Revisiting the markets in Lao PDR: Avian Influenza Risk Reduction Campaigns before the Pi Mai

By Cecile Lantican

April 4, 2012

I find this project activity very interesting. All my life, the market has been a significant part of my role as a mother --- and now as a country manager of an infectious diseases project.

I always go to the market to buy fresh fish, meat, vegetables, fruits and other commodities to suit my requirements in preparing food for my family, but I never realized that the market means more than a place where exchange of commodities and services takes place.

A fruit section of Thongkhankham market in Vientiane Capital.

My present engagement (representing the MID-BCC) with the members of the Market Working Group, which is led by the Department of Hygiene and Prevention under the Ministry of Health, has provided me the opportunity to closely look at the situation in the market and observe the behavior of traders and vendors that bear relevance to health – apart from making your food supplies available but also keeping these food supplies safe and clean, particularly, avoiding contraction of viruses and bacteria, which cause infectious diseases.

Markets vary in form, scale (volume and geographic reach), location, types of people, and types of goods and services traded. In Lao PDR, retail markets such as the local farmers markets are situated in town squares. Markets operate under the supervision of the Domestic Trade Department of the Ministry of Industry and Commerce. By 2007, 616 markets were officially registered (52 large, 130 medium and 328 small). Local farmers markets include vegetables, fruits, and backyard poultry.

Left photo: A village market in Houaxay district, Bokeo province where locally produced vegetables are sold	Right photo: The town market in Vang Vieng , Vientiane province where you can find exotic wildlife meat.

In Lao PDR, the street could even be an extension of the market. The morning market of Kouadin hosts farmers to sell their local produce from 5:00AM to 7:00 AM only.

Among local people, the market is the center for economic activities. Farmer-producers bring their products and sell these to either traders/sellers or directly to consumers. In the public health perspective, the market is a hub for rapid spread of infectious diseases with the continuous trading of live and slaughtered animals and movement of too many people. The market is one key segment of exposure to avian influenza.

Khounkham Xaymounvong and I joined the market working group team in the clean campaign at Thongkhankham market in Vientiane.

In 2007, with support from international donors and partners, the government initiated the creation of the national Market Working Group under the leadership of the Department of Hygiene and Prevention to monitor and implement activities to avoid the risk of transmission of avian influenza to animals and people in market places. Before the end of 2009, market working groups were also created in the key cities of  Bokeo, Luang namtha, Luang Prabang, Champasack and Savanakhet provinces.

The MID – BCC Project; provided support to the national Market Working Group by conducting a clean campaign to remind market  administrators, meat and poultry vendors, traders, and slaughterers to repeat the messages of hand washing and cleaning to avoid virus transmission from animals to animals and from animals to humans. Specifically, the technical assistance was aimed at: (1) seeking the cooperation of and re-orienting the members of the Market Working Group’s leadership to repeat the messages of hand washing, separation, cleaning and other bird flu-related messages; and (2) mobilizing market administrators and leaders to conduct a “clean” campaign in the market.;

The Pi Mai (Lao New Year) will be celebrated on the second week of April. It is expected that during the season, there will be voluminous trading and slaughtering of poultry in the market. MID-BCC has collaborated with the Ministry of Health, Department of Hygiene and Prevention to mobilize the Market Working Group, which was earlier organized through WHO and CARE under USAID and US-CDC funding, respectively, in 2009. Under the guidance of WHO, the government promoted in the past key messages to maintain a clean market environment to reduce the risk of avian influenza virus.

 

The clean campaign kicked off on March 19 to 21 in three main markets in Vientiane Capital – Thongkhankham market in Sisattanak district and Nongchan and Kouadin markets in Chantabouly district. The three markets are operated by private market owners or individuals but are sanctioned under government monitoring. The Thongkhankham and Nongchan markets cater to about 1,000 people a day whereas the Kouadin market provides services around 2,000 people a day.

   

At the Kouadin market, the market working group team lead by Dr. Phonexavay Chantaseng held the orientation among sectoral market leaders in the small office of the market administrator. The limitation of space was never seen as a problem for other interested market traders and vendors to participate outside the room.

   

The team did an ocular observation of the markets. Poultry meat vendors in particular clean their spaces after selling the products. Stainless tables at meat section in Kouadin market, which were provided through USAID and WHO assistance in 2009, are washed.

One objective of campaign is to remind people of the previous avian influenza prevention messages. Posters are still hanging on roof beams and posts. But I was not able to ask people’s insights if they still read the messages written on them.

Above posters: Wash your hands with soap every time you touch raw meat to reduce spread of disease.
Throw rubbish into the bins to reduce spread of disease.	Right poster: Zoning stalls will reduce spread of disease.
Proper hand washing techniques were reinforced during and after the orientation. Ms Siphay Vongsouangtham, technical staff from CIEH, MOH facilitated the demonstration. The washing facility was one of the market improvements provided by WHO with USAID support in 2009.

I was amazed by the creativity and proactive move of the market working group team to integrate in the orientation the hand washing practice to avoid other diseases like diarrhea and H1N1. Diarrhea is the most common health complaint among people living in the area surrounding the markets.

Left photo: Cleaning in the market is done at the end of the day	Right photo: One of the vendors who attended the orientation and demonstrated cleaning of her stall after selling all her dressed chickens.

This clean market campaign will be implemented in other main markets in Bokeo, Luang Prabang, Luang namtha, Savannkhet and Champasack. More to follow after completion of orientations and campaigns in target provinces.

Photos by Cecile Lantican | FHI 360

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