Karen News: Why is there a need for dengue awareness campaign?

PU-AMI: Before the rainy season, organisations implementing preventive health activities in the Temporary Shelters [refugee camps] along the border with Burma, organise a Dengue awareness campaign. Dengue is still highly present along the border and people need to be aware on how to protect themselves. Residents of Temporary Shelters are particularly at risk considering their living conditions.

In Maela,[the largest border refugee camp] this campaign is organized in coordination with all health stakeholders, under the leadership of Première Urgence – Aide Médicale Internationale. The purpose of such a campaign is to mobilize the community to prevent and control Dengue by raising awareness, providing health education, and encouraging environmental control measures.

Karen News: What is being done at the camp to prepare and educate residents about dengue prevention?

PU-AMI: Before the campaign is launched, meetings with the different groups (international and community organisations, Thai health authorities and camp committees ) are organised to coordinate campaign activities and prepare educational materials for dengue prevention – posters, flyers and videos..These meetings are important to build on previous experience and share lessons-learnt before the activities are launched.

Karen News: What activities are you planning as part of your dengue awareness campaign?

PU-AMI: On the 15th June Première Urgence – Aide Médicale Internationale launched a school campaign with Filmaid. PU-AMI preventive health workers organised in groups communicated in eight schools at Mae La camp, targeting 3,700 school children. There is Health Education available in the Out-Patient Department (OPD) waiting room.

Karen News: What is the process when there is a dengue outbreak? What can camp residents do to protect themselves and their families?

PU-AMI: Camp resident are encouraged to seek care at PU-AMI health facilities when they present signs and symptoms of the disease, in order to ensure early diagnosis and appropriate care. Home visits, where cases of dengue have been reported are also organised. Preventive health workers go to each house, with staff from Solidarites International, to inform the community about the disease and about individual protection (clothes that minimize skin exposure, the use of mosquito repellent, and to use mosquito nets for those who sleep during day time), as well as to conduct environmental and chemical control interventions aimed at preventing or minimizing the vector propagation and contact with humans. Environmental controls include, activities to manage solid waste and remove containers that have stagnant water that provide habitats for the vector. As complementary measure, chemical control is done with fumigation of the house and its surroundings. Mosquito repellent are also distributed.

Karen News: How many dengue cases so far this year? Are you concerned that 2015 will be worse than last year?

PU-AMI: As of 17th June there were 260 suspected cases in the two camps in Tak province – 242 in Maela and 18 in Nupo. No case fatalities have been reported.
Although a lower number of cases were reported (62) last year, recurrent outbreaks have been observed in the area during the rainy season. Therefore the coordinated efforts to enhance preparedness are essential to better detect and respond to Dengue outbreaks.

Karen News: How does the PU-AMI dengue response to outbreaks work and who does it involve – for example, Thai public health, INGO’s etc?

PU-AMI: During the second week of April a dengue outbreak was declared in Mae La by Première Urgence – Aide Médicale Internationale. Since then, the Surveillance and Rapid Response Teams have been activated in the camps to begin outbreak control measures according to the contingency plan that outlines the roles and responsibilities of the different stakeholders involved, in coordination with the camp health committee.
A strong surveillance system is in place to ensure up-to-date information and analysis on the evolution of the outbreak in order to adjust the response and maximize its effectiveness. Disease surveillance data is disseminated every week to all the partners, including the Thai health authorities (District and Provincial Health Office, and the Bureau of epidemiology at the Ministry of Public Health). A meeting with the health authorities at provincial level has been held to update them on the evolution, when they expressed their will to support the response to the outbreak.

In addition, several activities have been or are being implemented:
– Refresher training for the health workers in the camps, to ensure early diagnosis and appropriate clinical management of Dengue cases presenting in the health facilities
– Dissemination of health messages on loudspeakers with the support of Filmaid.
– Drama sessions on a daily basis to promote hygiene and provide health education in all sections of the camp with Solidarities Internationale.
– Home visits in each house where a dengue case has been reported to provide health education, and implement environmental and chemical control as detailed above –
-In addition, Solidarites International is organising fumigation in the camp and COERR is in charge of managing solid waste

Première Urgence – Aide Médicale Internationale has also been collaborating with Karen News to distribute their educational materials, posters and videos around the camp.

Karen News: Do you have enough resources to deal with a severe outbreak – what do you need?

PU-AMI: The coordination with all health groups and the community is essential to effectively respond to the outbreak in the camps. The collaboration with Thai hospitals is also crucial for the referral and management of severe and complicated cases when needed. Mae Sot and Umphang Hospitals, have been efficient and supportive and they have renewed their willingness to support the treatment of patients.