From IRIN comes this story on the life of chil­dren in the remote vil­lages of Myan­mar. Chil­dren often have to take care of them­selves while their par­ents are away work­ing, that means many chil­dren unwashed, unfed and unhealthy. This story focuses on edu­ca­tion efforts to help turn that around.

In the moun­tains between Min­dat and Madupi towns in Myanmar’s remote Chin State, 45-year-old Mo Reen is search­ing for orchids to sell dur­ing the cold season.

Her hus­band, mean­while, works the land for their slash-and-burn farm in Min­dat Town­ship, about an hour away. Their chil­dren, aged six, eight and 11, are left alone at home.

“When we were young, we were left by our par­ents, the way we leave our chil­dren now,” Mo Reen said. “The eldest of the sib­lings takes care of the younger ones, while the par­ents are away work­ing. It’s tra­di­tional here.”

But with­out proper care, her bare­foot chil­dren run around unwashed and unkempt.

Agen­cies say a lack of aware­ness about children’s health issues in Chin State, Myanmar’s poor­est, is leav­ing them vul­ner­a­ble to infec­tious dis­eases, some of them deadly.

“Most Chin par­ents, espe­cially in the remote areas, lack knowl­edge, not only about per­sonal hygiene, but also about the health of their chil­dren,” said Syed Shah Miran, the project health coor­di­na­tor for Chin State with Mer­lin, a med­ical NGO.

Poverty and low lev­els of lit­er­acy con­tribute to the lack of infor­ma­tion, while there is a need for more health awareness-raising cam­paigns in the state’s iso­lated, hilly areas, he said.

“Because of this lack of knowl­edge among par­ents, their chil­dren are very vul­ner­a­ble to … infec­tious dis­eases such as malaria,” said Syed Shah Miran.

Com­mon ailments

Accord­ing to the Canada-based Chin Human Rights Orga­ni­za­tion (CHRO) tuber­cu­lo­sis, typhoid, malaria, HIV, vit­a­min and min­eral defi­cien­cies, diar­rhoea and stom­ach prob­lems are com­mon ail­ments in Chin State, home to some 500,000 peo­ple and nes­tled along the bor­der with India.

A health worker from the Depart­ment of Health said most illit­er­ate par­ents did not know how to pro­tect their chil­dren against com­mon diseases.

“It’s very clear that they don’t know how to keep them­selves clean and healthy, [nor] do they know how to care for their chil­dren and keep them from being infected with dis­eases that could kill them,” the health worker said on con­di­tion of anonymity.

There is no data avail­able on the mor­tal­ity rate and causes of death in under-fives in Chin State, accord­ing to the UN Children’s Fund (UNICEF).

How­ever, it is assumed that causes of child mor­tal­ity are sim­i­lar to other states, UNICEF says, includ­ing infec­tious dis­eases, espe­cially pneu­mo­nia, diar­rhoea and malaria.

The most recent joint UNICEF and gov­ern­ment Mul­ti­ple Indi­ca­tor Clus­ter Sur­vey in 2003 showed a higher rate of mal­nu­tri­tion among under-five chil­dren in Chin State than the national average.

Chronic malnutrition-stunting among under-fives in Chin State is 36.5 per­cent, com­pared with the national aver­age of 32.2 percent.

At the same time, acute mal­nu­tri­tion among under-fives in Chin State is 8.7 per­cent, against the national aver­age of 8.6 percent.

Chin advo­cacy groups say mal­nu­tri­tion and chronic food inse­cu­rity have wors­ened since 2007 due to the destruc­tion of crops by a rat infestation.

Chal­lenges to rais­ing awareness

To edu­cate Chin peo­ple on the impor­tance of health­care, inter­na­tional agen­cies and the Min­istry of Health are con­duct­ing aware­ness cam­paigns. How­ever, there are chal­lenges in Chin State such as acces­si­bil­ity, health experts say.

“One of the chal­lenges is dif­fi­cult access to its moun­tain­ous ter­rains, espe­cially dur­ing the rainy sea­son,” Osamu Kunii, UNICEF Myanmar’s chief of health and nutri­tion, told IRIN.

Vil­lagers have dif­fi­culty access­ing health providers and facil­i­ties, while get­ting health providers to com­mu­ni­ties is a prob­lem, he said.

There are only 12 hos­pi­tals and 56 doc­tors for the pop­u­la­tion, and just four viable roads in the state, accord­ing to a Jan­u­ary 2009 Human Rights Watch (HRW) report.

In addi­tion, there are restric­tions in terms of data col­lec­tion and sharing.

Offi­cials also say they face dif­fi­cul­ties in con­vinc­ing par­ents of the impor­tance of health edu­ca­tion. “Per­suad­ing par­ents to come and join awareness-raising cam­paigns is quite chal­leng­ing for us as they’re busy farm­ing,” said the gov­ern­ment health worker.

Most peo­ple in Chin State are sub­sis­tence farm­ers and live hand-to-mouth.

“I’m sorry that I can­not spend time with my chil­dren,” said Lin Htan, 31, while she worked with her hus­band to pre­pare their farm in south­ern Min­dat Town­ship. “It’s because day in and day out, I’m busy find­ing food for them.”

Her eldest child, aged seven, has been left at home to take care of his younger brother and sis­ter. Lin Htan said she wor­ried about her chil­dren being infected with malaria or other fatal dis­eases, but she had no time or oppor­tu­nity to act on it.

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