1) Executive Summary Over sixty years of civil war in Burma have resulted in the displacement of hundreds of thousands of people. These people have fled their homes, been obliged to go into hiding for their own safety and have faced forced relocation. Compounding the loss of homes and security is a lack of basic human rights, including the right to health. People living along the country?s borders as well as inside ethnic nationalities? areas have been severely affected. The Back Pack Health Worker Team (BPHWT) has been providing primary health care for over ten years in the conflict and rural areas of Burma, where access to healthcare is otherwise unavailable. The BPHWT provides a range of medical care, community health education and prevention, and maternal and child healthcare services to internally displaced persons (IDPs) and other vulnerable community members in Burma. Doctors and health workers from Karen, Karenni, and Mon States established the BPHWT in 1998. The organization initially included 32 teams, comprising 120 health workers. Over the years and in response to increasing demand, the number of teams has gradually increased. In 2010, the BPHWT included 81 teams, with each team being comprised of 3 to 5 health workers. BPHWT teams now target displaced and vulnerable communities with no other access to healthcare in Karen, Karenni, Mon, Arakan, Kachin, and Shan States, and the Tenasserim Division. The teams deliver a range of health care programs to a target population of 180,000 IDPs and other vulnerable people. The BPHWT aims to equip people with the skills and knowledge necessary to manage and address their own health problems, while working towards long-term sustainable development with respect to community healthcare. In 2010, the BPHWT continued to work with communities in its target areas to implement its three health programs, namely Medical Care Program, Mother and Child Healthcare Program and Community Health Education and Prevention Program. Three new Back Pack teams were created in Kachin, Shan-Kayah and Palaung areas to serve communities with no other access to healthcare. BPHWT also worked in collaboration with Burma Medical Association, National Health and Education Committee and ethnic health organizations serving the Karen, Karenni, Mon, Shan and Palaung communities to plan, design and implement a health and human rights survey in eastern Burma; the results of this survey were published in October 2010 in the report entitled Diagnosis: Critical - Health and Human Rights in Eastern Burma. Displaced Mother with a Child 2010 4 The BPHWT?s Ten Years Report 1998-2009, detailing the BPHWT?s programs and organizational development from 1998 through 2009, was also published in 2010. The BPHWT continued to conduct its regular monitoring and evaluation activities throughout 2010. In addition, BPHWT workers were given technical support by the Global Health Access Program (GHAP) to implement an Impact Assessment Survey so as to evaluate the outcomes of the BPHWT?s three health programs in target communities. The results of this survey will be published in 2011. At the March 2010 Donors? Meeting, it was decided that an external evaluation would be conducted, in order to assess the BPHWT?s programs and management structure. A consultant was recruited and is currently conducting consultations with target communities, partner organizations and BPHWT medics, staff and Leading Group. The results of this evaluation will be published in 2011. After the November 2010 elections in Burma, increased armed conflict and conflictrelated abuses in areas of Karen State opposite Thailand?s Kanchanaburi, Tak and Mae Hong Song Provinces drove large displacement of populations, both inside Karen State and into Thailand. On the Thai side of the border, the pattern of civilian influxes evolved. The first large battles in November led to larger influxes of Burmese civilians openly fleeing into Thailand, where they were provided with temporary shelter in sites recognised by Thai authorities. But by the end of December, Thai authorities had shut down the last of the temporary shelter sites and the community network, under the overall coordination of the Mae Tao Clinic, was supporting a total of 9852 newly-displaced people - comprised of 2039 households with 7867 men and 3779 women. Out of these 9852 displaced people, there were 5212 children under five years of age among the newly-displaced people in hiding sites along the Thai-Burma border areas. Since the escalations in armed conflict and displacement in the aftermath of Burma?s elections, the Back Pack Health Worker Team has worked with the network of community organizations providing assistance to civilians displaced by ongoing conflict and human rights abuses along the Thai-Burma border. Inside Karen State, eight teams of Back Pack Health Workers were deployed to provide health services to civilians affected by the increases in conflict and conflict-related abuses. The BPHWT also set up a number of borderline mobile Out- Patient Department (OPD) clinics, to provide health care and assistance to displaced civilians hiding along the Thai-Burma border. Each borderline mobile OPD clinic was staffed by three to five experienced BPHWT medics and supplied with the medicines and equipment needed for the Displaced Mother and Children 5 provision of healthcare to the displaced civilians. On the Thai side of the border, BPHWT has worked as part of the community based Emergency Relief Team (ERT) providing assistance to thousands of newly displaced civilians in unofficial or hiding sites. BPHWT health workers worked with the Mae Tao Clinic and Burma Medical Association as part of the health team, providing medical assistance to civilians in hiding along the Thai-Burma border, particularly to those more vulnerable such as pregnant women, children and the elderly