Village Health Educators in Thailand Help Prevent Minority Mothers' Deaths

MAE HONG SORN, Thailand – Hidden between towering mountains, with forested slopes stretching to the Myanmar border, this province is covered with mist virtually all year round. The charming scenery can quickly turn deadly when local people need help from the outside world.

“Two months ago, I gave birth to my second child. It was early morning in the rainy season. We needed more than 10 men to help pull the car so I could get to the hospital safely,” recounts Tida Charoenjitnirun, 23, noting that the un-paved road was slippery and treacherous, so the men helped guide the car. ”Usually the trip takes only half an hour, but on that wet day we left before 3 a.m. and arrived around 5. I gave birth 10 minutes after arriving—it was lucky I did not give birth on the way.”

Tida, from Mae La Noi district, belongs to the Karen ethnic minority. She lives in an area that has one of Thailand’s highest maternal mortality ratios. Like other Karen mothers in her community, she did not bother coming down the mountain to seek health advice and services during her first pregnancy. “I used to think that when a mother or a baby dies, it is a tragedy but also a fact of life,” she recalls.

Challenging needless deaths

Her views changed after the Department of Health and UNFPA, the United Nations Population Fund, began training village health workers to educate their neighbours on maternal and child health. “In my second pregnancy we learned that I should get antenatal care, and my husband drove me to see the doctor every month,” she says. Today Tida is herself a volunteer health worker, offering lifesaving advice to other pregnant women.

Although she gave birth to her first baby at a hospital, she did not learn about exclusive breastfeeding. “After a month, we fed her ripe bananas and other soft food,” just as Tida’s mother had done with her children. “This time we learned it would be healthier if the baby had only milk for six months,” Tida says, smiling at the infant on her lap.

“Our first child, now almost 4, gets sick easily,” says Tida’s husband Uthai. He hopes the new baby will be healthier.

“Tida learned about many things after she became a village health worker,” Uthai says proudly. “When we go to church on Sunday, she shares her knowledge with other church members. The tasks she does may be simple,” he adds, “but they help pregnant women stay healthy and are good for the health of the children.

“We used to accept mothers’ deaths as a law of nature. But now we've learned how to reduce risks and prevent unnecessary deaths.”

Husbands play an important part

Uthai, 24, is keen to play his own part. “When I take my wife to the health centre, I usually learn things husbands can do to care for our wives and children.” He encourages family members and friends to have their blood tested before getting married and pregnant. “There is a lot of disease and illness. If we know our weakness, we can prepare better and try to prevent what might cause trouble.”

In Thailand, UNFPA supports a programme to strengthen human resources so health systems can meet women’s needs during the critical time of childbirth. Working closely with the Department of Health, the Fund aims to ensure that all women—including minority women—have access to contraception so they can avoid unintended pregnancies, to skilled care at the time of birth, and to timely emergency obstetric care when complications arise.

–Thitiporn Winijmongkolsin