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Mae Tao Clinic is viewed as an excellent training facility as it offers skilled trainers, including Burmese doctors, senior medics, and international professionals. Due to the Clinic’s high patient load, it also offers extensive practical training. Although travel from inside Burma to the Clinic is expensive and difficult, involving passage through areas of conflict and the passing of security checkpoints both in Burma and Thailand, participants come from all over Burma to attend trainings at MTC.
Health workers, doctors, or medical students arriving on the border in 1989, no matter their specialty, were all responding to the same emergency – Malaria. Residents in student camps with some type of clinic facility were the lucky ones. For the rest, illness meant long periods of travel, often on foot and by boat to seek medical care; there were simply not enough medical facilities to attend to the continual flow of new arrivals to the border. Eventually, each camp established its own health care facility, but staffed with only a few doctors and senior medics it was not enough. After about a year on the border, the health workers of the different camps began to discuss providing coordinated medical trainings, which led to the first formal medical trainings in the student camps.
At this point MTC was focused on offering referral services to patients, with Dr. Cynthia providing informal medical ‘discussions’ in the evenings as a means of training, with visiting doctors helping when they were there. Dr. Cynthia recalls, “We didn’t have manuals, textbooks, or a curriculum. We just started with the basics, physiology…malaria.” These informal trainings went on for over a year. After a couple years on the border, with acute treatment fairly well established, it was identified that lacking not only at the clinic, but all along the border were maternal and child health care services. As the students started to marry and have children, these services became essential.
Dr. Cynthia met with Women’s Education for Advancement and Education (WEAVE) to discuss the need for maternal and child health care training, which resulted in a 6-week programme. This training, the first formal training conducted by Dr. Cynthia, was conducted in 1991 inside Burma as it was identified that the services were most desperately needed in the IDP areas. The training focused on maternal health, especially safe motherhood and family planning. After this first training, some of the trainees who had come from different villages along the border decided to return to MTC, where a more comprehensive maternal and child health care training would be conducted. The training was run in 1992 and 1993 with a 3-month theory and a 3-month practical portion. Most of the participants of these first two years had previous health care training and so this acted as a specialised upgrade training. By 1994 this was no longer sufficient; there was a great demand for more basic health care workers, and so theme was expanded to 4-month theoretical, 4-month practical segments, covering basic health care so that individuals without any previous training could join the programme. The increases still were not providing adequate training for these new participants however, so the first 10-month Primary Health Care Training was offered in 1995/1996. This training was conducted for five consecutive years, with trainees from other ethnic groups and various camps along the border joining in.
In 2001, Burma Medical Association and the National Health Education Committee held a joint conference where the decision was made to begin coordinating the training programmes offered on the border, and to develop standardised curriculums for these programmes. It was concluded that all health organisations should be providing two levels of training: a 6-month Community Health Worker (CHW) Training, and a 2-year Health Assistant (HA) Training. MTC, BMA, BPHWT and NHEC began collaboration to develop standardised training curriculums. A commitment was made to ongoing Laboratory Training, as well as to standardise a Traditional Birth Attendant (TBA) training curriculum.
The growth and development of training programmes continued in this fashion – an organic response to the continually changing needs of the growing population on the border. The MTC Training Programme has grown to include trainings in: Prosthetics, Eye Care, Dental, and Comprehensive Reproductive Health, Emergency Obstetric Care Training (EmOC), Expanded Programme of Immunisation (EPI), Level II Medic Health Worker Training, Continuing Medical Education (CME), Advanced Life Support in Obstetrics (ALSO), Nurse Aide Training as well as an Internship Programme for previously trained health care workers to come for upgrade training. There are frequent short workshops available on topics such as: Leadership Training, Supervisor Workshops, Gender-based Violence, Community Management, Human Rights, and Environmental Health.
Mae Tao Clinic has developed itself to become a key training centre for ethnic and community based health workers along the Thai-Burma border. A variety of courses is offered, covering different subjects, departments and levels of care. MTC carries out a number of capacity-building sessions, as well as providing professional development opportunities through continuing medical education (CME). To ensure formal recognition of health workers’ skills and knowledge, MTC strongly advocates for its staff to enrol in and graduate from accredited courses at Thai universities. As MTC is a member of the Health Systems Strengthening (HSS) Eastern Burma consortium, training and capacity building is not only carried out for MTC staff, but also for health workers of 7 partner organisations within the HSS project. The Ministry of Health and Sports’ (MoHS) aim to realize Universal Health Coverage by 2030, calls for trained and accredited health workers that can fill the current gap in human resources. Members of the HSS consortium are collaborating to jointly train their health workforce, so they can deliver quality health care in the ethnic areas of Eastern Burma. As a strategy for future recognition and integration of their workforce in the formal Burmese health system, HSS partners are actively involving the MoHS in training curriculum review development.
Certificate in Public Health (full-time and part-time): This certificate course is one of the first steps towards recognized accreditation for health-workers at MTC and our partner organizations. In April 2016, MTC hosted the Certificate in Public Health (CPH) course. The training certificate is accredited by Thammasat University of Thailand. The training uses Magwe University training curriculum from Burma which includes 22 theory modules (391 teaching hours), first aid and laboratory practical sessions, plus, field trip and presentation activities.
Although the trainings are incredibly beneficial to the populations living both inside Burma and along its many borders, the fact that such a diverse group of individuals come to MTC for the trainings also poses one of the biggest challenges – that is to say, training a group of individuals from various social, cultural and political backgrounds, with different education and skill levels. A further problem is student retention, which can be as challenging as staff retention; although it is required that participants of the training programme have not applied for resettlement before beginning the training, this is not always the only problem and some students end up leaving the programme due to other obligations.
(Updated on 23th of August, 2017)