Polio Immunisation crosses conflict borders in Myanmar

By Mariana Palavra and Tin Lay Naing

Nang Kham Noon immediately confesses she doesn’t know much about health issues and how children’s health can be improved. The 18 year old Palaung girl lives with her parents and two younger siblings in Hway Lone village, Tangyang Township, a Shan State Army/Shan State Progress Party (SSA/SSPP) controlled area in Shan State.

©UNICEF Myanmar/2016/Tin Lay Naing

Despite her lack of knowledge on health, she didn’t think twice when she heard about a polio immunization campaign gathering, which was taking place at her village. “The village leader announced the location of this immunization post and said that all under 5 children must come”, she recalls. “Therefore, I brought my younger sister and brother to be vaccinated”. Five year old Nang Kham Loon [photo] and her 3 year old brother are now immunized against polio.  

In the past, routine immunization was absent from Hway Lone village. In fact, the government’s health care system does not reach many non-state controlled and conflict sensitive areas in Shan State, mainly due to conflict and lack of security, and because these areas are very remote and hilly and lack transportation. 

“In some of these areas, the Basic Health Staff (BHS) of the Department of Public Health could not effectively build the trustful relationship due to the limited access caused by security concern and especially if they could not communicate directly in the same language with the local community". Knowledge on health issues of local people is also very poor, which explains the high rates of communicable diseases, such as TB”, explains Nang Mya Nwe Tra Tun, Health & Nutrition Specialist of UNICEF Shan State.  “There are still some ‘no immunization villages’, where children haven’t received immunisation during the last four years”.

Shan State Youth Network Committee (SSYNC) is the only civil society organization working in the Shan State Army/Shan State Progress Party (SSA/SSPP) controlled area. Established in 2012 and based in Southern Shan, it is fully supported by the ethnic armed group and the local community. “Due to the on-going conflict, the mothers are running away with their kids whenever they see strangers.  When we go to the field, this does not happen, because they trust us”, confirms one SSYNC volunteer. The organization focuses on various issues, namely health, education, youth engagement, women and child protection.

UNICEF initiated dialogue with Shan State Youth Network Committee (SSYNC) after fighting broke out in October 2015 in central Shan State “in order to cover those children in hard-to-reach areas”, explains Khin Moe Aye, Chief of UNICEF Shan Field office. In addition, when the SSYNC offered to participate in the National Immunisation Days (NID), UNICEF facilitated contact and talks between the ethnic health organization and the government health authorities, both at State and townships levels. “This was essential to ensure consensus regarding areas of intervention, vaccine collection points, contact persons, etc”, adds the Chief of Field Office.  

“This partnership has been fruitful, as the number of children under five vaccinated has significantly increased in these hard-to-reach areas” says Daniel Ngemera, UNICEF Immunisation Specialist.  “In Some areas, it was the first time children received vaccination against polio.”

Through this collaboration, more than 1,400 children living in non-state controlled or conflict-affected areas in Northern and Southern Shan were vaccinated. “This is a very important step to achieve 100% polio immunization coverage, especially now that Myanmar has been conducting national polio campaigns after two cases were reported in 2015”,  adds Daniel Ngemera. “The concerted efforts of the government and all health partners will result in improved routine immunization coverage nationwide and low risks of vaccine-preventable disease outbreaks in future, including Polio”.

In 2016, UNICEF Myanmar will continue to work to fully establish a vaccine management and climate resilient cold chain system across the country, assuring quality immunization services and making sure 100% of children are immunized against polio, including in border areas of Rakhine, Chin, Kayah, Kachin and Shan States. To achieve this, the organization will continue to support joint programmes between non-state actors and the government to improve coverage not only in health, but also in nutrition, education and child protection, especially in ceasefire areas.

It is not true that Nang Kham Noon knows nothing about health issues. “I know that immunization is good for the health of any child”, she says without hesitating.  “I don’t know how we can improve children’s health, but we could start by opening a health clinic in our village”. As for her younger siblings, she already dreams about their healthy future: “I want to see my sister as a nurse and my brother as a teacher in our village”.