NASCENT HEALTHCARE IN IRRAWADDY DIVISION

C O N F I D E N T I A L SECTION 01 OF 02 RANGOON 000203

SIPDIS

SIPDIS

DEPT FOR EAP/MLS, DRL, AND IO
PACOM FOR FPA

E.O. 12958: DECL: 03/17/2018
TAGS: PGOV PREL PHUM BM AMED TBIO EAID
SUBJECT: NASCENT HEALTHCARE IN IRRAWADDY DIVISION

REF: 07 RANGOON 1118

RANGOON 00000203 001.2 OF 002


Classified By: Poloff Chelsia C. Wheeler for Reasons 1.4 (b) & (d)


1. (C) Summary. The Hinthada region of Irrawaddy Division is
one of Burma's backwaters. Few roads exist for
transportation, families have an average of seven children,
and dengue, malaria, and diarrhea are the most common
killers. While a single midwife provides healthcare in a few
villages, most lack any medical services. With funding from
Embassy Rangoon's small grants program, the Karen Women's
Action Group (KWAG) trained 31 women from 25 villages with no
medical care in basic preventative medicine. Now an
estimated 7,500 people living in the area have access to the
basic medical care we helped to provide. End Summary.

Hinthada: Fertile Soil, Few Resources
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2. (SBU) Irrawaddy Division, covered by a network of rivers
that comprise the multiple mouths of the Irrawaddy River, has
few regular roads. People travel by speedboat or oxcart
between villages, which normally remain very isolated from
one another. Villagers in the area earn a living by selling
rice, sesame, beans, betel leaves and bananas to the domestic
markets and a few exporters. Despite the rich crop yields,
villagers from the primarily ethnic Karen Hinthada area
estimate that only 50 percent of children can afford to
attend school beyond fourth grade. Their parents often
require them to help care for younger siblings or work in the
fields, and many cannot afford the relatively high school
fees.

What Healthcare System?
--------------


3. (C) On March 12 Poloff and LES traveled to Hinthada to
learn about the local healthcare system in the area and to
monitor the Embassy-funded Karen Women's Action Group (KWAG)
training on preventative medicine. The training, which
reached 31 young women from 25 villages, was already making a
crucial difference for most of the villages that
participated. Only two of the nine young women that we met
had midwives in their villages, and in those instances the
midwives alone represented the entire healthcare system.
Only five of the 25 villages that the project reached had
basic "medics," local people primarily trained in traditional
medicine, according to project coordinator Htoo Aye Shee.


4. (C) Because of the lack of medical care around Hinthada,
medical knowledge in the villages is almost non-existent,
with many villagers dying because of ignorance. For example,
Dr. Kyi Aye Thet who helped with the training explained that
many women attempt to solve the problem of prolonged labor by
standing on the laboring mother in order to force the baby
out. Others mix painkiller powders purchased from local
stores that have adverse effects when taken together.
19-year-old Nee La Lwe, one of the trainees, told us that
someone in her village died this way before she had the
training. A dearth of information about contraception, and
the conviction that having more children is a form of
insurance against destitution in old age, pushes families to
have an average of seven children, said the trainees.


5. (C) Unfortunately, eve if there were significantly more
medical knowlege around Hinthada, medical supplies would
remai in short supply, lamented Dr. Kyi Aye Thet. Even
basic supplies such as needles and sterilized banages are
difficult to come by. When asked whethr she knew how to
measure blood pressure, Nee La Lwe nodded. When asked
whether she had access to a pressure cuff, she said that she
did not. In this way the ability to treat common illnesses
such as dengue, malaria, and diarrhea is limited by a lack of
both knowledge and resources.

Understanding the Needs and Helping Where We Can
-------------- ---


RANGOON 00000203 002.2 OF 002



6. (C) The three-month Embassy-funded training that concluded
in the middle of February reached 31 people from 25 villages
around Hinthada. These villages are often 10 to 30 miles
from the nearest clinic, a distance that signifies the
difference between life and death when the only means of
transportation is an oxcart or a speedboat. The trainees
came from villages ranging in population from 200 to 500,
which primarily consists of the very young and the very old.
Working adults mostly go to Rangoon to work. The young
women, aged 17-35, mostly see themselves staying in their
villages in the future, especially because they now have
unique skills in their communities.


7. (C) The training focused primarily on preventative care
and treatment for emergencies, such as cleaning and dressing
wounds. We met with nine of the trainees, all of whom said
that they found the training extremely helpful. They can now
make appropriate recommendations about medication, give
advice on contraception, family planning and prenatal care,
and educate their communities on effective hygiene practices
and prevention of dengue, malaria, and diarrhea.


8. (C) Only a month after the completion of their training,
the trainees assert that they are making a difference in
their communities and are providing health services to an
estimated 7,500 people. Villagers come to them for advice,
as they are the only source of medical expertise. Soe Mu
Paw, 28, created a 10-member committee on February 20 to pool
money for medical care for those who cannot afford it in her
village. By the time we met her on March 14, she had
collected nearly $100 for the fund and the committee had
grown to 21 members. (Note: $100 in this area could buy food
for an average family for several months.) Other trainees
plan to hold workshops and discussions on the health
advantages of clean bathrooms and safe drinking water.


9. (SBU) Despite the success stories, many of the trainees
lamented that they are all the more aware now of the needs in
their villages. Further training that would enable them to
administer injections and treat common diseases effectively
would help their villages immensely, they said. In addition,
they need medical equipment. Without basic instruments such
as pressure cuffs and bandages, it is impossible to utilize
effectively what knowledge they do have.

Comment
--------------


10. (C) This project is another example of how our small
grants program provides valuable assistance and gives us
access to people in remote areas of Burma we would otherwise
not meet. The Burmese government devotes less than one
percent of its GDP to healthcare, and spends less than
$15,000 annually to treat dengue and malaria. This project,
which cost about $5,000, reached more than 7,000 people and
improved their standard of living. The Than Shwe regime
grossly neglects its people; projects such as this one
provides them with a better life now and for years to come.
VILLAROSA