Naw Thit Paw is in charge of a new initiative that we have started this year at the Rain Tree Clinic.
Hepatitis B is a big problem for people in low resource areas as it is possible to pass the infection from mother to baby at birth and the risk of transmission for babies exposed at birth without vaccination is considered to be around 90%. About 40% of these babies will go on to develop chronic liver disease and 25% will die prematurely of liver cancers.
The global standard is to screen the mother during pregnancy, and if she tests positive, then a Hepatitis B vaccine series is started from birth, along with a special immunoglobulin. This significantly reduces the transmission rate of hepatitis B from mother to baby and not only provides improved health for the baby, but it also lowers the long-term burden on the health system. This kind of program has not been possible for the rural communities in the past, so we find it an exciting initiative to be a part of. Early on, the plan was to simply vaccinate the baby with the special regime of vaccines. Then it seemed that there were a number of husbands who were testing negative despite their wives’ infection. So, we added the fathers to the equation. Then, a happy miscommunication saw the siblings in the first family who were testing negative to be given the vaccine also. It is now a trend we are continuing to vaccinate the whole family. So far, we have 6 families who have completed the series of vaccines.
Naw Thit Paw organises the testing of the women, the subsequent testing of the husband and children, and then she places the order. Despite requesting the women to deliver at the clinic as the vaccines need to be started in the first 12 hours of life – all women have delivered in the village and called for our team to assist. Naw Thit Paw packs up the vaccines and sends them with the team who respond. Each time the vaccines have been implemented within 4 hours of birth. This is quite the logistical accomplishment. Naw Thit Paw then tracks on when each subsequent dose is due and ensures that the families receive the message to return for the next dose. The ordering process is sometimes haphazard as often women come for their pregnancy check in the final moments of pregnancy, so it can be a scramble to get these in time, and sometimes it requires one of our PA heroes to make a rather muddy motorcycle journey to pick up the vaccines from another facility and carry to our RTC clinic.” – Mon, EMA Lead Midiwfe