Karen Department of Health and Welfare of Annual Report 2011

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and discussion and evaluation of education techniques and materials to be used in persuadingvillagers to accept the medications. The February workshop emphasized methodology forrandom sampling of households in preparation for the July 2011 seroprevalence survey. InAugust more attention was given to education techniques and materials.LF follow-up training for random selection of houses for prevalence surveyFuture PlansEfforts will continue to cover a higher percentage of the target population in Wah Ka Der withmass drug administration. When it is determined that methods and resources are adequate foradministering more MDAs successfully, funding will be sought to extend the program toadditional areas.We thank our partners in the KLFP:Hussman Foundation (Funding)Global Health Access Program (training and monitoring)47
Karen Immunization ProgramProgram BackgroundChildren in the internally displaced person (IDP) population of Karen state receive none of thechildhood immunizations that are a primary defense against child mortality throughout theworld. Absence of immunizations is one of several reasons why 138 of every 1,000 childrenborn alive in Eastern Burma die by the age of five, compared with 14 deaths in children underfive per 1,000 live births in Thailand. 5 There also exists in this unvaccinated population thepotential for a disastrous wide-scale measles epidemic.The long-awaited commencement of an immunization program in eastern Burma becamepossible in 2008, when the Border Green Energy Team (BGET) installed solar-poweredrefrigerators for storing vaccines at KDHW clinics near the Thai border. KDHW has developedprotocols to minimize the risk of vaccine spoilage when transporting vaccines from therefrigerator at a clinic to more remote locations. The program cannot reach more distant MHCareas, because the cold chain cannot yet be maintained for longer than a three days’ walk fromthe border. In April, 2009, the first round of systematic immunizations was given by KDHW inthree mobile health clinic areas, Day Bu Noh, Ei Tu Tah, and Ler Per Her (Figure 2a).At the end of 2011, the Karen Immunization Program (KIP) was operating in seven areas inKaren State, one new program area having been added in 2011. In the past, insecureconditions have been a major deterrent to the KIP in some areas. Two clinics have been closedbecause of military presence in their areas beginning in 2009. Ler Per Her clinic was closedbecause it is near a military base. Despite many attempts to restart the program in this area,program workers remain fearful of the Burmese army, and local leaders advise againstrestarting the program. Paw Bu La Ta restarted its program in mid-2011.Program ServicesChildren from birth to 14 years of age are immunized in sequences shown in Table 12. Clinicskeep a card for each immunized child in order to track their individual sequence ofimmunizations.Table 12. Ages and Sequences for ImmunizationsImmunization Age at First Inoculation SequenceBCG (tuberculosis) birth - 5 years single inoculationOPV (polio) birth - 14 years 4 consecutive dosesDPT (diphtheria, pertussis, tetanus) 6 weeks - 6 years 3 consecutive inoculationsMMR (measles, mumps, rubella) 9 months - 14 years single inoculationVaccination campaigns are implemented every three months. Thus, doses are separated bythree months for those vaccines with multiple doses. After an area completes four rounds ofimmunizations, the program focuses on immunizing newborn and newly arrived children.Community leaders notified in advance arrange for villagers to assemble at particular sites formass vaccinations, shortening the length of time that the vaccines must be kept inunrefrigerated coolers. Some clinic IP workers also carry refrigerators with small batteries.48
Page 2 and 3: Acronyms Used by KDHWACL Anterior C
Page 4 and 5: Program Background ................
Page 6 and 7: IntroductionIn Karen populated area
Page 8 and 9: KDHW Policy Statements1. RIGHTS TO
Page 10 and 11: Organizational Structure of KDHWThe
Page 12 and 13: Karen Mobile Health Clinic and Prim
Page 14 and 15: Figure 1b. The KDHW Mobile Health C
Page 16: Figure 2. 30 MHC Caseloads by Clini
Page 19 and 20: Karen Village Health Worker Program
Page 21 and 22: Program ServicesThe KMCP applies in
Page 23 and 24: MCP Health Workers Taking Inventory
Page 25 and 26: Program ServicesIn 2011 17 KTMP tea
Page 27 and 28: Program TrainingIn 2007 the KTMP de
Page 29 and 30: The KRHFP conducted a baseline surv
Page 32 and 33: RCHW performs neonatal resuscitatio
Page 34 and 35: Gender Based Violence Counseling Pi
Page 36 and 37: Karen Village Health Worker Program
Page 38 and 39: 216 VHWs living in 135 villages. On
Page 40 and 41: Karen Tuberculosis ProgramProgram B
Page 42 and 43: Table 7. TB Patient Identification
Page 44 and 45: Karen Vitamin A Supplementation and
Page 46 and 47: Program TrainingKADWP coordinators
Page 48 and 49: Program ServicesThe Karen LF progra
Page 52 and 53: Community education is an essential
Page 54 and 55: Karen Targeted Feeding ProgramProgr
Page 56 and 57: KTFP worker teaching mothers of mod
Page 58 and 59: to them. Each participant received
Page 60 and 61: It is very easy to get good stone f
Page 62 and 63: KPECP surgical team performing cata
Page 64 and 65: Karen Herbal Medicine ProgramThe Ka
Page 66 and 67: The Lu Thaw Paw Dayd KHMP center is
Page 68 and 69: Training and Capacity BuildingFor b
Page 70 and 71: A trainer from Mae Tao Clinic teach
Page 72 and 73: Trainer examining a patient during
Page 74 and 75: the previous module. The first modu
Page 76 and 77: Program TrainingKDHW’s health pro
Page 78 and 79: Proportions of expenditures on diff
Page 80 and 81: References1. Aide Médicale Interna

Karen Department of Health and Welfare of Annual Report 2011

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