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Myanmar, Republic of the Union of

In Myanmar, uniting for children’s health and nutrition

By Mariana Palavra

Despite the recent signing of a ceasefire between the Government of Myanmar and representatives of eight ethnic armed groups, an estimated 1.8 million children are not covered by the agreement, particularly those living in areas of Kachin and northern Shan states, where continued conflicts prevent children from accessing basic services.

The National League for Democracy recently won Myanmar’s first free elections in 25 years. When the new government assumes office early next year, it will face one of the longest-running civil conflicts in the world.

In areas that are hard to reach because of insecurity, poor geographical access and political constraints, UNICEF and the NGO Health Poverty Action are working together to strengthen access to primary health care and nutrition interventions such as infant and young child feeding support.

© UNICEF Myanmar/2015/Palavra
Lwan No fled civil conflict three years ago and lives in a camp for people who have been displaced. Now, she hopes her 5-month-old daughter will have a bright and successful future.

KACHIN STATE, Myanmar, November 2015 - “I could hear the planes bombing the area, the constant gun shots and mine explosions,” Lwan No recalls. Lwan No was caught in the middle of the civil conflict in Kachin State, in northern Myanmar. 

To save her life, Lwan No fled her village empty-handed. For the past three years, she has been living in a camp for internally displaced persons (IDPs) in Chipwe.

Chipwe is part of the former Kachin Special Region 1 (KSR1), which borders China. The region is now under government administration, but on the other side of the river, the area is controlled by an armed group, and conflict has been active.   

“Some nights, we are awakened by the shooting from both sides of the river,” Lwan No says. 

As part of the effort to reduce maternal and under-5 mortality, UNICEF and Health Poverty Action (HPA) have been working not only in government-controlled Kachin Special Region 1, but also in Special Region 2, which is controlled by another armed group. 

“We are committed to reach every child, wherever they live, and regardless of their ethnicity,” explains Bertrand Bainvel, UNICEF Representative in Myanmar. “This means reaching children in both government-controlled areas and areas controlled by ethnic armed groups.”

“This partnership directly contributes to peace, as it builds consensus between both sides in conflict to improve the health and nutrition status of children and mothers wherever they reside,” says Jiayin Li, HPA Myanmar programme coordinator. “Every single action – capacity building or service delivery – implemented in Special Regions 1 and 2 has to be agreed by both sides in conflict. This implies constant talks and negotiations facilitated by HPA between government and ethnic groups.” 

Improving health and nutrition services

Health indicators from the six townships in Special Regions 1 and 2 covered by this project are significantly lower than national averages. For instance, in the former Special Region 1, fewer than 50 per cent of women receive antenatal care, far below the 83 per cent national average. In the same region, around 28 per cent of children under age 2 complete the full course of immunization, while coverage at the national level stands at almost 89 per cent. The prevalence of anaemia among children under age 3 is 73 per cent and among mothers 62 per cent.   

Based on these results, UNICEF and HPA, in collaboration with the Kachin State Health Department and health representatives from the ethnic armed group, have been working to strengthen the capacity of basic health staff and community health volunteers to deliver quality health and nutrition services equitably. Throughout this year, 14 master trainers and 120 staff have been trained on maternal, newborn and child health care, as well as nutrition and immunization. In addition, 140 community volunteers have received training to provide basic health mobile services in hard-to-reach areas.

© UNICEF Myanmar/2015/Palavra

The training ensures that health field staff in Special Regions 1 and 2 have the same levels of professional knowledge and skills and follow the same standards for maternal, newborn and child health, nutrition and immunization services.

Help at any time

San Myaw, who lives in a government-controlled area, is a traditional birth attendants and took part in the trainings. In her 52 years, 23 have been spent helping women to deliver and providing basic primary health care to mothers and children around Mangtaung village – on both sides of the river, under separate control of the fighting parties. 

“Over the years, I have been called to help at any time, night and day. I have walked for hours and often fell in the darkness,” San Myaw says. “Once, while taking a boat, the engine died and we drifted. Another time, the boat almost sank.”  

Meeting the needs of all communities

Through the UNICEF-HPA project, around 19,000 children under 5 living in Special Regions 1 and 2 will receive immunization, nutrition and childhood illness management services. In addition, over 7,700 pregnant and lactating women will receive antenatal and postnatal care, safe delivery support, and counselling on nutrition and infant and young child feeding.    

“Alongside peace talks, efforts have to be made to create dialogue among health actors from both sides, not only to ensure that health and nutrition service delivery will not be interrupted, but also to build health systems that meet the needs of all communities,” says Bertrand Bainvel, UNICEF Representative in Myanmar.

In fact, during the 2015 measles and rubella campaign, through UNICEF and HPA mediation, the national and local health systems collaborated to make sure that children from both sides could be immunized.

“UNICEF urges all parties in remaining conflict areas to make every effort to make peace so that every child, wherever they live, can grow up in a united, peaceful and prosperous Myanmar,” Mr. Bainvel says.

Never afraid

Lwan No also dreams about peace and a better future. “I got married in this IDP camp, and five months ago I gave birth to my first child,” she says proudly as she breastfeeds her baby girl. “I want her to become a bright and successful businesswoman. She will have a big company and be rich, so she can support the rest of the community.”    

Meanwhile, traditional birth attendant San Myaw isn’t giving up her mission. She will climb mountains, walk night and day, paddle a boat or do whatever is needed to reach every child.

“I am never afraid. Not even when I approach the security checkpoints and different groups in the conflict shoot into the air to intimidate me,” she says. “I will go against every obstacle, because I must help, I want to help and I will help.” 



UNICEF Photography: Building nutrition security

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