Following a pilot phase, the METF has launched an ambitious malaria elimination project in Karen state (Myanmar). From the onset, community engagement emerged as the most important determinant of success. In this rural, remote population, affected by decades of conflict and political instability, gaining the trust and the support of the communities is complex and difficult. Given the absence of a conceptual framework adapted to this population, we developed our own approach and we determined some key basic notions such as the history of the people, their space and work, their knowledge of the world their believes, their relationship with health care structures but also their migration patterns, their economic systems and most importantly the power relations.