Intro to the camps

  Views from the drive

This week I got to visit Umpiem and Nu Po camps, which are the second and third biggest camps on the Burmese border.  Both camps are about a two hour drive from where we all stay in Umphang so we have a driver take us both ways each day!!

 

 

Here are views from the inside of Umpiem

The homes are made of bamboo and they're incredible. Umpiem houses just over 17,000 refugees.  There are 16 sections each averaging 200 households.  The people speak Burmese or Karen and identify as Buddhist, Christian or Muslim.  

Korravarn and Anne are the Assistant and Head RH Coordinators for ARC Thailand and will be helping me arrange midwife trainings in the next two weeks for EmOC (Emergency Ob Care).

The Microenterprise system set up in the camps is a Yarn Bank where women can borrow yarn for use in making sarongs and clothing that they can then sell and reinvest into the bank.

I spent the first day at Umpiem getting acquainted to the ARC services offered including RCH (Reproductive and Child Health), Sanitation, Micro-Enterprise and Labor and Delivery.  

Delivery Room at Umpieng 

Inpatient ward at PU-AMI (French NGO)

 Typical latrine with flush (aka pot to pour water)

On Tuesday, I went with Jenny to Nu Po to see the camp, watch one of her midwife training sessions.  Midwives here are not CNM (certified nurse midwives) like in the US but go thru a four month course thru ARC to be considered competent for midwifery.  They then progress thru four levels of clinical work over the next year.  We were able to help out with a delivery and get a little dirty that afternoon.

The homes are well decorated with gardens

On Wednesday, I started introductions with the CHEs (Community Health Educators) who I will be doing a few training sessions with.  They are so happy to have trainings and treat me with so much kindness.  They made me breakfast and lunch today and took me on two home visits to discuss malaria with the two families.  So far we've discussed the camp community and reviewed vaccinations today.  

 Rain rain, lots and lots of rain.  I have my umbrella with me always.



On Wednesday afternoon, Jenny and I went to visit the Camp Leaders (Leader, Asst Leader and Health Coordinator) at Umpiem to encourage the introduction of misoprostol, IUDs and Implants which they were supportive of.  We also visited with the KWO (Karen Women's Organization) to get their support as well.  Success!!  PPH (postpartum hemorrhage) is the leading cause of maternal death worldwide and a cause for frequent referrals outside the camp for expensive services (including incomplete abortions).  Hopefully introducing misoprostol will improve the RH care women are receiving in the camps. We were really happy after our meetings!!  Now we just have to figure out how to get the medicine here and I can start talking about it in midwife trainings.

There is concern that introducing IUDs and Implants and placing them in refugees may cause problems when they leave the camp.  Who will remove them and what if there are complications?  So we met yesterday with a British NGO that trains the "backpack medics" that serve the communities on the border in Thailand and Burma.  We reviewed the Burmese Border Guidelines that they use and will continue to work with this group to coordinate training their medics in IUD and Implant use, removal and care of complications.  Hopefully a future fellow will come to Thailand to do this!!  (Anna are you reading this?!?)

Today I made home visits with some CHEs and also visits Planned Parenthood of Thailand.  They used to place IUDs and Implants but lost funding.  I have a meeting next week with their headquarters for Umpiem to see potential barriers or concerns for introducing these methods in the camp.  Next week I'll also start EmOC training.  We're getting a lot done in a little amount of time but hopefully someone will come after us to keep moving things forward!