Whenever I read something like "Golden pagodas rise in the morning mist along the hills" I know I am likely to find something out of Kipling rather than solid information about Myanmar. But you gotta love hardworking midwives.
Is a fifty per cent decrease in malaria cases or deaths 2010 in Myanmar through 2013 entirely due to scaling up the response?
Jamie
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In Myanmar, “Red Angels” Fight Malaria
Global Fund News Flash
30 January 2015
Midwives in Myanmar wear bright red skirts and are known as “red angels.” Aye Aye Maw is a midwife in a small village of thatched houses on stilts on the banks of a broad and muddy river in northeastern Myanmar. The village has no electricity and no paved roads, and is accessed only by boat. Golden pagodas rise in the morning mist along the hills, and fishermen cast their nets from canoes. During the monsoon season, flooding turns the village into one big pool.
From her clinic, which is also her home, Aye Aye Maw looks over the wellbeing of the village. Like most midwives in Myanmar, Aye Aye Maw is responsible for much more than maternal health. She treats everything from snakebites to immunizations to diarrhea. She is also a crucial part of an international effort to fight malaria in Myanmar and in the Mekong River region, where the emergence of resistance to anti-malarial drugs has become a global health risk. With the support of the Global Fund partnership, the Government of Myanmar has embarked on an elimination campaign that relies on a network of community nurses and trained volunteers to distribute mosquito nets, identify cases and begin early treatment. “We need to eliminate malaria,” she said.
With mass distribution of mosquito nets and artemisinin-based combination therapy, or ACT, malaria rates have plummeted in Myanmar. In 2013, health authorities confirmed 333,871 malaria cases, including 236 deaths, more than a 50 percent decrease since 2010. In Kha Ywe, population 4,227, more than 1,100 long-lasting insecticide treated nets were distributed to the community’s 761 houses. “I have been here for six years. I used to have 20 or 30 cases per year. Now we have one or two cases. People are receiving ACTs and are also more aware of malaria,” Aye Aye Maw said. San Lin Do, an 18-year old forest worker, came to see the village midwife after suffering from chills and a high fever. “I was afraid I was going to die but she gave me drugs. After three days I started feeling better and went back to the field. Now I always take my mosquito net with me.”
But in some patients malaria parasites are not being cleared from the blood after taking ACT drugs, a sign of increasing resistance. Migrant workers, porous borders and the existence of low-potency drugs add to the challenges. “Resistance to artemisinin is a real threat in our region,” said Dr. Nayin Sint, director of the Mon state health department. “We need more microscopes and we need to strengthen our rural health systems and recruit qualified health staff.” There are about 20,000 midwives in Myanmar. Many are trained and then deployed in remote villages, where they supervise three to five local volunteers. With most of the country’s population living in rural areas, often with little access to hospitals or doctors, midwives form the backbone of Myanmar’s health system.
Aye Aye Maw feels a strong calling to her work. “I like to see people get cured. It makes me very happy to see them cured,” she said with a broad smile. But she warns her trainees that being a traveling midwife can sometimes mean long stays in remote places, so they should be prepared for loneliness. Villages like Kya Ywe are pretty quiet. Barefoot children play football by the river, interrupted from time to time by a certain cow that likes to graze in front of one of the goalposts. Aye Aye Maw used to fill her leisure time by singing, or watching movies on her old VCR, provided the village generator hadn’t crashed in a storm. Then two years ago, in Kha Ywe, she met a local man and got married. Her lonely outpost is not so lonely anymore. And on her next assignment, they’ll go together.
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