Grassroots solutions to deadly problems

Grassroots solutions to deadly problems

Chiang Mai villagers unite to combat dengue and drowning

Ekkasit Wongtharahas, a health promotion employee, shows a red flag used to fight the spread of dengue fever in tambon Ban Luang of Chiang Mai. (Photo by Onnucha Hutasingh)
Ekkasit Wongtharahas, a health promotion employee, shows a red flag used to fight the spread of dengue fever in tambon Ban Luang of Chiang Mai. (Photo by Onnucha Hutasingh)

Local empowerment has become the best prevention measure against diseases and accidents in two Chiang Mai communities, who have learned firsthand how collective grassroots action can keep them safe.

Dengue fever has terrorised the communities in tambon Ban Luang in Chom Thong district for years. Locals are well aware of the deadly dangers that the fever brings.

In Bangkok, dengue fever has killed 81 people and infected more than 77,000 others since the beginning of the year. The death toll for last year stood at 103, with more than 71,000 falling ill.

The fever did not spare any community, even in big cities like Bangkok, where the quality of public healthcare and access to medicine is relatively high. The rapid spread of the disease and the surging death toll intensified campaigns to control the fever.

But in remote Ban Luang, which is no stranger to the disease, dengue fever was defeated this year with zero deaths. The success, however, did not happen by chance.

After a 2012 outbreak left eight people sick in Ban Luang, the tambon of 19 villages decided to take action. Even though no one died, the communities agreed they must band together and tackle the disease at its source -- mosquito larvae.

Under the "Red and White Flags" project, residents began searching their properties daily to eradicate the larvae and their breeding grounds -- standing water. They also disposed of household garbage at public dumps, said Ekkasit Wongtharahas, a health-promotion official at Ban Muang Klang Hospital.

But residents went a step further in the larvae eradication process.

They devised a system whereby public health volunteers monitor local households for progress in extermination. The volunteers plant a red flag outside the homes where larvae are found and give families seven days to eradicate them. If larvae are still found a week later, the families are given a warning. A third failure incurs a fine of 200 baht.

Houses which completely eradicate the larvae are marked with white flags.

"The system has been in place all these years and no one in the villages has been fined. Several residents were issued warnings but the red flags were removed after second surveys," Mr Ekkasit said.

Last month, larvae were eradicated in six of the 76 houses surveyed. No one has contracted the fever so far.

Mr Ekkasit credits the success to "the coming together of local people".

"Everyone respects the rules," he said.

Thitima Techara, a public health volunteer, said each volunteer monitors 15 houses. They carry a torch to locate the larvae-infested spots and sprinkle sand to kill the grubs.

The volunteers also train youngsters to help detect the early signs of dengue fever.

"They will grow up to be informed adults who can protect themselves from the fever and take care of people around them," Ms Thitima said.

For the past 10 years, tambon Ban Luang has financed its dengue-eradication efforts with the National Health Security Local Fund Award. The fund uses money from the local administrative organisation and is also subsidised by the National Health Security Office (NHSO).

Swimming Lesson Learned

Elsewhere in Chiang Mai, another community has successfully devised its own programme to prevent child drownings.

Tambon Luang Nuea in Doi Saket district decided to act after the community lost a child in 2011, followed by two near-drownings soon after. Although the two children survived, they were left permanently paralysed. One of them later died and the other will have to be cared for by his family for the rest of his life.

"The emotional trauma is unbearable for the family," said the survivor.

Residents decided that something must be done to prevent similar tragedies. The community committee and municipal office rose to the occasion and launched swimming classes for local children, supervised by a coach, at a sympathetic local resort.

So far, more than 700 children in the tambon and nearby communities have attended the class. The young participants are also educated on rescue techniques and how to perform cardiopulmonary resuscitation.

The children are taught to shout for help if they come across someone drowning, and to never jump into the water. Instead they are told to find an object that can float, fasten it with a rope and throw it out to pull the person to shore.

Araya Umnang, 12, said the training is a lifesaver. She and other youngsters were eager to learn how to swim and rescue those in distress.

Drowning has been the number one killer of Thai children over the past 10 years. Last year, 231 children drowned.

NHSO deputy secretary-general Karun Khuntiranont said tambons Ban Luang and Luang Nuea lead the way in tailoring solutions to local problems. Each shows how communities can find effective and individual solutions to their own unique problems.

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