2023年中間報告書

Good Holdings Corporation

関連プログラム

小児医療基金（CMF - Children's Medical Fund)

Page

Executive Summary1

このプログラムは、深刻な先天性欠損症と診断さ

1. Why We Do It

2れたミャンマーとラオスの0～12歳の子供たちを

2. Updates

対象に救命手術と医療の提供を行います。

活動実施者

ContentsoooChildʼs Dream Foundation
238/3 Wualai Road
T. Haiya, A. Muang
Chiang Mai 50100, Thailand

Output analysis
Operational Updates
Outcome analysis

255

3. Financials

7

4. Case Highlights

7

i)

Attachments

8

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、不平等の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でき、そして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ために存在しています。
私たちが行うことは全て、彼らが社会の平等で活動的なメンバーとして、権利を与えられ自分で決定できる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。

Executive Summary

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6月30日までの小児医療基金(CMF)の主な最新情報を掲載しております。
報告期間中に、合計111件の新しい症例（110人の患者）がプログラムに受け入れ、67件の症例が終了し、そのうち82%が正常に治療されました。その結果、2023年
は現在までに55人の命が救われました。
2023年1月には、この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より多くの子供たちに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べて2倍に増加しております。

1

Childʼs Dreamが直接取り組む戦略目標

1.

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

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
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す。
Establishedin 2006, CMF provides access to life-saving operations and medical interventions for infants and children.
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、
In promoting health services, we prioritise treatments of congenital disorders as it is one of the leading causes of childmortality.
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
medication,
let alone the costly operations. With the majority of the patients coming from Myanmar, these familiesに、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now
have
additional
obstacles – the country’s healthcare system, overseen by the junta, is on the verge of collapse.
療従事者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
inflated cost. 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、これらの子どもたちのほとんどは早期に死亡するか、障害によって不自由にな
anorectal malformations, and neural tube defects. Without financial support and access to quality health care, mostり学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～6月
Updates -- January
to June 2023

Output analysis
評価グラフ

症例と患者数
300
247

239

症例数と患者数

200
111

136
110

131

100

67
30

0

報告期間中に登録された症例の総数

2022年から継続中の症例報告期間中の
新しい症例

67

30

報告期間中の再開された症例報告期間中に修了した症例
症例数

患者数

先天性疾患による症例数
total %, (total), n=247

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

81%

10%

心臓障害 (199)

肛門直腸奇形 (24)1%1%

筋骨格系欠陥 (2)神経管欠損 (4)27%一般または不特定 (18)プログラム別の患者性別による患者(total), total %, n=239(total), total %, n=239

タイ (20), 8%
ラオス

男性

女性

ミャンマー

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=239

44

31

患者数

25
23

21

17
13

13
10

11

7

8

3

5
-1

2
3

0
0

1

2

3

4

5

6

7

8

年齢

3

9

10

11

12

13

14

15

1

1

1

16

17

18

種類別の心臓障害の症例数( t o t a l ) , total %, n = 1 9 9

房室中隔欠損 (51)25.6%

ファロー四徴症 (47)23.6%

動脈管開存症 (24)12.1%

心房中隔欠損症 (17)8.5%

両大血管右室起始 (15)7.5%

大血管転位症 (12)6.0%

肺動脈弁閉鎖症/狭窄症 (8)4.0%

右胸心 (7)3.5%

僧帽弁閉鎖不全症 (5)2.5%

エプスタイン病 (2)1.0%

不特定 (2)1.0%大動脈弁狭窄症 (2)1.0%

単心室型心奇形 (2)1.0%

総肺静脈還流異常症 (1)0.5%

左心形成不全症候群 (1)0.5%大動脈狭窄症 (1)0.5%

三尖弁逆流 (1)0.5%

肺動脈性肺高血圧症 (1)0.5%

併存症のある症例の数(total), total %, n = 2 4心血管疾患 (19)5%78%

肛門直腸奇形 (4)

0%

17%
10%

20%

30%

その他

40%

50%

60%

遺伝性疾患

4

70%

80%

90%

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=85

n=324

術後検診
主要手術

119

治療のみ

22

治療のみ
診断

診断

35

88

主要手術

75

術前検診

17

21

術後検診

11

16

マイナー手術5

主な活動 - 2023年1月～6月
 2023年は現在までのところ、プログラムは中断することなく通常通り実行しております。
 CMFの新規患者受け入れ数は、新型コロナウイルス感染症流行前の同時期と比べて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。

 患者数の増加はプログラムの拡大に部分的に関係しており、現在タイ各地で様々な事業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に治療をおこなっております。
展開している事業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基金(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にバンコクの患者の受入れ対応のため、1名の新しいスタッフが加わりました。

評価グラフ

男性 (31),46%

性別による終了症例数

先天性障害による終了症例数

total%, (total) n=67

total, total %, n=67

女性(36), 54%

心臓障害 (46)69.0%一般または不特定 (13)
直腸校門奇形 (6)神経管欠損 (2)

5

19.0%
9.0%
3.0%

理由別終了症例数
total, total %, n=67

完治 (55)82%

治療不可 (3)5%

死亡 (2)

3%

症例に起因しない死亡 (2)3%パートナーへの紹介 (2)3%

治療拒否 (2)3%

治療不要 (1)1%

理由別および先天性障害による終了症例数
total, total %, n=67

完治 (55)
治療不可 (3)死亡 (2)
症例に起因しない死亡 (2)パートナーへの紹介 (2)
治療拒否 (2)
治療不要 (1)
0
心臓障害

0.1

0.2

一般または不特定

60.3
直腸肛門奇形

0.4

0.5
神経管欠損

0.6

結果別成功症例

救命
(55),
100%

2023年1月に、パートナー組織との連携が開始さ
Our collaboration with partner organisations
れました。 commenced in January 2023

We categorise successful case outcomes as either ‘lives
成功症例は”救命”または”生活改善”のいずれかに分類されます。この報告期間においての成功症例は、すべて救命処
saved’ or ‘lives improved’. For this reporting period, all
置でした。
successful cases were for life-saving treatment.

3.

財務

During the reporting period, CMF spent a total of USD 468,980, including 4% administration overhead costs.
報告期間中に、CMFは４％の管理諸経費を含む合計468,980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。

90% of the total expenditure was spent on medical treatment and surgeries. Besides food expenses which amounted
to 3%, another 3% was spent on caregivers’ accommodation, transportation, and other related expenses. We will
財務詳細については2024年1月の年度末レポートで再度ご報告いたします。
report again about the full financial details in the end-year report in January 2024.
4.

事例要約

Attached are some patient reports that were written by our Thai staff and that are directly extracted from our Patient
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。
Case Management System. Please note that we did not correct their English as far as we believed it can be understood.
この場をお借りして、皆様の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、まさに重要な時期であり、私たちが力を合わせることでさらに多くの子どもたちの生活
We would like to take this opportunity to express our deepest gratitude for your unwavering support and your trust.
に大きな影響を与えることができます。
It comes at a pivotal time for our CMF patients and their families who face so much uncertainty. Together we can makea significant impact on many children’s lives.

国境が再び開放され、救命サービスの需要増加によりプログラムを拡大し、2023年の予算は100万ドルに増加いたしました。今後も皆様
As the borders are now fully open again and because we have expanded the programme due to an increase in demandの貴重なご支援を賜りますようお願い申し上げます。なお、この高額な予算の確保の見通しはまだありません。

for life-saving services, our budget for 2023 has increased to USD 1 million. We truly hope that we can rely on yourvery valuable support moving forward. Securing this high budget is far from guaranteed.
Many thanks again!

チェンマイより、 2023年8月7日
Child’s Dream Foundation

Marc T. Jenni

Daniel M. Siegfried

Founder & Managing Director Operations

Founder & Managing Director Programmes

7Child’s Dream Foundation
Improving health and education for sustainable development
Patient No: 9921
CASE SUMMARY REPORTPatient name:Wan Yi Phone

Sex:

Male

Hospital Nr:

4138195

Date of submission:

Date of birth:
14 September 2022

27 March 2022

Date of closure: 06 February 2023

Final diagnosis: Cardiac disorder - Dextrocardia

Pre-treatment

Post-treatment

Pre-treatment profile
He was born at a private hospital in Lashio, Shan state, Myanmar. He was born like a normal baby. When he was two months old, hismother no ced that he had shortness of breath and was slightly blue when he cried. His parents took him to the provincial hospital,
where he was diagnosed with heart disease and told that surgery was required. His father heard that the healthcare in Thailand wasgood and that his son cold be treated there. He borrowed money from rela ves and neighbours to prepare his passport and surgery
costs. He had THB 130,000. His parents brought him to Chiang Rai Hospital, Thailand. There, the doctor told them that he could not
perform his surgery in Chiang Rai because his condi on is complicated and risky. The doctor gave his parents the referral le er to
Chiang Mai University Hospital for proper case management. At Chiang Mai University Hospital, the social worker requested support
from Child’s Dream because he did not have any health insurance in Thailand and the cost was around THB 500,000. His parents
could not aﬀord it for him.

Post-treatment profile
Wan Yi Phone’s father says “Thank you very much for your kindness to support my son’s treatment. I will keep Child’s Dream
organisa on in my mind. I will tell my son when he is growing up about your support. We were worried about our son’s health. He
had severe fa gue, respiratory infec on, diﬃculty breathing, periodic fevers, and cyanosis. Currently, he looks good, is ac ve, andsleeps and eats well. Four months in Chiang Mai gave new life to my son. We will go back home with the Wan Yi Phone’s stronger
heart. He will a end school and have a beau ful future as a normal child. If he wants to be a doctor, I will support him as I can. On
behalf of my family member, I would like to thank you very much to the donor who gave us new life, and all staﬀ who support us all
the me if we requested. We wish you all good health, happiness, and peace.”
Procedures
Date

Treatment information

12 September 2022
19 September 2022
06 December 2022

First consultation, echo shows multiple defects. Doctor plan do CTA
Admit for CTA, CAG and treat RSV pneumonia
Admit for total correc on, Stenotomy to Rt.ventriculotomy to intraventricular tunnel patch baﬄe 8/12/22 without post-op complica ons.

09 January 2023

Follow up, his condi on is good. He needs con nue take medicine for reducing his pulmonaty hypertension.
Parents could support for post op treatment.

16 January 2023

Follow up, his pneumonia is solved. His parents will return home and follow up at Chiangrai hospital

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

USD 9,484.34
USD 635.02
USD 183.12
USD 721.17
USD 11,023.66
USD 14,667.06

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: 9601
CASE SUMMARY REPORTPatient name:

Bible Chit

Sex:

Male

Hospital Nr:

3957462

Date of submission:

Date of birth:
04 September 2019

01 August 2018

Date of closure: 02 June 2023

Final diagnosis: Anorectal malformations - Hirschsprung's disease

Pre-treatment

Post-treatment

Pre-treatment profile
Bible Chit is a one-year-old boy who lives with his parents and a ﬁve-year-old sister in Myawaddy Township, Karen State, Myanmar.
His mother is a homemaker and his sister goes to kindergarten at their village school. Currently, his father works as a farmer and hehas to rent land to grow corn and beans. A er harvest, he is able to make around 30,000-40,000 baht (approx.1,000 -1,300 USD) in a
year.
He was born without any complica ons at Mae Tao Clinic (MTC). Five days a er they went home, he vomited the whole night andwas able to pass less stools. In the morning, his mother no ced that Chit’s abdomen was increasing in size and his mother decided totake him back to MTC. The next day, the medic referred him to Mae Sot Hospital, Thailand, where the doctor diagnosed him with
Hirschsprung’s disease. The next day, the doctor performed surgery, moving the colon to the peritoneal. His treatment was paused
for three years during COVID-19 because the border was closed. In 2023, the border was reopened, he went to Mae Sot Hospitalwhere the doctor gave him the referral le er for receiving deﬁnite surgery in Chiang Mai.

Post-treatment profile
His mother said “Before the last surgery, it’s not easy to change the dressing around the hole in his stomach, when he has diarrhea.
Some mes, I really feel stressed out and I am disappointed [that he was born with all these problems] as we do not have enoughmoney even for necessi es. Some mes we have to buy co on to change the dressing frequently [which is expensive]. And I have togive all my me to him, and I cannot help my husband on the farm at all. However, we are praying for him and we worry a lot abouthim. When he was admi ed in the hospital for the last surgery, I was very happy to see him as a normal boy. People around me
blamed me for his abnormality. I felt guilty and tried my best to take care of him. Now, I am very happy with his condi on. We will goback home with a new Bible Chit. I want him to be healthy and when he grows up, I want him to become a pastor. I am very happy
that my son received the chance to have treatment. If he had not, we would never be able to aﬀord to treat him. Now, I feel likesomething heavy that I had to carry, has disappeared. We would like thank the donors and all involved staﬀ both in Mae Sot andChiang Mai.”

Procedures
Date

Treatment information

09 September 201912 November 201913 February 2020
01 July 2022
20 August 2022
12 September 2022
19 October 2022
14 November 2022

First consultation, plan do BE
Admit for BE but he had food hand mounth disease
admit for BE
get new app
Admit for Duhamel operation with appendectomy. Dilate anus with candle no 12 BID.
f/u, his wound is not good, need dressing every 2-3 days.
Post op check up, abdominal wound is good. Dilate anus no. 18, twice a day, for 1 month.
Follow up, his condi on is well.
Dilate anus with candle no.18 BID in Nov & Dec.
Dilate OD in Jan - Feb 23.
Dilate EOD in Mar - Apr 23.
However, if his condi on is well, he doesn't need come back to CM in May.

15 May 2023

Mother called staff to inform about the patient's condition is good. So they don't need to come back to CM.

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

USD 3,310.79
USD 1,341.30
USD 585.64
USD 366.64
USD 5,604.38
USD 3,520.09

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: 9901
CASE SUMMARY REPORTPatient name:

Aung Hein San

Sex:

Male

Hospital Nr:

4133091

Date of submission:

Date of birth:
10 August 2022

28 November 2021

Date of closure: 06 February 2023

Final diagnosis: Neural Tube Defects

Pre-treatment

Post-treatment

Pre-treatment profile
The child was born to ethnic Karen parents in Karen state, Myanmar. Like many other families, the parents make their earnings
through buying and selling local products. There is a small farm belonging to the family. Some mes, the family receives ﬁnancial
support from rela ves working and living abroad. The income is not regular and the family is struggling to make ends meet.
Meanwhile, their child developed swelling in the nose region at the age of 4 months. The swelling became larger gradually andextended up to the forehead covering half of the forehead. While looking for op ons for the child’s health in the Myanmar side, thefamily found it diﬃcult to live in their place as the armed conﬂict in their area escalated since December 2021. Considering thedanger to their lives due to security reasons, the whole family decided to take refuge in Maela camp while ﬂeeing from their villageof origin on the Karen side. The family then approached the refugee camp health hospital for an ini al consulta on and poten al
support. An IRC staﬀ member referred him to Child’s Dream for suppor ng the costs of medical care.

Post-treatment profile
Her mother says “I would like to say a million thanks to the donor, IRC and Child’s Dream Founda on. You gave us a new baby. Since
he was born and the sac was growing up drama cally, we couldn’t sleep and tried to get money to treat him. He could not li hishead up, and also could not sit. We le our hometown, were hopeless, and always had air strikes, gun ﬁre, and ﬁgh ng. We feelsafer in the Maela refugee camp, although we have no job, and no opportunity to get money, but we get dona ons from the Thaigovernment and interna onal organiza ons. I hope that my hometown will have peace soon. I want to go back home.”
Procedures
Date

Treatment information

11 August 2022
12 August 2022
11 August 2022
05 September 2022

First consultation, she has appointment with plastic surg.
She has fever, crying all the time, take patient to ER.Doctor prescribed her medicine.
Surgeon give Sx schedule.
S/P.excision FEEM with skin and so ssue coverage 7/9/22. Post op she had ﬂuid like CSF ﬂuid leakage. Doctor
set OR on next day for VP shunt.
S/P. Rt VP shunt with le pareintal VP shunt 8/9/22

27 September 2022
11 October 2022

Neuro Sx give him post op follow up on 21/10//22
Post op check up & s tches oﬀ. Her wound is good. No need dressing wound. VP shunt has something wrong,
he need visit neuro doctor.

17 October 2022
13 December 2022
27 January 2023

f/u, his condition is good.
Follow up, his condition is well. Close him from program.
Post op check up, his condi on is well. No need follow up wth neuro-surg. Plas c surgeon will perform hissurgery when he is 15-17 years old.

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

USD 5,470.70
USD 604.61
USD 148.71
USD 435.68
USD 6,659.69
USD 7,333.53

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