While public health systems often fail to include migrants and other people whose dwelling is not permanent, mosquitos transport malaria parasites from person to person indiscriminately. This means that some people who are unable to access quality healthcare services risk suffering from malaria in silence. In addition to the personal suffering caused by untreated malaria, low awareness of transmission and treatment of the disease poses a threat to malaria elimination efforts.
Sub-recipient American Refugee Committee is working to make malaria information, treatment and care easily available to the marginalized people who fall into the category Mobile and Migrant Populations (MMPs) in South-eastern Myanmar. MMPs comprise communities engaging in traditional farming such as slash-and-burn agriculture, forest workers, people who commute to Thailand for work, seasonal agricultural workers, people who live in unauthorised housing developments, and others. One thing the MMPs often have in common is that they have lower access to malaria prevention services than the rest of the population. One of ARC’s priorities as a Global Fund sub-recipient is to meet MMPs’ malaria prevention and care needs on the routes they travel.
“We thought: Why not create a service that can help people access malaria information, diagnosis and care in the places they frequent? It was this idea that led us to establish malaria posts on the Myanmar-Thai border”, says Rachel Sismar, Senior Program Coordinator. ARC has been active as a sub-recipient both in Myanmar and in Thailand, which makes the organization well-placed to tackle the cross-border transmission of malaria, including artemisinin-resistant strains of the disease. ARC has set up 14 low-threshold border malaria posts close to the informal border crossings that Myanmar people use to go to work in Thailand. Migrants can visit the border malaria posts to learn about malaria prevention, pick up a free LLIN mosquito net, or be tested and treated on their way to or from work in Thailand. The border malaria posts also serve as information gathering points, as learning about patterns of movement among MMPs is crucial to tailor effective anti-malaria interventions targeting this elusive group.
“The fluctuations of mobile and migrant population within static communities in remote areas are a significant concern and problematic for malaria elimination in Myanmar. Innovative outreach programmes specifically tailored to mobile and migrant populations are crucial“, says Project Manager Dr Thet Myo Tun.
ARC has also conducted more systematic research to shed light on MMPs’ migration patterns and behaviours, malaria risk factors for, access to malaria health information and access to public health services. Prompt diagnosis and treatment of malaria is necessary to start timely treatment and prevent life-threatening complications, but only 50 out of the 137 MMPs interviewed by ARC sought medical advice and malaria testing within 24 hours of fever onset. The remaining 87 MMPs – 64 percent – did not seek medical care because it is not available within 24 hours, that it was impractical to travel to health facilities, for instance due to adverse weather conditions, or that they did not consider fever as a sign of serious illness.
