Douangpi (far right) stands with Health Poverty Action staff and local people infront of a malaria awareness sign in rural Laos
Laos is one of the poorest countries in Southeast Asia, with almost a quarter of people living under the poverty line. In the remote areas of southern Laos where we work, many people have to travel long distances to find work. These mobile populations often move through areas with high malaria prevalence, and can spread malaria parasites to new areas.
Malaria is a serious problem across southern Laos, accounting for 95% of reported cases in the country. It can be life-threatening if left untreated. Preventative measures, rapid diagnosis and targeted treatment are essential in tackling the disease, however, health facilities are frequently understaffed and inaccessible to many rural communities. Without much-needed funding and improvement within the healthcare system, effective diagnosis and treatment does not always reach these key groups. With support from The Global Fund, Health Poverty Action are operating at both a national and local level to ensure systemic change.
We are working closely with local health facilities and volunteers to conduct testing and provide treatment for malaria. We have established mobile malaria clinics in 48 villages in the border regions of Champasak Province, the first of their kind in the country. These small clinics send out teams to provide diagnosis and treatment services to remote villages and mobile populations. This eliminates the need for trips to urban hospitals, which often involve long and expensive journeys.
Douangpi works at the Khamchalearn village malaria clinic in Champasak Province. He works with some of the most marginalised and high-risk populations, including ethnic minority groups, mobile and migrant workers and forest settlers who are not always aware of the risks associated with living in the forests.
“Malaria clinics make my job more professional and official, and people are more likely to trust me and believe that the services we provide to treat malaria are reliable and effective.”
Traditionally these remote communities have been hesitant to trust outsiders but, slowly, Douangpi and his colleagues are earning their trust. Since Health Poverty Action introduced the clinics, more and more members of the community are seeking the treatment they need.
“The situation is improving and it is not as difficult as it was before to build strong relationships with forest settlers and mobile migrant workers. This is because these groups are now receiving more information about malaria and they are becoming increasingly aware of their health and wellbeing and the issue that malaria presents…They trust me because I have worked with them for so long. These relationships are important to maintain so that they feel comfortable seeking my help.”
“The number of malaria cases in southern Laos is still high because people continue to access the forest areas. They do this because the forest provides them with livelihoods. It is a large contributing factor to the number of malaria cases happening.”
One of the biggest difficulties in the struggle against malaria is that the parasites are becoming increasingly resistant to medicine, which is threatening to reverse recent successes. There is also a high-level of cross border movement, with people from Cambodia, Thailand, Vietnam and China crossing into Laos regularly in search of work. Movement of these groups between malaria endemic areas is a major contributor to the spread of treatment resistant strains of malaria.
Language barriers are also an issue. Migrant workers often feel the need to travel back to their home country to seek treatment when they fall ill. Health Poverty Action has worked locally to implement simple solutions such as strategically located signboards that educate about the spread of malaria, as well as the early warning signs, in four languages.
“The malaria clinics work very well because people that are not from Laos will also visit them because they recognise the signboards which are written in different languages. They know that these facilities have been set up to treat malaria.”
Together we are ensuring that long-term, sustainable solutions are put in place by providing local health workers with the skills and equipment needed to test and treat malaria. Our work with teachers, administrators and the Lao Women’s Union has enabled us to improve malaria outreach, and the overall standard of health in Laos. Local communities are increasingly aware of the risks of malaria, and Health Poverty Action’s work across 15 districts in southern Laos has contributed to an 87% decrease in malaria cases since 2000.
With your ongoing support, we will continue to work alongside the Laos government in their goal of eradicating malaria in the country by 2030.