HIV/AIDS
To prevent and treat AIDS, Medical Action Myanmar aims to have a one-stop service where all services including testing, counselling, treatment and support for food and transport fees are provided the same day to improve compliance and make it possible for the patient to live a normal life and return to their job. In 2013, Of 1719 patients who started treatment, 1467 were still on treatment and 74 patients were referred to a treatment centre closer to home (90% still on treatment). 97 patient died over the past 5 years (5.6%), all of them had a low baseline CD4 count (<100, an indication of severe disease) and 81 patients were lost to follow up. 90% of patients who were still on treatment were fit enough to resume daily activities or return to work. These treatment results compare very well to other projects in 3rd world countries. We believe that the low number of deaths and treatment failures is a reflection of the quality care package we give. Next to good clinical management we provide travel expenses and food for 6 months when patients cannot yet return to work. Patients who are very sick or who live far away can temporarily stay in the MAM guesthouse, which we built nearby the clinic. These financial and social issues can have a detrimental effect on treatment compliance (like patients selling their medicines to solve urgent financial problems). MAM also has a special treatment for HIV+ pregnant women. These treatments saves their lives, which makes them able to take care of their children, but it also prevents the spread of HIV to their unborn babies. After their baby is born, they are in the program for up to 1, 5 year to make sure their medical and nutritional status stays in balance.
CHILDREN
Children with acute severe malnutrition are extremely vulnerable for infections and death (50% mortality rate) and need treatment as soon as possible. Tuberculosis is one of the main reasons of child malnutrition. With the help of therapeutic feeding and tuberculosis treatment, we are able to increase their life expectancy to 90%. Luckily, most of the time a child progresses well after one treatment and does not need to come back for repetition of the treatment. Children under 5 years old are also most vulnerable to infections as dengue, cholera, measles and pneumonia. In rural slums, where infectious diseases are rampant, high mortality rates are a fact. All children that come to the clinic with severe malnutrition and/or infectious diseases receive therapeutic feeding and medical treatment. Some children, who are moderately malnourished, receive a supplementary feeding package to prevent severe malnutrition.
Sexual health
Some people are at a high risk of becoming infected with reproductive tract infections (RTIs) including STDs and HIV. RTIs facilitate the transmission of HIV and it is therefore even more essential to prevent them through the use of condoms. As many women and to a lesser extent men with STI have no symptoms, and persons without symptoms do not seek treatment, clinic-based STI management should be combined with active regular screening and treatment of high-risk people. MAM clinics will provide STI screening and treatment. In order to reach the large group of a-symptomatic STI carriers, people at high risk (female sex workers and homosexuals) will be invited to come for monthly clinic visits for STI screening. To convince people who are at high risk, but who have no complaints, to come to the clinic, a good relationship between the health provider and high-risk persons, including brothel owners, is essential. MAM tries to set up such relationships to ensure regular infection screening.
MALARIA
Malaria is a very common problem in Myanmar. The contaminated mosquitoes trouble especially the remote areas. Baring in mind that the treatment of uncomplicated malaria costs only 2 USD for an adult and 1 USD for a child, it is unacceptable that many people decease of the infection. If uncomplicated malaria is not treated well, complicated malaria, which is much harder to cure, can follow. MAM supports a number of governmental clinics,private clinics and village health workers in remote areas by distributing laboratory tests and anti-malaria medicines. Besides curing the disease, treatment is also very effective for the prevention of the further spread of Malaria. In addition to treatment, MAM also provides specific areas with impregnated bed nets for prevention of mosquito bites.
OTHERS
Family Planning
Many women have more children than they want or can care for adequately. This leadsto poor health of both mothers and children. Family planning is offered to all womenwho visit the clinics.
Other health needs
In the end it doesn’t really matter what diseases people have who visit the clinic. If they can’t afford the health services they need, Medical Action Myanmar tries to provide treatment and support.
Research
To support and improve the activities practical research will be undertaken to improve implementing strategies, including diagnosis and treatment of diseases.