Mekong

In collaboration with the Liliane Foundation and local partner organizations, NLR Mekong conducted exploratory missions in 3 countries: Myanmar, Cambodia and Vietnam. Findings from the missions will be used as input for the annual plan 2017 and NLR Mekong’s strategy for the coming years. This is an improvement on previous years’ practices.

NLR Mekong worked with disability experts and multi-project stakeholders to conduct a study on living conditions and status of people with a disability, including people affected by leprosy in Gia Lai province, Vietnam.

The findings from the study are used as baseline indicators for the local partners to mobilize participation and resources from multi-stakeholders in planning for the 3-year project (2017-2020).

NLR Mekong prepared for phasing out structural financial support for all leprosy control activities in all Mekong countries in 2017 and supported these partners in this transition while promoting local ownership. NLR Mekong also introduced a plan of transitioning activities to a local organization, following the decision of NLR to stop its funding for the Mekong countries in 2017.

In the These Shoes Are Made For Walking project, support is continued for the international training of young orthopaedic shoe technologists from different countries in South and South East Asia. The 2nd cohort students completed their final exams in December 2016. The 3rd training course (3rd cohort) for Orthopaedic Shoe Technology started with 10 students in Hanoi on 30 May 2016.

Combating leprosy in Mekong

In 2016, NLR Mekong supported 28 local partner organizations (6 in Cambodia, 3 in Myanmar, 17 in Vietnam, 1 in Thailand and 1 in China) to provide rehabilitation services to more than 10,000 people with a disability, including people affected by leprosy and children with disabilities. The rehabilitation services provided by the partner organizations include health checks, assistive devices, school support, vocational training and job opportunities.

The 1st orthopaedic shoe workshops were started in the home countries of some of the 1st cohort students of the These Shoes Are Made For Walking project; 4 potential shoe workshops in Myanmar and 1 in Laos have been visited for review and guidance. The workshop at Vietnamese Training Centre for Orthopaedic Technologists (VIETCOT) for the VIETCOT clinic was developed and started to receive patients with foot problems and produce orthopaedic footwear on a regular basis.

 

Realization: €1,090,067

Combating leprosy in Cambodia

Number of new cases detected 154

Proportion of new cases presenting with grade-2 disabilities 20%

Number of new cases detected in the area where we work 154

Number of self-care groups supported/formed:

b) New groups formed and supported in 2016 5

Number of people provided with assistive devices (wheelchairs + crutches + sunglasses + protective/ orthopaedic footwear + prostheses) 84

Number of people financially supported for education 277

Combating leprosy in Myanmar

Number of new cases detected 2,609

Proportion of new cases presenting with grade-2 disabilities 13.7%

Number of new cases detected in the area where we work 2,609

Number of people receiving leprosy-training 389

Number of self-care groups supported/formed:

b) New groups formed and supported in 2016 5

Number of people disabled by leprosy and other diseases trained in self-care 358

Number of people financially supported for education 54

Combating leprosy in Vietnam

Number of new cases detected 123

Proportion of new cases presenting with grade-2 disabilities 24%

Number of new cases detected in the area where we work 123

Number of self-care groups supported/formed:

b) New groups formed and supported in 2016 13

Number of people provided with assistive devices (wheelchairs + crutches + sunglasses + protective/ orthopaedic footwear + prostheses)

Prostheses: 192

Crutches: 43

Protect.glasses: 20

Footwear: 3,000

Number of people financially supported for education 210

Combating leprosy in Thailand

Number of new cases detected 163

Proportion of new cases presenting with grade-2 disabilities 15%

Number of new cases detected in the area where we work 163

b) New groups formed and supported in 2016 13

Number of people provided with assistive devices (wheelchairs + crutches + sunglasses + protective/ orthopaedic footwear + prostheses)

Wheelchairs: 26

Prostheses: 85

Crutches: 4

Foot braces: 4

Footwear: 1,035

Number of people provided with micro credit 36

Number of people financially supported for education 347

Combating leprosy in China

Number of new cases detected 672

Proportion of new cases presenting with grade-2 disabilities 28%

Number of new cases detected in the area where we work 672

b) New groups formed and supported in 2016 2

Projects

Project

Disability Resource Centres in Myanmar

The project aims to support and empower persons with disabilities, including people affected by leprosy. The 14 Disability Resource Centers are organizing many community-based rehabilitation services to promote educational and socio-economic services and rehabilitation for persons with disabilities in rural villages in Myanmar. In 2016, the Disability Resource Centers reached 60,804 persons from 20,843 households in 134 communities for disability screening and provided rehabilitation services to 2,543 persons with disability (1318 M & 1225 F), which is 3.3% of the population in the mostly rural target areas. Of them, 114 are persons affected by leprosy and 655 are children (367 boys and 288 girls). Sessions to increase awareness of leprosy, disability and rights of persons with disability (UNCRPD) and the national law were held in the project’s 134 communities. A total of (11,633) people attended these awareness sessions.

Project

Leprosy hospitals in Myanmar

Capacity building workshops and skills training in reconstructive surgery and hand therapy for medical and paramedical personnel of the two leprosy hospitals (Yenanthar Leprosy Hospital in Mandalay and the Mawlamyine Christian Leprosy Hospital) took place in January and February of this year. A total of 60 patients were screened and 25 of them received surgery during the surgical trainings. The hand therapy training workshops were attended by over 70 medical and paramedical participants in each of the hospitals. The eagerness (and need) to learn among medical professionals in Myanmar is enormous since the country has recently opened up after having been in isolation for so long.

Project

Integrated rehabilitation projects

These projects for people with a disability consisted of social events, multi-sector dialogues and booklets and documentary films to promote the rights of people with a disability and people affected by leprosy in Vietnam. The projects support the organization of self-help groups to widen participation in community development activities. The project in Kon Tum province consisted of a large number of activities in 2016 that benefited more than 1,000 people. From the number of beneficiaries, 180 persons with a disability and local government officials were trained together in social policies and advocacy skills; 500 students and teachers took part in events to raise local awareness about the right to education for disabled children; 20 families received house adaptations; 42 families of persons with disabilities and affected by leprosy were supported to improve their income. Booklets with “Helpful information for persons with disabilities” were printed and handed out to persons with disabilities in the province. Project activities in 2016 in Gia Lai province involved more than 250 participants. Out of that number, more than 150 persons with disabilities and government officials took part in the project baseline surveys and focus group discussions; disabled people organizations and community-based organizations were consulted for the survey too. The survey serves as a preparation tool for the project implementation plan for the coming 3 years.

Project

Inclusive education

NLR Mekong conducted physical accessibility audits in several public schools in Vietnam. Key findings were, among others, that the conditions in most public schools do not encourage pupils with a disability to go to school. Accessibility is limited and there are many barriers for wheelchair users. To attend these schools, pupils with disabilities depend too much on the help of parents, teachers and classmates. The findings from these audits will support NLR Mekong in developing inclusive education initiatives with the Lilian Foundation in the region. The findings will serve as baseline indicators for NLR Mekong’s POs to monitor on-going programs to improve schools’ physical accessibility.

Peter Donders Foundation in the Netherlands continued to finance and support a large number of essential assistance services for persons affected by leprosy in Vietnam in 2016. Their support provided new prostheses to 192 persons with an amputation due to leprosy, many of them suffering a double leg amputation; a further 319 amputees received prosthetic care and repair of their prostheses; 3 poor leprosy-affected families without shelter received a simple house with toilet and water access; 82 elderly single and severely disabled leprosy patients received extra food relief throughout the year; and 79 children of poor leprosy-affected families continue to go school with the support of the Peter Donders Foundation

With seed money borrowing from the saving-credit group, I have a good farming business

Story from the field

Mrs. Truong Thi Nga, is a 59 year old widow with a leprosy-related disability, living in the rural village of Nguyen Phic commune, U Minh DIistrict in Ca Mau province. In 1976, Mrs. Nga and her husband were diagnosed with leprosy. Because the hospital was very far away from their place of residence, they did not receive regular treatment and their leprosy symptoms became worse and worse. In 2000, Nga’s husband passed away, so the new widow had to look after their six children (one son and five daughters) on her own.

Supported by the NLR-program, the Center for Social Disease control in Ca Mau provided treatment and wound care for Nga; the women’s Union invited her to take part in the saving-credit groups for training courses on family business planning. Nga got loans from the saving-credit group to buy ducklings, chicks, piglets and a small python. In June 2015, she sold the baby pythons, ducks and chicken to buy a new TV and table, and re-invest in her small husbandry business.

At a meeting with NLR’s project officer, consultant and local authority on 10 January 2017, Mrs. Nga stated: ‘Thanks to support from NLR-projects in 2016, I had the opportunity to get proper treatment and rehabilitation services. Also, I got the opportunity to take part in some training courses with other women, and with seed money borrowing from the saving–credit group, I now have a good farming business.’

Mrs. Nga now lives with her son in a concrete, stable house, with a large garden, big python cages and pigsties. Mrs. Nga was proud to disclose that ‘all of my daughters are married, and they have happy families. They are now confident to tell their friends that their mother is a self-reliant woman and a great mother.’

Lessons learned in 2016

Two out of 6 partner organizations in Cambodia ended the year with some underspending and need to improve their annual budget planning and implementation process to ensure all project activities are implemented on schedule. In 2017 NLR Mekong will improve its monitoring of the POs and help the POs in their planning and implementation process. NLR Mekong has also strengthened its own monitoring and evaluation system. Together with the introduction of the AKVO reporting system by NLR international office, this will ensure better and more effective monitoring.

The co-financing by the NLR and LF of the jointly supported project for the The Leprosy Mission Myanmar (TLMM) Disability Resource Centres (DRCs) w as approved and the partnership agreement was signed in the 1st half of the year. The DRC’s operation in its present form is relatively costly for a country as poor as Myanmar. It is therefore worthwhile to continue to explore how this model can be incorporated into the state’s health and social programs.

NLR together with Sasakawa Memorial Health Foundation (SMHF) continued piloting integrated rehabilitation projects that aim to bridge the gap between access to services for people with a disability due to leprosy and services for those with disabilities due to other causes. The pilot project was replicated and expanded to Gia Lai province in the central highland of Vietnam.

In October 2016 NLR made the decision to stop financing the Mekong program, which was up to that point covering Vietnam, Cambodia, Laos, Myanmar, Thailand and China. The NLR Mekong office in Hanoi plans to evolve into a locally-registered organization in Vietnam, and to develop more in-country (Vietnam) and regional (Cambodia and Myanmar) programs linked with similar organizations working on disability, for which new external funding needs to be found. For 2017 and 2018 the team received transitional NLR funding to enable the transition towards a local NGO that will attract more external funding.

Plans for 2017

NLR Mekong will continue its partnerships with 16 partner organizations (9 in Vietnam, 5 in Cambodia, 2 in Myanmar) funded by the Liliane Foundation, to carry out social, educational and rehabilitation activities for children with disabilities from low-resource families.

With support from NLR and SMHF, NLR Mekong will continue the projects for integrated rehabilitation for people affected by leprosy in Kon Tum and Gia Lai provinces and the scholarship program in the financial year 2017 (from April 2017 to March 2018).

With support from the National Postcode Lottery, NLR Mekong will continue the project for Orthopaedic Shoes Technology (These Shoes Are Made For Walking).

NLR Mekong is working with other partner organizations to pilot initiatives for integrated rehabilitation and community inclusive development.