Tuesday, December 1, 2015

Children’s health and nutrition helps build peace in Myanmar

Nobel Peace Prize winner Aung San Suu Kyi and her National League for Democracy (NLD) has won a landslide victory in Myanmar’s first free elections in 25 years. When NLD assumes office early next year, it will face one of the longest running civil conflict in the world.

Despite the recent signing of a ceasefire between the Government and representatives of eight ethnic armed group, an estimated 1.8 million children are not covered by the agreement, especially those living in some areas of Kachin and northern Shan, where conflicts continue and prevent children from accessing basic services. UNICEF and the NGO Health Poverty Action work together to strengthen access to primary health care and nutrition interventions, such as infant and young child feeding support in areas that are hard to reach due to conflict, poor geographical access, and political constraints.
 
By Mariana Palavra
 
Kachin State, November 2015 - Lwan No was caught in the middle of the civil conflict in Kachin State, Northern Myanmar. “I could hear the planes bombing the area, the constant gun shots and mine explosions”, she recalls. This was in 2011, when the civil conflict broke out in Kachin. 
 
Lwan No got married in this IDP camp, after fleeing from the civil conflict three years ago. Now, she wants her five-month old baby to become a bright and successful businesswoman.
©UNICEF Myanmar/2015/Mariana Palavra
 
To save her life, Lwan No had to flee from her village empty-handed. For the last three years, she has been living in Chipwe’s camp for Internally Displaced Persons (IDP).
 
Chipwe is part of the former Kachin Special Region 1 (KSR1), which borders China. The region is now under government administration, however, on the other side of the river, the area is controlled by an ethnic armed group, and conflict has been active.   
 
“Some nights, we are awakened by the shooting from both sides of the river”, Lwan No says. 
 
UNICEF and Health Poverty Action (HPA) have been working not only in government-controlled Kachin Special Region 1 but also in Special Region 2, which is controlled by an ethic armed group, to reduce maternal and under five mortality. 
 
“We are committed to reach every child, wherever they live, and regardless of their ethnicity”, explains Bertrand Bainvel, UNICEF Representative to Myanmar. “This means reaching children in both Government-controlled areas and areas controlled by ethnic armed groups”.
 
“This partnership directly contributes to peace as it builds consensus between both sides in conflict to improve the health and nutrition status of children and mothers wherever they reside”, reveals Jiayin Li, HPA Myanmar programme coordinator. 
 
“Every single action – capacity building or service delivery - implemented in Special Regions 1&2 has to be agreed by both sides in conflict. This implies constant talks and negotiations facilitated by HPA between Government and ethnic groups”. 
 
Health indicators from the six townships in Special Regions 1 and 2 covered by this project are significantly lower than national averages. For instance, in the former Special Region 1, less than 50% of women receive prenatal care, far from the 83% national average. In the same region, only 27% of children under two complete the full course of immunisation, while at the national level the percentage stands at 88%. The prevalence of anaemia among children and mother is 72% and 62%, respectively.   
 
Based on these results, UNICEF and HPA, in collaboration with the Kachin State Health Department and health representatives from the ethnic armed organisation, have been working to strengthen the capacity of basic health staff and community health volunteers to deliver quality health and nutrition services equitably. Throughout this year, 14 master trainers and 120 staff have been trained on maternal, new-born and child health care, as well as nutrition and immunisation. In addition, 140 community volunteers have received training to provide basic health mobile services in hard-to-reach areas.
 
The training ensures that health field staff in Special Regions 1&2 have the same levels of professional knowledge and skills, and adopt the same standards for maternal, new-born and child health, nutrition and immunisation services. 
 
In San Myaw’s 52 years of life, 23 have been spent helping women to deliver, and providing basic primary health care to mothers and children on both sides of the river.
©UNICEF Myanmar/2015/Mariana Palavra

San Myaw is one of the traditional birth attendants, living in a government controlled area, who was part of these trainings. In her 52 years of life, 23 have been spent helping women to deliver, and providing basic primary health care to both mothers and children around Mangtaung village, on both sides of the river, under the respective control of the warring parties. 
 
“Over the years, I have been called to help at any time, night and day. I have walked for hours and often fell in the darkness”, San Myaw says. “Once, while taking a boat, the engine died and we drifted. Another time, the boat almost sank.”  
 
Through this project, around 19,000 children under five who live in Special Regions 1&2 will receive immunisation, nutrition and childhood illness management services. In addition, over 7,700 pregnant and lactating women will receive antenatal and postnatal care, safe delivery, as well as nutrition and infant and young child feeding counselling support.   
 
“Alongside peace talks, efforts have to be made to create dialogue among health actors from both sides, not only to ensure that health and nutrition service delivery will not be interrupted, but also to build health systems that meet the needs of all communities”, says Bertrand Bainvel, UNICEF representative to Myanmar.
 
In fact, during 2015 measles and rubella campaign, through UNICEF and HPA mediation, the national and ethnic health systems collaborated to make sure that children from both sides could be immunised.
 
“UNICEF urges all parties in remaining conflict areas to make every effort to make peace so that every child, wherever they live, can grow up in a united, peaceful and prosperous Myanmar”, Bertrand Bainvel concludes.
 
Lwan No also dreams about peace and a better future. “I got married in this IDP camp, and five months ago I gave birth to my first child”, she says proudly while she breastfeeds her baby girl. “I want her to become a bright and successful businesswoman. She will have a big company and be rich, so she can support the rest of the community.”    
 
Meanwhile, traditional birth attendant San Myaw won’t give up her mission. She will climb mountains, walk night and day, paddle a boat, or do whatever is needed to reach every child. “I am never afraid. Not even when I approach the security check points and different groups in the conflict shoot into the air to intimidate me”, she says. “I will go against every obstacle because I must help, I want to help and I will help”.  
 

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