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 -------------- ¶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