Support our work in Myanmar: Make an online donation

 Cyclone Nargis - From Emergency to Recovery - Photo Gallery

 Community health workers provide support

 From the field: Turning salty water into clean drinking water

 Search for jobs with Merlin in Myanmar

 Support our work in Myanmar: Make an online donation

On 2 May 2008, the Ayeyarwaddy Delta was devastated by Cyclone Nargis. Extreme wind, rain, and a 10-foot-high tidal surge killed at least 140,000 people and severely affected a further 2.4 million.

Cyclone Nargis – One year on

Merlin was already well established in the Delta region when the cyclone struck, and therefore was one of the first NGOs to respond. Community health workers trained by Merlin responded immediately, providing basic health care to victims injured in the cyclone, referring more complicated cases for treatment. And Merlin teams were providing emergency health care, shelter and clean water within four days.

Working alongside other organisations, Merlin expanded its response in size and scope to include building and rehabilitating health clinics and helping communities to rebuild their livelihoods. As the largest international NGO operating in Laputta Township, Merlin is running a comprehensive and integrated program, covering over 500 villages in the Delta.

As a result of Merlin’s immediate and effective emergency response, we have played a leading role in the international relief effort. Merlin’s country director is co-chairing the health cluster, responsible for coordinating the international aid agencies’ health response. And we have also seconded expertise to develop and lead on joint assessments, working with the UN and the Association of South East Asian Nations.

Community response

Tragically, 94 of the 549 community health workers (CHWs) trained by Merlin were killed during the cyclone. Of those that survived, many lost their entire families. But they formed a vital part of Merlin’s response and continue to do so. A network of over 600 Merlin-trained CHWs now complements Merlin’s team of 249 Myanmar and 18 international staff.

“Through Merlin’s support we have achieved many things in the community. Villagers are very happy to have us here,” says Okaying Lain, a CHW. “Because we are members of the community they trust us and come to us if something is wrong.”

Mobile health clinics
We are delivering health care to 273,536 people
During the emergency phase, Merlin deployed a fleet of 36 boats to transport mobile health teams to inaccessible affected areas, as well as materials for repairing damaged homes. Our 180-foot flagship "Pandaw 4" was used as a floating clinic and treated 29,980 patients.

Ten mobile teams, consisting of one doctor and one nurse each, have been providing medical treatment and primary health care with a focus on maternal and child health. They are also on 24-hour call-out for emergency cases.

Water and sanitation

Access to clean drinking water has always been a challenge, but this was exacerbated by the cyclone, which washed away and destroyed many of the water sources and contaminated them with salty water. Merlin’s water and sanitation team was quick to respond, immediately delivering clean drinking water and then pumping out the contaminated community ponds. Now 148 ponds have been pumped and guttering and water tanks repaired at health centres and schools to aid water catchment.

In addition, Merlin is running ten water treatment units, which desalinate water in strategic locations in the Laputta district. These units not only supply enough drinking water for the villages and surrounding villages where they are located, but also for remote villages suffering from drinking water shortages. Since January, we have distributed approximately 4 million liters of clean drinking water in 90 villages, reaching a population of 34,000.

The team has also been working with communities to build latrines and promote better hygiene practices.

Rebuilding livelihoods

Work has also been underway to ensure a sustainable approach to food security by providing villagers with the means to re-establish their livelihoods. In partnership with Mercy Corps, Merlin has been supporting farmers, fishermen and small businesses by distributing fishing nets, tools and high-quality rice seed. Merlin has also given families seeds and plants for kitchen gardens.

Key achievements

• 10 mobile clinics in Laputta (and one floating clinic – the Pandaw) have seen over 81,367 patients
• Two new health centers that were completely destroyed in the cyclone are currently being rebuilt; 20 damaged health centers have been rehabilitated
• 57 health centers have received drug supplies
• Over 14,000 children have been screened for nutritional problems in approximately 75 percent of the 560 villages in Laputta Township
• Since January, 4 million liters of clean drinking water has been distributed in 90 villages, reaching a population of 34,000
• 148 ponds have been cleaned, 21 ponds renovated and 32 village wells cleaned
• 50 rainwater harvesting systems have been constructed and 42 rehabilitated
• 557 latrines have been constructed and 4,663 education sessions on improved hygiene practices have reached 91,632 people
• 3,075 ceramic filters have been distributed to households, schools and community buildings, such as health centers and monasteries
• 145 water committees have been revitalised
• 16 boats have been donated to the 16 health centres in Laputta District to be used for emergency referrals
• 7,885 households with a total population of 40,000 people have been reached through the agriculture, small business and fishery support programme
• 13,074 village members have received payments for rehabilitating and cleaning their community (such as the renovation of roads, foot trails, jetty construction, cleaning of schools, monasteries and households.

Donors supporting Merlin’s Work

EuropAid, 3DF/UNOPS, DFID, ECHO, OFDA, DEC, several corporate and trust funds

How Merlin is helping – Longer-term work

Merlin has been working in Myanmar since 2004. Even before the cyclone, lack of clean water and sanitation facilities in Laputta contributed to a high risk of waterborne disease outbreaks such as dysentery and diarrhea. There is an urgent need to improve health care at all levels in Myanmar. According to the World Health Organisation, around one in 10 children in Myanmar dies before the age of 5. Maternal death rates are also high—the lifetime risk of dying during pregnancy is one in 75.

Establishing and maintaining mobile clinics
Mobile clinics reach areas with a population of 350,000 in Laputta Township and 50,000 in Thantlang & Tamu Townships.
Mobile clinics are key to providing primary health care, to populations who have little or no access for malaria prevention and control and health education. In Chin State, seven mobile clinics equipped to provide primary health care services and malaria prevention and control visit 12 health posts (one in each village tract), serving 100 villages. They are open to all, but actively target pregnant women and children under 5 years old.  In Laputta, 10 mobile clinic teams travel by boat to provide primary health care and to carry out health and hygiene promotion sessions in villages affected by Cyclone Nargis.

Supporting community health workers in Laputta (CHWs)
CHWs are integral to every aspect of Merlin’s program. In the majority of cases there is one CHW per village. They are trained to provide basic health care and give out basic drugs in the villages in which they live. CHWs are also involved in raising community awareness and providing peer-to-peer education and health promotion sessions. A Merlin Street Theatre group is 22,387 people in 55 villages. In addition, 4,663 general health education and hygiene promotion activities were conducted in 455 villages, covering topics including birth spacing, nutrition, breast feeding, malaria, newborn health, and dengue fever, reaching 91,632 people. CHWs have provided front-line health care services to 120,984 people including 23,465 children under five years old.

Malaria prevention and control
We are reaching 80,000 people
We are helping to prevent, diagnose and treat malaria in three States/Divisions - the Ayeyarwaddy district in the South and in Chin State and Sagaing Division in the northeast of Myanmar. Working with the Ministry of Health, we are also strengthening the national malaria control program, including training staff in epidemic preparedness and response. Community Health Workers are central to our response, ensuring that populations at risk of malaria are protected with long lasting insecticide-treated mosquito nets (LLITNs) and trained in their correct use, as well as providing diagnosis and treatment.

Key achievements
• 400,000 people have access to Merlin mobile clinics.
• More than 70,000 consultations a year are conducted at Merlin-supported health facilities.
• Merlin has opened new offices in Kalay and Hakka at Sagaing Division to allow for the expansion of our malaria prevention and control programme to 51 new villages. Merlin is now the leading INGO delivering health care across four townships in Chin State/Sagaing Division.

Read more about Myanmar