In Union-managed areas of Myanmar, COVID-19 is causing disruption to the provision of care and support to people with tuberculosis (TB) and multidrug-resistant TB (MDR-TB).
Despite the pandemic, The Union is continuing to provide DOT (Directly Observed Treatment) and home visits to people with MDR-TB. Home visits are also an important means by which Union staff can provide monthly financial support, in the form of cash, to people unable to receive their money via automated teller machines (ATMs).
To maintain support whilst considering the need for social distancing, The Union has set up a ‘Wave Money’ platform to transfer the financial support to people via mobile phone or through local agents. The use of Wave Money as part of the COVID-19 response has now been initiated in five townships. Here are some of the stories from the people affected, demonstrating how simple technology can have a big impact on people’s lives.
Daw Kyein Ngeik Nyaung has beentaking treatment for extensively drug-resistant TB since July 2019. She lives in Khampat, which is 54 km from Tamu Township, near the border with India. Daw Kyein is eligible for monetary support from The Union’s MDR-TB Care project which receives funding from the Global Fund.
Every month, Daw Kyein receives 58,000 MMK in cash for costs related to transportation and nutritional supplements. The Union nurse passes on the cash, either during home visits or follow-up visits. To travel to Kampat takes the nurse about 90 minutes by bicycle through various checkpoints. Since COVID-19, the nurse can only conduct home visits to Daw Kyein every two months because of government restrictions relating to social distancing. Since there is no ATM in Khampat, Daw Kyin’s daughter must therefore travel to Tamu Township hospital to withdraw the cash.
Implementation of the Wave Money platform has saved time and costs in transportation for both Daw Kyin, her daughter and the nurse, with the cash instead being received via local agents on a monthly basis.
U Than Soe lives in Zee-phyu-pin village of Naung-Cho, Lashio Township. His son was diagnosed with MDR-TB on 30 April 2020 and was registered for MDR-TB treatment and support. His package includes financial support of 58,000 MMK each month for follow-up visits and nutritional support as part of The Union’s MDR-TB Care project. At present his son has been admitted to a TB hospital in Patheingyi Township, Mandalay, because of the seriousness of his illness.
During this period, it would have been difficult for U Than Soe to have obtained a bank card or access a cash machine. However, since July, the Union’s Wave Money initiative has meant he has received the cash automatically in the second week of the month. Wave Money has proven very convenient for U Than Soe and he has had no difficulties in withdrawing the cash.
Wai Mar Aung is a community MDR-TB Nurse in Patheingyi Township where most of the people with MDR-TB receive their monetary support from an ATM on a monthly basis, except for those where Wai Mar takes the cash directly to the people in their homes. Carrying cash on her person by public transportation to remote villages has placed Wai Mar at risk.
Following the launch of the Wave Money initiative, Wai Mar no longer needs to carry cash, with the money instead going via local agents straight to the people who need it. The platform also saves Wai Mar much-needed time.
The community-based MDR-TB Care project partners with healthcare workers, nurses and community volunteers to establish an extensive network of people equipped to provide MDR-TB care and support services. The project is currently implemented in 27 high burden townships in three regions of Mandalay – Sagaing, Magway and the State of Shan. Support to people with MDR-TB includes financial and nutritional support, community mobilisation through specially trained volunteers, evening DOT, systematic household contact screening and adherence assistance, and psychosocial and nutritional advice, whilst ensuring infection control practices and timely referral for the clinical management of any side effects from treatment. To date, 3,672 people with MDR-TB have received monetary support through the project.