Ed Wilkins in Myanmar: Week 18

Now as blog first paragraphs go, what follows would be oddly described in my teenage years and in the company of my long-haired hippy university peers as ‘heavy’, so apologies. But what is happening in Myanmar is just like a sequel in a box-set of ‘life-of-a country’ series. And it seems to transpire nearly every time a country emerges from stable autocracy such as military dictatorship when capitalist opportunities arise. And that is there are a few very lucky winners and a population of losers; the ‘haves and the have-nots’. In Myanmar where democracy is slowly but surely awakening, you are therefore witnessing the trappings of wealth with designer clothes, off the production line top-of-the range Bentleys, and jewelry or Myanmar bling being sported in a plethora of modern pricey bars, plazas, and super-posh hotels: capitalist society at its very worst. But at the same time, you also observe hand in hand the cruelty of modern life with an absence of any support for virtually everyone else who live a street existence unsupported by any semblance of a social system including good state health care. And of course, my home-from-home with reliable Wi-Fi is just such a place where denim jeans outstrip traditional longyis, and where everyone is buying muesli, cheese, and wine, all at exorbitant prices, including me.

Having had my cathartic moment for the day, I can start to write something a little more interesting. After all, there is a truer love than money and therefore, with very few exceptions, the Burmese love their country, lifestyle, food, culture, and of course leader Aung San Suu Kyi, and appear untouched by the affluence of the few. So, it was interesting last night to hear from a wonderful woman and her husband who have worked tirelessly for a decade to raise money for MAM through any number of initiatives, including charm but most importantly their credible passion for a worthwhile cause, that tourism is down because of the Rakhine issue and concerns that would-be tourists have over their own safety. There will always be a two-step forward one step-back emergence for such a country as Myanmar where interruption of the income generated from tourism will be a major setback. So, keep on coming everyone if not to work just to see this beautiful land on a well-earned holiday and support the livelihood of the local craftsman.

I often grump about the approach to patient diagnosis and try to get the MAM doctors to think outside the box of ‘TB until proven otherwise’ because the ‘proven otherwise’ part requires not only good medical training and knowledge but an excellent laboratory and imaging service to make or exclude the correct cause. It’s one of those which came first ‘chicken or egg’ scenarios: do you train the doctors to base their decisions on hard-to-obtain investigations, but which are expensive and take time to turn around at the private labs and at the end of the day will probably be a waste of time because patients are so sick and need to get on with treatment. Or, do you invest in the kits and hardware, so you can run the tests internally with a quick turn-around-time, but which means using limited revenue for something that may not be used efficiently. The answer of course is that they need to go up the aisle together. Until that time of course, as dear Tony would say, it’s a case of ‘Education, Education, Education’, which is my mantra also.

So, after what is now 20 weeks in Myanmar I have at last visited the final clinic in Yangon and number 7 on the list of the 11 clinics around the country (right). The clinic is only part run and financed by MAM and not without difficulty, but the partner NGO is the ‘Free Funeral Service’; not a catchy name for a clinic trying to promote health you might think (below left). But the history of the organisation is amazing. Initially, set up in 2001 by a film director to provide exactly what it said on the can, funerals for free for the poor, it has funded more than 100,000 funerals since inception and has since expanded into an ambulance transport service to get the sickly into hospital; recently it has commenced a refuse service to clean up the city. Any of you who have travelled around Yangon will realise how desperately this is needed. Finally, and of relevance here, they set up a health clinic – the number 5 MAM clinic in Yangon and the final one on my list – and where health messages abound (below). For those not in the know, H1N1 is one of the strains of influenza and we’ve recently had an outbreak. Interestingly the only two elements in English which therefore you’ll be able to understand (unless you’re Burmese!) are the two most important ones; the temperature and the word ‘mask’. Hopefully, the non-English speaking Burmese can understand these two words! Interestingly, I discovered that the President of the Free Funeral Service is one of the most successful leading men in Burmese cinema but an HIV awareness film he was involved in was blocked by the government censorship board in 2007 and I don’t believe has ever seen the light of day alas.

So, I’m going to finish this blog now as there’s still another to write tomorrow but with a slightly selfish theme, (I think I’m allowed to do that in my own blog at week 18) and that is to thank my family who have recently visited (right). I can’t say they exactly ‘roughed it’ during their holiday but they have certainly all made individual sacrifices to visit me out here. Most of all to my youngest who had to travel on her 19th birthday which is tough and because of the time difference she got five and a half hours less than what she was due. And then of course my wife, who has had to sacrifice her time with me to allow me to come here. Thanks. We all had a wonderful time!

Number 19 coming shortly.

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