Burma is not a good place to get sick. It's a bad place for a lot of things -- basic freedoms, rule of law, taxis (the fleet in Rangoon is about 30 years old and suffering from some seriously gnarly transmission ailments). Still, the government has an abysmal record when it comes to helping the sick: In 2005, UNICEF reported that the government spent a paltry 40 cents a year on health care per citizen (in comparison, the Thai government spent nearly $61 per person). In 2000, Burma's health care system was ranked190th out of 191 countries by the World Health Organization.
It's one thing for journalists and political activists to assume names and maintain low profiles, but what struck me as particularly poignant is the fact that doctors, too, must take on aliases and watch their step when they decide to forgo state-sanctioned employment and help fellow Burmese on their own.
KK, we'll call him, looks too fresh-faced to be a doctor -- less "Grey's Anatomy" and more "Doogie Howser." But he graduated from Rangoon medical school after the requisite six years of education and now works underground, crisscrossing the country on his motorbike and helping to train local health workers in remote parts of the country. His work is partially funded by a Western organization, but he is, for the most part, a staff of one.
When we meet, it is at a remote table in a largely empty restaurant. Despite the apparent privacy, KK speaks in hushed tones when explaining that his organization sends pharmaceuticals to the Centers for Disease Control in the U.S. for testing, because most of the drugs in Burma come from China and the Burmese government does not control their quality. Complicating matters even more, antibiotics are available readily, without prescriptions, throughout the country; as KK explains, to self-prescribe medication without understanding one's ailments, especially when using low-quality drugs, creates an iffy proposition.
KK is only one man and there's a limit to what he can do, but Burma's national health care is so atrophied that citizens flock to competent care. The most impressive operation in this respect is the Mae Tao Clinic, headquartered on the Thai border and teeming with Burmese who have traveled -- by foot, in many cases -- to seek basic care. Mae Tao birthed 2,433 babies last year and had 140,937 visits. The clinic offers primary care, dental care and eye surgery, neonatal health programs, vaccinations, treatment and counseling for HIV and AIDS. The Backpack Worker's Health Team, based at the clinic, trains and supports underground teams of community doctors inside Burma as they assist patients in remote villages where no services are available. For victims of landmines (planted in ethnic areas by the Burmese military regime), Mae Tao fashions prosthetic limbs. Many of the prosthetics specialists are victims of mines themselves. (Click on the video below to see some of the Mae Tao operations.)
The head of Mae Tao Clinic is Dr. Cynthia Maung, a Karen refugee. Maung, like KK, is a graduate of a Burmese medical school -- though her education took place nearly three decades ago. Forced to flee the country in the wake of the 1988 pro-democracy protests and subsequent government crackdowns, Maung established her clinic on the Thai-Burma border, aiming to serve a population desperately in need of basic care. Though Mae Tao offers comprehensive services, there is a constant struggle for funding. Twenty years have passed since Maung established the clinic, yet she does not have an official license from the Thai government to practice medicine -- only a series of temporary permits. Needless to say, Maung cannot go back to Burma for fear of reprisals from the regime.
The sheer enormity of the task at hand -- helping victims of landmines and military gunfire, children lacking medicine for diseases that the rest of the world has long since overcome, thousands of refugees who have been living, on the run, in the jungle without the most basic health care -- is heartbreaking. For people like Maung and KK, to do so under threat of government crackdown and with only rudimentary weapons to stave off illness, is heroic.
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