Bright Future organized the 2nd Face to Face Workshop on 26th December 2016.

Rationale of the Face to Face Meeting

Bright Future and its partner NGO implemented activities on collective voices on health throughout the
year 2016 as Stage II operation activities under Collective Voice Project.

Main Objectives of the Work Shop

The main objectives of the workshop are

1) To briefly present the project updates of Bright Future Implementation on Collective Voices to
health service providers and community representatives; and other stakeholders (NGO, Civil
Societies, other public sectors (GAD, Veterinary Science and ethnic health organization)
2) To share significant findings, issues and challenges, community feedback found from community
suggestion box, report through direct hunt line, and Providers suggestion on presented issues
3) To discuss the inter-sectoral cooperation and collaboration for community demanded health
services and other health related affairs
4) to update the communities about current health activities and ways to get best health services
by communities including migrants and mobile population
5) to help the health committees to continue such model platform of think-tank to freely discuss
local health issues with health service providers and other stakeholders

The Collective Voice in Mudon Township is being undertaken by Bright Future and its 3 partner NGOs.

The Main Discussion, Findings and Recommendation

1) Though the anti-snake venoms are distributed at Township Hospital and Station Hospital level, there
are still mortality cases of snake bite due to not timely referral to the mentioned health centers. The
communities found that the first aid knowledge and prevention of snake bite is needed. Some
representatives of the village and migrant communities supported and shared their experience of
significant increasing snake bites. Health Providers responded that the Anti-Snake Venom needs to keep
at certain temperature. It also needs Emergency Management of Shock because few patients might
suffer anaphylactic shock due to this ASV injection.

Community also raised that most snake bites are viper and it affects the renal function. Quoted to a
community representative from Mudon, he said that there is no dialysis machine in either Mudon
Hospital or Mawlamyine State Hospital and for dialysis, the patient was transferred to Yangon General
Hospital which is a very long route and ended with unnecessary death on the way or unrecovered organ
failure due to not getting timely medication. According to the response of Retired State Minister as well
as retired State Health Director, it was not possible now that though the equipment for dialysis can be
donated but there is constraint in human resource on health to operate these sophisticated equipment.
The issues will be informed to Township Health Department which will hopefully pass this information
to Regional and Central level requesting further solution.

2) Some community representatives discussed about increase more TB cases than past years. The TB
suspected cases are sporadically found in different places. Due to lack of health knowledge, the suspect
doesnt visit to Health Centers for TB screening. There are also no incentives for them to seek treatment.
Some suspected cases have awareness on TB due to the education of health project including Bright
Future and its partner CBOs.

3) The communities also discussed on increase drug and alcohol use among the young people. One of
the factors of the increase drug use is due to imitation from relatively older group of young and middle
aged persons. There are also drives from older persons to use drugs and alcohols. Another big challenge
is due to the abundance of drugs and freely available different alcohol with cheaper price.

4) The young aged rape were some issues in the communities and migrant clusters. The Health
Education sessions are tailed to priority health topics together with prevention and mitigation of such
crimes.

5) The audience are also aware that during these years, there is increase of more occupational related
diseases like low back pain. This was also discussed by private practitioners and the audience requested
any intervention (Health Education on Prevention and Getting Treatment) on this.

6) Moreover, the participants also discussed and requested feedback from health service providers on
overcoming traditional and cultural belief in decision not to delay referral. The hospitals and health
centers become only last resort for the patients delaying necessary health intervention.

7) The representatives also raised about the increase use of mixed drugs dosing by road side grocery
stores and street vendors. The unpermitted dye was abundantly used in food industry and it was
reported that imported sweets have unpermitted dye. The drug resistance rooted from the use of non-
proper dose of drugs sold by private grocery sellers. For managing unpermitted dye containing snacks,
Bright Future with School Health Focal persons are wandering around the school providing health
education for balanced diet, healthy food, nutritious food and not eating imported unpermitted dye
containing snack etc

8) The Programme Manager shared the activities of Bright Future and partners and updated about the
training on sex and gender, gender based violence; 24 hours round the clock work schedule of women;
and decision making powers in the households. Bright Future collected health related information from
community meetings, providers meetings, festive booths, community outreaching, Health Education
Campaign and this face to face workshop. The gender based violence are now heard more than before.
In addition, there are also unwanted pregnancy cases; most of which were ended up in septic abortion
in either at their local places or at other side in foreign country. The finding from festive booth found
that community youngsters started to use alcohol and narcotic drugs together with peer pressure which
would initiate sexual violence.

9) The health providers and community representatives brainstormed on the above mentioned issues
and find the best ways to get efficiency and effective service.

10) The communities also discussed on issues of strayed dogs which were abandoned and risk of rabies
infection at any time. The Veterinary Sector also discussed that they have enough shots for vaccine for
animal sector. Moreover, for the deficit of vaccine, the animal-human sector will work together to get
enough vaccines from well-wishers. The retired Regional Health Director also said that the township
health department is also injecting anti-rabies vaccine free of charge for those who were dog-bitten.

Advantage of the Meeting

The meeting is quite advantageous in following reasons:

1) The Face to Face meeting created the platform for all health providers and community
representative in the presence of other stakeholders to brainstorm on the health issues; find
solution and update health information and it facilitated the communities to understand more
on health service provision by both private and public sectors.
2) The meeting also raised the communities to discuss more on demanded health services which
were really essential in the ground situation
3) The meeting also made community learnt health indicators; health policy of public sectors and
health operations that are being undertaken; by knowing health services of the public sector,
the communities can find solution for better efficient and effective services for the communities
and migrants.

Recommendation and Suggestion from the meeting

Communities want to continue such Face to face platform at least biannually to share more health
related experiences.

Community representatives will provide the feedback from meeting to their respective representative
communities; provide more education, updated knowledge.

Communities came to know the issues and challenges of health providers in their health service delivery.
If they are linked to certain community management, the representative of communities will find the
solution together with health providers; and if they are manageable in communities and migrant, they
will undergo and make health services more efficient.

Communities requested more occupational health NCD to be intervened for reducing chronic back pain;
more intervention on TB Case Finding, Diagnosis and Treatment. Moreover, Bright Future and its
partners are ready to work on these areas by providing health education if they are assign to do so.

It was recommended that Health Providers need to inform bottlenecks of their routine health
intervention to Communities Representatives and they will disseminate such information to respective
communities for better service delivery.