Child Care

HEALTH SERVICES ADULT CARE REPRODUCTIVE HEALTH SURGERY & TRAUMA EYE & DENTAL CARE PARAMEDIC SERVICES OTHER HEALTH SERVICES

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Child Inpatient Department

The Child Inpatient Department was established in 2005 as it was realised that the needs of children are very different to those of adults. The department treats mainly malaria, acute respiratory infection, and diarrhea.

Established in 1999, the Medical IPD was a combined service for both adults and children. Among children, malnutrition is also a common case, and this was one of the leading reasons for the development of a separate Children’s IPD in 2005; children with weakened immune systems needed to be separated from patients with contagious illnesses.

The most common cases seen continue to be malaria, acute respiratory infection, and diarrhea, with a continuing increase in the number of chronic cases being seen at the clinic, including cancer, sclerosis, hypertension, nephritic syndrome, and heart disease.

In 2017, 1,396 children were admitted in the Child IPD. Of them 65% are under 5-year-old and 52% crossed the border to get treatment. Dengue fever, diarrhea, thalassemia, acute malnutrition, influenza and pneumonia together account for 64% of the diagnoses.

Achievements

We have isolation rooms for general, malnutrition, diarrhea and can separate patients with contagious diseases from patients with non-communicable diseases. The Child IPD in the old Mae Tao Clinic was often crowded, with limited space and bed numbers. Some patients even had to sleep on the floor. Currently at the new Mae Tao Clinic, the 32 beds are sufficient. Our staff can treat patients without being pressed for time. Other departments saw high staff turnover after Mae Tao Clinic’s funding crises and the more stringent policy of Thai immigration towards migrant workers in 2017, but the number of Child In-Patient Department staff has remained stable. We work with 22 staff in 3 shifts to efficiently run the department day and night. We look after around 20 to 25 children on daily basis.

Capacity

We can treat children’s diseases that are prevalent in the region, such as pneumonia, diarrhea, malnutrition and thalassemia. We have the capacity to administer a blood transfusion for thalassemia patients. The common diseases along the Thai-Burma border are caused mainly because children’s poor living conditions: caregivers have a lack of knowledge and lack of resources for good nutrition and hygiene. Consequently, many children have a weakened immune system.

Limitations

We cannot treat patients who suffer for acute bowel obstruction, appendicitis, severe pneumonia and heart diseases. For the aforementioned cases, we need to refer them to a government hospital, either in Thailand or Burma. Due to our limited funding, we cannot cover all referral costs. Either we support 3,000 THB for the patients who cannot afford referral expenses, or we refer the case to one of our partner organizations, such as Burma Children’s Medical Fund (BCMF).

Challenges

The majority of our patients have poor living conditions in terms of hygiene. They may not have good knowledge of the importance of cleanliness. For instance, even though we placed rubbish bins in the ward, some just throw the garbage on the floor. While patients are admitted, we raise awareness and provide parents with health education in hygiene, nutrition, and disease prevention.

Due to limited funding, we are able to refer less patients to the Thai government hospital. While we provide counseling to patients on their diagnosis and need of referral, we also explain them our funding situation and our challenges. We know some have come all the way to Mae Tao Clinic from Burma, how burdensome it must be for them even to pay transportation, how much frustrated they are when we have to tell that we cannot cover all the medical expenses in case of severe disease. Although this is the reality we have to ask them to contribute to referral costs, e.g. for X-ray, advanced laboratory testing or referral costs.

Meet Our Patients here: https://maetaoclinic.org/our-services/our-patients/

(Last update: 29 March 20218)

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Child Outpatient Department

The Child Outpatient Department (Child OPD) provides care for children with acute or chronic conditions, aged 2 months up to 14 years. A standard consultation includes assessment for malnutrition, and if needed, supplementary feeding programmes are offered, including vitamin-A supplementation and (preventative) de-worming treatment.

History and Present

Prior to establishing the department, adults and children were treated in the same department. As numbers of patients rose, Child OPD was separated and staff received more specialised training. In the first few years after the department opened, it serviced mainly children of migrant workers from Burma living in Thailand, but as the clinic has expanded and more people became aware of its services, it has increasingly seen cross-border patients. The demographic of patients in Child OPD is now 69% residing in Thailand and 31% crossing the border from Burma.

The department focuses on curative care, growth monitoring, nutrition assessment and malnutrition, and is committed to treating the common illnesses it sees, such as dengue fever, anaemia (hematologic disorders), diarrhoea and acute respiratory infections.

Health education is one of the department’s main priorities, so that when patients leave they will be better informed on health and child development issues. For example, the staff will tell the parents what food is best for a malnourished child, or for a breastfeeding mother. When a child is immunised, they will tell patients about alternative places for immunised if they cannot follow up at MTC. Ideally, patients will take this information back with them to their communities.

The department is cooperating with Burma Children Medical Fund (BCMF) to refer patients in need of advanced level care to Mae Sot Hospital or Chiang Mai Hospital.

Challenges

During the rainy season, the number of patients with seasonal diseases increases rapidly. The high caseload number results in long waiting and some patients going back home without receiving treatment. In addition, since we moved to the new clinic in 2016, some patients that are strongly advised to come for follow-up (e.g. malnourished children or chronic disease) find it hard to reach the clinic. To tackle this issue, we schedule for monthly follow-ups instead of every 2 weeks.

Staff
There are 5 health workers at Child OPD, providing essential healthcare service and psycho-social support to children. Child OPD consists of 4 examination rooms and has 1 ultrasound.

(Last Update: 25 June 2018)

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Immunisation

Immunisation programme

Immunisation programme is supported by the Thai Ministry of Health, as MTC follows the Thai EPI (Expanded Programme on Immunisation) programme. The immunisation programme offers services to children in the clinic, to students in the school, to pregnant women, to injured adults and to our health workers. BCG and Hepatitis B vaccines, provided just after the birth were given to nearly 100 % of babies born in our reproductive health department. Access to immunisation inside Burma is difficult due to the cold chain limitations. Sadly, we are still seeing children suffering from vaccine preventable diseases such as tetanus.

In September 2016, an outbreak of Japanese Encephalitis occurred in Karen State. In response, a campaign was organised to vaccinate children from Burma. In 2016, 5,563 JE vaccine doses were given.

(Last Update: 27 April 2018)