Tuesday, March 06, 2007

Saving lives on the Burmese border

Saving lives on the Burmese border
In the third of a series of articles from the Thai-Burma border, the BBC's Kate McGeown looks at the medical teams who do their best to help Burmese civilians in the region - sometimes risking their lives in the process.

If you were to trek into the jungle in eastern Burma, and mention the name Dr Cynthia, people would know immediately who you meant.

Cynthia Maung is well-known to Burmese in the border region, because her clinic in the Thai town of Mae Sot offers free healthcare, whatever the circumstances.

Most of the staff - including Dr Cynthia herself - are living in Thailand as refugees, having fled from Burma's harsh military regime.

Her clinic caters for thousands of other refugees, as well as economic migrants, and every year an increasing number of patients also come across the border from Burma, especially for treatment.

Such is the draw of the clinic - and the paucity of Burma's healthcare facilities - that even Burmese soldiers, with access to the country's best medical care, have been known to abandon their posts and turn up at Dr Cynthia's door.

"There is a real need for Burmese people to get access to basic healthcare, because conditions there are so bad," said Dr Cynthia. "We treat everyone we can, and we don't discriminate."

Allied to the clinic is another organisation, the Backpack Health Workers Team, which trains and equips local people to provide basic medical services in their communities back in Burma.

Often working in active conflict zones, riddled with landmines, these backpack medics risk their lives for their work - in fact seven have already been killed.

But as one young medic, Sa Muna, put it: "If we didn't do this, people would have no help at all."

'Waiting to die'

Both Dr Cynthia's and the backpack team have their origins in 1988, when a crackdown against pro-democracy demonstrations forced thousands of people to flee the country for Thailand - among them Dr Cynthia and backpack team director Mahn Mahn.

"We began by treating some of the people with us - a lot had malaria and were malnourished," said Dr Cynthia, "but soon we established a proper clinic."

She has never looked back. In 1989 her clinic had 2,000 patients, but last year more than 80,000 people received some form of treatment.

For many Burmese people, going to a Thai medical centre is not an option, partly because of the expense and also - for illegal migrants - it is an unsafe advertisement of their presence in Thailand.

So instead they pour into Dr Cynthia's.

The treatment on offer has revolutionised lives. "First I went to hospital in Burma, and I had to sell all my land to pay for it, but I still didn't get well," said 59-year-old Saw Raymond. "So my two sons brought me here, and I'm feeling a bit better already."

A quiet 34-year-old woman in the corner said she had come to get a supply of anti-retroviral drugs. She recently found out that she had HIV, and her whole village clubbed together to pay for her journey to Dr Cynthia's.

"I couldn't afford any treatment in Burma. If it wasn't for this clinic I'd just be waiting to die," she said.

Treating the enemy

A building at the back of the clinic houses a workshop for Maw Keh and his team, who construct prosthetic limbs for the many landmine victims in the region - a legacy of the long conflict between government and rebel soldiers.

"We often see people who have waited years for a new leg," said Maw Keh, who himself lost a leg to a landmine while fighting for the KNLA (Karen rebel army).

Most staff at the clinic, like Maw Keh, are ethnic Karen, and many openly support the rebels. But they say they will treat anyone who needs help, and true to their word a young soldier from the DKBA ( Democratic Karen Buddhist Army) - a group that split off from the KNLA and now fights on the government side - was being treated at the time of my visit.

"My motorbike hit a landmine, probably set by the KNLA," said 21-year-old Daniel Tun. "I don't know why I was brought here, but these people are good to me."

The backpack medics work under the same principle, although perhaps for them it is even harder to stay true to this creed. Their job is extremely dangerous, and they are often escorted by rebel armies for safety.

"I work in a war zone," said 29-year-old Ehkalu, who is usually based in an ethnic Karen region but is currently in Mae Sot for training. "A gun is an essential piece of my equipment."

There are now 300 backpack medics, chosen from the communities they serve.

It is obvious how much they are needed. "One day we went to a village, and there were Burmese soldiers there, so it wasn't safe for us to go in," said Sai Lao, an ethnic Shan medic. "The people brought their sick out to us in the jungle, on make-shift stretchers."

But sadly there are sometimes situations that can prove just too difficult.

"Once I had to help a woman who had a difficult labour. Normally it would have been fine, but were in a battle zone, and we couldn't get her to the clinic in time. She and her baby died," said another medic, Sa Muna.

Burma's healthcare system is teetering on the brink of collapse, and more and more ordinary people are looking to organisations like Dr Cynthia's and the backpack medics to help them.

"Even if there are radical changes, the country will need time to rebuild before it can care for its people again," said Dr Cynthia. "We'll be here for many years to come."
(BBC News, Monday, 5 March 2007)

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