3.

TOWNSHIP HEALTH PROFILE

AMARAPURA TOWNSHIP
MANDALAY REGION
(2022)

3.1 Background Information Of The Township

1. Map

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 2. Background history

Amarapura, known as "The Immortal City," was once Myanmar's capital

but is currently a Mandalay municipal township. The Irrawaddy River borders
Amarapura on the west, Chanmyathazi Township borders it on the north, and
the ancient Ava (Inwa) capital site borders it on the south. In connection to
Mandalay, it was once known as Taungmyo (Southern City). Amarapura is
now a part of Mandalay due to urban growth. Traditionally, the municipality
has been recognized for its bronze casting and weaving of cotton and silk. It is
about 80.11 Square Kilometer.

3. Population(2022)

Total - 219463
Male - 105621
Female - 113842
Sex Ratio - 1:1
<1 yr. - 3750
<5yr - 19329
0-14 yrs. - 50576
15-49 yrs. - 53943

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3.2 Organization Setup and Functions of Township Health Department

Organization Setup of Amarapura Township Health Department

 H/A – (1)
 LHV – (1)
 MW – (3)
 PHS (II) – (1)
 Security – (1)

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Functions of Township Health Department

The Township Health Department, led by the Township Medical Officer (TMO)
Dr. Soe Ko Ko Zaw and supported by basic health staff, executes the following
functions:
1.Medical Care
2.Community Health Care
3.Disease Control Activities
4.Environmental Sanitation
5.Administration:

1. Medical Care

2. Community Health Care

a. Maternal and Child Health Care

Community Health Care and Maternal and Child Health Care are integrated
services, not distinct vertical programs. They are delivered through the Urban
Maternal and Child Health (MCH) centers in urban areas and Rural Health Centers
(RHCs) in rural regions. Within the MCH center, various maternal and child health
services are provided, including birth spacing.
b. Birth Spacing
To facilitate birth spacing, clinics are established in township hospitals, station
hospitals, and rural health centers. Contraceptive methods available in Amarapura
Township include oral contraceptive pills, injection-based contraception, and
intrauterine contraceptive devices

3. Disease control activities

a. VBDC program
To manage the four main vector-borne diseases (malaria, DHF, Filariasis, JE),
the following initiatives are implemented. Personnel from township-based Vector-
Borne Disease Control (VBDC) units collaborate with health staff, placing a strong

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emphasis on community participation for sustained control measures involving
insecticides. Treatment is applied selectively. Adequate provision of Rapid Diagnostic
Test (RDT) kits ensures the detection of malaria cases.
b. STD control project
In the STD control project, case identification among pregnant women is
conducted by workers from the STD team. Adequate provision of Rapid Diagnostic
Test (RDT) kits ensures the detection of AIDS cases in this context.

4. Environmental Sanitation

Environmental sanitation activities follow this program:

 Implementing fly-proof and water-proof sanitary latrines as part of the fly-proof
latrine project.
 Ensuring proper refuse disposal methods.
 Installing sanitary latrines in schools.
 Providing adequate and safe water supplies.
 Contributing labor for special occasions dedicated to environmental sanitation
efforts.
5. Administration

The nature of administration can be classified into:

a. General administration
b.Hospital administration
c. Field administration
(a) General administration
The work involves collaborating with various government bodies and non-
governmental organizations, overseeing the administration of township health units,
station health units, and RHCs, and ensuring their effective coordination.
(b)Hospital administration
It involves distributing tasks among medical officers, nurses, and staff,
managing equipment, medications, buildings, and medical supplies, collaborating
with the hospital administration committee, and giving necessary directives when
needed.

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(c) Field administration
This involves frequent visits and oversight of Station Health Units and RHCs,
as well as collaboration and coordination with other government sectors.

Maternal and Child Health Centre

The functions of the Maternal and Child Health (MCH) center include:
1. Promoting reproductive health and providing care during the stages of
antenatal, intranatal, and postnatal periods.
2. Preventing, identifying, and managing prevalent diseases in the area, especially
those impacting mothers and children.
3. Offering guidance and services for fertility regulation, counseling, and birth
spacing.
4. Providing healthcare for children under 5 years old.
5. Collecting vital statistics related to maternal and child health.
6. Conducting immunization activities for pregnant women, infants, and within
the Universal Child Immunization (UCI) program.
7. Providing care and support for infants.
8. Supervising the physical and psychological development of children and
adolescents, addressing issues like malnutrition.
9. Maintaining records and reporting on health-related matters.
10. Delivering health education on nutritious food and providing demonstrations
for better understanding.

Station Health Unit

The Station Health Unit is under the guidance of the Station Medical Officer (SMO).
The roles of a Senior Medical Officer (SMO) encompass several facets:
1.Technical Professional Specialist: Providing specialized expertise and
technical knowledge in the medical field, offering guidance and direction
based on professional skills and experience.

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 2.Administrator: Overseeing and managing the administrative aspects of medical
facilities or programs, ensuring smooth operations, resource allocation, and
adherence to protocols.
3.Community Leader: Acting as a leader within the community, fostering
relationships, advocating for public health needs, and actively engaging with
the community to address health concerns and promote well-being.
4.Government Official: Serving as a representative of the government within the
healthcare sector, implementing policies, adhering to regulations, and aligning
medical practices with governmental directives and standards.
Station Health Unit is performing the following functions;
1. Medical care
a. Hospital services
The Station Hospital comprises a 16-bed capacity with segregated wards for
male and female patients. It includes essential facilities such as one operation theatre,
a delivery room, and a mortuary, although there isn't a specialized unit. The hospital
offers inpatient and outpatient care, delivery services, and childcare.
As a referral center, it handles cases referred from rural and sub-rural centers. Cases
requiring specialized care are directed to the Township Hospital and subsequently to
the District Hospital. Although the hospital offers operation services, it lacks
laboratory and X-ray services. Despite these limitations, the hospital prioritizes efforts
to minimize both mortality and morbidity rates.
b. Social security services
Social security services, as outlined in the Social Security Act, encompass a
range of provisions to support individuals in various situations. These services
include:
1.Free Medical Care: Ensuring access to medical services without financial
burden.
2.Sickness Benefit: Providing financial assistance during periods of illness.
3.Temporary and Permanent Disability Benefits: Offering support for
individuals facing temporary or permanent disabilities.
4.Survivor's Pension Due to Employment Injuries: Providing financial
assistance to the dependents of individuals who have suffered employment-
related injuries.

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 5.Maternity Benefits: Supporting individuals during maternity, potentially
covering medical expenses, and offering financial assistance.
6.Funeral Grant for Death in Any Case: Providing assistance for funeral
expenses in the event of death, irrespective of the cause.
c. Reproductive health
Reproductive health services are implemented with the goal of ensuring safe
deliveries and reducing Maternal Mortality Rate (MMR) and Infant Mortality Rate
(IMR). Couples are provided with health education on family planning and birth
spacing to promote reproductive health and well-being.
d. Immunization
The Expanded Program on Immunization (EPI) is extensively implemented to
eradicate Vaccine-Preventable Diseases. Recently, Pentavalent vaccines have been
introduced into the program. Additionally, pregnant mothers receive two doses of
Tetanus Toxoid (TT) injections. Extensive health education about the EPI programs is
disseminated to the public to ensure children receive proper immunization.
e. School Health Services
School health services aim to address the nine components of Health-Promoting
Schools, ensuring a holistic approach to the well-being of students. These components
include:
1.Comprehensive School Health Education: Providing a well-rounded
education that includes information on various aspects of health.
2.Healthy School Environment: Creating a physical and social environment that
supports the health and well-being of students.
3.Nutrition Promotion and Food Safety: Promoting healthy eating habits and
ensuring the safety of food within the school.
4.Prevention of Diseases: Implementing measures to prevent the occurrence and
spread of diseases among students.
5.School Health Services: Providing healthcare services within the school setting
to address the health needs of students.
6.Sports and Physical Activities: Encouraging physical fitness and sports
activities to enhance overall health.
7.School to Community Outreach: Establishing connections between the school
and the broader community to promote health initiatives.

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 8.Counseling and Social Support: Offering counseling services and social
support to address the mental and emotional well-being of students.
9.Research: Conducting research to understand and address health-related issues
within the school community.
By incorporating these components, school health services contribute to creating a
health-promoting environment for students, fostering their overall well-being.
f. Occupational Health Services
Occupational health services are offered with the objectives of preventing
occupational hazards, facilitating early diagnosis, ensuring prompt and adequate
treatment, and promoting the overall health of workers.
g. Nutrition Services
Nutrition services are actively conducted with the goal of managing Protein-
Energy Malnutrition (PEM), addressing iron deficiency anemia and vitamin B1
deficiency, and eradicating deficiencies in vitamin A and iodine, thereby combating
related disorders.

2. Disease control activities

 VBDC program
 Covid 19 vaccination program
 TB control program
 STD control project

3. Environmental sanitation activities

 Assessing bazaar sanitation
 Assessing water sanitation
 Checking refuse disposal
 Checking excreta disposal

4. Administration
 General administration
 Hospital administration
 Field administration

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Functions of Rural Health Center

The Rural Health Center (RHC) undertakes a variety of functions to ensure

comprehensive healthcare and community well-being:
1. Administering vaccinations as per the Expanded Program on Immunization
(EPI) to prevent communicable diseases.
2. Issuing Birth and Death Certificates within the community.
3. Offering healthcare services tailored for students' health needs within schools.
4. Gathering essential health-related information and vital statistics for analysis
and planning.
5. Providing guidance and services for family planning and birth spacing.
6. Offering information and educational initiatives to promote health awareness
within the community.
7. Implementing measures to prevent and manage infectious diseases within the
community.
8. Monitoring and improving the cleanliness and hygiene of the environment.
9. Offering additional nutrition support to address deficiencies or improve overall
health.
10. Ensuring cleanliness and hygiene in marketplaces.
11. Ensuring the quality and cleanliness of water sources to prevent waterborne
diseases.
12. Managing the operational aspects of the center to ensure efficient service
delivery and coordination.

Duties and Responsibilities of Health Assistant

The duties and responsibilities of a Health Assistant (HA) typically include:

1.Overseeing and managing the operations of the Rural Health Center.
2.Facilitating communication and coordination among various health department
services.
3.Assigning responsibilities during festivals and emergency situations to ensure
smooth operations.
4.Conducting surveys and developing programs for health-related initiatives.

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 5.Assessing the health status of the community and overseeing the documentation
of birth and death certificates.
6.Providing healthcare services tailored for students' health needs within schools.
7. Compiling and submitting reports on health-related activities and outcomes.
8.Offering information and educational initiatives to promote health awareness
within the community.
9.Ensuring the provision of healthcare services specifically tailored for mothers
and children.
10. Executing and managing specific health programs designated for the
community.
11. Fulfilling tasks assigned by supervisors to contribute to effective health
service delivery.

Duties and Responsibilities of PHS II

The duties and responsibilities of a Public Health Supervisor II (PHS II) typically
involve:
1.Implementing health initiatives guided by township/ward/village health
supervision implementation committees.
2.Carrying out health programs directed by Township Medical Officer (TMO),
Township Health Officer (THO), Maternal and Child Health (MCH)
personnel, Medical Officers (MOs), Assistant Surgeons (AS), and Senior
Medical Officers (SMOs).
3.Assuming responsibility for community health care initiatives within townships,
stations, or villages.
4.Overseeing and managing the activities of Public Health Supervisors I and other
basic health workers.
5.Gathering essential health-related data and statistics.
6.Maintaining records and submitting reports on health-related activities and
outcomes.
7.Offering educational programs to promote health awareness within the
community.
8.Encouraging and implementing initiatives to improve environmental hygiene
and cleanliness.

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 9.Monitoring, tracking, and managing the spread of communicable diseases
within the community.

Duties and Responsibilities of Lady Health Visitor

1.Providing guidance, assistance, and education to midwives, auxiliary midwives,

and community health workers to enhance their skills and knowledge.
2.Implementing measures to monitor, prevent, and manage diseases that spread
within the community.
3.Conducting home visits, offering health services in schools, and running open
clinics to ensure comprehensive health care for families.
4.Educating the community on health-related matters to promote awareness and
healthy practices.
5.Initiating programs and activities to maintain a clean and healthy environment
within the community.
6.Ensuring all children receive the necessary vaccinations to protect against
preventable diseases.
7.Promoting and supporting initiatives that improve nutrition within the
community.
8.Conducting activities targeted at managing and controlling various diseases
prevalent in the area.
9.Gathering essential health-related data and statistics for analysis and planning
purposes.
10. Maintaining records and submitting reports on health-related activities and
outcomes.
11. Offering essential health services at the primary level to address community
health needs.
12. Collaborating with non-governmental organizations to enhance health services
and initiatives.
13. Ensuring appropriate and effective utilization of essential medications.
14. Providing guidance and support for family planning and birth spacing
initiatives.

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Duties of a midwife

1.Working under Supervision: Operating under the direct supervision of a

Maternal and Child Health Officer (MCHO) or a Lady Health Visitor (LHV).
2.Assisting Clinic Work: Supporting clinic operations and activities related to
maternal and child health care.
3.Communicable Disease Control: Participating in efforts to control and prevent
the spread of communicable diseases within the community.
4.Home Visiting and Domiciliary Care: Conducting home visits and providing
care for pregnant women in their homes, including postnatal care and
managing
normal labor cases.

Role of a Midwife

The role of a midwife involves providing essential care and support for pregnant
women, assisting in clinic duties, participating in disease control efforts, conducting
home visits for maternal care, and contributing to environmental sanitation efforts
within the community.

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3.3 Township Health Profile Amarapura Township, Mandalay Region

1. Health Facilities

Number of MCH - 2
(1) Myo Ma MCH
(2) Myint Nge MCH
Number of SHU - 1
Ye Loon Kyaw SHU
Number of RHC - 4
(1) Shwe Kyet Yet RHC
(2) Sar Taw RHC
(3) Ta Mu Soe RHC
(4) Ta Lin Gyi RHC
Number of S/C - 23

2. Health Manpower (2022)

CATEGORY Dr HA1 HA LHV PHSI MW PHSII

Sanction 13 1 8 9 6 41 37

Appointed 1 1 5 6 1 15 11

Vacant 12 - 3 3 5 26 26

3. Health Volunteers

V.H.W C.H.W A.M.W T.T.B.A

Trained (new) 17 37 -

Functioning 5 12 -

4. School Health

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 PERCENT OF 2020 2021 2022
% Coverage of Schools Examined 100% 100% 100%

% Coverage of primary school students 99.8% 100% 100%

Examined
% Coverage of School with Sanitary Latrine 96% 100% 100%

5. Health Education

2020 2021 2022

Average No of HE frequencies per month 207 543
Average No of HE frequencies by BHS 26 64

6. Environmental Health

2020 2021 2022

% Coverage of Sanitary Latrines (Rural) 92 92 95.6

7. Primary Health Care

2020 2021 2022

Rate of General Clinic Attendance (%) 20.8% 5.3% 10%
No. of Cases Referred 949 107 317

8. Reproductive Health

2020 2021 2022

AN Care Coverage (%) 90% 25.5% 45%

%of Home Deliveries by BHS 10.5% 4.2% 16.0%
% of Institutional Delivery 88.4% 85.1% 81.5%
% of skilled birth attendant 97.2% 85.1% 97%
Rate of Referral (%) 35.7% 19.4% 24.2%
Avg. no. of Attendance (AN) 5 5 5

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 Avg. no. of Attendance (PN) 5 5 3
% of Postnatal care coverage 98.5% 48% 63%

9. Child Health

2020 2021 2022

% OF ORT Use Rate 100 100
% of Antibiotic coverage in Pneumonia Cases 0.1 85
% of newborn care Coverage within 3 days 89 50

10. Nutrition

2020 2021 2022

% of newborns with Low Birth Weight 1.7 1.0
% of under-five children with underweight 0.1
% of villages/ wards with Qualified 100% 88%
consumption of Adequately iodized salt

11. E.P.I

2020 2021 2022

BCG% 99.8% 51 86%
OPV3% 98.5% 50 58%
Pentavalent 3% 98.5% 50 56%
Measles% 88% 41 50%
TT2% 98.7% 31 35%

12. Common Diseases In DUNS

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 Morbidity Mortality

Malaria (per 100,000 Pop) 0.7 -

ARI (Pneumonia) (per 100,000 Children) 115 -

Diarrhea (per 100,000 Pop) 601 -

Dysentery (per 100,000 Pop) 101 -

TB (Sputum Smear +) (per 100,000 Pop) 141 -

Snake Bite (per 100,000 Pop) 14 -

13. Health Impact Indicators

2020 2021 2022

Population Growth Rate % 1.26 1.3 1.16

Reported 1MR/1000 LB 9.5 7 8

Reported U5MR/1000LB 11.8 10 11.0

Reported MMR/100,000 LB 0.5 0 0

14. Malaria, Tuberculosis and Leprosy

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 2020 2021 2022

No. of malaria cases Among out-patients

3 -
(New)

No. of new TB sputum-positive patients 166 80

No. of TB sputum-negative Patients 133 119

No. of extrapulmonary TB Cases 53 39

Remaining leprosy cases (PB) 1 0

Remaining leprosy cases (MB) 2 0

15. Non-Communicable Diseases & Risk Factors

2020 2021 2022

Number of Hypertension Cases 2086 1596

Smoking Cases per 1000 >15 Years 42 4.1

Population
Alcoholic Cases per 1000 Population 0.02 1.9

Deafness Cases per 1000 Population - - -

Blindness Cases per 1000 Population - - -

16. Accident And Injury

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 2020 2021 2022

RTA Cases per 1000 Population 6.2 4.4

Injury Cases Due to Assaults

0.5 0.5
Per 1000 population

Suicide Cases per 1000 Population

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 3.3.1 Prevalent Diseases and Health Problems

According to the data obtained, the prevalence of diseases and health problems in
Amarapura Township are
1. RTA
2. ARI
3. Diarrhea
4. DHF
5. Skin infection

RTA

A traffic collision, known as a motor vehicle incident, car crash, or car

accident, happens when a vehicle hits another vehicle, pedestrians, animals, road
debris, or any stationary object like a tree, pole, or building.
In Myanmar, road traffic accidents (RTAs) are a major cause of fatalities,
especially in Amarapura township due to its proximity to highways where express
cars and trucks consistently drive at high speeds day and night. The area also sees a
significant number of motorcycle riders, a common trend across townships in
Myanmar. The primary types of accidents include collisions between cars and
motorcycles, cars and pedestrians, and car-to-car collisions.
Several factors contribute to these RTAs, such as alcohol consumption,
speeding, driving without lights, fatigue, drug use, and neglecting the use of seat belts
and helmets for safety.

ARI

ARI often arises due to dusty environments causing air pollution. While
viruses and bacteria are unavoidable, certain factors can heighten the likelihood of
contracting the disease. Overcrowding contributes to this risk, particularly affecting
the immune systems of children and older adults, making them more susceptible to
viral infections. Children, in particular, face increased risk due to their frequent
interaction with other kids who may carry viruses. Their lack of consistent

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handwashing and tendency to touch their faces spreads infections easily. Individuals
with heart or lung issues have an elevated risk of contracting acute respiratory
infections, which can lead to long-term health complications and potentially develop
into chronic diseases, impacting daily activities with persistent coughing. Symptoms
of ARI encompass congestion, sore throat, cough, fever, runny nose, and fatigue.
Upper respiratory infections stem from acute pharyngitis, acute ear infections,
and the common cold. Lower respiratory infections include bronchitis, pneumonia,
and bronchiolitis.

Diarrhea

Diarrheal illnesses stand among the primary reasons for sickness and fatalities
worldwide, with children being particularly vulnerable. Diarrhea presents as
unusually loose or watery stools, mostly stemming from bacteria, viruses, parasites, or
chronic digestive system disorders.
Inadequate sanitation plays a critical role in spreading diseases like cholera,
dysentery, typhoid, intestinal worms, and polio. Factors such as low socioeconomic
status, substandard hygiene practices, and the contamination of water and food
contribute significantly to the prevalence of diarrhea.
The symptoms of diarrhea encompass stomach pain, abdominal cramps,
bloating, weight loss, fever, body aches, and chills.
DHF

Dengue Hemorrhagic Fever (DHF) stands as a primary endemic ailment in

Myanmar. It is caused by the dengue virus transmitted through mosquito bites,
particularly by the Aedes aegypti mosquito. Inadequate drainage also contributes as a
risk factor. The severity of the disease is categorized into Grades 1 through 4, with
warning signs including intense stomach pain, vomiting, breathing difficulties, or
instances of blood in the nose, gums, vomit, or stools.
Symptoms and indications of Dengue Hemorrhagic Fever encompass severe
abdominal pain and sensitivity, continual vomiting, vomiting blood, bleeding from the
gums or nose, dark stools, swelling, feelings of lethargy, confusion, or restlessness, as
well as symptoms related to liver enlargement, pleural effusion, or accumulation of
fluid in the abdomen (ascites).

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Skin infection

Skin infections arise when bacteria invade the skin and occasionally the
underlying tissues.
Varieties of skin infections include bacterial ones, often caused by
Streptococcal or Staphylococcal bacteria, viral infections like chickenpox or warts,
fungal infections such as yeast infections, and parasitic infections like scabies.
Common symptoms across many skin infections encompass rashes, swelling, redness,
pain, pus formation, and itching.
The use of contaminated well water can lead to excessively dry and irritated
skin. Given that well water might contain elevated levels of calcium and magnesium,
residues of these elements can affect the skin.
Residents in Amarapura township face risks due to the potential use of river or
well water contaminated with waste or microorganisms.

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 3.3.2 Factors Related to Health Problems and Possible Solutions

ARI

It’s a severe infection that disrupts regular breathing functions, often showing
symptoms like coughing, a sore throat, shortness of breath, or coryza.
Factors that increase the risk include living in dry and dusty environments,
having a low socioeconomic status, facing overcrowding, dealing with poor
environmental sanitation, maintaining inadequate hygiene practices, and having poor
nutritional status.
Potential solutions involve practices like washing hands thoroughly with soap
and water or alcohol-based sanitizers, minimizing overcrowding whenever feasible,
and aiming to improve socioeconomic conditions in the region.

Diarrhea

Diarrhea is characterized by the passage of three or more loose or liquid stools

daily, presenting in three clinical types: acute watery diarrhea (lasting hours or days,
including cholera), acute bloody diarrhea (also known as dysentery), and persistent
diarrhea (lasting 14 days or more).
Factors contributing to the risk include insufficient water supply, unsafe
drinking water, improper human waste disposal, low socioeconomic status, poor
hygiene, limited healthcare access, and inadequate health knowledge.
Possible solutions involve providing health education, implementing proper sanitary
measures for waste disposal, ensuring adequate and clean water supply, and
promoting regular handwashing with soap and water after handling anything
potentially contaminated.

DHF

Dengue Hemorrhagic Fever (DHF) is a viral illness transmitted through the

bite of an infected Aedes mosquito, posing a significant public health concern. Its
symptoms encompass high fever, headaches, body aches, nausea, and a distinctive
rash.

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 Factors contributing to its risk include environmental elements like the rainy
season, stagnant water in containers serving as mosquito breeding grounds, and
inadequate sanitation. Certain host-related factors, such as age (more prevalent in
children under 15), obesity, congenital heart issues, and various chronic diseases like
diabetes, hypertension, asthma, renal failure, and liver cirrhosis, also increase
susceptibility. Additionally, patients undergoing steroid or NSAID treatments are at
heightened risk.
Potential solutions involve tackling breeding areas by draining stagnant water,
implementing effective water management strategies like piped water supply,
disposing of water-holding containers, utilizing mosquito nets and repellents, and
educating communities on maintaining cleaner environments for health.

Skin infection

Skin infections can arise from a multitude of germs, spanning thousands of

types including bacteria, viruses, fungi, and parasites. These infections can exhibit
symptoms that vary from mild to highly aggressive.
Risk factors contributing to their occurrence include water pollution,
particularly since the township is situated along a riverbank, as well as air pollution
stemming from overcrowding. Additionally, outside germs from commonly touched
public items and lifestyle factors linked to poor socioeconomic conditions play a role
in susceptibility to skin infections.
To address and prevent these infections, implementing good personal hygiene
practices such as regular handwashing is essential. Avoiding skin-to-skin contact with
individuals who have skin infections and refraining from sharing personal items like
razors, towels, and clothing are also important measures. Health education campaigns
focusing on personal hygiene and promoting environmental cleanliness can further aid
in preventing skin infections within the community.

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Road Traffic Accident (RTA)

A Road Traffic Accident (RTA) is characterized as an unforeseen and

unplanned event that may result in injury, representing a widespread issue of non-
communicable diseases in the present century. Across the globe, 93% of road
fatalities occur in low- and middle-income countries, with RTAs being a primary
contributor. In Amarapura Township, these accidents significantly contribute to
morbidity and mortality. The challenges in the area include a substantial presence of
pedestrians and animals sharing the road with vehicles and, a lack of proper
separation. Moreover, the increasing use of motorcycles, scooters, and mopeds,
coupled with low driving standards, adds to the risk. Unusual behavior exhibited by
both humans and animals, overspeeding, failure to wear helmets and seatbelts, non-
compliance with traffic rules, engagement in multiple activities while driving,
prolonged periods of duty without adequate rest, and the use of alcohol and drugs
further compound the problem.
Addressing these issues requires a concerted effort toward following road
safety rules, ensuring the proper use of seatbelts, and promoting the correct use of
helmets while riding motorcycles.

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 3.3.3 Health Activities Addressing Health Issues

Station Medical Officers, under the jurisdiction of the Township Medical

Officer, lead health initiatives in collaboration with NGOs. These initiatives
encompass various health concerns and involve:

1. Road Traffic Accidents (RTA)

Educating individuals on road safety practices includes teaching them about

adhering to traffic rules, using seatbelts properly, wearing helmets when riding
motorcycles, maintaining prescribed speed limits, refraining from driving under the
influence, and avoiding mobile phone use while behind the wheel.

2. Acute Respiratory Infection (ARI)

Efforts to address Acute Respiratory Infection (ARI) involve a multifaceted

approach. This includes educating individuals on the dangers of smoking and the
impact of air pollution as preventive measures. Counseling sessions delve into the
various social factors that contribute to lung-related ailments, offering guidance and
awareness. Early identification of potential issues and efficient referrals play a crucial
role in ensuring timely intervention. Continuous follow-up care is emphasized to
monitor progress and maintain health. Ensuring infants are covered by the Essential
Package of Immunization (EPI) is integral. Advocacy for breastfeeding, mitigating
indoor air pollution, and collaborating closely with healthcare professionals contribute
significantly to ARI control. Educational sessions held in schools and workplaces
disseminate crucial information while empowering individuals with the necessary
skills to either quit or reduce smoking habits forms a vital part of these comprehensive
efforts.

3. Diarrhea

Education plays a pivotal role in raising awareness about the perils of diseases,
emphasizing the dangers posed by various illnesses. A crucial aspect within this realm

26
involves advocating for basic yet potent measures, such as handwashing with soap,
which stands as a simple yet effective preventive measure against bacterial infections.
Moreover, instilling practices of safe food preparation not only ensures healthier
eating but also minimizes the risk of contracting foodborne diseases. This goes hand
in hand with promoting a clean and balanced diet, fostering overall well-being, and
bolstering the body's immune system. Addressing fundamental necessities like access
to clean water and proper sanitation facilities is paramount for maintaining public
health, reducing the spread of illnesses, and ensuring communities thrive.
Additionally, advocating for environmental cleanliness serves as a broader approach
to disease prevention, tackling factors that contribute to the proliferation of various
health hazards. These holistic efforts collectively form a comprehensive strategy to
safeguard individuals and communities against diseases, underlining the significance
of education and proactive measures in preserving public health.

4. Dengue Hemorrhagic Fever (DHF)

Efforts aimed at curbing mosquito-borne diseases are multifaceted,

encompassing strategies that target the elimination of potential breeding grounds for
mosquitoes. This involves proactive measures such as clearing vegetation and
eradicating stagnant water sources, which serve as fertile breeding grounds for these
disease-carrying insects. Concurrently, advocating for the use of mosquito repellents
and insecticide-treated nets stands as a crucial preventive measure, providing a barrier
of protection against mosquito bites and subsequently reducing the risk of contracting
diseases like malaria or dengue fever. Education plays a pivotal role in this context, as
communities benefit greatly from understanding environmental control measures that
disrupt the mosquito life cycle, mitigating their population growth. By combining
these approaches, communities can significantly reduce the prevalence of mosquito-
borne diseases, fostering healthier and safer living environments for all.

5. Skin Infections

Encouraging personal hygiene practices serves as a cornerstone in disease

prevention, particularly through the promotion of regular handwashing. This simple
yet effective habit significantly reduces the transmission of various infections.

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Advising against the sharing of personal items like clothing or razors plays a vital role
in preventing the spread of infections, as these items can harbor bacteria or viruses.
Furthermore, emphasizing the avoidance of skin-to-skin contact with individuals
displaying skin infections serves as a preventive measure, minimizing the risk of
contracting contagious conditions. Collectively, these practices form a comprehensive
approach to safeguarding against the transmission of infections, empowering
individuals to take proactive steps in maintaining their health and preventing the
spread of diseases within communities.

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 3.3.4 Role of NGOs in Community Health Care

NGOs augment the services rendered by official agencies and the functions vary
according to the purpose for which they are established. They provide great forces in
the community not only for the improvement of health services but also for having
effective health care delivery.
1. Myanmar Maternal and Child Welfare Association (MCWA)
2. Red Cross Association
3. World Vision
4. Other Associations
a. Myanmar Medical Association
b. Nurse Association
c. HA Association
d. Myanmar’s Heart Association

1. Myanmar Maternal and Child Welfare Association (MMCWA)

Maternal and Child Welfare Association in Shwe Kyet Yat is affiliated to

MMCWA which was formed on 30th April, 1991. The headquarters of MMCWA are
in South Okkalapa Township, Yangon. It focuses on promoting the health and well-
being of mothers and children by means of media attention, direct appeal campaigns,
and political lobbying. Currently, the following activities are being performed by the
association.

A. Health activities
By means of community-based health activities and conducting health talks, it
assists in the implementation works of health awareness programs, prevention,
control, and elimination of infectious diseases, and basic health development projects
that are being carried out by the MOHS.
In cooperation with the MOHS and UNFPA, the association has carried out
projects in reproductive health, behavioral change communication, adolescent
reproductive health, and provided reproductive health education for young people
with a special focus on HIV/AIDS and the prevention of narcotic drug abuse.

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 By opening a maternity clinic, it provides access to reproductive health care
services, care during pregnancy, safe delivery with professionals, postnatal care,
health education, vaccination, birth spacing for the health of the mother and the child,
breast-feeding, and the prevention of mother-to-child transmission of HIV/AIDS, to
reduce MMR, IMR, and USMR which are included in Sustainable Development
Goals (SDG).
Regarding the nutrition of children, the association is working to ensure under-five
nutrition by
 conducting a survey of malnourished children
 setting up village food banks in villages and townships
 opening community nutrition centers
 initiating a growth monitoring program to ensure the nutrition of children
 carrying out education programs for mothers on nutritious cooking
 demonstration of cooking techniques
 conducting training courses
 giving supplements for iodine deficiency, iron deficiency, vitamin A
deficiency, and other conditions caused by malnutrition

B. Education activities
Pre-primary schools are set up by the association with the aim of supporting
all-round early childhood development, both physically and intellectually.
Assistance such as education stipends is provided to enable children to complete
primary school education. Literacy campaigns for the middle-aged and the elderly are
also carried out in order to achieve a higher literacy rate.

C. Economic activities
The association is making special efforts to provide vocational training, assist
in finding jobs, create income-generation opportunities with the aim of raising family
incomes and living standards.

D. Social activities
The association provides assistance to those with health problems such as
cataract patients and patients with congenital defects, cleft lips, and cleft palates. It is

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also engaged in providing care for the elderly as part of its contribution to social
welfare work. It is also carrying out humanitarian activities in partnership with the
Government, departments concerned, and NGOs Cooperation with local and foreign
organizations Planning annual programs for future activities.

2. Red Cross Association

The Red Cross Association is a part of the Myanmar Red Cross Society
(MRCS), which operates as a primary community-based humanitarian organization in
Myanmar, particularly focusing on aiding the most vulnerable individuals.
Established in 1939 and acknowledged as a National Society by the International
Committee of the Red Cross (ICRC), MRCS is headquartered in Botahtaung
Township, Yangon.
The society's core mission is to alleviate human suffering. It achieves this goal
through various supportive activities like health promotion, disease prevention, and
providing assistance to those in distress. Here are some functions performed by
MRCS for community welfare:
 Provision of Basic and Standard First Aid
 Conducting First Aid Instructor and Refresher Courses
 Commercial First Aid Training
 Child Protection Projects
 Community-Based Health and First Aid (CBHFA)
 Community-Based Health and Resilience Project (CBHRP)
 Community-Based Health Development Project (CBHDP)
 Community-Based Malaria Prevention
 HIV/AIDS and Reproductive Health Programs
 Family HIV Prevention
 HIV Case Support and Treatment
 Community Health Development Projects related to HIV/AIDS
 Outreach to Highway Bus/Truck Drivers for HIV/AIDS
 Youth Reproductive Health Education
 Tuberculosis Initiatives
 Water and Sanitation along with Hygiene Promotion (WASH)
 Public Health in Emergencies

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  Disaster Management, Preparedness, Response, and Risk Reduction
(Community and School-Based)
3. World Vision

World Vision, an international NGO, was founded by Rev. Pierce with a focus
on enhancing the welfare of at-risk children and families. It originated in response to
the dire situation of orphans after the Korean War, expanding its reach globally over
the ensuing decades. In 1991, World Vision International was asked by MOHS to
initiate an HIV/AIDS project in Myanmar, leading to the establishment of World
Vision Myanmar's first office in 1993. Their initiatives initially centered on
HIV/AIDS efforts along the Thai-Myanmar border and later broadened to include
child protection, health, and developmental programs in Myanmar.
This organization engages in various activities, such as advocating for
children's rights, fostering development, managing disasters, providing education and
life skills, promoting health, ensuring water and sanitation, enhancing resilience and
livelihoods, and striving for child equity and rights.

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