified as International Safe Community

Prof. Lu Pai from Taiwan, Prof. Shumei Wang from China, and Dr.Choung Ah Lee from Korea, the delegates from WHO Collaborating Center on Safe Community Safety Promotion (WHO CCCSP) in collaboration with “Board of Community Empowerment for Injury and Disaster Prevention” under the authority of National safety council, Child Safety Promotion And Injury Prevention Research Center (CSIP) inspected communities in Thailand so as to giving the safety development directions for international safe

community designation. The on-site inspection was held on 25 February 2011 in Muang Nan Municipality, Amphoe Muang, Nan Province (last evaluation for certifying). After on- site inspection, it showed that safe community programs involved participation from all groups of community members and networking collaborations for the diversity of safety interventions.

Meeting with the Deputy Nan Governor Talee village presenting flood and other disaster prevention

Visiting and talking with elderly Visiting safe school/safe playground at their houses

2. Internal Evaluation Internal evaluation was conducted by the Medical Social Work Clinic of Nan hospital to analyze injury incidence and rate during 2007-2010 in Muang Nan Municipality based on data from the International Disease Classification (ICD -10).

2.1 Safety Improvement Muang Nan municipality has carried out safe community project since 2006. Figures below show injury rate during 2007-2010 after commencement of safe community project. • Decreased rate of injury and mortality 1) Number of injured people associated with motorcycle accidents in Muang Nan Municipality in 2010 who hospitalized in Nan hospital decreased from the previous years.

2) Number of all types of injury and road accidents in Muang Nan Municipality in 2010 who hospitalized in Nan hospital decreased from the previous years.

3) Number of injured children aged below 20 years in associate with motorcycle accidents and needed hospitalization showed a decreased rate.

4) Number of injured people related with drinking alcohol in boat racing festival decreased. From the data of emergency room of Nan hospital, it showed that: • Injured people from accidents and drinking alcohol decreased 80% • Injured people who needed hospitalization decreased • Death rate decreased 1-2 persons yearly, and showed no death from injury in 2008-2009

Results

Table showed the results of injury during 2006 – 2010 Category Index Change rate per 100,000 people

All injury All type injury (8088.34 6246.83)

Unintentional injury Injury rate by age Aged 0-5 (202.81552.68)

Aged 6-12 (983.67 633.80)

Aged 13-18 (938.03 806.20)

Aged 19-60 (5121.18 3346.50)

Aged 61 or older (1110.43 907.61)

Traffc injury 1698.16 1373.33

Fall injury (1384.05 1298.04)

Exposure to inanimate (3175.46 2099.18) mechanical forces

Exposure to animate (922.70 841.70) mechanical forces

Drowning injury (0 0)

Intentional injury Self-attack injury (8 0)

Remarks : Decrease Increase Unchanged

Data analysis and data collection on the rate of all type injuries during 2006-2010 such as road injury, falling injury, injury exposure to animate / inanimate mechanical forces, drowning injury, self-attack injury; all which information were from ICD 10 of Nan hospital.

2.4 Collaboration and networking Muang Nan municipality collaborated with a variety of safety networking teams on the safe community works such as public health volunteer, Nan provincial police, Nan education service area office No.1, Nan Excise Department, Nan Health Provincial Office, Nan Provincial Social Development and Human Security Office, Nan Children’s Shelter, Office of Disaster Prevention and Mitigation.

2.5 Meetings and knowledge exchange • Regular meetings on monthly basis held by safe community working team with public health volunteers regarding safety in community. • Attended provincial and national conference regularly such as meeting with Board of Community Empowerment for Injury and Disaster Prevention • Provided exchange and learning forums about safe community works. Participants involved safe community working teams, relevant agencies, Muang Nan municipality, Nan hospital and Nan Provincial Police.

• The Medical Social Work Clinic of Nan hospital, Muang Nan municipality, and Nan Provincial Police carried out the assessment of safe community works of all 28 communities and presented a certificate of safe community attendance.

Indicator 6: Ongoing participation in national and international Safe Communities networks

1. Participation in Domestic Conference

1.1 Community level • Meetings of safe community working teams

• Provided exchange and learning forums about safe community works. Participants involved safe community working teams, relevant agencies, Muang Nan municipality, Nan hospital and Nan Provincial Police.

• Carried out the assessment of safe community works of 28 communities and presented a certificate of safe community attendance.

• Meetings between Nan hospital and Nan provincial police to find out road injury preventive measures from young drunken driven and the compliance with Alcohol Control Act in d2008.

• A workshop by ‘Don’t Drive Drunk Foundation’ to rehabilitate the victims of road accidents from drunken drivers on 3rd November 2010.

1.2 Provincial level • Safe community provincial forum The forum was held on 6 November 2009 to promote and encourage Nan community members the self-safety management on a basis of problem learning, and to promote networking collaboration with public and other local organizations associated with safety works.

• Safe child care center provincial forum The forum was held on 6 November 2009 to give a presentation report on safety activities in child care centers in Nan province and promotes child care centers the self-safety management on a basis of problem learning.

• Discussion forum on ‘Safe school mobilization in Nan Province’ Target of this forum included school administrators, teachers at amount of 350 teachers. Objectives of this forum was to support safe school activities and development in Nan province, to prevent all kinds of injury either from schools or communities, to promote safety for individual, to collaborate with external agencies for solving problems associated with safe school activities and to promote self- safety management on a basis of problem learning.

• By ‘Safe Kid Thailand’, a show about danger from insects (bee in particular which led to hospitalization) on target child at age 9-14 years was performed by Sri Nan Girl school, Nunthaburi Wittaya school, Yuwittaya school, Nan Christian school, Racha Nuban school, Sinjong school, Samakkee Wittaya school, and Jum Pew Wanitaporn school. Safety knowledge was transferred into 5 adventure play games such as traffic accident, drowning, teenager risk, dangerous products and safe school—safe playground.

• Extend the idea of safe community to all Sub-district Administrative Organizations in Nan province for knowledge exchange and work integration of safe community, safe schools and child care centers in 2012.

1.3 National level • Report progress of safe community activities, problems and obstacles, learning experiences to the “Board of Community Empowerment for Injury and Disaster Prevention” • Presented safe community works in The 2nd National Conference on Safe Community: “The Sustainable Pace of Safe Community” and Safe Community Designation Ceremony

• Presented safe community works in the academic conference on National Health Information System.

2. Participation in International Conference • Attended the 19th International Conference on Safe Communities dated 23 - 26 March 2010 at Suwon, Korea.

• Publication and Presentation in the ‘6th Asian Regional Conference on Safe Communities in Toshima’ during November 28-30, 2012 in Tokyo, Japan.

3. Inspection and Field Trip

• The public health volunteers together with The Women and housewife group of Muang Nan Municipality carried out a field trip to share experience about safe community works at The Administrative Authority of Taladkriab District, Ayutthaya province.

4. Award and outstanding performance

• Granted the plaque on the 1st award of Northern provinces and the 4th award of Thailand on ‘the Pleasant City’ from Municipal League.

• Granted PCD AWARD 2002 for the waste disposal.

• Granted the honor certificate in 2003 for the effective waste disposal.

• Granted the honor plaque on ‘the outstanding Local Administrative Authority in Disaster Mitigation and Prevention’ in 2009 from the northern provincial level and the medium Local Administrative Authority level.

• Granted the award ‘the Pleasant Nan city’ in 2008 from Local Development Foundation.

• Outstanding performance in the control of alcohol consumption.

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Future Plan

1. Monitor and evaluate the programs/activities already carried out. 2. Financial support and local subsidization on safe community activities directly to villages. 3. Establish the Municipality Law on the control of alcohol selling in the old town areas. 4. Educate traffic volunteers and patrol police 5. Personal Helmet campaign (safe riding – one man one helmet) 6. Cooperation with relevant agencies required to comply with the Alcohol Control Act in 2008. 7. The Best Dormitory (Star Dormitory campaign) 8. Safe Game Shop (White Game Shop Zone campaign) 9. Municipality Law on entertainment zoning in the old town areas. 10. Start the local education program on ‘safety in local’ in 2011 11. Defining the bicycle tracks

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