VISA RUNNERS from Phuket to Ranong who cross to Victoria Point will be greeted in Burma these days by a couple of nurses in surgical masks.

One of the nurses will pop a fancy thermometer in your ear and check your temperature. The other will attend to a hand-written list.

It's quite strange to see this kind of medical technology being applied on shore beside the pier at Victoria Point, which, like most of Burma, is usually free of sophistication, especially when it comes to health.

The oddest thing of all is that visa runners tend to want to get their visas renewed as fast as possible and get back on the boat for Ranong, on the Thai side of the shallow estuary.

A few may do a brief tour of the town, but that's about it.

Whatever the health of the visa runners, they are usually only in Burma for 20 minutes, sometimes less.

A reliable source in Ranong tells us that the health check in Burma is because of a serious outbreak of chikungunya, the debilitating mosquito-borne disease that has already swept across Phuket.

One contact in Victoria Point, who claimed to have been in hospital for two weeks with chikungunya, said there had been ''many deaths'' locally from the outbreak.

Phuketwan's network on the other side of the Burma-Thai border is not great and we are attempting to confirm the scale of the outbreak.

Phuket has had more than 2000 cases of chikungunya in the first half of 2009 and Public Health officers are trying to rid the island of the mosquitoes that carry the disease before there is a fatality.

The other trigger for the temperature checks in Burma could be the H1N1 virus.

There has been acceptance of the pandemic in many countries, with attention turned to mitigation rather than attempting to prevent the virus from spreading. That's now impossible.

But health authorities fear that less developed countries without the capacity to treat large numbers of people could suffer a disproportionate number of deaths, as was the case in Mexico earlier this year when ''swine flu'' first emerged.

Delegates from Bangladesh and Burma have appealed to the World Health Organaisation for help in procuring vaccines or making them more affordable.

''Developing countries like us, we have to fight this war without vaccines,'' Mya Oo, deputy health minister of Burma told a news site online. He urged pharmaceutical companies to consider selling the vaccines to developing countries at just above cost.

WHO flu chief Keiji Fukuda says two drug makers had pledged to donate 150 million doses of vaccine to poorer countries by the end of October.

WHO has stressed that most cases of the H1N1 virus are mild and require no treatment, but the fear is that new infections could overwhelm hospitals and health authorities, especially in poorer countries.

However, the health check (for expats only) on the swift in and out required to Burma remains mystifying.


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