Strengthening Healthcare Capacity in Thailand - Myanmar Border: A One Health Training Journey

Along Thailand’s northern frontier, remote hill‐tribe villages and health‐promoting hospitals grapple with hard‐to‐reach terrain, limited laboratory infrastructure, and a heavy burden of zoonotic diseases. Recognizing this vulnerability, the Center of Excellence for Hill Tribe Health Research at Mae Fah Luang University launched a SEAOHUN One Health Research and Training Awards project. Under the leadership of Assoc. Prof. Dr. Tawatchai Apidechkul, we sought to transform frontline capacity by blending epidemiology, environmental science, veterinary insights, and community engagement into a comprehensive, five-day training—ultimately equipping district health officers and hospital staff to detect, investigate, and control threats where human, animal, and environmental health converge.

Project Implementation Journey

Our journey began with a joint needs assessment conducted in collaboration with the Chiang Rai Provincial Public Health Office, six district health offices, and twenty health-promoting hospitals. Drawing on this consultation, we assembled an interdisciplinary faculty—epidemiologists, environmental health experts, veterinarians, and laboratory scientists to co-design a curriculum that mirrored real‐world challenges.

Curriculum development took place over May and June 2024, during which our team held weekly workshops to refine learning objectives and materials. We faced inevitable obstacles: several invited speakers proved unavailable on original dates, prompting us to tap into local networks and invite additional experts from the Department of Livestock Development and Faculty of Medicine at Chiang Mai University. Financial hiccups also arose when SEAOHUN disbursements were delayed; the CEHR team promptly bridged funding gaps with internal resources, ensuring no interruption to our timeline.

By early July, we had recruited 27 fellows (20 female, 7 male) from sub-district and district levels based on clear selection criteria: at least two years of experience in disease investigation and a bachelor’s degree in health sciences. A pilot workshop in Nong Saeb Village tested our Epicollect questionnaires and environmental sampling protocols, leading to minor adjustments in field exercise plans.

Building One Health Expertise

From 1–5 July 2024 at Phufa Waree Chiang Rai Resort, participants dived into morning lectures on One Health principles, epidemiological methods, and key zoonoses scrub typhus, leptospirosis, and emerging viral threats. Afternoons alternated between:

• Laboratory Demonstrations: Microscopic identification of Anopheles, Aedes, and Culex mosquitoes; intestinal parasite examinations in human and animal stools; water quality assessments using portable test kits; and microbial contamination checks in food samples.

• Field Exercises: Small‐group data collection in village households, engaging local health volunteers to map livestock exposures and water sources.

• Data Analysis Workshops: Hands-on training in SPSS for descriptive and inferential statistics, culminating in each team presenting a mini-analysis of One Health datasets.

These activities were never abstract; they sprang from case studies drawn directly from our midterm findings on hill-tribe health research and the COVID-19 response, grounding theory in frontline realities.

When a mid-week power outage threatened to derail our microscopy session, the group simply migrated outdoors under lanterns. Far from stalling progress, the impromptu “lantern circle” deepened peer learning, as trainees shared their own parasite‐control experiences a testament to adaptability and community solidarity.

Measurable Gains and Evaluations

Pre- and post-training tests demonstrated dramatic improvements: average scores surged from 26.00 (SD 5.16) to 42.19 (SD 6.49) out of 50 (t = 15.41, p < 0.001), confirming significant knowledge acquisition. Participant feedback rated the relevance of field exercises and interdisciplinary discussions highest, with many noting newfound confidence in designing surveillance protocols and risk communication plans.

The training report recorded 37 total attendees including two facilitators, eight organizers, and observers highlighting broad institutional engagement. Age breakdown showed 15 participants under 30, fostering vibrant intergenerational exchanges alongside seasoned public health officers.

Embedding One Health into Education and Practice

To cement sustainability, we integrated the five-day curriculum as a three-credit elective in MFU’s Bachelor of Public Health program. Starting next semester, over 100 students, including 30% international will train in the same laboratory, field, and analysis modules, ensuring the ripple effect extends beyond current fellows. Simultaneously, we established a dedicated LINE group and scheduled annual follow-up workshops to maintain peer support, troubleshoot implementation challenges, and update materials based on evolving disease patterns.

Ripple Effect in Border Communities

Already, alumni have partnered with village health volunteers to standardize water sampling and collaborate with livestock officers on pasture management measures to curb leptospirosis spikes during monsoons. In one district, rapid detection of a dengue cluster triggered coordinated vector control and risk communication, likely averting a larger outbreak. These early wins underscore how district-level capacity building cascades into community resilience.

Lessons and Insights

Our experience revealed that anchoring training in locally generated data transformed abstract concepts into urgent imperatives. Fellows were galvanized by prevalences such as 70% positivity in environmental samples prompting swift adoption of control measures. Flexibility emerged as equally critical: whether adjusting schedules for speaker availability or relocating labs due to infrastructure hiccups, agile management kept momentum alive and fostered collective problem-solving.

Multi-sector engagement proved foundational: from village chiefs to provincial directors, involving stakeholders from Day 1 ensured that training outcomes translated into concrete policy and budget commitments. Establishing ongoing communication channels through digital platforms and scheduled check-ins has kept the network vibrant, turning a single workshop into a living, evolving One Health community of practice.

Looking Ahead

As we draft a manuscript to share our curriculum and impact data, we are also preparing budget proposals with Chiang Rai authorities to secure recurring funding for One Health training in the 2025 fiscal year. Mid-2025 follow-up visits will assess long-term trends in surveillance practices, outbreak response times, and community health indicators ensuring that our model remains both evidence-driven and community-centered.

Conclusion

Our SEAOHUN-supported initiative has not only elevated individual competencies but also seeded a durable One Health ecosystem along Thailand’s most vulnerable borderlands. By weaving rigorous science with community wisdom and embedding the curriculum into academic programs, we offer a replicable blueprint for resilience, one that empowers trainees to become leaders, institutions to commit resources, and communities to safeguard their own health for generations to come.

Project Leader: Dr. Tawatchai Apidechkul – Director, Center of Excellence for the Hill Tribe Health Research, Mae Fah Luang University, Thailand

Team Members:

• Dr. Thapakorn Ruanjai – Public Health, Mae Fah Luang University

• Dr. Woottichai Nachaiwieng – Biomedical Science, Mae Fah Luang University

• Dr. Anuwat Aunkham – Environmental Health, Mae Fah Luang University

• Dr. Jongkon Saising – Biomedical Science, Mae Fah Luang University

• Dr. Puckavadee Somwang – School of Medicine, Mae Fah Luang University

• Dr. Nawarat Ninprapha – DVM, FETP, Department of Livestock Development, Nan Province

• Dr. Phitsanuruk Kanthawee – Public Health, Mae Fah Luang University

• Dr. Pamornsri Inchon – Public Health, Mae Fah Luang University

• Mr. Anusorn Udplong – Public Health, Mae Fah Luang University

• Ms. Thanatchaporn Mulikaburt – Public Health, Mae Fah Luang University

• Mr. Ratipark Tamornpark – Public Health, Mae Fah Luang University

• Mr. Panupong Upala – Biomedical Science, Mae Fah Luang University

• Ms. Chalitar Chomchoei – Public Health, Mae Fah Luang University

• Mr. Chaloemphan Kaewkanta – Occupational Health, Mae Fah Luang University

• Ms. Fartima Yeemard – Center of Excellence for the Hill Tribe Health Research

• Ms. Buathanya Srikua – Center of Excellence for the Hill Tribe Health Research

• Mr. Manasawin Kampun – Center of Excellence for the Hill Tribe Health Research