Mae Tao Clinic ThaiBurma Border

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Mae Tao ClinicThai-Burma Border

• Emily Sydnor
• University of Virginia School of Medicine
• Class of 2003

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Mae Sot, Thailand

• Western Tak province
• Humid, tropical environment
• 7km from Burmese border
• Border town with mixture of Thai, Karen, Burmese,
  and Chinese people
• 95 Buddhist, 4 Muslim, and the remainder are
  Christians, Hindus, or Sikhs

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Burma, A brief history

• Former British colony for over 200 years
• Gained independence from Britain in 1947
• In 1961, military leader Ne Win staged a coup and
  the military took control, oppressed the people,
  the economy crumbled, and they have maintained
  rule since that time.
• There have been many revolts and peaceful
  protests, with the largest being in 1988 with
  over 200,000 people gathered in the capital city
  of Rangoon, to peacefully protest for democracy.
  The government fought back violently and what
  followed was one of the most brutal massacres of
  non-violent demonstrators in history.
• Estimates are that 10,000 people were killed,
  although the world has very little record of the
  event since cameras and very few outsiders are
  allowed within Burma.
• People of different ethnic minorities who live on
  the borders of Burma, have been mistreated for
  years by the government, and have become the
  target of military brutality, as they murder,
  rape, or enslave people.

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The story continues

• In order to regain their reputation, in 1990 the
  military held the first nationwide elections in
  26 years.
• Aung San Suu Kyi and the National League for
  Democracy won 82 of the seats in parliamentary,
  yet the military has never recognized the
  election results.
• Aung San Suu Kyi was placed under house arrest
  for six years because the government feared her
  popularity and her movements for democracy.
• After the massacre of 1988, many students fled to
  neighboring countries as refugees or to live as
  illegal migrant workers.

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More

• Refugee camps in Thailand are at full capacity,
  often dirty, and the people have no chance of an
  education past high school, they are forbidden
  from making money, thus they must just sit and
  wait.
• People on the Thai-Burma border either live in
  refugee camps that they cannot leave, bribe the
  Thai government for Thai ID cards, or live
  illegally in Thailand with the everyday fear of
  being sent home by the Thai police.

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Dr. Cynthias Clinic

• Established in 1988
• Has grown over last 15 years and now provides
  free health care for Burmese refugees, migrant
  workers, and people crossing the border from
  Burma.
• Funded by NGOs and private donors
• Also a center for Health Assistant Training
  students come from camps along the border local
  ethnic health departments, or from villages
  within Burma.
• Most medics join the Back Packers Program and
  travel within Burma to provide assistance to
  Internally Displaced People.
• Awards won by Dr. Cynthia include the Jonathan
  Mann Health and Human Rights Award, the John
  Humphries Freedom Award, and the Foundatin for
  Human Rights Award.

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Services provided by the clinic

• Adult and child (including vaccination and
  malnutrition programs) general outpatient clinics
• Reproductive health and family planning
• Minor surgical procedures
• Prosthetic workshop for land mine injury patients
• Adult and child general medicine inpatient
  facilities
• OB/Gyn with two delivery rooms
• Trauma area for dressing changes, osteomyelitis
  treatment, etc.
• Laboratory whose functions are limited to
  malaria smears, Hb, urinalysis, glucose testing,
  blood typing, and screening donated blood for
  HIV, Hep B and C, and Syphilis.
• Blood donation center

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Clinic Life

• At any one time, roughly 300 people live at the
  clinic including medics, trainees, support staff,
  patients, and their families.
• The clinic is linked to a school program that
  includes illegal schools for children of medics
  and migrant workers around Mae Sot.
• Medics and support staff receive a small stipend
  and are provided with food and clothing in
  addition to accommodations.

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Annual Report 2001

• 53,320 total visits to the clinic in 2001
• Most common diagnoses were malaria, acute
  respiratory infection, acute diarrheal disease,
  malnutrition, and anemia.
• In 2001, there were 3130 cases of malaria treated
  in the OPD, and 1862 admitted to IPD for
  treatment. Case fatality rate was 2.
• The ratio of PFPV in the OPD was 1.51. In IPD,
  the ratio was 12.81.
• 563 births at the clinic in 2001
• 4492 antenatal visits
• Most common problems I saw were malaria,
  tuberculosis, acute diarrhea, upper respiratory
  tract infections, land mine injuries, and
  malnutrition. Others included rheumatic fever,
  tetanus, presumed typhoid fever, zoster,
  nephrotic syndrome, liver abscesses, worm
  infestation, scabies, and psychiatric problems.
• Accurate statistics are not available for
  HIV/AIDS due to lack of testing, even with
  presumed cases.

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