Various attempts have been made to control malaria for mobilised population, especially those with living habits pushing themselves at risk of getting malaria such as sleeping in the forests, crossing borders. In that context, the cooperation of the civil-army health sectors along the border area of Vietnam-Lao PDR provided some good experiences in the management of malaria.

Quang Tri has long been o­ne of the most severely-hit provinces of malaria in Central Vietnam, especially in the border districts with Lao PDR such as Huong Hoa and Dak Rong. With a border line of 156 kilometres long, Quang Tri is facing tremendous problems of malaria management due to uncontrollable border-crossings, both legally and illegally.

Cooperative activities between civil and army health sectors in the border area

In border area such as Thanh and Xy communes, malaria morbidity plunged in 2009. This has urged the involved bodies to pay much attention to reducing malaria situation in the remote and outreached areas. Therefore, under the directions of the provincial health department together with the borderguard headquarters, the health facilities in civil and army units have improved staff performance and working capacity, especially at the communal health stations, coordinated civil-army clinics, which contributed a great deal to protecting the community health in general and controlling malaria in particular. As per the reports by the borderguard army health sector, in 2009 the army units carried out 28 times of health education for 2,456 people, including 458 army troops. This has raised the awareness of the soldiers and local communities against malaria. Outbreak surveillance and vector control activities have been referred to as the fundamental technical measures in malaria control; therefore, the borderguard army health unit coordinated closely with the provincial preventive centre of medicine, district health centres of Huong Hoa and Dak Rong to keep an eye o­n the disease at border communes; and to actively implement effective control measures. Accordingly, the microscopic points at the borderguard posts took 1,015 blood slides for malaria parasites; impregnated totally 858 bednets for soldiers and 1,638 for local community; carried out residual spraying for 375,000 sq. metres of army camps and 738 sq. metres of local people's houses. Treatment and management of malaria cases have been a regular work of the civil-army cooperation. For 2009 o­nly, there were 715 malaria cases detected and treated, including 140 cases at the borderguard posts and the remaining 575 cases at the civil-army cooperative health stations. These patients treated at the latter included 391 Vietnamese, 184 Laotians and 23 severe cases. In addition, the stand-by treatment was also given to 622 soldiers and mobilised people at risk of getting malaria. Consequently, thanks to the timely detection and prompt treatment, there were no severe and complicated malaria cases at the borderguard army health stations.

Rice donation to local people at A Vao commune (courtesy of bienphong.com.vn)

However, some shortcomings still existed in assome areas such  loosen cooperations, low-quality microscopic points leading to misleading diagnosis and treatment, lack of supports from upper levels in terms of malaria treatment, and difficulties in communication activities, yielding low effectiveness.

Helping Lao PDR to provide diagnosis and treatment for people living along the borderline

Along the border line o­n the Laotian side, there are 112 villages of 3 districts of Se Pon and Muong Noong (Savanakhet province) and Tu Muoi (Salavan province) with the population of 21,135 living in 4,956 households. These are the villages in difficulties socially and economically, with low quality of education and backward practices and customs. Yet, the two local communites have close relationship and relatives for a long time. The communities o­n the both sides of the border are of the Van Kieu and Paco ethnic minorities, sharing the same culture, language, writings, religion, and mutual traditions of conquering the nature and fighting the same enemies.

Regarding the health care network, there are seven health stations of 6 assistant doctors, (without any doctors), and 16 nurses concentrating at economic centres and border gates. The health facilities at these stations are in short of necessary equipment, incapable of meeting the needs for medical treatment of the local community. Because of the complicated topography, sparsely distributed population at the borderline and health care inaccessibility, Laotians usually enter the Vietnam's side for treatment upon getting diseases. In order to strengthen the Viet-Laotian relationship, to keep the border in peace, relationship, cooperation, harmony while respecting the sovereignty of each country; between 2003 and 2009 the border army health units conducted examinations, first-aids treatments for 3,126 Laotian patients living o­n the borderline and provided 4,373 doses of stand-by treatment. For 2009 o­nly, the district health centre of Huong Hoa (Quang Tri province) carried out epidemiological surveillance, examination and treatment for Laotian villages at the border, taking 100 blood slides and detecting 48 positive cases. However, there should be cooperative procedures between the two health services (i.e Quang Tri and Savanakhet Health Services) in order to faciliate the health cooperation and supports for the sake of Laotian's health.

Living at the Viet-Laotian borderline (on Quang Tri	side), local people are still in great deal of supports

Civil-Army health cooperation in border area

The border areas of Vietnam-Lao PDR, Vietnam-Combodia, Vietnam-China are regarded as the malaria severely-endemic zones. The cooperations for malaria control at the borders are of great importance, especially the roles of the borderguard army health stations in their close relationship with the civil health sector in malaria case management. Therefore, the results of the civil-army health cooperation at the Viet-Laotian borderline in Quang Tri province provided some good experiences for those sharing the borders with Lao PDR and Cambodia in the Central-West Highlands, Vietnam.

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