Laos: Attention to the public health service in the midst of economic crisis


  • International staff: 11


  • National staff: 45

    With the economy still suffering the effects of the regional economic crisis, the budget for health and education has been reduced to 3.6% of GDP. Only 30% of the population has access to health care. Given minimal state resources and the privatization of the private health sector, MSF has focused on support for the Laotian public health service.
    Assistance in the provinces

    Three technical assistance projects have been aimed at revitalizing the health services in the southern provinces of Champassac and Sekong and in the northern province of Bokeo. The goal has been to improve access to health care and the quality of the medical services, and to ensure that minority groups and the poor are not excluded.

    In December 1999, MSF handed over to the local authorities a project that had run for ten years in the Champassac district of Champassac province. MSF supplied medical equipment and rehabilitated the district health structures, and trained health workers in the specialities offered by the reference hospital serving the southern part of the province.

    A cost recovery system - key to ensuring access to health care in a country with a weak public health service and rapidly growing private sector - is now in place. A new pharmacy will be completed in late 2000, as should reconstruction work on health facilities elsewhere in the province.

    In Bokeo, where programs will come to an end in fall 2000, MSF has improved water supply and sanitation, and promoted domestic hygiene and health education - all carried out through a network of volunteer health workers trained and supported by the MSF field team. Most recently, a health center was opened in Pak Tha district.

    Sekong, an isolated mountain province

    MSF also works in Sekong, a mountainous area where many of the minority communities are several days' walk away from a health center and the monsoon season isolates the province for six months of the year. The organization made improvements at the provincial hospital and two smaller hospitals in Kalum and Dakchung, and organized training sessions related to hygiene and good prescription practices for health personnel. MSF also did several vaccination campaigns. Results from an MSF study on resistance to standard malaria drugs were handed to the authorities, with a view to improving treatment protocols.

    The growing problem of AIDS

    As growing economic contacts with neighbouring Thailand push the spread of STD and HIV/AIDS, an MSF team has been conducting evaluations and training hospital personnel who work with people suffering from these diseases.

    MSF has been working in Laos since 1990.