The Global Fund Program in Myanmar Newsletter

Save the Children

ISSUE 2 APRIL 2012

You Could Never Forget the Deep Sense of Satisfaction After Saving a Life
Chit Htwe and Sein Tun have been VHVs since the beginning of 2011. The two villagers are among 581 VHVs recruited and trained in Sidoktaya Township, Magway Region, under the Global Fund anti Malaria project. The area manager Nay Myo Tun recounted the early days, We opened our area office in January 2011. The following month saw us traveling to all the 116 villages in the area. We met with the community and selected the enthusiastic persons to act as the village health volunteers. Among them, we selected 181 persons and trained them to become Community Case Inside this issue: Management Providers or CCMPs. Training sessions for VHVs and A Sick Migrant 2 Tapper Came CCMPs began in April, 2011. Dr. Si Rubber Home To Be Saved Thu Aung has been the project By IOM officer of Sidoktaya area from the PSI TOP Center 4 beginning and led these trainings. The has certainly inspired Beginning from April 2011, we ... trained VHVs in behavior change Future Light Shows 5 communication. For CCMPs, the the Path to Recovery a Dawei Orphan training package included malaria for Girl diagnosis, treatment and testing. They 6 also do case management at When Cranes Fly, They Soar High And community level. We also formed Fly off.. village health teams with these persons. One month after moving to Thet Lae village, the twelve year old Zaw Shine Oo (alias) fell ill. It was in January, at the height of the winter season. Three days later, Ko Shine, as known locally, still had high fever. The worried mother informed the CCMPs in the village. The CCMPs conducted the Rapid Diagnostic Test and found out that the boy suffered from Malaria. They treated Ko Shine with anti-Malaria drugs for three days, but still there was no sign of recovery. At last, the VHVs took Ko Shine to Sidoktaya hospital, five miles away.
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The Village Health Volunteers (VHVs) assist local communities in bed net with insecticide tablets @ Save the Children

treating

The rains fell relentlessly on Kyaukphu village as the evening slowly gave way to night. Inside a small hut, Ko Soe Win (alias) and his wife looked on anxiously at their only son Min Htet Aung (alias), lying on a mattress. The boy moaned with high temperature. He was into the fourth day of high fever. Village Health Volunteers (VHV) Ko Chit Htwe and Ko Sein Tun, examined and found out that the boy was suffering from Malaria. They decided to transfer the boy to the hospital. Together with Ko Soe Win, they negotiated through the slippery pathways clogged with muddy water to the public hospital in Sidoktaya. They arrived at the hospital after traveling about five hours in the pouring rain. After three days, Min Htet Aung recovered. The relieved parents were much grateful, Now my son can play again. Its because of our village volunteers and Save the Children who has trained them.

Global Fund Grant Intensifies the Malaria Control in Myanmar

A village woman in Magway Region , central Myanmar, waiting for the impregnation of mosquito nets. The distribution of long lasting impregnated sleeping nets (LLIN) and the impregnation of sleeping nets from the local communities are one of the major program activities being carried out by the partners of Global Fund Round 9 anti-Malaria program for Myanmar. Together, the seven partner organizations implementing Malaria control Medecins Sans Frontieres MSF (Holland), Population Services International (PSI), International Organization of Migration (IOM), World Vision, Merlin, Cooperazione e Sviluppo Onlus (CESVI) and Save the Children have achieved the following the during the Year 1 (1 January to 31 December 2011) : 1. 2. 3. 4. 5. 203,427 LLINs distributed 321,591 blood slides taken 48,960 ACT distributed 59,363 CQ distributed 3,173 VHVs supported

The achievements in Malaria Control, like the other two disease control programs, have been accomplished with the coordination and collaboration among the Save the Children and partner organizations , ensuring the similar and more robust achievements in the Year 2 of the project.

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A Sick Migrant Rubber Tapper Came Home To Be Saved By IOM

Home to more than 5,000 people, Setse is a village in southern Mon state on the eastern shore of Andaman Sea. Traditionally, the majority of villagers work as hawkers or daily wage earners in rubber plantations and rice paddies. With the rapid economic expansion of Thailand, more and more people from Setse and from the region are traveling across the border, where the pay is better but the working conditions difficult. U Soe Win is such an individual. He left his wife Daw Kyu (not their real names) and three children in 2002 to work as a rubber tapper in southern Thailand. Although he earned more than working in the native village, life was hard. Rubber tapping is usually done at night. So we would start around ten in the evening, working the whole night and finishing at two in the next afternoon. Then, work starts again at ten in the evening. He received one day of rest for every three days of work,. The fatigue began to show. In early 2011, U Soe Win, now almost 47 years, began to feel especially weak, losing his appetite, unable to sleep and then suffering from fever and cough. He finally went to the local pharmacy and purchased anti-influenza drugs, but did not really improve. He recalled those days, After some weeks, I went to a ( private) clinic. There was the language barrier. The Thai doctor did not seem to understand my real problem. So he attributed my sufferings to normal illness. Although the drugs helped ease U Soe Wins fever and cough, they were not completely gone. Four months passed. Finally, U Soe Win went to the hospital. Upon examination, the physician explained that he was suffering from severe tuberculosis (TB). He was shocked to learn that his lungs had scar tissue, signaling the severity of his illness. He also learned that TB is a curable disease. However, he lacked
A township medical official : TB case findings have improved significantly because of these CHWs. They go to one house after another looking for TB patients and giving health education. knowledge. These CHWs certainly saved U Soe Win @ IOM

health insurance and therefore could not afford to pay for the six months treatment course. U Soe Win explained, The services there were good, but very expensive. For my first visit, it cost more than USD 100, much more than I could afford. Besides, I could not work and earn money when I was ill. So, I decided to return home. Back at Setse Village, U Soe Win told his sufferings to his family with a heavy heart. He felt like a stranger at home. The most heart-wrenching thing was that his family had to take care not to become infected. Fortunately, his wife Daw Kyu had some
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You Could Never Forget the Deep Sense of Satisfaction After Saving a Life
The group traveled by motorcycle taxis which saved time. The poor family was able to cover the expenses with the ten thousand kyats borrowed from the Village Health Fund. Ko Shine expressed gratitude, I was saved by Save the Children. Their initiative for village health fund system is very good for poor families like us. Otherwise, I couldnt imagine how I could have reached the hospital in town. During 2011, the material support given to Sidoktaya rural communities consisted of 12,005 Long Lasting Insecticide Nets (LLINs), 198 ACTs, 5570 Chloroquine tablets, as well as 26,345 Primaquine tablets. In addition, Save the Children has initiated Village Health Funds (VHF) packages to 114 villages in the township. The area manager, Nay Myo Tun, explained, For each village, we gave seventy thousand kyats as a starter. The village health teams manage these funds. People can also contribute to the funds. The good point is that they are able to use these funds for a variety of health issues. In one village, the funds were used to support a pregnant woman for hospitalization. For the year 2012, through the Global Fund, there are plans to distribute more anti-Malarial drugs and more LLIN distributions. Furthermore, the field teams will conduct the impregnation of mosquito nets in the region. The effort would include both the distributed LLINs as well as those of rural communities. Dr. Si Thu Aung explained, This would serve as the publicity campaign for our anti-Malaria project in the region. People would flock to the mosquito net impregnation places. We conduct basic health talks at those places. We hope that such events could encourage the change of behavior and attitude in community. Ko Soe Win agreed, Before, we knew very little about health hazards. Now we know, thanks to VHVs. Most households have sleeping nets. We had never had anti-Malarial drugs or means for rapid diagnostic tests in village. These days, we have VHVs, health teams and health funds as well as means for prevention and care. The village health volunteer U Sein Tun summed up, You could never forget the deep sense of satisfaction after saving a life. For this I thanked my trainers from Save. Without them this could never have happened.
(Written in collaboration with Save the Children )

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A Sick Migrant Rubber Tapper Came Home To Be Saved By IOM...

knowledge on TB as she attended Health Education sessions (HE) led by the community outreach workers from the International Organization for Migration (IOM) under the Global Fund Program. The organization has been active throughout the Mon State strengthening community capacity and health systems in relation to HIV ,TB , Malaria, and other health issues. Therefore, as soon as she found out her husbands sufferings, Daw Kyu sought advice from the local outreach health workers. With the help of IOMs outreach health workers, Daw Kyu brought U Soe Win to the public hospital in Mawlamyine. There he was tested again and prescribed a nine month course of Direct Observed Treatment System (DOTS). All the medical expenses and transportation costs to the hospital were provided by IOM through the Global Fund. Moreover, the organization also provided nutrition support in the form of rice, bean and cooking oil to the family for the duration of Staff from IOM examining villagers in Mon State as part of TB Day Camtreatment. These supports eased the hardships for the family paign. IOM has been providing mobile clinic services for the community in as their chief bread winner could not work for a long time. target villages under the Global Fund Project @ IOM Daw Kyu would never forget it, Without this support, it would be very difficult to get proper health services for my husband. Besides, we had to provide for the family. I sell providing health education. Therefore, a large number of rural seasonal snacks and weave palm roof sheets. It is not enough, communities nowadays are well aware of TB problem and they however. The eldest son, 17 years old, was a rubber tapper. have gained other health knowledge. Together, mother and son supported the family while father At the completion of his advanced DOTS course, U Soe Win recuperated. is beginning to recover his strength. He looks forward to U Soe Win is just one of thousands of beneficiaries receiving working again, only this time in a nearby rubber plantation due assistance from IOM under the Global Fund TB control to his advancing age. His voice choked with emotions, U Soe project. For the year 2011, during the first year of receiving Win summed up, I am truly grateful for the assistance by the Global Fund support, IOM assisted over 4,800 TB patients IOM. It saved my life and reduced the hardships my family with incentives in the form of transport costs for diagnosis faced. Without this support, I shudder to think what would and/or treatment. Besides giving assistance to clients like have happened. U Soe Win, IOM also facilitated HIV counseling and testing for (Written in collaboration with IOM) TB patients over 15 years of age. It has supported a cadre of 153 Outreach Health Workers (OHW) who are actively involved in TB case finding and/or treatment. The township medical officer from Bilin Township, one of the IOM target sites, was much impressed, TB case findings have improved significantly because of these OHWs. They go to one house after another looking for TB patients and

Global Fund Scales Up the Tuberculosis Control in Myanmar

A staff from a mobile clinic run by the International Organization for Migration (IOM) performing test on a Tuberculosis (TB) suspect in a village in Mon State. Performimg tests for TB suspected rural communities is just one of the tasks performed by partner organizations of the Global Fund project which aims to scale up the TB Control in the country. From 1 January to 31 December, 2011, the five partner organizations of the Global Fund Round 9 anti-TB program International Organization for Migration (IOM), Population Services International (PSI), Merlin, Cooperazione e Sviluppo Onlus (CESVI) and World Vision have achieved the following : 1. 2. 3. 4. 20,980 TB patients receiving transport incentives 3,142 TB patients tested for HIV 19,193 Public-Private Mix Direct Observed Treatment (PPM-DOT) 3,372 Community Health Workers trained

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The TOP Center has certainly inspired a new Me. I feel like Ive been reborn.
Dont think that you are alone, there are many people like you out there. You must fight the disease and make life enjoyable at the same time. This is how the 26 year old Swe Swe (alias), a community worker for the sex worker outreach program run by PSI, usually encourages her fellow sex workers who are infected with HIV. For Swe Swe, life had been cruel enough. She ran away from home at 18 and later became a sex worker. Lacking health knowledge, Swe Swe had never used condoms. Swe Swe explained why, I carefully selected the men I went out with. I had not used condoms because I thought that I would be safe with them. Besides, I thought that only street women who go out with random men have to use condoms. This led to her becoming an HIV positive during her first pregnancy in 2008. Fortunately her husband was not infected. Dejected, Swe Swe stayed away from people. At first, I stayed alone. I was afraid that my neighbors would marginalize and exclude me. I wept Health Education Session of sexually transmitted infections and knowledge on HIV and AIDS @PSI TOP Center alone for days. I did not want to die. After giving birth to a healthy baby girl, Swe Swe, then a divorcee, learned about the PSI TOP Center in Yangon from a friend. The first visit to the TOP Center changed her life. All the people there looked happy and enjoyed their life no matter what their HIV status was. Their happiness spread to me, too. That was the first time I felt that I would not be alone, said Swe Swe. She learned about the effective use of condoms, knowledge of HIV and AIDS, Sexually Transmitted Infections (STI) plus other general health knowledge. In addition, Swe Swe benefited from the psycho-social support package given by the Center. It includes core group discussion sessions, legal counseling for sex workers, series of peer talks and voluntary confidential counseling. No longer did Swe Swe harbor defeatism. She was full of the will to fight back . She said, My worries and negative thoughts were gone. My health also improved. The PSI TOP Center has certainly inspired a new Me. I feel like Ive been reborn. I started thinking about my life in positive way. In 2009, the new Swe Swe married a second time to a 28 year old man who is not HIV positive. In 2010, after discussing with TOP peer educators, medical doctors and counselors about the risks involved she delivered a second child. Her family members are not infected with HIV because she now knew how to protect them. During the same year, Swe Swe became a Peer Educator (PE) at the TOP Center. She has attended trainings on HIV and AIDS care, support and protection, and talks on STIs. She also attended sessions explaining referral systems. As a PE, Swe Swe taught the karaoke bar girls about protective measures against HIV and gave counseling sessions to HIV positive sex workers. Whether you are rich or poor, you will be vulnerable if you do not protect yourself, said Swe Swe. Since January 2011, PSI has been participating in the Global Fund program to fight HIV and AIDS in Myanmar. The participation accelerates the existing PSI programs for limiting the HIV and AIDS epidemic in the country. Under these various projects, one group of People Living with HIV and AIDS (PLHA) that PSI targets is Female Sex Workers (FSW). In 2011 more than 32,300 FSW were been reached by PSI HIV prevention interventions. In early 2012, Swe Swe became a community worker. Her work was well recognized. She explained, Now, all my neighbors know what I am doing and they no longer look down on me. This makes me regain self-confidence. She attended
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Global Fund Expands the Fight Against HIV and AIDS

A field staff from Future Light Community Based Organization in Dawei caring an HIV positive girl during a home based care visit. For the fight against HIV and AIDS, there are 12 partner organizations . Prior to the Global Fund project, many of these organizations have been implementing various HIV and AIDS programs on their own . Participation in the Global Fund Round 9 HIV project provides them with more resources and opportunity to reach out to larger number of infected people. During the Year 1 of the Project, the following figures have been achieved by the 12 partner organizations : 1. 4,425 Community Home Based Care visits undertaken 2. 3,515,353 condoms distributed 3. 26,483 HIV and AIDS patients treated with ARV 4. 63,873 Sex Workers received assistance by the program 5. 75,745 Men Who have Sex with Men received assistance by the program 6. 4,363 Injected Drug Users received assistance by the program 7. 147 patients reached out by Methadone Maintenance Therapy 8. 24 TB patients able to start ART

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Future Light Shows the Path to Recovery for a Dawei Orphan Girl
Daw Hla May (alias) sat in a creaky small house, and watched her granddaughter Yin Min Aye (alias) playing on the floor pockmarked with holes. Morning sunlight shone through the tiny holes on the walls. Outside, people of Ka Hmyaw Kin village went about their own business. Then, the clock chimed eight oclock. The six year old Yin Min Aye rose up, took out a bottle from the only cupboard in the house. Its medicine time. Grandma explained with some pride, She takes ARV like eating some snacks! She quite gets used to it. When asked, Yin Min Aye replied with an innocent smile, I take it two times daily. Its good for my wellbeing. It cures my cough. The early years of Yin Min Aye were full of pain and sufferings. During her infancy, little Yin Min Aye suffered tuberculosis. For more than a year, she had to be treated with anti-TB drugs. No sooner had she recovered from TB than a new tragedy awaited. Her mother was hospitalized and when the family made blood testing the young Yin Min Aye was found to be HIV positive. The Grandma remembered those days, I cried at night when I was alone. My granddaughter was so thin and fragile that I thought she might not survive long. Besides, their father had been away even long before his wifes death. So the responsibility lies with me. It was the legacy of her parents who had worked in Thailand for some eight years that made Yin Min Aye an HIV positive. Life was cruel for the girl as her elder sister, eight years older than the girl, was found to be non-positive. In late 2010, a neighbor introduced Yin Min Aye to Future Light, a community based organization, in Dawei. This proved to be a savior for the thin and fragile Yin Min Aye. Future Light Community Based Organization is a partner organization of the International HIV and AIDS Alliance in Myanmar. Founded in 2007 from a group of People Living with HIV and AIDS (PLHA), the CBO nowadays is a fledgling organization. The aim of the CBO is to create a secure life environment for the PLHA population. The present membership numbers about 365 of various age groups (165 males and 200 females). The CBO has been participating in the Global Fund Round 9 HIV Care and Prevention project since the beginning of January 2011. The project sites include Dawei, Long Lone and Thayet Chaung Townships. From 1 January to 31 December 2011, a total of 156 orphan and vulnerable children (up to 12 years old) received assistance from Future Light,. The assistance includes home based care support, nutrition support, education support and providing hospital expenses. In January, 2011, Yin Min Aye started the ARV treatment at the Myitta Yeik clinic, run by Medecins Sans Frontieres (Swiss). At the same time she also began to receive assistance from the Global Fund project through Future Light. Since then outreach workers from the CBO have been visiting her monthly. In addition, for three months beginning from July, she received

Little Yin Min Aye realizes that her wellbeing depends on taking ARV regularly @Future Light, International HIV and AIDS Alliance in Myanmar

nutritional support such as rice, cooking oil and beans. Gradually, her health improved. The new year 2012 saw Yin Min Aye fully recovered. She gained weight and no longer suffered from high temperatures. Her loving grandmother and caring aunt were much relieved. For Yin Min Aye, the worst was over and life was returning to normal. When the new school season begins in June, Yin Min Aye will be enrolled in the kindergarten class in the village school. Daw Hla May said, The headmistress is very understanding. She would keep silent about my granddaughters status. There are other HIV Positive kids in the school, too. However, its better that such facts should be kept away from young children. They should be gradually told about it when the time comes. Future Light has made up plans for this kind of situation. A senior staff from Future Light explained, Children less than eight years old are considered too young to be informed about their health status. As the preparation, we will hold gatherings for orphan and vulnerable children. As usual, entertainment and learning would be mixed. There will be times for play as well as for health talk. PLHA children would gradually learn about HIV and AIDS. The OVC gatherings will be held quarterly in 2012, funded by the Global Fund HIV program. Each OVC gathering intends to target different age groups so that as many PLHA children could be invited. These gatherings would soften the impact for these children when the time for revelation comes. Yin Min Aye would certainly be invited to one of such gatherings. In this way, she would be meeting friends with similar experiences. Daw Hla May summed up, The best thing she could learn from such gatherings is that she is not alone. The revelation would foster confidence which is her real friend for the life .
(Written in collaboration with the Alliance and Future Light)

The TOP Center has certainly inspired a new Me. .

language skills trainings and personal leadership skills trainings. Furthermore, she is an active member of the Saturday Group, formed by PLHA sex workers. The members meet every Saturday at the TOP Center. They talk about their challenges, their experiences and their knowledge. They also share health services for PLHA. Eyes shining with confidence, Swe Swe said, Nowadays, I no longer feel dejected by my HIV positive status. I just think and plan how to live ahead. Indeed, the future looks just fine for her.
(Written in collaboration with PSI)

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When Cranes Fly, They Soar High And Fly Off Towards The Destination.
The room fell silent as the young man at the head of the table expounded his ideas enthusiastically. About 20 other young men in the room listened intently. Outside, city life carried on noisily. Inside the room, the air seemed to vibrate with the enthusiasm. It could be done if we are willing, and united. There may be challenges ahead. However I am certain we shall overcome them. There were choruses of approval. They are the citizens of the city of Pyay, some 270 kilometers north of Yangon, and from the neighboring towns like Zeegone, Shwe Taung, Paungte, Nattalin and Thegone. They come from all levels of life: graduates, university students, wage earners, etc. Yet, all of them have one thing in common: the will to decrease and stop the HIV and AIDS epidemic in their neighborhood. These informal group meetings originated in the enthusiasm of 14 Volunteer Educators (VE) from the Myanmar Business Coalition on AIDS (MBCA) Pyay office. In January 2011, the MBCA began the implementation of the Global Fund Round 9 HIV and AIDS prevention, care and treatment project, Working with Men to Address HIV, focusing on Men Who have sex with Men (MSM). For the project, MBCA works together with the Burnet Institute which provides technical and institutional capacity building assistance. One of the VEs, the 25 year old Zaw Khine Oo (alias), explained, We realize the menace of HIV on our generation. Large numbers of youths are still ignorant of HIV and its implications on society as whole. A large number of people living with HIV and AIDS are of hidden sub-type of MSM. We must educate them. So Zaw Khine Oo and other VEs went out among the youths in every nook and corner of the city. They held health education sessions, and looked for and developed the networks among people living with HIV and AIDS (PLHA). By September 2011, the VEs had held health talks to a sizable number of youths, many of them being their friends and friends of friends and so on. In this way, the 14 VEs from MBCA, Pyay, have formed a large network of enthused youths. Their enthusiasm was such that they agreed to found a new Drop in Center (DIC). Zaw Khine Oo recounted with a touch of pride, Opening a DIC means we will have more opportunity to reach out to a large number of youths, our target audience. As usual, PLHA would frequent it. In addition, we would like to attract youths who are not PLHA. We will give them health talks. We will encourage them to bring their friends to DIC. It would certainly expand the network among the youths of Pyay. They have made up their mind about expanding their informal group into a DIC. Win Maung Tun (alias), a 22 year old VE said, We have other organizations to look upon. To open a DIC, we need to prove that our group could carry out a lot of activities. And that we have a wide systematic network among PLHA population. We would like to request MBCA and Burnet Institute to advocate NAP on our behalf. They have also
The materials such as texts and photographs included in this newsletter contain project-related information for internal use only. They are provided by non-governmental organizations implementing the Global Fund project activities with Save the Children. The appearance of specific organizations in the newsletter does not imply preference over other organizations. Save the Children is not responsible for any third party contents in the newsletter. Save the Children appreciates all the organizations for every kind of assistance provided.

Volunteers Educators from MBCA preparing group presentation in Peer Education Training conducted at Burnet Institute Office in Yangon @ Burnet Institute

thought up about securing the financial resources to sustain their group. Zaw Khine Oo explained, With the recognition , we will apply for some micro-finance assistance programs. We would like to purchase a paddy thresher. It would cost some 2.2 million kyats. Some of our friends come from paddy growing areas and they know how to run the machine. We would do threshing for a certain fee. In this way, they could secure some kind of financial support to further their plans. Under the Global Fund project, the Burnet Institute trained a total of 60 VEs from MBCA offices around the country. The topics varied from advocacy skills, qualitative data collection, logical framework, basic concepts on self help groups, leadership and team building and community outreach and peer education in HIV and AIDS. For the institutional development, Zaw Khine Oo said that they had acquired trainings from Burnet Institute. All of us attended training sessions on qualitative data collection and leadership and team building. Some of us also got trainings on advocacy, logical framework and basic self help group concepts. These are very good concepts, showing us the way to expand and develop. For these young people, future is full of possibilities. They expected that in next few years their networks could and would cover a large number of youths in the region. Zay Ya Thu, another VE, said, We will strive utmost to achieve good results. Ours would be an example for other youths like us to secure their place in society. Eyes sparkling with enthusiasm and determination, he concluded, You know, when cranes fly, they soar high and fly off towards the destination.
(Written in collaboration with the MBCA and Burnet Institute)

For Further Information Barbara Greenwood Save the Children in Myanmar Wizaya Plaza, 226 U Wisara Road, Bahan Township, Yangon Myanmar Fax: (95-1) 513187 Phone: (95-1) 375 739, 375 747, 375 791, 375 796, 375 801 Email: bgreenwood@savechildren.org.mm