Page 102 - Journal of Special Operations Medicine - Fall 2017

through the process of participatory learning action,whereas Trauma care training of Back Pack medics.
the BPHWT finds out what kind of problems the communi-
ties have and how they can solve the problems by themselves
with the BPHWT’s support. The participants come from a
wide variety of backgrounds and community groups, includ-
ing village leaders, religious leaders, members of women and
youth organizations, and shopkeepers. This wide and varied
participation increases the likelihood of knowledge spreading
and reaching all levels of the community.

The School Health Sub-Program and Village Health Work-
shops work synergistically with respect to village health edu-
cation. By educating the students, it is expected that they will
educate their parents. And similarly, by educating the parents Photograph: BPHWT
in Village Health Workshops, it is hoped they will, in turn,
educate their children.

In high-intensity conflict zones, the Back Pack teams are pri- first aid training of the villagers and school teachers in its
marily oriented toward the medical care of those fleeing fight- target areas.
ing and with war trauma injuries. Medical care and maternal
and child health care are generally provided to populations in In the field, Back Pack teams are currently organized into 21
moderate-intensity conflict zones, while all three programs— field areas, each with two to nine Back Pack teams. A field
MCP, MCHP, and CHEPP—are delivered to populations in area is managed by a field-in-charge, who organizes field
low-intensity conflict zones. In these latter zones, water and meetings and workshops, distributes medicines and supplies,
sanitation systems can be installed given a somewhat lower collects and reports data, organizes health worker security
possibility that they would be destroyed by invading Burma and transportation, and coordinates with the administrative
military forces or abandoned by villagers who must flee ad- and program staff at the BPHWT head office. Depending on
vancing Burma military units and live in internally displaced the health and security situation in the field area, the field-
areas in the jungle. in-charge is supported by an MCP-in-charge, an MCHP-in-
charge, and a CHEPP-in-charge.
The three programs have program coordinators who coor-
dinate their respective program with the program field staff, The BPHWT’s current program design has one Back Pack
field area and border-based EHOs/CBHOs, and partner or- team working in one tract of villages with a target population
ganizations, including international nongovernment organi- of approximately 2,000 people. In a typical target area, there
zations. The program coordinators consolidate field reports are three health workers on a Back Pack team who travel in
and data, prepare budgets, review and approve expenditures, the area and network with five VHWs and five to 10 TTBAs
conduct program workshops, oversee training, and order/dis- embedded within local villages in their assigned village track.
tribute medicine as well as medical and other supplies. On a Back Pack team, one health worker occupies a leadership
role for both the team and the MCP, another for MCHP, and
The BPHWT has various training programs to support its pri- a third for the CHEPP.
mary health care model. Level I or community health worker
training is basic medical training that lasts for 6 months with These health workers carry essential medicines, medical sup-
an additional 3-month placement at the Mae Tao Clinic in plies, and data forms, and some teams carry more specialized
Mae Sot, Thailand. Level 2 training is medic training for 12 equipment such as surgical tools for trauma patients and sup-
months, and Level 3 training is health assistant training that plies for water and sanitation systems. Each Back Pack team
takes 2 years to complete. travels between the villages in their assigned village tract to
carry out their duties. They also travel to and serve numerous
Also, the BPHWT trains TTBAs with a 6-week training course. small, temporary communities of internally displaced persons
The course is short since the TTBAs are already experienced (IDPs), hiding from the Burma military and their allied eth-
as traditional birth attendants in their own village. Before nic militias. The teams typically carry enough supplies to treat
becoming affiliated with the BPHWT organization, they had their target population during a 6-month period.
been previously looking after pregnant women, doing home
deliveries, and providing contraceptive methods for women in Back Pack teams typically spend a minimum of 3 days in a vil-
their villages. The BPHWT enhances their skill sets and pro- lage, but different lengths of time are spent with each commu-
vides them with delivery and maternity kits. nity depending on the movement of communities and the need
to avoid Burma military forces. Some communities become
The BPHWT conducts VHW training that lasts for 3 months. inaccessible if the route becomes too dangerous. However, as
The village chooses and sends a person to their local Back members of the communities they serve, a Back Pack team is
Pack team for VHW training. VHWs take responsibility for familiar with the local terrain and security situation and usu-
their own village and make a commitment to live and work ally able to overcome these obstacles to provide health care to
there for an extended time period. VHWs provide basic first served populations in conflict and remote areas.
aid and support health education, installation and mainte-
nance of clean water and sanitation systems, and disease sur- Every 6 months, Back Pack team members meet with their
veillance in their communities. Back Pack teams also conduct field-in-charge in a field meeting to submit health data and

98 | JSOM Volume 17, Edition 3/Fall 2017