Getting Oriented

This week began with orientation for the three new fellows over a Burmese breakfast: warm chick peas and onions sautéed in oil eaten with warm naan and accompanied by sweet milky tea. The formal GHAP orientation is a week-long process in July, but because we missed that week and have arrived during such a busy time, we’ve had to somewhat orient ourselves on top of what the staff has provided.

The program I’ll be working on is called the Village Health Worker (VHW) Program, run by KDHW (Karen Dept. of Health and Welfare) with assistance from GHAP. The program seeks to expand the reach of basic health interventions in conflict-affected, underserved areas of Karen State, Burma using a network of Village Health Workers. Level 1 of the VHW program constitutes recognizing and treating diarrhea, delivering Oral Rehydration Solution and zinc supplements to dehydrated children, teaching mothers and caretakers about the appropriate use of ORS and zinc and how to make ORS, and educating the community and individual households about hand washing and safe disposal of feces.

In the spring of 2009, KDHW trained 13 VHW supervisors from areas representing 5 districts of Karen State. The supervisors were trained in implementing basic diarrhea interventions, but also in teaching methods in order to pass the knowledge to Village Health Workers, whom they selected once they returned home. The goal was to train one VHW for every 200 villagers in the target areas, with supervisors visiting regularly to monitor and evaluate the program, manage supply distribution, and facilitate community events.
Data collection for this program is much harder than one might think. In Karen State, as well as in other areas where active resistance to the SPDC (State Peace and Development Council; Burma’s ruling military junta) continues, the SPDC has instituted the “four-cuts policy,” which attempts to counter insurgency by cutting the four crucial links between them and local villages (food, funds, recruits, and information) and increasing Burmese army control over the local population. Therefore, it is incredibly difficult for information to be transferred easily to KDHW, and has to be done in person, or passed from person to person until it reaches Mae Sot.

The next step for the program is an “Assessment” training for the VHW supervisors, who have been invited to come to Thailand in October. It will basically be a time to debrief with them about how the program is going, teach them about program modifications, and train them in ways to evaluate the performance of their VHWs. There will be two one-week trainings, one in northern Thailand on the Burmese border, and one south of Mae Sot. The planning for these trainings has barely begun—so that’s where I come in. This week, I have been reading many background documents, working closely with Beth, the other intern working on VHW, and meeting with Hei Ku Wah, the KDHW VHW coordinator. Hei Ku Wah is young, speaks very good English, and is extremely capable and efficient. GHAP’s job, and my job, is to “capacity build.” This can mean a variety of things—but basically means that we help our partners do their job with the goal of working ourselves out of a job. For instance, rather than planning the training for Hei Ku Wah, it is my job to gather information from other sources and ask questions that will help her to plan it on her own (or, at least, plan a lot of it).

Beth will be on vacation next week, and my direct supervisor, Jen, will be out of the country until the end of October, which means I am pretty much being dropped into the deep end of the swimming pool. But as emphasized during orientation, GHAP hired us because we seem like the type of people who can figure things out on our own, ask the right questions, and get the job done. So hopefully with what I’ve learned this past week I’ll be able to hit the ground running.

A note about the heavy use of acronyms:
With so many long organization names, acronyms do make communication among GHAP people much easier, but there is another reason for their use. We mostly use acronyms in order to protect our partners, especially over email. None of the exiled Burmese organizations in Mae Sot are registered in Thailand, which means they are illegal. GHAP isn’t registered either; that’s why I had to get a Thai tourist visa and have to leave the country every 60 days to renew it. I asked one of the staff why GHAP wasn’t registered—and although they really haven’t made a huge effort to initiate the process, GHAP probably wouldn’t be approved anyway because of assisting illegal Burmese partner organizations. The whole situation is very politically complex—for instance, just last weekend, Thai police officers raided several Burmese organizations in Chiang Mai. While they did arrest a few people, they also raided the organizations on a Sunday, when few people were in their offices, making it seem like the raid was meant more for show than to actually cause problems.

Still, the offices in Mae Sot, GHAP included, don’t have signs out front, which makes them look like any other house on the street. And we as GHAP fellows were instructed not to talk to any strangers about our work—because you never know who might be an SPDC informant who could get our partners in trouble. I even asked if it was a problem to write about work in my blog, and was told that as long as it is only circulated to family and friends, it’s OK.

In other news, I have moved out of the guest house into the fellows’ house, which has an empty room until one of them returns to Mae Sot in late October. It’s a little bit longer of a bike ride from the office, but well worth the effort. There are several rice fields, (with mountains in the background---not too shabby), even a couple of water buffalo grazing within a block of the house. I’m excited to explore more of the surrounding area in the coming weeks!