Responding to Migrants’ Vulnerability to Malaria in Vietnam

Date Published: Wednesday, April 20, 2016

Dinh Thi Buon was born in 1967. An ethnic H’re woman from Quang Ngai, she migrated to Dak O commune, Bu Gia Map district (Binh Phuoc province) two years ago along with her husband.

They live with their daughters Hieu and Trieng, their two sons-in-law and a three-year-old grandson. The couple has another son who is married to a local woman named Huong and lives about 3km away.

Apart from working on call, Buon’s family has rented about 1,000 square metres of land where they plant cassava. They live in a small tent in the middle of their land. The tent has a fireplace at its centre for cooking, around which the family members sleep at night in hammocks. “It’s important to find work, the place you sleep doesn’t matter too much,” says Hieu. The family gets water from a spring, and light from a battery torch because they have no electricity.

Both Hieu and Trieng’s families are seasonal migrants. They only stay in Bu Gia Map for two or three months each time until there is no more work. Currently their work involves removing grass in pepper and cassava fields and spreading fertilizer for rubber plants. They all migrate because jobs are scarce in their hometown. “We come when we can’t find work there (in Quang Ngai). There is plenty of work here. One can hope to earn one hundred or one hundred fifty thousand dongs a day here, while at home we earn only fifty or sixty thousand.”

Buon and her husband have just been discharged from the hospital for malaria and are still recovering. Last year they contracted the same disease. Huong and her son have also had malaria before. “My little boy had malaria when he was four, because we brought him along when we were planting rice in our farmland on slopes near the forest and stayed the night there. My husband has fevers every year and these fevers would just continue for so long,” says Huong.

She adds, “People here go to the forest to harvest herbs and rattan shoots without any hammocks or mosquito nets. They stay there one or two nights and run a fever when they return. They go to the medical station and are diagnosed with malaria and given drugs for treatment and then the fever goes away.”

However, Huong points out that quite soon after that, they return to the forest and run a fever again. “This year my husband has not contracted malaria because he is not allowed to go to the forest anymore,” says Huong with a wry smile on her face.

Of the four (Buon, Hieu, Trieng and Huong), only Huong and Hieu know about malaria because both of their sons have had malaria. Hieu’s son contracted malaria when he was two years old. One morning he had a fever and convulsive fits on that confused her at first. She did not know it was malaria until she brought her son to the medical station that afternoon. Now she knows these are some of the symptoms of malaria.

Huong became aware of the disease from a flier that her son brought back from an awareness program at his school and had it glued on their wall. “This serves two purposes: to patch up the torn wall and to teach people something useful about a disease,” says Huong. Once, when the local authority called for people to come and soak their mosquito nets in insecticide, Huong did not go because the station was too far and she did not have a bike.

On the other hand, Buon confesses that she did not know that malaria could be lethal.

Hieu and Huong know they should avoid mosquito bites by sleeping in nets at night and use repellent during daytime but they cannot always practice this due to their lack of money.

Buon sleeps in a hammock hanging above the fireplace without a mosquito net. None of her family members have medical insurance.

Huong’s family used to have free insurance thanks to their status as a poor household, but they have recently been removed from this category and no longer have it. However, she cannot afford to buy new insurance.

The above excerpts are from a yearlong study conducted November 2014-2015 by IOM Vietnam on the challenges faced by migrants regarding malaria. Even when respondents know what measures they can take to prevent mosquito bites, acting on this knowledge can be an insurmountable challenge. Without the money to afford bed nets and preventative care, migrants like Buon and Huong are at high risk of both contracting the disease and of not having it properly treated. In order to End Malaria for Good, IOM is working with partners in Vietnam to raise awareness amongst migrants about malaria and how access to treatment can be improved.