During the night, Myanmar military leaders took power in the country, declaring the state of emergency and suspending most of the communications through telephone and internet line for hours.
At the moment the situation is very precarious, as soon as the internet line was restored we heard the entire local staff acknowledging that they are fine, there are no problems in the Kawthaung area.
In this critical situation, we have decided to keep the doors of the Kawthaung Clinic open for patients who need our help, while we will suspend the Mobile Clinics in the coming days. This temporary measure was taken to ensure the safety of patients and our staff, to prevent the gatherings that occur during mobile clinics in the villages from being misunderstood with meetings for political purposes, endangering the most fragile people.
It is difficult to predict what will happen in the next few days. We will continue with our work to improve the health of the poorest people who do not have access to the Burmese health service.
Since the Coronavirus pandemic began, MedAcross has responded to local needs in the shortest time possible.
Our Kawthaung clinic is the only clinical facility open, in addition to the hospital, in the city. From the endo of March 2020 our MedAcross staff has adopted the protocols of physical distancing and deep sanitation. In this way we can guarantee care for the poorest families in the area and to target potential Covi-19 patients in Quarantine Centers organized by the government.
Since May we have been distributing Coronavirus protection kits to the poorest population in southern Myanmar, THESE ARE OUR NUMBERS:
Here is a short video that shows you a part of our actions to manage the ongoing pandemic:
In the Kawthaung district, the first cases of Coronavirus have been confirmed, if the pandemic were to spread in the region, the few health resources available would be exhausted within a few days.
Kawthaung hospital is the center of reference for all Coronavirus cases in the district, despite being without intensive care, without ventilators and with only 4 beds for the most serious patients. For these reasons, it is essential to concentrate all efforts on prevention to avoid an announced disaster.
MedAcross has decided to act in a capillary way, in collaboration with the health authorities of the region, the Red Cross and Istituto Oikos, to bring timely aid where there is the greatest need. Here is what we are doing:
If the pandemic were to spread uncontrollably, many people would die without any hospital care. You can help us by donating and following our activity!
If the epidemic arrives in countries like Myanmar, it won't be impossible to control: over 200,000 inhabitants live in the province of Kawthaung and there is no intensive care in the reference hospital!
As an association formed by doctors, we monitored the situation of the virus, activating preventive safety measures for the pandemic in progress. It's essential to continue our free health care for the poorest families who are more fragile during the health crisis.
We have alerted our Kawthaung staff to follow the rules recommended by the World Health Organization.
HOW WE ARE ACTING:
On MedAcross's spontaneous initiative, the staff received specific training to recognize the symptoms of Coronavirus and educate the population to change their habits to prevent the virus from spreading. In places like these, prevention is the only possible way, not being able to count on efficient healthcare.
In February 2020, we realized a new, big goal: to visit patients from the Andaman Islands, where there are no hospitals or pharmacies. As a first mission, we chose the island of Makyone Galet, 130 kilometers from Kawthaung. The families that live on this island have been fishing for generations, but intensive fishing from neighboring countries is threatening their environment, making them extremely poor.
When a resident of these islands gets sick, he has to go to the mainland to buy a medicine. Usually patients make the expensive trip to the hospital only when their condition is extremely critical. This unfortunately means that it is often too late to solve the problem.
To carry out this project, our medical staff from Kawthaung started the day at 6 in the morning, traveling two hours on the road with the Mobile Clinic to reach the coast. From there we embarked all medical equipment on a boat to reach the island. It was not an easy path. The sea can be very rough if you come across a sudden storm (a very probable reality in a monsoon climate). Arriving in Makyone Galet we found the local community to welcome us and helped to unload the bulky medical supplies. We set up a visit point under the shelter of a canopy. In one day we managed to visit 95 patients by providing many of them with their first structured medical examination, complete with a health booklet in which to record all the follow-ups of the next visits. To understand the importance of our intervention, read the story of Nilar, whom we met in Makyone Galet.
Specchio dei Tempi, at our side since the first day, believed and supported us in this new challenge to treat the most isolated people in Myanmar.
Luca Cordero di Montezemolo is the president of MedAcross' Scientific Committee and is a Pediatry professor at the University of Turin.
In October 2019 Luca decided to leave for Myanmar to closely observe the daily work of our new Burmese doctors: Thin Thin and Hsu Nandar.
Here is his account: "Today I am leaving with the Mobile Clinic to reach the village of Lone Phaw, on the border with Thailand, the journey is long and the day begins at half past six in the morning. The nurses and doctors talk and hum throughout the trip, making the two-hour off-road journey to the village pleasant. When we arrive there are already about thirty patients waiting for us. We set up the waiting room under a canopy by the river that separates us from Thailand and we have all the medical material to start the visits. The doctors and nurses divide the tasks so that they can visit all the patients, who have increased in the meantime. The visits last all day and I am pleased to note that the doctors, despite their young age, have excellent skills in managing patients. They are careful in understanding each patient's illness and in providing adequate care. The inhabitants of Lone Phaw and nearby plantations cannot afford to buy the medicines they need and live in places so remote that they can't get them (imagine you have to walk 80 km to buy an antibiotic!). When we visit chronic patients in Clinica Mobile, we provide them with the treatment that can last until our return, which takes place after about a month. Insulin for diabetics is critical, but the costs of sustaining these treatments are our biggest challenge."
Myanmar is the poorest country in Southeast Asia. In the Tanintharyi region, south of the country, the vast rain forests have been cleared to make way for oil palm plantations. 65% of the population lives in these places, mostly plantation workers and their families, without any kind of infrastructure. Here 30 thousand people live in wooden stilt houses on the sides of the plantation, without roads and separated from the first pharmacy or hospitals by hours of walking.
In March 2019, thanks to the contribution of Specchio dei Tempi, we start the Mobile Clinic project. In this way, we are able to visit 8 rural sites every month, which are two to four hours away by car from Kauthaung, our headquarters.
With this intervention we are able to provide free visits and medicines to 1000 patients every month who would otherwise be completely excluded from health services.
In one year we have treated children suffering from malnutrition and respiratory problems, provided antimalarial prophylaxis to entire families and managed many traumas caused by heavy hours of work on the plantations.
MedAcross started working in Myanmar in October 2016, renovating the Basic Health Clinic in Kawthaung which currently has over 3,000 patients treated, with an average of 50 visits per day.
The Kawthaung district is located in the southernmost region of Myanmar, on the border with Thailand. Of the over 200,000 inhabitants of the district, around 30,000 come from different regions of Myanmar with the hope of finding work in Ranong, the first Thai city on the border. Only 35% of the population lives in the city and can easily reach hospitals, clinics and clinics, while the remaining 65% live in rural areas, where health facilities are few and it's hard to find a pharmacy.
This region is among the poorest in the country and the costs of health services are prohibitive for most of the population. For this reason, we started our free medical treatment program in Kawthaung because where a hand is needed we put our heart into it.
In Kawthaung, in the extreme south of Myanmar, MedAcross works to guarantee the right to health for all.
In this area, sometimes extreme poverty makes it difficult for families to cope with daily expenses and access to healthcare is often at risk. In addition, the high school dropout rate turns into other serious social plagues: prostitution and the spread of HIV. The low level of schooling produces generations of illiterate people for whom it is impossible to find a decent job. In this situation, the only chance of survival is to sell your body but the consequences are devastating, especially in a society where AIDS still constitutes a great stigma.
The clinical activity will be officially started on March 5, 2017. At the MedAcross Basic Health Clinic, patients will be assisted by local doctors for complete visits and will be able to collect the drugs for free at the internal pharmacy. The nurses will also support the inclusion of HIV patients in the state program that provides life-saving drugs weekly, as well as managing the Nutritional Program, an economic support that allows families of patients in difficulty to buy healthy products and drinking water.
We want to share with you the story of C, a patient entered in the HIV program at the end of 2020, after the launch of the ongoing fundraising campaign on GlobalGiving.
At first she was very shy due to the strong stigma she has suffered since she discovered her illness. Over time, she has established a relationship of trust with MedAcross doctors and nurses, talking about her life which she defines as "a road full of holes".
"I was born on an island near the delta of the Irrawaddy River, in a large family of farmers. Life went slowly there before the arrival of the cyclone, which destroyed everything in 2008. In one night I lost many friends and family, the mud did not even bring their bodies back to me, I could no longer recognize any place of my childhood so I decided to move south with my sister. Arriving in Kawthaung we were deceived by an friend who forced us to become sex workers. I worked in a tea house until I met my husband with whom I rebuilt a normal life. I thought I had left my problems behind my shoulders, but after a few years I started feeling sick all the time: the doctors told me it was because of AIDS, hypertension and diabetes. I didn't know how to pay for my medicines and MedAcross helped me a lot. Every month I get visits and medicines and I follow the advice of the doctors who really support me."
Poe Poe Ei is 2 years old, weighs just under 5 kg, does not walk or talk. Medacross Mobile Clinic has been her first medical visit in her life in July 2020.
When we met her she had just passed bad pneumonia, she was in a serious situation. MedAcross doctor took her to the hospital in Kawthaung, where we paid for all her treatment during for her illness: malnutrition. Her hospitalization lasted one month, during that period of time was closely monitored by MedAcross doctors, in collaboration with hospital paediatricians.
We are continuing to support little PoePoe Ei from home as well, providing her with protein food and closely following her as she slowly gains weight and gains the energy she has lacked for so long.
In February 2020 we expanded the Mobile Clinic also on Boat.
The province of Kawthaung overlooks the Andaman sea, and where there are many islands cut off from any health service. As the only medical non-profit organization operating in the area, we have decided to act.
On the island of Makyone Galet we visited an 8 year old girl, Nilar, accompanied by the school teacher. Since she was born, Nilar has had a bad chest malformation. Visiting her, the doctors of MedAcross diagnosed her with severe arrhythmia, due to a heart defect.
Nilar's parents are Moken, a population of nomadic fishermen who have lived in these lands for centuries and have no access to health care on the mainland, so the girl never received a medical examination before we arrived on the island.
Unfortunately, in a country with so few resources, it is not possible to definitively cure children like Nilar. But what we can do is provide the medicines free of charge to give Nilar and children like her a normal life.
Kin is an 8-month-old girl, her mom brought her to our Basic Health Clinic in Kawthaung because pustules continued to form on her head. Sister Rosa, one of our nurses, has tried to remove the pustules previously hoping that it was a small skin infection so easy to contract in Kawthaung in the absence of sewerage and drinking water. But the pustules kept coming back and so did Kin and his mom at our clinic. Dr Ettore Rossi, one of our pediatricians from Turin visiting the Clinic was able to visit Kin in depth, discovering that the little girl had a more serious infection originating under the skullcap. At eight months the babies' fountain is not yet closed and this infection had crept into Kin's head causing those pustules. Our doctors intervened immediately providing the right antibiotic that could stop the infection and avoid causing much more serious damage. Kin's mom couldn't have afforded the antibiotic cure, so we provide all our patients with not only the visits but also all the medications they need. For free. Now Kin has learned to walk and has no memory of the time when he was sick, but knowing us in health is an important result. We know that without the right care today he would not be among us.
In Myanmar, the Mary Chapman School for the Deaf Children is the first and only school in Yangon for deaf children and provides free education for over 400 deaf children. In Myanmar public schools, there are no support teachers for deaf pupils, who consequently often encounter insurmountable obstacles in learning and only 1% manage to pass the exam at the end of the primary school cycle.
Nyunt Nyunt Thein, director of the school, tells us about the difficulties that her pupils, and especially the girls, face in everyday life, when they return to their villages for the summer holidays: "At Mary Chapman School girls can live in a safer environment because we all understand what it means to be deaf. In the villages, however, they are not so available and unfortunately these girls are sometimes also targets of rapists. Among our girls there are countless cases of rape that occurred during the break summer, when students have to leave Yangon and return to their villages for three months. Their disability and difficulty communicating with loved ones is used as an advantage for rapists, who sometimes come from their own family. Three months are long and often unbearable for our girls, we would like to be able to protect them even in summer, a moment that should be carefree and instead turns into a nightmare". Medacross happily accepted Mary Chapman School's request for help. In 2019 we will guarantee 25 girls and girls the certainty of spending a peaceful summer.
The MedAcross Mobile Clinic regularly visits a rubber plantation more than four hours by car from the city of Kawthaung. About 40 families live there with more than 100 children, also completely isolated from access to medical care.
Even today in the rural villages of Myanmar half of the children do not reach the age of 5 because the sting of a mosquito, a domestic accident or a simple virus can be fatal.
One of our patients, May, is 8 years old and suffers from asthma and was registered by the Mobile Clinic for the first time in July 2017. Although she had been ill for several months, she had never been able to reach the visiting area, because she lives with his family in a part of the village unreachable by car and about an hour's walk between steep paths and rubber trees. As soon as she arrived at our mobile clinic, she fell to the ground, exhausted by the journey she had undergone, mostly traveled on her dad's shoulders.
In August we went to find May who greeted us smiling and full of energy. For some months now she has returned to class, even though it is always difficult to reach school, more than an hour's walk from her stilt house.
May Thu Aye is 18 years old and comes from a large Hindu family. The mother lives and works in Thailand to send some kyat (the local currency) to the children left in Myanmar. Being her older sister, May had to take care of her little sisters, dropping out of school at just 11 years old to start working with her grandmother in the rice fields. Six months ago she learned of the existence of the textile workshop offered by the RNDM for young girls and immediately decided to participate in order not to miss this important opportunity. Thanks to the laboratory, May has found her way: her dream is to become a good seamstress and to be able to earn enough to help her sisters continue their studies.
Medacross works in Myanmar in collaboration with the Religeuses de Notre Dame de Missions. Sister Hellen works full-time to assist AIDS patients in Kawthaung and neighboring villages. Today a young mother was waiting for her with her baby girl, both suffering from HIV. The program is now famous in the region. Many like them come from villages hours away from Kawthaung to reach Sister Hellen.
Ma Ku Kuu, the mother, needs help to register in the hospital and get free medicines: sister Hellen knows all the procedures and there will be no need to ask the hospital staff anything: shame is the most difficult obstacle to face for an AIDS patient in Myanmar. Her little girl, who is also ill, shows no more than two years, is very thin but smiling, does not walk alone or speak yet. We ask for his age. He turned four in April.
Cho is a 24 year old girl. She lives with her father in the slum area of Kawthaung. She got AIDS 5 years ago, shortly after her marriage to an already sick boy who had never told her about her problem. Following the separation Daw Cho returned to live with her widowed father, who takes care of her with love.
During our visit she sits on a mat on the ground, where they both sleep. The wall behind it is completely bare except for two photos that portray a beautiful girl: she tells us that she is a couple of years ago. We find it hard to believe that it can be the same person who sits in front of us. It got a lot worse last month because her already weakened body had to struggle with a gastrointestinal virus. He probably drank contaminated water, but in Kawthaung drinking water does not come through the pipes, it must be purchased and its price sometimes touches $ 2.50 in the dry months, when there is no rainwater to collect.
As we leave, we think about how much difference between life and death can make it possible for her to be included in MedAcross's help program for HIV positive people.