Laos 1998

International staff:18 National staff: 19 HEALTH SERVICE NEEDS BOLSTERING With the socio-economic indicators among the lowest in Southeast Asia, less than 20% of the largely agricultural-based population have access to even the poor quality of care offered by the public health structures. MSF provides technical assistance to energize the health structures in the provinces of Champassack, Sekong and Bokeo. Teams work alongside local personnel and collaborate with district and provincial authorities to improve health services. Activities include basic curative and preventive care in health centres, medical training and preparation of treatment protocols. Medical activities are organised and supervised at district level, including EPI, an epidemiological surveillance system, and health information for villagers. A revolving fund for essential drugs is being developed to ensure stock replacements, as well as a cost recovery system. MSF's work is greatly appreciated by the authorities. Management support is given to the provincial health service, and technical support to provincial hospitals and health centres, in Sekong province where the population is mainly composed of underprivileged minority groups. MSF completed and translated a clinical and therapeutic manual, which was presented to the Ministry of Health with a view to its eventual use as a standard reference. An MSF economist worked with a national committee on the preparation of a guide to the practical implementation of a rolling fund for essential drugs and implementation of five provincial pilot projects. In April 1998, MSF began a six-month assistance programme for four villages for lepers following the second consecutive year of flooding that ruined crops and resulted in serious food shortages.