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Objectives

* Increase access to basic health services for migrant workers in rural Phop Phra.
* Increase access to family planning supplies for migrant workers in rural Phop Phra.

Target Population

* Migrants from Burma in 44 communities of rural Phop Phra, Tak Province
(Approximately 18,000 people live in this area, based upon a survey SAW conducted in October 2011)

The Mobile Medical Team (MMT) has been operating since 2010. Previously, between 2000 and 2003, the team worked in heavily populated migrant areas in Mae Sot but was forced to stop due to security reasons and limited resources. Since 2010, the MMT has been operating in Phop Phra.

The rural area of Phop Phra is made up of approximately 100 smaller communities that are home to both Thai and Burmese people. Communities are isolated and this makes the area an ideal route for human trafficking and other illicit activities. Drug and alcohol abuse in these communities is widespread and has resulted in many instances of violence. The migrants who live and work in Phop Phra earn between 70 and 100 THB a day in the agriculture and construction sectors, and the vast majority of migrants are undocumented. Therefore, migrants live in constant fear of being deported at police checkpoints and during police raids.

Many communities are located adjacent to the fields where migrants work, near the homes of Thai employers. Houses are typically made of bamboo and rice sacks, with roofs made of leaves. Employers or landlords rarely provide sanitation systems and running water, so migrants are forced to use water from rain, ponds and streams for washing, cooking, and drinking. The ponds and streams are contaminated because of chemical run-off from farms, which is a primary cause of many health issues since in the dry season this is the only source of water for the communities. Thai health authorities have banned the use of the ponds, but migrants do not have an alternative water source.

Since the recommencement of activities SAW has provided basic medical treatment to 2-3 communities on a weekly basis, rotating between 44 target communities throughout the year. During each visit the doctor provides basic health care in the form of checkups, family planning information and supplies, and medications such as de-worming pills, antibiotics, and topical treatment for skin infections. The MMT also administers pregnancy tests, and distributes mosquito nets. Before any kind of medication or contraceptive is given to the patient, the doctor provides individual or group counseling on how to use it and what kind of follow-up is necessary. If the doctor believes a more serious medical procedure may be necessary he will discuss this with patients and refer them to local medical facilities. SAW provides logistical and financial support for this referral. The number of communities in need is high and resources limited, meaning that each community is only visited every three months. Between September 2010 and March 2012 SAW provided treatment to a total of 6,831 persons. On average, SAW’s MMT serves 70 patients a week; slightly less than 300 a month.

The MMT is led by a doctor and supported by two social workers. One social worker lives in Phop Phra and is in charge of identifying the communities most in need and facilitating the logistics for community members to receive assistance. This social worker is also responsible for facilitating transportation for any referrals made by the doctor. The second social worker assists the doctor in registration and data collection during consultations, ensuring that information is recorded in a database back in Mae Sot. A driver and an additional volunteer accompany the team. When the team arrives a social worker registers patients before they can see the doctor. The doctor begins the consultation by doing a general intake and then examining the patient. The doctor records data about each patient, including the treatment provided and recommended follow-up.

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