Mae Tao Clinic collaborates with other organisations to ensure continuity in medical training along the border.

Burma Medical Association

How does it happen that a small community-formed organization, initially with no funding is eventually cited in medical journals?[1]  The Burma Medical Association (BMA) was founded in Karen State, Burma in June 1991 by a group of medical professionals led by Dr. H. M. Singh from Burma.  Although formed in the Karen state, BMA was a collaboration of many ethnic groups who were represented in the Manerplaw stronghold.  The National Coalition Government of the Union of burma took the initiative to coordinate and join forces across ethnic groups to create BMA and to improve health care coordination in the ethnic areas.  The organization serves as a leading body in the coordination of public health policy and promotion of health care among refugees, migrants and IDPs from Burma.  Since its inception, the BMA has provided medical and first aid teaching to community health workers, mobile medical teams, community health education workshops, HIV prevention education, and health education materials in appropriate languages.

In 2000, Dr. Cynthia became Chairperson of the BMA, which formalized her and MTC’s role as a mentor and technical advisor to the group, providing training and technical assistance for BMA.  Starting in 2007, the ‘push’ of improved funding and resources coupled with the ‘pull’ of the ever-increasing health needs of the IDP community in Burma, led to an ongoing evolution of BMA towards becoming a more rigorous and far reaching organization.  Although Dr. H. M. Singh passed away in 2000, his legacy lives on in the passionate desire of those working for the BMA to provide public health infrastructure in Burma.  To this end, the BMA has been the key partner in an innovative pilot program in the border area, Mobile Obstetric Maternal Health Workers (MOM) Project.  The project involves collaboration between Johns Hopkins Center for Public Health and Human Rights (USA), Mae Tao Clinic, Global Health Access Program (USA), and local Burmese Health Organizations.  The goals of the project include: improving access to essential maternal health interventions among vulnerable communities in eastern Burma, capacity building, delivering evidence-based maternal and newborn health care and providing information to inform service delivery strategies in similar settings.  The target population for the pilot study was 60,000.[2]

These days, BMA is supporting over 30 clinics, serving approximately 200,000 people across six states in Burma.  BMA serves eight different ethnic areas in Burma, with a footprint spanning the Thailand, India and China borders.  The distance in kilometres is not necessarily the challenge, but rather, crossing through various security checkpoints and unstable areas to the reach the patient populations.

The BMA, in coordination with MTC, Ethnic Health Organization and the Back Pack Health Worker Team, has coordinated a wide variety of services including; training and curriculum development for maternal and child health, training for traditional birth attendants, school health, hygiene practices in medical settings, water and sanitation, malaria management, solar panel installation and maintenance, emergency obstetric care, health information and documentation and health policy and system development activities along the Thai-Burma border.  These activities have been ongoing for over five years in an effort to reduce maternal mortality and morbidity rates among women as well as to decrease prevalence of communicable diseases such as malaria and gastrointestinal tract infection for populations living along the Thai-Burma border.  Since 2005, BMA has been running several projects on Reproductive and Child Health and has partnered with migrant and ethnic health organizations to increase access to reproductive health (RH) services and information.

BMA’s work is not only focused on IDP areas in Burma.  BMA one of the first partners with MTC for school health promotion and HIV prevention education in the migrant areas of Thailand.  This collaboration began in 1999, with MTC and Doctors of the World to improve migrant health.   This migrant outreach program has grown, with other CBO’s complementing these efforts through collaboration.  It is also notable that this was the first of many collaborations with the Thai Ministry of Health.

BMA also began publishing the Nightingale Health Journal is 2003, which aims to promote an exchange of health-related knowledge among internally displaced, migrant and refugee communities in border areas, with a monthly circulation of 2,000.

BMA has evolved since its inception.  Initially, the goals were focused on coordination and friendship among the health care workers and service providers in Burma.   After a conference in 2000, the goals became more focused on specific public health goals;  improving health information, delivery and standards across ethnic areas.  The future challenges for BMA include: securing long term funding, attempting to keep up with the growing and unmet health care needs of their patient population, and managing the security of health workers.  BMA hopes to achieve increased access to maternal and child health services and reproductive health information and services.  BMA will continue to collaborate with MTC to work towards international advocacy to improve cross-border health care.

Shan Health Committee

After the massive forced relocation of over 300,000 Shan people in 1998, the Shan Health Committee (SHC) established Tin Tad Clinic on the Thai side of the border, which still operates today in Fang. MTC helped to establish this clinic, which has now been officially recognized as a Thai health post.  Today, this clinic in Fang is recognized by the Thai Ministry of Health as a model clinic for migrant workers in Thailand.

In staff exchanges similar to those done by the Karenni Nationalities Health Worker Organization, SHC sent their medics to MTC for training and did staff exchanges and knowledge transfer.  They also work with the Burma Medical Association to the same end.   SHC also worked in partnership with MTC and set up a prosthetics workshop, and conducted their own community health worker and laboratory training.   SHC is an example of partnerships creating an empowered community.

[1] Mullany et al, “The MOM Project:  Delivering Maternal Health Services among Internally Displaced Populations in Eastern Burma”, Reproductive Health Matters, 2008; 16 (31) 44-56.
[2] “The MOM Project:  Delivering Maternal Health Services among Internally Displaced Populations in Eastern Burma”, Mullany, Lee, et al, Reproductive health Matters 2008; 16(31): 44-56.