Building a base for sustainable healthcare in rural Thailand

By Joe Lowry

A remarkable health intervention in Northern Thailand is coming to an end – and to a new beginning. In early 2010 a joint IOM/UN/Government of Thailand programme set out to bring primary health care to some of the remotest villages on the border with Myanmar with the modest outlay of USD100,000 a year.

Next month the programme – till now funded by the UN’s Office for the Coordinaiton of Humanitarian Affairs -  will be officially handed over to the Thai Ministry of Public Health, who will fund eight out of the 13 health posts established by IOM. This means that 50,000 vulnerable migrants, local people and ethnic minorities will continue to receive essential health treatment and health education. One other health post will be funded by Ministry of the Interior.

Uraiwan Kanjan, is the field coordinator of the Mae Hong Son Border Health Project. When the project was conceived she was tasked with establishing health facilities and at the same time strengthening community involvement in provision of health services and health promotion.
“We went into the heart of these remote communities to explain what we were doing”, says Uraiwan, “and we found people to train as Community Health Workers. Most of them only had primary education but after two months live-in training in the hospital in Mae Hong Son they were ready to work in the health posts.”

The project was a hit with local communities right away, and they topped up the IOM budget by donating meals, accommodation and labour.

Apart from building four health posts from scratch, refurbishing nine more and training all the staff, the project also focused on getting communities to think in a healthier way. This involved information sessions on malaria and TB, and also how to get rid of plastic rubbish, how to keep livestock, and how to store water.

Monitoring the project demonstrated, quite clearly, its success. Anti-malaria bed net use went up from 64 to 95 per cent (as against a target of 80 per cent) and mothers demonstrated a vastly-improved recognition of signs of illness in their children. Knowledge of serious communicable diseases, such as HIV/AIDS, tuberculosis and malaria also increased significantly.

A mobile clinic came from the local hospital every three months to augment the input of the community health workers.

“This has been a great success story for IOM and for the people of this remote part of Thailand”, said Jeff Labovitz, IOM’s Chief of Mission in Thailand. “Through involving the communities in the earliest stages in the planning and execution of the project we have ensured a lasting and sustainable health legacy for one of Thailand’s poorest regions, and for the migrant workers that come to work in the agricultural sector.”

Joe Lowry is the Senior Media and Communication for IOM