Tamu Trip Report

As the first place winners of Save the Children's case study competition, the staff from the Middle Islands chose to visit the region of Tamu. Tamu is located in the North of Myanmar's Chin state, which borders neighboring India. Save the Children's main project in this area is to combat HIV/AIDS through various means, including consultation. Other organizations that have projects in Tamu are CARE, The Myanmar Nurses' Association (MNA), and Marie Stopes International (MSI)

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Participants
1. U Ko Ko Latt – APC – M&S - Thingangone
2. Ko Sow Lwin – APC- M&S – Dee Du Gone
3. Saw Eden – APC – M&S - Thingangone

Period
12th May – 17th May, 2010

Activities Report
12th May, 2010, Wednesday

8:00AM
Checked in at Yangon Airport

9:45AM
Departed from Yangon
12:15PM – 12:35PM
Received field exchange program guide lines from Gmail
12:15PM-2:00
Shared program activities between winning team and receiving team
Visited the drop in center (DIC) room of Care Myanmar.
The receiving team is comprised of an outreach worker Save the Children, Program Officer and Program Assistant from Care
2:00PM
Departed from Kalay by Car
5:05PM
Arrived in Tamu


5:05PM-6:30PM
Met with receiving team
Planned for field visit to 3 villages (Chaung Net Kyi, Khun Moon Nun, Nant Phalon)
Planned for Village dialogues with program staff
Planned for the meeting of the winning team and receiving team


13th May, 2010, Thursday

9:00-10:30AM
Visited DIC
Shared programs with Myanmar Nurses' Association (MNA)

10:30AM
Travelled to "Nan Phalon" village by motorcycle
11:00AM
Arrived at Nan Phalon
11:00-12:30PM
Met with Daw Kyaing, AMW of Nan Phalon ward 13
Conducted home visits to 8 women with children 0-28 days old
Because of the weather, post natal mothers were not able to attend our community dialogues. We decided to pay them visits at
their households in order to donate baby blankets and educate them on newborn health.


12:30-1:30PM
Met with Daw Nay Hnin Kyan, AMW
Asked for the list of pregnant women, and women with children 0-28 days old
Recorded names and villages of women who received baby blankets
Visited homes and distributed baby blankets

1:30-2:20PM
Lunch
2:20PM
Departed from Tamu via motorcycle
3:00PM
Arrived at Khun Moon Nun Village (at the village leader's house)
3:00-4:00PM
Conducted community dialogues with the villagers and local birth attendants
Asked community members about their issues and suggestions regarding newborn health and child survival (NCS)
Shared how we have implemented NCS in our community
Distributed baby blankets to 2 post natal mothers and explained the purpose of baby blankets / newborn health
4:00PM
Travelled back to Tamu
5:30PM
Arrived at Tamu

14th May. 2010, Friday

9:00-10:00AM
Visited the DIC room
Prepared for the coordination meeting
10:00AM-2:00PM
Coordination meeting with Marie Strope International (MSI), Care Myanmar, MNA, and Save the Children
2:00-3:00PM
Community dialogue with 3rd trimester pregnant women from Nan Phalon ward 12
As we had limited amounts of baby blankets, we did not distribute blankets to them.
We took a list to distribute at a later time
3:00-4:00PM
Lunch
4:00-7:00PM
Bought new baby blankets from Nan Phalon Village
Home visited 11 mothers of children 0-28 day old children in Nan Phalon

15th May, 2010, Saturday (Holiday)
9:00AM-2:00PM
Sightseeing
2:00-5:00PM
Took 2 care studies from MSM (male sex with male), sons of people living with HIV/AIDS (PLHA)
These case studies will be submitted by an outreach worker from Tamu to the HIV program


5:00-8:00PM
Returned back to Kalay by car
8:00-9:00PM
Dinner with the staff of Care Myanmar
9:00-2:00AM
Helped the receiving team in writing 2 case studies
Wrote a proposal for the child focus project receiving team

Lessons Learned

Outreach workers (OW) in Kalay and Tamu are committed and have a high capacity. They are performing program activities efficiently without any Project Assistant (PA) or Project Officer (PO) or AM despite of high risk situation (both HIV risk and political risk).

Mothers are found with many children (More than 5 children) and they are not accustomed to birth spacing.

The Middle Island team are doing 7 programs in our community. We get the chance to learn the HIV program run by consortium (Save the Children, Care, Marie Stopes and MNMA).

Inle Trip Report

The second place winners of the case study contest chose to visit Inle, which is in Shan state. Save the Children's main projects in this area are early childhood care and development (ECCD), and building a structure that acts as a preschool for children ages 3-5 years old; and a training facility for teachers.



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Day 1

- Ideas from the receiving team on how they can improve their Newborn and Child Survival (NCS) activities.

o During teacher training, they can train teachers to be able to make children practice health promoting behaviors e.g., personal hygiene, hand washing.
o They can train teachers and give health education such as noticing the danger signs of childhood illnesses; and how to use oral rehydration salt and zinc tablets for diarrhea.
o Though the villages don’t have electricity, they can show educational videos using a generator weekly/once per 2 weeks.
o If they can get information, education, and communication (IECs) e.g. pamphlets, they can be used in Early Childhood Care and Development (ECCD).



- Suggestions on activities for hand-raising.

o If we can provide them with successful stories regarding NCS, they can be used to increase the number of hand raisers for NCS in these villages.
o Pre-existing health volunteers in the education committee can become hand raisers.

Day 2

- Went to 2 villages, Yay Mae Pin Village and Kyan Pont Nge Village.

- Community Dialogues

o They lack access to quality health care and are using traditional medicines and/or taking treatments from quacks.
o ECCD centers can be facilities for health education, immunization and communal meetings. In one village, the ECCD centre was used for child immunization.
o The community members and mothers said that if we can provide technical assistance, they can take part in NCS.

- Staff comments

o They have heard of the EVERYONE initiative, but don’t have a full understanding of NCS.
o They are interested in Newborn and Child Survival and if we can provide IECs and technical trainings, they can take part in NCS.



Lessons Learned from the Trip

1. Success stories from other Area Offices can be used for mobilization and Hand Raising for NCS.
2. Pre-existing health volunteers in the education committee are an asset for NCS.
3. Awareness of the health problems by the community itself is essential for NCS.
4. Most of the areas in Myanmar need healthcare to varying degrees.
5. The field learning exchange trip is useful in order to share ideas from different area offices for improvement of NCS activities and to make the receiving team participate in NCS more.
6. The community regards the need of Health Care as a priority in most of the areas.
7. There are activities that most of the staff can do as part of their activity in their sector, e.g., hand washing practice and education about the use of oral rehydration solutions (ORS) and Zinc tablets for diarrhea. These activities can save the children’s lives as well as increase the community’s trust for our staff and hence can improve our work.
8. Though the Inle Team doesn’t have health and nutrition sectors, they can still give health education to the community if we can provide them with IECs.
9. Staff working for one sector have less workload than staff working for many sectors; even if the staff number and target village number are nearly the same.

Muse Trip Report

Located in northern Myanmar's Shan state, bordering China, Muse is an area in dire need of aid. Children are being raised in an environment where human trafficking and drug abuse are very real dangers, both to themselves and their caretakers. In response to these conditions, Save the Children's Newborn and Child Survival (NCS) program sends out members who educate mothers on the proper way to care for their children. Additionally, donations made to the Baby Blanket campaign provide mothers with clean attire for their newborns. The following report details the efforts of 3 Save the Children staff members to spread awareness of our NCS program as well as the Baby Blanket donation initiative in the villages within Muse.





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Date

3.6.2010, Nong Kong Village, Namkhan Township
4.6.2010, Mant Maw and Nam Tau Village, Muse Township

Participants- Male(14), Female(65)

The village of Naung Kaung has 172 households with the majority of the population being of Palaung descent. The Early Childhood Care and Development (ECCD) and Child Protection (CP) programs are being implemented in this village.

The village of Mant Maw has 112 households with the majority of the population being of Palaung descent. The CP and NFE programs are implemented in this village.

The village of Nant Taung has 234 households with a mixture of Kaching, Palaung and Lisu people. CP and NFE programs are implemented in this village.

During our discussion with the community, we introduced ourselves and explain the objectives of NCS. The communities were encouraged to actively participate in achieving the goals of the five-year project.
In these villages, children under five years old are dying from preventable diseases. By 2015, we plan for the mortality rate to be reduced by two-thirds. By 2017, we hope for a significant reduction in child mortality rates. Parents are encouraged to join NCS to help prevent the deaths of 6 million children every year.



In order to reduce child mortality, mothers are told to take care of themselves by staying healthy during pregnancy. They should eat nutritious food; receive regular checkups from Health Care centers; and be vaccinated. In order to ensure a smooth delivery, midwives have to check the position of the baby regularly.

We explained that if pregnant mothers do not receive regular checkups from trained personnel, it could potentially lead to birth complications.

Parents were advised to exclusively breastfeed the child for at least six months. In these villages, parents will sometimes give their child water and rice when a child turns a month old. We discouraged this practice by letting parents know that breast milk contained enough nutrients to sustain a newborn child. Supplementary food should be added to breastfeeding only when the child turns six month old. Children are to be vaccinated when they reach one month, two months, three months, nine months, and 18 months old. We demonstrated ways to protect children from diarrhea and influenza. For example, we told parents that a child's inactivity can be a danger sign for certain diseases.



We explained the purpose of the EVERYONE initiative and baby blanket donations. The baby blanket donors' information were presented to the mothers. We distributed baby blankets to mothers that were six to nine months pregnant and mothers who have newborn babies (within 28 days).



We noticed that mothers who were in the later stages of pregnancy or had newborn children were not present during our presentation. When asked why, the villagers informed us that the custom in their village is to prohibit these women from leaving their homes. They believe that women in this period are unclean and thus must be avoided by the men in the village.

Due to this, we elected to visit the mothers in their households. We made sure that they were aware of NCS and the baby blanket donation. The mothers were unaware of good health practices and were more than happy to form them into habits for their children. Villagers were welcome to donate baby blankets.



Naung Kaung village received 14 baby blankets; Mant Maw village received 18 baby blankets; and Nan Taung village received 23 baby blankets. A midwife from Nan Taung, who donated two baby blankets, is very active and interested in the NCS initiative. She said she will let others know through word of mouth that Save the Children is donating blankets. She took a baby blanket as a sample to show villagers.

Marie Stopes International came and donated some blankets to their poor clients. We donated five blankets to the mothers.

All staff in the office have been briefed about the NCS initiative. The objectives of NCS are clarified and seven successful cases from Thahton have been given prizes. Although there is no health program in Thahton township, they still won awards. This township does not have health programs but staff can contribute to the initiative by reporting cases of child abuse as well as by increasing NCS awareness through public activities in targeted villages. Staff are greatly encouraged to dig up more cases and participate in the second competition.

Staff from Muse and Namkham have discussed their cases and will send additional cases in the second round competition.

Difficulties
Some villagers could not speak the standard Myanmar language. We were forced to rely on interpreters for the Palaung people. Due to this, we felt unsatisfied with our discussions.

Lessons Learned
Before entering the village, we were unaware of key village traditions and customs. For example, we did not realize that in one village, mothers could not leave their households during the first month of their babies' birth. In the future, we will be better informed of local customs prior to visiting the villages.

Reported by,
Htay Htay Myint: Project Officer (PO), CP program, Thahton
July Moe Pwint: Project Assistant (PA), CP program, Thahton
Myo Thandar Aung: Outreach Worker(OW), CP program, Thahton