Thursday, May 19, 2011

On the road for the Health Review

As part of his current work looking at the Lao PDR health system Andrew spent a week in the southern provinces of Khammoaun and Savannakhet. It is a good 6 hour drive to the 1st province on the agenda



The aim was to meet Provincial and district health administration officials to discuss finance topics and visit health facilities at all levels to learn how they manage Donor and Government funds.

A short summary of the Lao Health situation is that health indicators are poor, but improving.
  • The health situation of women and children in Laos is amongst the poorest in Southeast Asia;
  • Infant mortality rate is 70 per 1000 live births and under five mortality claims 98 per 1000 live births.
  • Only half the population has access to safe water and 30% have access to sanitation facilities.
  • About 50% of rural children under-5 years are severely malnourished and 40% of all under five children are moderately stunted.
The government pays the salaries of health workers but everything else is user pays.  There are now some schemes in place to make free health care available to the poor.  These are making a difference but the progress is slow.

Once out in the District Offices and in the villages the level of poverty is evident.
 

But at the same time the provinces are also lovely

There were no patients in the hospital the he visited.  The 1st picture below is a district hospital and the 2nd is a village health centre

 
  The facilities are clean but very basic. There are no hospital meals. If you want to eat, your family needs to provide the food.


At one facility there was no running water and the water was carried by hand from this murky pond.


Heading into the very rural countryside was the area where the Ho Chi Minh trail was located – this was a series of routes for supplies and troops used by the North Vietnamese Army between North and South Vietnam and was mainly located in Laos (a link to more information about the trail http://www.britannica.com/Ho-Chi-Minh-Trail).

Areas have been fenced off to preserve the history and the dense vegetation shows the how tough the job would have been.

Even back in the main provincial towns life remains quite rural. Cows cross the road to the place where Andrew and a colleague went to have a beer. Yet just over the river the prosperity of Thailand is visible.


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