Mae Tao Clinic

We finally were fortunate enough to set foot in the famous Mae Tao Clinic run by Dr Cynthia (who was not there on our first day, so we haven't met her yet).  Our collective first impression was WOW.  Compared to what we've seen and experienced over the last 7 weeeks in Kenya and Lebanon, this clinic is so well organized, structurally appealing, clean, well staffed, FULL of patients who are calm and quiet, and incredibly multi-disciplinary (i.e. - in addition to the standard adult and pediatric wards, they have a fully functional dental clinic, acupuncture clinic, mental health clinic, prosthetic clinic, and school for unaccompanied children.

This clinic has been around since 1989, and was started by Dr Cynthia Maung and six "students" (referring to educated people within Burma who were part of the opposition, not specifically medical students) after a brutal military crackdown in Burma.  The clinic, or what would now more closely resemble a hospital, started out in a small rickety wooden building with only the medical instruments and medications that Dr Cynthia packed in a woven bag that she carried with her when she escaped through eastern Burma over the course of 10 days.  Today their budget is $2.9 million and has a staff that is primarily Burmese and Thai, but includes many foreigners.  They see 2,500 deliveries per year, and have been able to work with the Thai government to give these previously stateless newborns a birth certificate, which does not grant them citizenship or nationality, but does allow them to access the Thai education system (for regular tuition fees) and to have an identity.  Something we all take for granted - just to have an identity on paper.

We have been coordinating our time here with a woman named Eh Thwa, who introduced us to Kun Way, our liason on our first day.  As if a thick Burmese accent was not hard enough to decipher, add to it the local tradition of chewing Betel Nut and what you get is a conversation peppered with "what was that?" "i'm sorry, can you repeat that?" "huh?"  but he was great and very patient with us as we asked all kinds of questions about the clinic!

We ran in to a doctor in the OB/Women's Health department from UC Davis who frequently works at Mae Tao, named Terry Smith.  The maternal mortality rate within Burma is approximately 1/100.  That's insane.  Fortunately many women are able to come to the clinic here to give birth, and the clinic also helps train Traditional Birthing Attendants to be able to assess high risk births and know when to bring women to the hospital.  The woman laying next to her newborn was in the room for women in labor and recently delivered, she will be going home soon and will take part in a teaching seminar held under the shade of a tin awning, informing women on what to expect, and giving them options for family planning.  One thing I remember noticing was how many fathers were present for these teaching sessions, they seemed incredibly involved.

We came across the crowds of mothers and babies who came to the clinic on this sunny saturday morning for the vaccination clinic, which has been around for over a decade.   Despite the cries of the babes, the endless string of parents were so relaxed while they waited, and the set up was so streamlined.

The other photos are from:
- an empty 2L Sprite bottle holding all the used acupuncture needles at the acupunture clinic, which was started by a german MD/acupuncturist several months ago.  He says he gets sent all the patients who have failed all other treatments and are at their last resort.
- the lab where bloodwork is done, however they only have the resources available to check for malaria, check hemoglobin levels, check blood glucose, and one other test i'm blanking out on.  Some tests can be sent off to the Mae Sot Hospital (the local Thai hospital), but it's really frustrating when you have a patient with suspected liver and kidney problems and you can't even get basic liver function tests, urinanalysis, or basic chemistry panel.  They had a visiting hematology fellow from the U.K. who had taught them how to do a manual CBC (counting blood cells under the microscope - done by machines in developed countries), but they no longer do them.
- the eye clinic, where trauma to the eye, glaucoma, and cataract are common.
- the dental clinic...fun.

FYI - "Betel chewing has been claimed to produce a sense of well-being, euphoria, heightened alertness, sweating, salivation, a hot sensation in the body and increased capacity to work."