End-Year
Report 2023
2023年年末報告書

Good Holdings Corporation

Project
concerned
関連プログラムChildren’s Medical
Fund (CMF)Medical Fund）
小児医療基金（CMF‐Children's
このプログラムは、深刻な先天性欠損症と診断されたミャンマー
Providing life-saving operations and medicalとラオスの0～12歳の子供たちを対象に救命手術と医療の提interventions for children, aged 0-12 years,
供を行います。

from Myanmar and Lao PDR, who werediagnosed with critical, congenital birth defects

活動実施者 by
Implemented

Child’s Dream Foundation
238/3 Wualai Road
T. Haiya, A. Muang
Chiang Mai 50100, Thailand

Contents1

1. Why We Do It

2

2. Updatesooo

Output analysis
Operational Updates
Outcome analysis

8

4. Case Highlights

8

Attachmentswww.childsdream.org | info@childsdream.org

Vision
教育と権利を与えられた人々は、責任をもって次世代にとって公正・公平で健全な社会を形成し維持していくことができます

Mission
私たちは、不平等な影響を受けているメコン地域の子供や若者たちが、健康的に成長し、質の高い教育とより良い雇用機会を得ることができるようにすることを目的としています。
私たちのすべての取り組みは、彼らが社会で平等で活動的なメンバーとして権利を与えられ、自分で選択した生活を送れるようにするだけでなく、変化を導く責任あるリーダーになる可能性も生み出します。

CMFが直接取り組む持続可能な開発目標（SDGs）

本レポートでは、2023年1月1日から12月31日までの小児医療基金（CMF）の最新情報を掲載しています。
報告期間中に、合計274件の症例（患者数270名）を受入れました。172件の症例が終了し、うち79％が正常に治療されました。その結果、136名の命が救われました。
2023年1月には、プログラムがタイの各地域に拡大され、医療ケアを必要とする子供たちにより多く手を差し伸べることができました。治療を受けた患者の数は、新型コロナウイルス感染症流行前の同時期と比較して2倍に増加しています。

Child's Dreamが直接取り組む戦略目標

1

2
5
6

3. Financialsi)

エグゼクティブ・サマリー

Page

Executive Summary91.

私たちがサポートする理由：乳幼児死亡率と長期的な障害の軽減
Why We Do It: Reducing Childhood Mortality and Long-term Disability

CMFは、2030年に向けた国連の持続可能な開発目標(SDGs)、特に「目標３：すべての年齢層の健康な生活を確保
lives and promote well-being for all ages.
し、福祉を促進すること」をサポートするため、2006年の設立以来、乳幼児や子供に救命手術や医療提供を行っておりま
Establishedin 2006, CMF provides access to life-saving operations and medical interventions for infants and children.
す。
In promoting
health services, we prioritise treatments of congenital disorders as it is one of the leading causes of child
先天性疾患は乳幼児死亡の主な原因の１つであるため、医療サービスの推進ではその治療を優先しています。通常、
mortality.
The surgical procedures are normally expensive and complex; none of the families can afford the necessary
外科的処置は費用が高額かつ複雑であるため、家族のだれもが手術はおろか必要な薬を買う余裕がありません。さらに、
medication,
let alone the costly operations. With the majority of the patients coming from Myanmar, these families
患者の多くがミャンマーから来ていますが、軍事政権による医療崩壊の危機でさらなる障害に直面しています。医療従事者
now
have
additional
obstacles – the country’s healthcare system, overseen by the junta, is on the verge of collapse.
達が軍事政権に反発しボイコットを起こしており、また利用できる医療ケアは高額となっているのです。
Many
healthcare professionals refuse to work under this regime, and for services that are available, they come at an
医療ケアを必要としている患者は心臓疾患、肛門直腸奇形、神経管欠損と診断された0～12歳の子供たちです。経済
inflatedcost. The primary service-users are children aged 0-12 who have been diagnosed with cardiac disorders,
的支援や質の高い医療提供がなければ、これらの子供たちのほとんどは早期に命を落とすか、障害によって不自由になり学
anorectal
malformations, and neural tube defects. Without financial support and access to quality health care, most校に通うことができず、貧困の連鎖が続いてしまうことになります。
of these children either die prematurely or are crippled by disability, and are unable to attend school, perpetuating thecycle of poverty.
2.

更新情報：2023年1月～12月
Updates - January to December 2023

評価グラフ
Outputanalysis

症例数と患者数
500

症例数と患者数

400

393

387
274

300

270
172

200

119

100
0

43
報告期間中に登録された症例の総数

170

118

2022年から継続中の症例報告期間中の
新しい症例

43

報告期間中の再開された症例報告期間中に終了した症例

症例数

患者数

先天性疾患による症例数
total %, (total), n=393

90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

84%

9%
心臓障害
(331)

肛門直腸奇形
(36)

1%

1%

筋性心室中隔欠損
(3)

神経管欠損
(3)

2

5%
一般または不特定(20)

プログラム別患者数

性別による患者数(total), total %, n=387(total), total %, n=387

タイ (31), 8%

男性 (203),52%

女性 (184),48%ラオス(47), 12%ミャンマー(309), 80%

報告期間中の性別による患者数

報告期間中の出身地別患者数

年齢別の患者数
n=387

69

患者数

45
39

37

32

31
22
21

17
13
12

10

9

9

0
-1

4

4

4

3

15

16

17

18

5
0

1

2

3

4

5

6

7

8

年齢

3

9

10

11

12

13

14

1
19

種類別の心臓疾患の症例数( t o t a l ) , total %, n = 3 3 1
心室中隔欠損症 (81)24.5%

ファロ－四徴症 (77)23.3%

動脈管開存症 (45)13.6%

心房中隔欠損 (35)10.6%

両大血管右室起始 (24)7.3%

大血管転位症 (15)4.5%肺動脈弁閉鎖症/狭窄症 (15)4.5%

右胸心 (7)2.1%

僧帽弁閉鎖不全症 (7)2.1%

エブスタイン病 (4)1.2%

完全型房室中隔欠損症 (4)1.2%

単心室症 (4)1.2%

不特定 (2)0.6%大動脈弁狭窄症 (2)0.6%

三尖弁閉鎖不全症 (2)0.6%

総肺静脈還流異常症 (2)0.6%大動脈縮窄症 (2)0.6%

左心低形成症候群 (1)0.3%

総動脈幹症 (1)0.3%

肺動脈性肺高血圧症 (1)0.3%

原因別の併存疾患のある症例数(total), total %, n = 4 9筋性心室中隔欠損 (1)2%8%

心臓疾患 (41)76%
2%

肛門直腸奇形 (7)

12%
0%

10%

20%

30%

その他

40%

50%

遺伝性疾患

4

60%

70%

80%

終了した症例に提供された治療

継続中の症例に提供された治療

n=433
主要手術
術後検診
診断
治療のみ
術前検診
マイナー手術
往診

n=527
診断

138
129

190

治療のみ

136

主要手術

86
63

114

術後検診

11

59

術前検診

5
1

マイナー手術26
2

主な活動－2023年1月～12月


このプログラムは、年間を通じて中断することなく予定通り実行しました。



CMFの新規患者数は、新型コロナウイルス感染症流行前の同時期と比較して２倍に増加しました。この増加により、チェンマ
イ大学病院での待ち時間も増加しました。



患者数の増加は、このプロジェクトの拡大に部分的に関係しており、現在タイ各地で様々な活動を展開しておりますが、依然としてミャンマーかラオスの患者、またはタイの難民キャンプからの患者のみの治療に専念しています。
活動内容は次の通りです。

o

私たちはバンコクで２つのパートナー組織と協力しており、これらの組織はタイ中部の対象コミュニティと協力しています。
これによりチェンマイ大学病院での待ち時間が軽減されます。

o

私たちはタイ北部にあるターク県のメーソート病院で心臓患者を検査するための移動診療所を運営している小児心臓手術基金（PCSF）およびタイの心臓疾患小児期金（TCCF）と協力しています。

o

合併症のない症例はすべてバンコクで手術を受けます。複雑な症状を持つ患者は長期にわたる治療が必要なためチェ
ンマイのCMFセーフハウスに滞在し、治療と手術を受けます。

o

CMFには、バンコクの患者受け入れ対応の為、新たに１名のスタッフが加わりました。



2023年10月、CMFはラオス最大の病院であるマホソット病院で大規模な検査を実施しました。心臓手術が必要と診断された患者は、バンコクにある２つの病院のうち１つで手術を受けることになります。
タイへの渡航に必要な書類のサポートを含めて、子供たちの交通費、食費、医療費はChild’s Dreamが負担支援しています。
92人の子供が検査を受け、そのうち37人が心臓手術が必要と診断されました。



タイのメーソート病院では、年に2回の検査が行われ、147人が受診し、そのうち75人が手術が必要と診断されました。
メーソート病院で健康診断の普及活動に参加する子供たちとその家族

5

評価グラフ性別による終了症例数

先天性障害別の終了症例数

total%, (total) n=172

total, total %, n=172

女性(90), 52%

男性 (82),48%

心臓疾患 (140)81.4%

肛門直腸奇形 (17)9.9%一般または不特定 (15)8.7%

理由別終了症例数
total, total %, n=172

完治 (136)79%

パートナーへの紹介 (11)6%

死亡 (8)

5%

治療不要 (8)5%治療不可 (3)2%

症例に起因しない死亡 (4)2%

治療拒否 (2)1%6理由別および先天性障害による終了症例数
total, total %, n=172

完治 (136)
治療不可 (3)死亡 (8)
症例に起因しない死亡 (4)パートナーへの紹介 (11)
治療拒否 (2)
治療不要 (8)
0

0.1

心臓疾患

0.2
一般または不特定

0.3

0.4

0.5

0.6

肛門直腸奇形

結果別成功症例

救命

2023年1月にパートナー組織との連携が開始しました。

私たちは、成功した症例の結果を「救命」または「生活改善」のいずれかに分類します。
この報告期間において、成功した症例はすべて「救命」として完了しています。

7

0.7

3.

財務

2023年に、CMFは4％の管理諸経費を含む合計1,173,742米ドルを費やしました。
総支出の90％は治療と手術に使用され、食費が3％、介護者の宿泊費および交通費と、その他関連経費が3％という内訳です。

4.

事例要約

次ページからは、タイ人スタッフが作成した患者症例管理システムより抜粋した患者レポートを掲載しております。一部英語の内容に不備がございますが、ご理解いただける範囲のものと判断し、原文のまま掲載しております。
この場をお借りして、皆様の変わらぬご支援やご信頼に心からの感謝を申し上げます。
困難に直面しているCMFの患者やその家族にとって極めて重要な時期であり、私たちが力を合わせることでさらに多くの子供たちの生活に大きな影響を与えることが出来ます。
国境が再び完全に開放され、救命サービスの需要増加によりプログラムを拡大し、2024年の予算は100万ドルに増額したままとなっております。今後とも皆様の貴重なご支援を賜りますよう、よろしくお願い申し上げます。
なお、この高額な予算確保に見通しはまだございません。

チェンマイより、2024年2月19日

Child’s Dream Foundation

Marc T. Jenni

Daniel M. Siegfried

Founder & Managing Director Operations

Founder & Managing Director Programmes

8USBからTHB
為替レート

患者関連費用90.54% 医療費

2.50% 食費

2.80% 宿泊費、交通費、その他諸経費

医療費3.08% 従業員給与

交通費1.08% その他管理費

宿泊費

食費

その他諸経費合計

CMF管理者 関連費用
給与

通信費

事務経費

肛門直腸奇形

交通費

心臓疾患

一般または不特定

その他

宿泊費

その他諸経費

総経費

合計

ラオスプログラム経費

医療費内訳
肛門直腸奇形
心臓疾患

一般または不特定

筋性心室中隔欠損

神経管欠損

ミャンマープログラム経費
タイプログラム経費

ラオスプログラム経費
ミャンマープログラム経費

タイプログラム経費

患者関連経費CMF管理者 関連経費

Child’s Dream Foundation
Improving health and education for sustainable development
Patient No: 10037
CASE SUMMARY REPORTPatient name:

Kaung Khant Ky

Sex:

Male

Hospital Nr:

4169031

Date of submission:

Date of birth:
03 April 2023

21 September 2020

Date of closure: 31 October 2023

Final diagnosis: Anorectal malformations - I- Anal agenesis without fistulaPre-treatment

Post-treatment

Pre-treatment profile
Kaung Khant Kyaw was born at home in Karen state, Myanmar through an expected delivery. When he was one day old, the tradi onal
birth a endant no ced that he could not pass stool, and his stomach became distended. She checked his anus and noted that the anus
was too small. She told the mother that something might be wrong because he could not pass stool. He was then brought to the local
hospital. When he arrived at the hospital, he was placed in the intensive care unit (ICU), and his parents were not allowed to see him.
They were not informed of the inves ga ons the doctor had completed. The next day, the doctor explained to them that his anus hole
was too small, causing a blockage for the stool. He could not pass stool, which had caused his stomach to become distended, so hewould need a colostomy to be able to pass stool. The doctor performed the colostomy the next day. A er spending 20 days admi ed
to the hospital, he was discharged. Before his discharge, a nurse explained to his mother how to clean around his stoma and how tochange his colostomy bag when needed. The doctor told his parents that he would need to go to Thailand to receive another surgery
to pass stool normally before the colostomy could be closed. His parents decided to cross the border to seek help in the refugee campclinic. They stayed at their parents' friend's house.
Currently, he has a colostomy and an over prolapse of the colon, 45 cm. His mother needs to take good care of him to ensure he does
not develop an infec on in his stoma. She needs to check his stoma o en to see if it needs cleaning and has to avoid giving him things
that can cause cons pa on. She is also worried that if they do not watch him closely, he might fall and injure his stoma while playing.
Some mes, he will try to scratch his stoma, so his parents have to stop him before he does so and develops an infec on. His mothersaid, “Some mes I want to take him with me when I go out, but I worry that if he passes stool, then others will smell it. He passes stoolo en, so he just stays at home. I want him to receive treatment and recover soon so that when we go out, he is able to come with us
without us having to worry about anything.”

Post-treatment profile
A er spending four months in Chiang Mai with three surgeries, his father says, “I am very happy to see my son without a large
intes ne protruding. We struggled with the limita ons of traveling during Covid-19 for two years. My wife and I prayed for him to gethelp from IRC to organize surgery here. We truly appreciate your support, especially from donors and Child’s Dream staﬀ, who kindly
supported us while we were here. I will return home with my new son. He is now an ordinary boy, passing stool via the anus, with nointes ne outside, and playful. We will send him to school in the refugee camp. On behalf of my family, I would like to thank you verymuch to all of you.”Procedures
Date

Treatment information

05 April 2023

During the ﬁrst consulta on, the doctor admi ed him to the hospital for a revised colostomy.
S/P.Revised colostomy
S/P.PSARP

24 May 2023
31 May 2023

follow up, his wound is good, dilate candle no.16
S/P.colostomy closure 6/6/26 >> post-op surgical site infec on >> solved >> D/C#Urethra stenosis

21 June 2023
03 July 2023
19 July 2023
06 September 2023

Post-op check up, ststches off.
Follow up, he still has fecies in colon. Doctor did evacuation and follow next 2 weeks.
Follow up, his condition is good.
F/U, his condition is fully recovery.

Total cost
Medical cost
Non-medical cost
Administration cost
Overhead
Total cost
Estimated cost

USD 6,755.18
USD 769.57
USD 50.62
USD 530.28
USD 8,105.66
USD 3,529.41

Child's Dream Foundation
238/3 Wualai Road, T. Haiya, A. Muang, Chiang Mai 50100, Thailand
Email: info@childsdream.org • Website: www.childsdream.org • Tel. +66 (0) 53 201 811 • Fax +66 (0) 53 201 812

Child’s Dream Foundation
Improving health and education for sustainable development
Patient No: 10045
CASE SUMMARY REPORTPatient name:May Ya Ya - BC

Sex:

FemaleHospital Nr:

66012620

Date of submission:

Date of birth:
25 April 2023

13 July 2013

Date of closure: 15 August 2023

Final diagnosis: Cardiac disorder - Ventricular septal defect (VSD)

Pre-treatment

Post-treatment

Pre-treatment profile
May Ya Ya is a 9-year-old girl who lives with her grandmother, parents, and a younger sister in Kalaw Taw Village, Mudon Township,
Mon state, Myanmar. Her parents are rubber farmers, working on their own land. When she was two years old, she had diarrhea, so
her mother took her to a local clinic. At that clinic, the medic told her mother that her heartbeat was abnormal and advised her to go
to a hospital in Yangon for further inves ga on. However, her mother could not aﬀord to bring her to Yangon. She had a fever and had
diﬃculty breathing frequently. At Baho Hospital in Yangon, she received an x-ray and an echocardiogram; then she was diagnosed witha ventricular septal defect (hole in the lower chamber of the heart). The doctor told them that she needed surgery to close the holeand that she needed to get surgery in Thailand. Her mother knew about Mae Tao clinic, Maesot, Thailand, which was a free medical
clinic recommended by her friends. Then her parents brought her to Thailand to meet Burma Children Medical Fund - BCMF.
Currently, she experiences heart palpita ons and feels fa gued. She feels very red and has diﬃculty breathing whenever she plays
and runs with her friends. Her mother is sorrowful and worried about her daughter’s future. Her mother said, “Because the treatment
cost is very expensive, it is impossible for us to pay to treat her ourselves.”

Post-treatment profile
On 29 January 2023, she met a doctor from Bangkok at Maesot Hospital. The echo screening was hosted by the pediatric cardiologist
and cardiac surgeon from the Pediatric Cardiac Surgery Founda on – PCSF. The test conﬁrmed that she has a hole in her heart –Ventricular Septal Defect, a congenital heart defect. The doctor told them that she would need heart surgery in Bangkok at Kasemrad
Hospital for free, which will be supported by the Child’s Dream Founda on.
She stayed in Bangkok for 14 days and was assisted by a BCMF translator. Her surgery went well; she had no post-opera vecomplica ons. She was well treated and looked a er by the doctors and nurses. She said that all the doctors and nurses were very kindtoward her, and she felt very comfortable during her admission.
Before she had the surgery, she o en experienced heart palpita ons. She had li le appe te and could not eat or sleep well because ofher condi on. She could not walk any distance without becoming very red and short of breath. Now, a er the surgery, she is very
happy. She no longer has heart palpita ons, and her appe te has returned. She does not feel red like she did before. She said, “Oneday I want to become a doctor and save lives like I have been saved by the doctors. I would like to say thank you to the organiza on
BCMF, the doctors, nurses, and all the donors who supported my treatment.”Procedures
Date

Treatment information

29 January 2023
02 May 2023
08 July 2023

Investigated by PCSF and get Sx schedule.
S/P.VSD clsoure, TV repair, with fibras patch resectia 3/5/23
S/P post check up: Her condition is good, she do not feel any other of her sickness

Total cost
Medical cost
Non-medical cost
Administration cost
Overhead
Total cost
Estimated cost

USD 4,411.76
USD 132.71
USD 42.07
USD 321.06
USD 4,907.60
USD 4,705.88

Child's Dream Foundation
238/3 Wualai Road, T. Haiya, A. Muang, Chiang Mai 50100, Thailand
Email: info@childsdream.org • Website: www.childsdream.org • Tel. +66 (0) 53 201 811 • Fax +66 (0) 53 201 812

Child’s Dream Foundation
Improving health and education for sustainable development
Patient No: 10051
CASE SUMMARY REPORTPatient name:Shine Htet Aung

Sex:

Male

Hospital Nr:

66014184

Date of submission:

Date of birth:
25 April 2023

01 January 2019

Date of closure: 23 August 2023

Final diagnosis: Cardiac disorder - Tetralogy of fallot (TOF)

Pre-treatment

Post-treatment

Pre-treatment profile
Shine Htet Aung is a four-year-old boy who was ﬁrst referred to Burma Children Medical Fund (BCMF) in 2019 for heart surgery. He
lives with his parents and grandmother in Kyone Doe Village, Kawkareik Township, Karen State, Myanmar. His father works as a trishaw
taxi driver, while his mother is a homemaker. He was born at Kyone Doe Hospital, and his mother had a normal delivery. When he wasfour months old, he started to have diﬃculty breathing, experienced heart palpita ons, and the ps of his nails and toes turned blue.
His parents took him to the nearest clinic, and the doctor informed them that he has a heart problem. Worried about their ﬁnancial
situa on, his parents did not know where they could aﬀord to go. A villager who had previously received treatment at Mae Tao Clinic(MTC) in Mae Sot, Thailand, suggested they go there. When he was ﬁve months old, he was taken to MTC. He was then referred to
BCMF for help in accessing further treatment. He went to Chiang Mai Hospital several mes for his follow-up appointments. Later on,
in 2020, they could not return to his appointments due to the closure of the Thai-Myanmar border following the outbreak of COVID19. While wai ng for the border to reopen, he con nued to take the medica ons the doctor in Chiang Mai had given him.
Currently, he experiences shortness of breath when he runs or climbs stairs. His lips, ﬁngers, and toes are blue- nged. As their ﬁrst
baby, his parents worry a lot about him. His father said, “I feel really sad when I see him struggling to breas eed. His grandmother also
worries about him because he is her ﬁrst grandchild, so she has always sacriﬁced her me to accompany him to the clinic or thehospital.”

Post-treatment profile
He was re-diagnosed on 29 January 2023 by the Pediatric Cardiac Surgery Founda on – PCSF at Maesot Hospital. The doctor told his
parents that he would need surgery in Bangkok. His heart defects are congenital diseases that can only be ﬁxed by surgery; medica on
doesn't cure it, just provides suppor ve treatment. BCMF staﬀ explained to his parents that the medical cost would be provided byChild’s Dream Founda on. He spent 17 days in Bangkok and underwent cardiac catheteriza on for pre-op evalua on and surgery. His
surgery went well.
He and his mother did not encounter any diﬃculty during his admission at Kasemrad Hospital. Because BCMF staﬀ assisted them, hismother also found that all the hospital staﬀ were kind towards her and took good care of her son.
His mother said, “I am so happy to see my son recover that I can’t express it in words. I feel relaxed, like I am rid of a burden. Before hegot surgery, I worried about him constantly, and I could not sleep at night. I needed to be with him all the me, and I had no me towork and earn money for my family. Now, I believe I will be able to work and earn extra money to support my family. Thank you soPost-treatment profile
much to all the donors for helping my child. When he grows up, I want him to go to school and become educated.”
Procedures
Date

Treatment information

29 January 2023
04 May 2023
16 May 2023
08 July 2023

Investigated by PCSF doctor, echo shows TOF.
S/P total repaire of TOF with take down shunted 17/5/23
S/P Total repaired of TOF and take down shunt- 17/5/2023
S/P post chek up: Hiscondition is good, He does not feel sickness any more

Total cost
Medical cost
Non-medical cost
Administration cost
Overhead
Total cost
Estimated cost

USD 5,935.66
USD 154.41
USD 42.07
USD 429.25
USD 6,561.40
USD 7,352.94

Child's Dream Foundation
238/3 Wualai Road, T. Haiya, A. Muang, Chiang Mai 50100, Thailand
Email: info@childsdream.org • Website: www.childsdream.org • Tel. +66 (0) 53 201 811 • Fax +66 (0) 53 201 812