|Whenever there are any misunderstandings about the malaria elimination programme, the team needs to engage the community immediately, even it means climbing the hills and crossing the rivers.
||This supervisor is visiting the malaria post in a remote Karen village. She works as part of the malaria elimination programme. She visits each of the villages under her supervison weekly to collect data and make sure all are functioning well.
||At SMRU clinical care, research, and humanitarian aid happen side-by-side. One humanitarian service was the establishment of a health insurance scheme in collaboration with other key partners, as migrants are not eligible for Thai health insurance. Here, M-Fund staff in one of SMRU clinics explains about the migrant insurance, and offers health education on family planning, seasonal illnesses, hygiene and other basic health knowledge.
|Around a time of a Karen celebration, a malaria post near the ceremony ground reported a case of malaria in a four year old child. This family sometimes goes to a refugee camp but does not live there. With help from local authorities, we screened the whole family to reduce the risk of further malaria transmission. The malaria post provided free Rapid Diagnostic Test (RDT) and treatment of all fever cases that approached them. Some of the research evaluates strategies for malaria elimination.
||Staff arrive in rainy season. Many clinic and research staff live on the other side of the border. During rainy season the crossing can be too dangerous and staff can be caught on the wrong side of the border, needing to find a place to stay for the night or even several days until the waters recede.
||Under the midday sun the body of a Burmese migrant worker who has died was brought back to a village on a tractor to be cremated. I followed the tractor to the cemetery even though I didn’t know those villagers personally. It was the first time I observed a cremation process. Even though the village is big, not many people came to the funeral rite. The family members live outside the village. Later in the evening we received an invitation from their landlord to join them for prayer at the farm house. A few more people came. I still don’t know why not many turned up. Was it because they were afraid of death and ghosts, or just because they don’t know each other, or because he was a migrant worker?
|Some of the local rural health centres provide general basic health care and simple malaria treatment, so that villagers do not need to go all the way to the major health centres, which are far away, or in the city. Healthcare workers are trained in a number of places including the Mae Tao Clinic (MTC), Karen Department of Health and Welfare (KDHW), Backpack Health Worker Team (BPHWT), Burma Medical Association(BMA), and at SMRU.
||In the delivery ward of SMRU Clinic, midwives, health workers, and obstetricians are working together. They look after every woman and every child with dedication. Some nights, the workers have to cope with up to five deliveries. Safe delivery is essential to reduce maternal and infant mortality.
||Among Karen people SMRU clinic is known as ‘Moh Der Tar Sar He’ which means ‘pregnant women hospital’. This woman struggled during the antenatal period but with the support of staff and family she and her baby did well. The day I met her she greeted me cheerfully. Her teenage daughter and her husband were there to support her. It was a joy to witness someone’s stormy time that turned into a rainbow. Here I saw the power of support for maternal mental health alongside maternal physical health, despite a lack of formal services. These were also the last few visits I had at that clinic in Maela refugee camp before we had to move out due to impending government closures. These are fragile moments to support each other during a transformative period for both care receivers and care givers.
|Hiking the hills of the Dona Range in Karen State with the community engagement team of the malaria elimination programme, we sat only briefly because the place was full of tiny leaches thirsty for blood.