WORTHY OF SUPPORT
With fascinating slide show and video
Dr. Cynthia Maung,
Founder, Mae Tao Clinic and Chairperson, Back Pack Health Worker Team
When I was studying medicine at university in Burma, I undertook two clinical internships during 1980 – 1985, one at Mingaladone Military Hospital and the other at North Okkalar Civil Hospital. It was then that the problem for access to health care in Burma and in particular for the poor and rural populations first became apparent to me. At North Okkalar most of the patients came from the outskirts of the city and were poor; the hospital facilities were terribly inadequate and the staff overworked. There the staff struggled against many challenges, lack of medicine, lack of staff and also struggling to make ends meet for their own families. There were no preventive services and many patients arrived seriously ill. The differences between Okkalar and Mingaladone were striking in terms of the resources and who could access the services.
After I finished study, I was an intern at Moulmein Hospital, where the situation was very similar to North Okkalar, but so many of the patients had to travel 3 – 5 hours by bullock cart or boat to reach the facility. It became clear to me that for rural populations, preventive care was non existent and emergency services were not accessible. Government services were simply not accessible to all.
After I graduated, I went to work in the village of Eain Du in Karen State and there I realized the role of poor social and economic development on health as well as the affects of militarization. Young boys, called up for their “volunteer” work, to serve the army in building military camps or in carrying military supplies, returned to the village malnourished, injured and with untreated malaria. The fear of the military was pervasive, and villagers’ ability to work to raise enough for their own food and livelihood was severely impaired. The effect of militarization on the villagers was very clear.
The village was only 15 km from the State Hospital, but there was only public transport 2 times a day at night, or for emergencies, referral was really difficult. The hospital in Eain Du village had a 12 bed facility for a 20,000 – 25,000 population. During the 11 months that I stayed in Eain Du, a doctor was only available for 3 months. There was no medicine available. Nurses and midwives operated out of their houses, providing private medical services. Public services were barely provided. I soon knew that the Burmese health system had in fact collapsed.
When I fled to the border, we passed through the jungle, walking for 7 days. At that time I met with many villagers and internally displaced people who had never been able to access any government health care systems.
Since 1988, the health workers coming to the border have always been quick to identify and respond to the needs of the local villagers and internally displaced populations living along the border. Gradually mobile medical teams emerged and where possible, community health clinics were established. Most health work on the border started with medical services, but gradually expanded to public health, maternal and child services, school health programmes and basic trauma care. Through maternal and child health programmes and school health programmes, the community understanding of health issues and how to participate in their own health provision increased.
Each organization on the border was operating their own mobile medical teams, traveling for 3 – 6 months at a time. During 1996 and 1998, many ethnic areas fell under the control of the military regime; some clinics had to close down and the challenges in providing health care increased. In 1998, a series of meetings were held among different ethnic organizations and through these, the Back Pack Team model was developed. Through this effort, it was possible for standardization of service delivery and a great collaboration was initiated. Everyone involved was very proud of its establishment and it was so impressive that we were able to begin immediately with 38 teams in 1998.
Since the Back Pack Health Worker Team started 10 years ago, awareness of the health and human rights situation facing internally displaced people from Burma has increased and continues to grow.
http://www.backpackteam.org/
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