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Mobilised population in Dak Lak province: Risks of getting malaria
So far, iIllegal movements of population from the North to West Highlands have imposed considerable difficulties on not only the governmnent's management but also on health care sectors, especially when there is unavailable and feasible malaria control measures for this group. Like any other countries in South-East Asia, Vietnam is facing a great deal of difficulties in applying malaria control activities for mobilised people. Every year, there are dozens of thousands of people moving from northern mountainous provinces (eg. Lao Cai, Cao Bang, Lang Son, Ha Giang) to the West highlands provinces of Dak Lak, Dak Nong, Binh Phuoc. They are mainly ethnic minorities such as H'Mong, Dao, Tay, Nung, San Chi, who take forest-related work as their main occupation. Upon resettlement, they practise their traditional jobs and habitate deep in the forests of the extensive highland areas. As a result, numerous forests in the protected areas are severely destroyed, and mobilised people themselves face threats of diseases, especially malaria. According to the statistics of IMPE Quy Nhon, 80% of the annual deaths from malaria are mainly among mobilised people.  | Mobilised people's habitation |
In March 20, 2009, the IMPE Quy Nhon, the Malaria Control Centre of Dak Lak province, and the district health centre of Easup in coordination with the standing Vietnam Television Station (VTV) in the West highlands conducted the survey on evaluating malaria situation among mobilised people and providing suitable measures of malaria control such as: blood slide examination for malaria parasites; diagnosis and treatment for malaria, and distribution of antimalaria drugs; indoor residual spraying and bednet impregnation for vector control; and delivery of posters and leaflets for malaria control for mobilised group at village no.13, CuKBang commune, Easup district. This group of population is composed of 1,026 people mainly of the H'Mong, Dao, San Chi ethnics, migrating from Lao Cai, Cao Bang, Lang Son, Ha Giang during 2008-2009. They are living in poorly-structured huts, constructed with low-quality wood or bamboo wattles, and roofed with torn tents.
 |  | Daily life of | mobilised people |
Although it is very difficult to have a proper management and of mobilised people, the local health system has made all possible efforts to provide those concerned subjects with primary health services, especially the supplemental malaria control measures such as indoor residual spraying at their tents, impregnated treated bednets, provision of malaria drugs for self-treatment. These measures helped to limit down malaria mobidity and mortality rate among these mobilised people. In his answer to the interview on television, Mr. Thao Seo Vanh, village head of the H'Mong ethnic said that "During their visits at the our houses, the health workers usually carry out bednet impregnation with insecticdes, indoors insecticide spraying. They also give us malaria drugs for self-treatment and recommend us to go to communal health station upon getting malaria." In reality, when the survey group came to the village, they received the active participation from the mobilised people. As a result, there were only 4 malaria positive cases detected from 400 examined people. However, their unsettled living has been driving themselves at risk of malaria infection: they live in scattered groups of houses outreaching the accessibility of health care faclities, no matter how hard the health workers have tried, they cannot protect the mobilised from getting malaria.
Management of mobilised people has been of great concern of sectors of all levels. This has become more severe when the unstable way of living is out of the management and control of local authority and the health sector as well. Therefore, just as important are the roles of the local authority together with the grass-roots health system in terms of taking statistical figures of the mobilised group at a typical time and place. This work should not be only done once, but on the monthly basis in order to facilitate the prompt protection measures. In addition, there should be meetings on mibilised people among to-and-from provinces, which help to provide the mobilised with necessary protection measures not only from malaria but from other diseases; and to resettle their lives and their cultivating habits. By doing these, we can be able to protect those at most risk from malaria, to stabilize their lives and also, to retain the evergreen forests in the West Highlands.
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