A doctor with the Japanese NGO, the Association of Medical Doctors of Asia, attends to a young patient at a clinic in central Myanmar.

MR Noburo Kimura faces a plethora of challenges in leading a Japanese non-government organisation operating in central Myanmar, the country’s driest region. Figuring out what people want isn’t one of them.

“The villagers say their first need is water, second is water, third is water,” he said, “third and fourth is nothing, but sixth is water.”

Mr Kimura’s organisation, Bridge Asia Japan, has been trying to provide water to people in the region for nearly 10 years. Based in Nyaung U, he and his staff of twenty conduct geographical surveys, build wells and train communities on how to manage and maintain them.

The 21,000-square-mile region is a focus of many NGOs, which are working to fill the most basic needs of residents.

Project managers say the lack of clean water exacerbates every aspect of poverty in an area where infertile soil and low crop yields make survival a daily struggle.

BAJ is trying to solve the problem at its most fundamental level, while others are addressing the needs of residents in terms of healthcare and education.

Another Japanese NGO, the Association of Medical Doctors of Asia, has been providing basic healthcare to three townships in the region for almost a decade - enough time for AMDA employees to develop a trusting relationship with residents.

“We’ve been there for almost ten years, so we’ve built up a reputation,” said Mr Toshiharu Okayasu, the country representative for AMDA.

That reputation has allowed AMDA to expand its operations from primary healthcare to an HIV-AIDS program in 10 townships. AMDA representatives say the program, which focuses on behavioural change and awareness, initially encountered some community resistance.

“We are dealing with sensitive topics like sexual health, so it was not easy at first,” said Ms Makiko Kinoshita, a project director at AMDA.

“It took some months for us to be accepted by the community, but with the reputation we already have, our behavioural changes are being adopted slowly.”

AMDA takes a comprehensive approach to healthcare, and the organisation’s activities extend from micro-finance to sanitation, disaster management to building schools.

To provide access to its hospitals and clinics, AMDA has had to expand its activities to road construction.

However, Mr Okayasu says the organisation’s first project – primary healthcare – remains the most effective. Staff members of AMDA’s primary healthcare project have built a solar powered hospital and set up a mobile clinic to treat diseases common in the region, such as trachoma and dengue fever.

While AMDA’s projects span a range of needs, Ms Kinoshita says there is a need to provide more training for farmers.

“The zone isn’t fertile at all and it’s hard to grow vegetables. The food they can grow is not very nutritious,” she said.

Most dry zone residents are farmers, but few organisations have the technical expertise to provide them with training.

An exception is the Organisation for Industrial Spiritual and Cultural Advancement, a small Japanese non-profit group that holds yearly training courses in organic farming. OISCA spends about $50,000 a year training batches of 20 farmers to transform the way they work the land.

Ms Chika Mizu-guchi, a coordinator for OISCA, says the organisation has spent years trying to convince farmers that they can increase crop yields by switching to organic methods. OISCA’s representatives believe the farmers’ use of fertilisers is destroying the soil and threatening the region’s agricultural output.

“They are facing decreasing food production, and it will not be sufficient for their income,” said Ms Mizuguchi.

“They know production is decreasing but they don’t know why.”

OISCA representatives set up an eight-acre agricultural training centre in 1997.

Ms Mizuguchi says encouraging nontraditional methods of farming and water conservation initially met with much skepticism.

“We collected shower water and used it to water the vegetables. But when we brought the vegetables to market, no one wanted to eat them,” she said.

Ms Mizuguchi says she and the project leader, a 73 year old Japanese agronomist, have been able to overcome the farmers’ initial doubts.

“At first they didn’t believe we could grow crops without fertiliser. But seven years later, we have gotten double the yield of other villages. Now they are interested in what we are doing,” she said.

Project coordinators say one of their biggest challenges is communicating effectively with the communities they serve. The United Nations Development Program, which has been active in the region since 1994, has tried to overcome the problem by recruiting young community development facilitators from the region’s villages. Trained by international consultants and UNDP representatives, the youths liaise between other UNDP staff and the villagers.

Mr David Dallah, assistant resident representative at the UNDP in Yangon says the liaison role has been useful in dealing with a cultural reluctance by farmers to discuss their concerns.

“They’ll always tell you everything is good. Of course, we want to hear what is going right, but more than that, we want to hear what is going wrong. The villagers often won’t tell us that – they tell us only nice things. But they do tell these kids. They’ve watched them grow up – they perceive them more as theirs,” he said.

The UNDP is working to alleviate poverty in three townships in the dry zone.

With its multi-million dollar budget, UNDP is by far the best funded organisation working to eradicate poverty in the area. Mr Dallah says the agency prioritises community cooperation and responds to the requests of villagers, rather than trying to determine their needs unilaterally.

“Basically we sit together with the communities and find out what they perceive to be their biggest problems in terms of livelihoods, social assets, etc,” he said.

“One village may identify water as their prime concern, another may identify education. But before we get into talking about whether it’s a school or teacher or textbooks or a water supply scheme, the main thing we want them to do is get together and talk to each other.”

But like other organisations working to bring prosperity to the villagers, Mr Dallah says the UNDP’s ability to help is limited by its budget.

“We perceive that there is a huge need and even now our feeling is that we are reaching a very small proportion of the population,” he said.

Waiting for their project proposals to be approved and the funds to come in, many NGOs in Myanmar scrape by on short term grants that must be renewed every few years.

Ms Akiko Mori, an assistant coordinator from Bridge Asia Japan, says the organisation is awaiting a response on a request for funding from UNDP. Meanwhile, she said, BAJ will continue to build wells for as long as they can find the cash.

Mr Kimura, the program manager in Nyaung U, says all that’s needed to improve the villagers’ standard of living is some cash, capacity building and technical expertise. He has a simply formula for improving the lives of people in the parched landscape of central Myanmar.

“One village, one well,” he said.