“We knew that no matter how hard we tried, without successful community participation we would fail,” said Dr Aung Kyaw Phyo, the Project Coordinator of Medical Action Myanmar (MAM) in Kyainseikgyi Township, in southern Kayin State.
The importance of community involvement and the collaboration of its members cannot be stressed enough for successful malaria prevention and control and improved community health.
MAM field team giving health education during a house-to-house visit
MAM field team in a group discussion with village leader and key people in the village
MAM has been implementing its project “Containment of artemisinin-resistant malaria in hotspots along the Thailand–Myanmar border” under the Regional Artemisinin-resistance Initiative (RAI)/Inter-country Component 1 since 2014.
When MAM decided to start piloting a Mass Drug Administration (MDA) project for malaria in Kyainseikgyi Township, it was aware of the significant challenges involved.
Communities there have a low level of education with little knowledge and awareness of malaria.
They were unaware of MDA for malaria and the area is characterised by continuous migration and frequent border crossing to and from neighbouring Thailand and some security concerns along the border.
There is a general lack of trust in western medicine, as people had been cut off from the rest of the world, living in forest and mountain areas, hiding from long-standing domestic conflicts.
Once, a head of a family told the MAM team that they did not need any medicines and that he did not trust western medicines; the family was healthy and had so far survived malaria in the forests and mountains. Like him, most of the community was unwilling to participate in MDA, which for them was something new.
MAM's community engagement (Karen) staff in discussion with villagers explaining about malaria and importance of MDA
Health education and meeting with villagers when villagers return from their farms in the evening
Despite these challenges, the MAM team did not give up, but instead tried their best in every way they could think of to achieve the highest coverage of MDA.
They were able to overcome these challenges through patience, sincerely listening to and learning from the community members to gain an understanding of their perspectives and concerns around health issues and malaria.
The MAM team gradually reached out to the community through meetings and health education sessions to raise awareness of malaria, and explained the risk of antimalarial drug-resistance and the need to prevent further spread of artemisinin resistance in the region. After that they explained the aims of the project.
MAM staff helping the villagers in their farm as part of community engagement and trust building
It was the collective work of this highly motivated team that finally led to MAM's success in engaging the community to accept the pilot project.
“We are very happy and proud of our success. We have spent much time with the community, waiting patiently for their participation and acceptance of the MDA pilot. We are eager to announce that we have achieved an average MDA coverage of 88 per cent of the population”, said Dr Aung Kyaw Phyo.
The goal of RAI is to accelerate the elimination of P. falciparum malaria in the Greater Mekong Sub-region and avert the spread of artemisinin resistance.
You can read more about the work of MAM here.
