Myanmar: Helping the most vulnerable

Malaria is a concern throughout the country, and MSF has been involved with malaria-treatment programs in Myanmar for nearly a decade. MSF's studies on parasite resistance to malaria medications in this country contributed to the government's decision to change the national malaria-treatment protocol to artemisinin-based combination therapy (ACT).

MSF teams run malaria projects in Mon state, Kayin state, Rakhine state and Thanintharyi division, operating village malaria clinics that provide a variety of basic health care services and conducting mobile clinics in more difficult-to-reach areas. In some cases, the mobile clinics are run exclusively by national staff due to restrictions on travel by foreigners.

In Rakhine state in the western part of Myanmar, MSF provides basic health services to Rakhine Muslims (or Rohingya), a vulnerable and poor group whose citizenship is disputed and whose movement is restricted.

In this region, which has scarce health care services, MSF teams support a network of simple malaria diagnosis-and-treatment sites - many of them based within state health structures - and hold "mobile malaria days" to improve access to treatment. In 2004, MSF tested more than 350,000 people and treated more than 175,000 for malaria in Rakhine state.

MSF provides HIV/AIDS services in the country's capital, Yangon, and in Tanintharyi division, Kachin state, Shan state and Rakhine state. Activities include health education, condom promotion, outreach to high-risk and vulnerable populations, treatment for sexually transmitted infections and general health services, including antiretroviral (ARV) treatment and home-based clinical and palliative care. HIV-prevention efforts target groups engaging in high-risk behavior, such as commercial sex workers and intravenous drug users.

MSF began providing ARVs to its patients in 2003, and the next year, approximately 541 patients received this treatment.

MSF recently began a project in Kayah state on the Thai border. In this area, the local population suffers from the consequences of intermingled clashes between the army and its opponents. MSF teams aim to provide basic health care through two fixed clinics and two mobile clinics.

As part of its response to the tsunami of December 2004, MSF carried out needs assessments along the southern coast of Myanmar and found no urgent medical needs. MSF teams also traveled to the west coast of Thailand, where Burmese migrants work in six Thai provinces. In response to the poor health conditions facing this group, MSF plans to open a project to improve their access to health care.

MSF has worked in Myanmar since 1992.