contain + eliminate = no parasite

Reaching Out To Migrant Workers At The Thai Border

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Workers from Cambodia making their way to Thailand at the border crossing in Sampov Lou. Pix by WHO/Sonny Krishnan

Pong Nam Ron District, Chantaburi Province — “Mom” lives in this camp with other people who come and go between Thailand and their homes in Cambodia whenever there is work.

A recent secondary school leaver, “Mom” said her family spends about two months here before they go home to Boseth Commune in Kampong Speu, a province located southwest of Cambodia’s capital Phnom Penh, or a day’s drive away from Chantaburi on the Thai side.

In her Thai, which was understandable though not fluent, she remembered having repeated the journey about 10 times, and having done some work herself on some occasions. “We pick whatever fruit is in season,” she said.

About 20 people who usually spend less than six months just inside Thailand were living in this camp when a team from the officials from Bureau of Vector Borne Diseases, World Health Organisation and the Malaria Consortium paid a visit. The conditions at the camp located on the edge of a longan orchard were stark. Spindly tree trunks propped up the houses, with synthetic fiber sheeting or newspaper sheets as walls.  But there were water jars in the camp, suggesting some permanency or continuity in the movements of these itinerant workers.

Chantaburi is renowned for its wealth in fruits such as longan, longgong, rambutan, durian, mangosteen, among others. But fruit-picking is rated by Pong Nam Ron District authorities as a “high risk” occupation.

Piyaporn Wangroongsarb, a specialist in migrants for the Bureau, pointed out that people from Cambodia cross the border into Thailand regularly, perhaps every month, for work because there was constant demand for longan fruits in markets abroad.

A key partner in the  $22.5 million Containment Project largely supported by the Bill & Melinda Gates Foundation, the Bureau of Vector-Borne Diseases “plans to impregnate ordinary nets with permethrin that either kills or repels mosquitoes, and to distribute bed-nets already treated with the chemical to those who have no nets at all,” added Piyaporn.

Chantaburi is renowned for its wealth in fruits such as longan, longgong, rambutan, durian, mangosteen, among others. But fruit-picking is rated by Pong Nam Ron District authorities as a “high risk” occupation.

The high-risk rating, explained Saowanit Vijaykadga, head of the bureau’s Malaria Cluster, referred to those fruit-pickers who “stayed overnight inside orchards and did not take precautions, such as protect themselves with long-lasting insecticide-treated nets and repellents.”

While the Bill & Melinda Gates Foundation-funded containment project is now able to diagnose and treat falciparum malaria cases effectively with quality drugs, other measures like the targeted distribution of long-lasting insecticide-treated nets and long-lasting insecticide-treated hammock nets, together with repellents, have significantly brought down the number of cases of this deadly form of malaria.

The Fixed Schedule Malaria Clinic that began operating in this malaria hot-spot area in April 2009 is strategically placed on the Thai-Cambodia border. Its twice-weekly mobile clinics enable quick diagnosis and treatment of malaria cases. Between April 2009 to September 2010, blood samples were drawn from 3,267 people and only five of them tested positive for falciparum malaria.

There seemed no doubt that the new interventions acted as a catalyst for the existing network of voluntary malaria workers to quicken their pace. Before the project started, the voluntary malaria workers tested only 156 people and found three positive falciparum malaria cases. When the project kicked in, these volunteers tested nine times as many people and found that those who tested positive had increased by four times.

Chantaburi, with Pong Nam Ron and Soi Dao districts as the busiest areas for fruit cultivation, probably ranks as the main recipient of short-term workers from Cambodia across the eastern border.  Trat, Sa Kaeo, Buri Ram, Surin, Si Saket, and Ubol Ratchathani are the other six provinces included in the project to contain artemisinin-resistant falciparum malaria.

Chantaburi’s Pong Nam Ron and Soi Dao districts hosted 15,424 temporary workers from Cambodia at the start of 2009.  Among these, those who stayed less than six months almost tripled those who stayed longer.

Khun Saowanit, a veteran in the Ministry of Health who has worked to curb malaria and other mosquito-borne diseases, understands the pattern of  movements of persons from across the border and impacts on their health, as well as those of persons living  close by.

“Our understanding of the pattern of movements of groups of persons helps us to develop media materials and tools that are suitable to each group,” he pointed out.

The challenge is how to come up with an original formula to better protect and treat adults and children who spend so much time on the move, and to make that also available to residents living in the vicinity.

Anuraj Manibhandu


Written by malariacontainment

October 20, 2010 at 3:48 pm

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