The VHW are based in remote communities and provide malaria screening and treatment services, conduct tuberculosis case finding and patient follow-up, deliver a basic health care package, and refer people with health emergencies to the hospital.
Malaria has been a major public health threat for generations in Paletwa Township, which has the highest malaria burden of all 330 townships in Myanmar. One out of five malaria-positive cases in Myanmar in 2018–2019 was from Paletwa. Most positive cases were found to be Plasmodium falciparum, a species that causes a severe form of malaria, which if untreated can result in death. In Paletwa in 2019, more than 7,600 P. falciparum malaria cases were identified and treated by 204 VHW, trained by MAM with the support of the Global Fund.
Delivering health services in this very remote township is never easy and has become more difficult since late 2018 due to armed conflicts. The fighting has worsened in recent months. The Internet was shut down, a curfew was put in place, public transportation is frequently disrupted, and access to villages can be temporarily blocked, depending on the conflict locations.
Ye Min Naing is very worried about the high number of malaria cases in Paletwa and has seen some patients die of malaria. Although working in the context of no electricity, no Internet, no phone, and serious security issues, he is determined to reduce the malaria burden with the help of his staff and VHW. One of the challenges is to ensure every VHW has enough malaria supplies. Ye Min Naing has overcome many hurdles to make this happen, such as using alternative travel routes, meeting VHW at locations outside of the villages, negotiating with soldiers at armed checkpoints to allow transportation of drugs, and negotiating with authorities for access to VHW villages. His persistence has resulted in a continuous supply of drugs to VHW, so villagers can receive malaria testing and treatment in their own village at all times.
Another obstacle is the ban on gatherings of more than five persons. To tackle this, MAM mobile field teams are doing door-to-door visits to provide patient consultations and health education sessions. These health education sessions are aimed at encouraging villagers to visit the VHW as soon as possible when they have a fever, so the VHW can test and treat, thereby reducing the transmission of malaria.
The latest challenge is the emergence of the COVID-19 pandemic. Travel restrictions have become stricter and fear of the unknown disease is high among villagers. Ye Min Naing is confident that he can manage this challenge and sustain the malaria control activities of the VHW. In fact, his teams are already giving health messages on COVID-19 to the communities, which helps with building trust and maintaining access to the villages.
Ye Min Naing said, “At times I am tired, but when the VHW and villagers tell me how much they appreciate our services, I feel happy and energized again. I am also proud of the dedication of my staff, who are working in such challenging conditions.”
