2024年 中期報告書
関連プログラム

小児医療基金Children’s Medical Fund (CMF)
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供を
行います。

活動実施者

Contents1

1. Why We Do It

2

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

Page

Executive Summary

Output analysis
Operational Updates
Outcome analysis

2
5
6

3. Financials

8

4. Case Highlights

8

i)

Attachments

9

www.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。

エグゼクティブ・サマリー

CMFが直接取り組む持続可能な開発目標（SDGs）

This
report covers the main updates for the
本レポートでは、2024年1月1日から6月30日までの小児医療基金（CMF）の最新情報を掲載しています。
Children’s
Medical Fund (CMF) from 1 January until
30 June 2024.
報告期間中に、合計111件の症例（患者数111名）を受け入れました。132件の症例が終了し、うち86％が正常に治療されDuringthe reporting period, a total of 111 new
ました。その結果、114名の命が救われました。

cases (111 patients) were accepted into the
全てのプログラムは予定通りに進行しています。また、ラオスでのprogramme.
132 cases were closed, of which 86%
需要の高まりをうけて、新たにプログラムコーディネーターが新たなメン
were treated successfully. As a result, 114 lives
バーに加わりました。
have so far been saved in 2024.

Child's Dreamが直接取り組む戦略目標

All programme operations have been goingaccording to plan. We have employed a new
Programme Coordinator in Laos as the demand forour services are increasing there.

1

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

CMF
supports the United Nations Sustainable Development Goals (SDGs) for 2030, specifically Goal 3: Ensure healthy
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し、
lives and promote well-being for all ages.
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す。
Established in 2006, CMF provides access to life-saving operations and medical interventions for infants and children.
In 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、外promoting health services, we prioritise treatments of congenital disorders as it is one of the leading causes of child
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、患者
mortality. The surgical procedures are normally expensive and complex; none of the families can afford the necessary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。医療従事者達が軍
medication, let alone the costly operations. With the majority of the patients coming from Myanmar, these families
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。
now have additional obstacles – the country’s healthcare system, overseen by the junta, is on the verge of collapse.
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。経済的inflatedcost. The primary service-users are children aged 0-12 who have been diagnosed with cardiac disorders,
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校に
anorectal malformations, and neural tube defects. Without financial support and access to quality health care, most of
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。
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：2024年1月～6月

評価グラフ

症例数と患者数
400

340

336

症例数と患者数

300
229

225

200
111

132

111

132

100
22
0

報告期間中に登録された症例の総数

2023年から継続中の症例

報告期間中の新しい症例

22

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=340

100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

88%

7%
心臓障害
(299)

肛門直腸奇形
(25)

1%

2%

1%

筋性心室中隔欠損
(3)

神経管欠損
(8)

一般または不特定(5)2

プログラム別患者数

性別による患者数(total), total %, n=336(total), total %, n=336

タイ (13), 4%
女性(162), 48%

ラオス(65), 19%男性(174), 52%

ミャンマー(258), 77%

報告期間中の出身地別患者数

報告期間中の性別による患者数

年齢別の患者数
n=336

45
45

36

29

患者数

25

25
20

23
18

14

11

11
10

6

5
5

2

3

2

1

18

19

0
-1

0

1

2

3

4

5

6

7

8

年齢

3

9

10

11

12

13

14

15

16

17

種類別の心臓疾患の症例数( t o t a l ) , total %, n = 2 9 9

ファロー四徴症 (76)25.4%

心室中隔欠損症 (69)23.1%

動脈管開存症 (35)11.7%

心房中隔欠損症 (30)10.0%

両大血管右室起始 (24)8.0%

大血管転位症 (16)5.4%肺動脈弁閉鎖症/狭窄証 (15)5.0%

完全型房室中隔欠損症 (8)2.7%

僧帽弁閉鎖不全症 (5)1.7%

大動脈縮窄症 (5)1.7%

右胸心 (4)

1.3%

エブスタイン病 (3)1.0%

三尖弁閉鎖不全症 (3)1.0%

単心室症 (3)1.0%

総肺静脈還流異常症 (2)0.7%

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 = 3 6筋性心室中隔欠損 (1)3%14%

心臓疾患 (31)72%
3%

肛門直腸奇形 (4)

8%
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=169

n=340

術後検診

主要手術

111

主要手術

108

術後検診

28

88

術前検診

12

治療のみ

52

治療のみ

10

診断

46

マイナー手術6

術前検診

2

マイナー手術診断

43
3

主な活動 － 2024年1月～12月▪

今年度、本プログラムはこれまでのところ中断することなく予定通り実行しています。

▪

1月にCMFはパートナーと協力してメーソート病院で2日間のアウトリーチクリニックを実施し、44件の新規症例を受け入れました。
このうち23名の患者がパートナー病院で無事に手術を受け、残りの患者は道路の破損、雨季、農作業の都合、その他の理由によりタイへ移動できませんでした。

▪

6月には、ラオス・フレンズ子ども病院（LFHC）で2日間のアウトリーチクリニックが開催されました。

o このクリニックから37名の患者がタイで心臓手術が必要であることが判明しました。
o さらに、2023年のアウトリーチクリニックからの39名の患者がすでにタイで無事に手術を受けており、このようなクリニックの重要性が示されています。

▪

タイ小児循環器学会は、患者をCMFに紹介することに関心を示しており、10月にはタイ北部の2つの病院でのアウトリーチクリニックに参加するよう招待されました。これにより、医療支援が必要な患者の数が増えると予想しています。

▪

2023年にラオスの都市、ルアンパバーンにプロジェクトオフィスを開設して以来、ラオスからの患者が増加すると予想されるため、現地での介入とアウトリーチ活動を監督するプログラムコーディネーターを新たに1名迎えました。これにより、ラオスでの患者治療の数が増えるだけでなく、より効率的に作業を進めることができるようになります。

6月には、ラオス・フレンズ子ども病院（LFHC）で2日間のアウトリーチクリニックを実施しました。

5評価グラフ先天性障害別の修了症例数

性別による終了症例数
total%, (total) n=132

total, total %, n=132

心臓疾患 (125)

女性(65), 49%

男性 (67),
51%

95.0%

肛門直腸奇形 (4)3.0%

筋性心室中隔欠損 (2)2.0%一般または不特定 (1)1.0%

理由別終了症例数
total, total %, n=132

完治 (114)86%

治療不可 (5)4%

音信不通 (4)3%

死亡 (4)

3%

治療拒否 (2)2%パートナーへの紹介 (1)1%

移住 (1)

1%

症例に起因しない死亡 (1)1%6理由別および先天性障害による終了症例数
total, total %, n=132

完治 (114)
治療不可 (5)死亡 (4)
音信不通 (4)
症例に起因しない死亡 (1)パートナーへの紹介 (1)
治療拒否 (2)
移住 (1)
0%

10%

20%

30%

40%

50%

60%

筋性心室中隔欠損

心臓疾患

一般または不特定

肛門直腸奇形

70%

80%

90%

結果別成功症例
n=114

100%
治療成功

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。

メーソート病院で実施されたアウトリーチクリニックに参加する子どもたちとその家族

7

3.

財務状況

2024年上半期、CMFは合計で863,485米ドルを支出し、その中には4%の管理費が含まれています。
支出の91%は医療費や手術費用に充てられました。食費として2%が使われ、さらに3%が介護者の宿泊費、交通費、その他関連費用に使われました。

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。
この機会をお借りして、皆様の変わらぬご支援と信頼に対して、心から感謝の意を表したいと思います。
将来が不確かな状況に直面しているCMFの患者やその家族にとって非常に重要な時期であり、私たちが共に協力すること
でさらに多くの子どもたちの人生に大きな影響を与えることができると信じています。
プログラムの拡大に伴い、ラオスでのサービスも拡大していますが、これは命を救うサービスの需要増加によるものであり、予算の増加も伴います。今後も皆様の貴重なご支援に依存できることを心から願っています。
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8月13日

Child’s Dream Foundation

Marc T. Jenni

Daniel M. Siegfried

Founder & Managing Director Operations

Founder & Managing Director Programmes

8Child’s Dream Foundation
Improving health and education for sustainable development
Patient No: 9975
CASE SUMMARY REPORTPatient name:

Saw Nanda Linn

Sex:

Male

Hospital Nr:

4158324

Date of submission:

Date of birth:
21 January 2023

21 May 2016

Date of closure: 19 May 2024

Final diagnosis: Anorectal malformations - Hirschsprung's disease

Pre-treatment

Post-treatment

Pre-treatment profile
Saw Nanda Linn is a six-year-old preschool student who lives with his parents, grandparents, uncle, cousin, and younger sister in Naung
Tai Village, Hlaingbwe Township, Karen State, Myanmar. His father and grandfather are hired farmers during the rainy season, and theyreceive paddy as payment for their work. His aunt, who lives in Bangkok, Thailand, sends some money to his grandparents every
month. He was born on May 21, 2016, at Hlaingbwe General Hospital through a normal vaginal delivery. A er his birth, his father
no ced that his stomach was distended a er he was breas ed, and he had diﬃculty passing stool. He informed the midwife at thehospital, who gave Linn medica on that helped him pass stool. A erwards, he was referred to Hpa-An General Hospital for further
inves ga on, where he was diagnosed with Hirschsprung’s disease. The doctors gave him oral medica ons to help him pass stool
before he was discharged. The medica ons some mes helped Linn pass stool, but not always. His condi on worsened, and he could
not pass stool. He was rushed to Hpa-An General Hospital, where the doctor referred him to Yangon General Hospital for further
treatment. However, Linn’s father took him to Mandalay General Hospital instead because they had heard that the hospital has acharity group that helps with the cost of treatment. He was admi ed and discharged several mes.
At the beginning of 2021, his parents were told that a doctor was planning to perform surgery on him to ﬁx his small intes ne and thatthe doctor would contact them. Unfortunately, no doctor ever contacted them that year. “All capable doctors ran away a er the coupon February 1, 2021, so no one could do the surgery at that hospital,” said his father. In June 2022, his father learned that a group oforganiza ons from Thailand called the Backpack Health Worker Team (BPHWT) had come to their village. He then asked their staﬀ tohelp his son get treatment. He explained to the staﬀ about his son’s condi on and his ﬁnancial problems. A erwards, the staﬀ from
BPHWT referred Linn to the Burma Children Medical Fund (BCMF) and Child’s Dream for assistance in accessing further treatment.
Post-treatment profile
His father said, “My family is very busy taking care of Linn. We have to look a er his hygiene, such as washing his soiled clothes,changing him into a clean pair of clothes, and changing his colostomy bag. We ﬁnd it hard to work to make money because he needs
someone to take care of him. He is shy to go to school because his stools pass through the stomach. He wants to go to school but
avoids going there. I felt so happy when I learned that a donor will help my son get treatment. I will never forget the donors' help andtheir kindness. One day, I hope I will be able to give something back to the donors as my way of saying thanks. I want Linn to become ateacher in our village when he grows up because there are not enough teachers in our village.”Procedures
Date

Treatment information

25 January 2023

First consulta on and doctor admi ed him to hospital for BE and rectal biopsy. Doctor plan do Duhamel
opera on.

21 April 2023
10 May 2023
22 May 2023
22 July 2023
06 August 2023
06 February 2024
04 March 2024
13 May 2024

S/P.Duhamel operation 25/4/23
Follow up, doctor startng dilate anus with no 12 BID
Post op check up, his condition is good. Dilate anus no 13- 18, change every week.
S/P. colostomy closure 25/7/23.
Follow uro, doctor plans do VCUG
Admit for VUCG
f/u, VUCG result showed normal study.
PO check up, his condition is fully recovery.

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

USD 5,618.29
USD 1,143.42
USD 128.65
USD 482.33
USD 7,372.69
USD 4,252.91

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: 10188
CASE SUMMARY REPORTPatient name:

Olivia Phanmysy

Sex:

FemaleHospital Nr:

67-000413

Date of submission:

Date of birth:
13 November 2023

26 June 2022

Date of closure: 30 June 2024

Final diagnosis: Cardiac disorder - Atrial septal defect (ASD)

Pre-treatment

Post-treatment

Pre-treatment profile
Olivia is the ﬁrst child of her family. Her mother works in a hospital as a pa ent assistant, and her father works for a company in Luang
Prabang. She was born at LFHC with a normal delivery. The doctor suggested that she has a congenital heart defect and that surgery is
required when she weighs more than 10 kg.
In October 2023, the LFHC management team became aware of an opportunity to help children with heart defects when a team ofThai heart surgeons, cardiologists, nurses, and support staﬀ decided to bring their program to Laos. This team is from the Paediatric
Cardiac Surgery Founda on (PCSF) in Thailand and works closely with and is supported by the INGO Child's Dream Founda on (CDF).
They also collaborate with the Thai Red Cross and the Thai embassy in Vien ane.
LFHC's clinicians selected 20 children from the current list with known heart defects, and they traveled to Vien ane. They were all seen
and assessed at Mahosot Hospital, Vien ane, in October 2023.
Olivia was diagnosed by the PCSF on that day. The echo showed an ASD, and surgery is required. She will receive surgery at Kasemrad
Hospital in Bangkok.
Post-treatment profile
Olivia is a one-year-old with a hole in her heart called an ASD. This condi on can cause heart failure and results in poor growth and low
energy. The opera on was completed on the 8th of January, 2024, and was a success. She returned safe and sound to Luang Prabang
and can now live a healthy life.
On June 15, 2024, she met with the PCSF doctor, and an echo was done for post-opera ve evalua on. The result was good, and her
condi on is fully recovered. A er surgery, she eats well and is able to run more, but at the beginning of the month, she had a slightcough.
Procedures
Date

Treatment information

13 October 2023

The pa ent was diagnosed by PCSF on 13/10/23 at Mahosot Hospital, Vien ane, Laos. The echo showed ASD
and surgery is required. She will receive surgery at the Kasemrad Hospital, BKK.

07 January 2024
07 February 2024
15 June 2024

S/P Atrial Setal Defect and PDA closured on January 8, 2024.
PO f/u, her condition is good.
Post-op check up, her conditioni is fully recivery

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

USD 4,252.91
USD 443.44
USD 0.00
USD 328.74
USD 5,025.09
USD 5,103.49

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: 10217
CASE SUMMARY REPORTPatient name:

Ma Su Nadi (BCSex:

FemaleHospital Nr:

66036645

Date of submission:

Date of birth:
29 November 2023

12 June 2018

Date of closure: 30 May 2024

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

Pre-treatment

Post-treatment

Pre-treatment profile
Ma Su Nadi is a ﬁve-year-old girl who lives with her parents, grandparents, an aunt, and a younger sister in Mandalay City, Myanmar.
Their total monthly income is 120,000 kyat (approximately 120 USD), which is enough to cover their monthly expenses, including basic
healthcare. She was born at Mandalay General Hospital through a normal delivery. When she was one year old, she started tofrequently have fevers and coughs. Her grandfather took her to a local clinic, where they were advised to take her to Mandalay
Hospital, but they could not make any trips during the COVID-19 outbreak and the coup.
She was admi ed several mes to Mandalay Hospital and Parami Hospital due to a high fever, fa gue, and shortness of breath. She
received an echocardiogram (echo) and was diagnosed with tetralogy of Fallot (TOF). The doctor told them there was no capacity toperform her surgery locally, and she needed to go to Thailand for the procedure. She and her grandfather arrived in Mae Sot, Thailand,on November 3, 2023. The next day, they went to Mae Sot Hospital for a free echo screening hosted by the Paediatric Cardiac Surgery
Founda on (PCSF). Her diagnosis was conﬁrmed, and she will receive surgery at Kasemrad Hospital in Bangkok. BCMF has enrolled her
in their program and requested ﬁnancial support from Child’s Dream.
Post-treatment profile
Post-check-up at Mae Sot Hospital on January 13, 2024, with the PCSF team, Ma Su Nadi's condi on is good. She needs to takemedica on and schedule a follow-up appointment at Mae Sot Hospital. She does not need further surgery. Her grandfather said, "Onbehalf of our family members, we extend our enormous thanks to BCMF, PCSF, and Child’s Dream for helping provide life-changing
surgery for our child. The 20 days in Bangkok were a good experience that changed her life. We could not aﬀord the medical andtransporta on costs in Thailand. We were living hopelessly in Myanmar, troubled by Ma Su Nadi's sickness. In our experience, a baby
born with dark-blue nails and lips would die within a few years. It was unbelievable that Ma Su Nadi could survive and turn pink like anormal child a er surgery. Now she has more energy, is playful, smiles, and likes to go to school. A er surgery, she no longer has
respiratory infec ons. We will take care of her as best we can, and hopefully, she will a end school and get a job in the future."
Procedures
Date

Treatment information

04 November 2023
03 December 2023

S/P diagnosed @ mae sot on November, 4 2023
S/P Tetralogy of Fallot total correc on Pulmonary Repaired on December 4, 2023 ,coil emboliza on on December 14, 2023

30 November 2023
13 January 2024

S/P Cardiac Computed Tomography Angiography on November 30, 2023
Post check up in Mae Sot Hospital on January 13, 2024. Her condi on is good. She needs to take medica on
and needs to schedule for follow up in Mae Sot Hospital. She does not need for further surgical so CMF closed
her cause.

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

USD 11,007.49
USD 226.03
USD 0.00
USD 786.35
USD 12,019.86
USD 9,923.45

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