Where there are no doctors (WWW.WTINAD.org)
Burma, the predominantly Buddhist country famous for rubies, heroin, and fierce fighting during World War II, lies to the west of Thailand and to the south of China. A British colony until the end of WW II, Burma gained independence in 1948 but quickly fell under brutal military rule. Many ethnic tribal groups, including the Akha, Karen, Lahu, Lisu, Mien and Mon were subjected to especially severe treatment. The military would come to a village, steal all of the rice, shoot and then eat the farm animals, rape the women, kill the men, and conscript the children. (This type of ethnic violence has continued in Burma until recently. The current victims of ethnic violence are the Rohingya Muslims- most likely migrants from Bangladesh generations ago- who have been fleeing Burma in the tens of thousands, creating a refugee crisis that is one of the worst in world.)
These hill tribes fled the violence and have tried to create new lives for themselves by practicing slash and burn agriculture (mainly rice and bananas but more recently coffee) across the border, on the very steep hills of Northern Thailand. However, even after one or two generations, these hill tribe villagers remain in a state of permanent limbo because the vast majority of them are ineligible for Thai identity cards which are necessary for employment and to obtain even the most rudimentary medical care.
During the 50 years of military control in Burma there have been sporadic attempts to protest the political oppression and economic mismanagement of the ruling junta. Unfortunately, these protests have been violently suppressed. One such pro-democracy uprising occurred in August, 1988 and is known as the 8888 uprising. This predominantly student led uprising was brutally suppressed and thousands of protestors were killed. (The 1995 critically acclaimed film Beyond Rangoon starring Patricia Arquette is about the 8888 uprising.) The 8888 uprising led to the arrest and imprisonment of Aung San Suu Kyi, who would later win the Nobel Peace Prize in 1991. One student organizer of the 8888 uprising was a second year medical student named David Mar Naw. Though many of his friends were slaughtered by the military as they crushed the student led protests, David escaped to the jungle and eventually made his way to a United Nations refugee camp on the Thai/Indian border. After more than a year in the camp, David was scheduled to be resettled in Canada, but a benevolent missionary gave David another option- he would pay for David to resume his medical education in India. After several false starts, which including escaping a Burmese Military Intelligence spy, David was able to finish medical school in Puna, India. After several years practicing medicine in Southern India, a Burmese friend who had been resettled in Canada contacted David and told him about a NGO operating in Northern Thailand. In 2002 David moved to Thailand and began working with the hill tribes of his native Burma. He quickly left the NGO (“all the money stayed with the NGO and none of it got to the villagers”) and started to work on his own, providing medical clinics in several hill tribe villages on a rotating basis.
He quickly realized that most of the medical problems facing the villagers resulted from poor water access and lack of sanitation. To address the root of these illnesses, Dr. David mobilized visiting volunteers from all over the world to construct toilets and water collection systems. By laying hundreds of meters of PVC piping, he was able to install systems in multiple villages to transport water from uphill freshwater springs to the villages. By installing one toilet per household, he was able to halt transmission of gastrointestinal illnesses, as well as prevent the spread of diseases prevalent in villages with communal toilets.
Life in the villages, which we experienced through a homestay with a local family, is very basic. Without electricity or running water, these villages are completely isolated from Thai society. Families live in stilted homes, made from bamboo and teak, with homemade straw roofs. A central mud hearth occupies much of the living room, often filling the house with smoke due to lack of chimney or vent. Underneath the bamboo planks, animals roam freely. We woke each morning (at 3am) to the first crowing of the roosters, followed by the second and third crowing at the far more reasonable 4am and 5am! Pigs, ducks and dogs also roam free, with an occasional water buffalo in the more low-lying fields.
Life is lived very close to the floor – there is no furniture of any kind in the home. Sleeping is on mats under mosquito netting in the corner of the living room. Cooking is done on the floor near the hearth, and the food is cooked on a wok over an open fire. Breakfast and dinner are the main meals, and both are similar. Breakfast included a stir-fried chicken (killed and plucked early in the day) – one rooster down! Hill tribe rice, a delicious short -grained variety, harvested and threshed by each family, makes an appearance at every meal. As does chili paste, made fresh each day from charred tomatoes, onions, Thai chilies and garlic.
Dr. David continues his rotating medical clinics, and now serves 50 hill tribe communities. We contacted him directly through his website www.WTINAD.org , and were able to arrange for our family to accompany him to serve 2 villages, accessible only by 4-wheel drive and by crossing a fairly wide river with no bridge. About 2 hours drive from the nearest city, Chiang Rai, these villages are truly off the grid. Prior to leaving Chiang Rai we had stocked up on medicines from a pharmacy that Dr. David trusts as they also supply the hospitals in the area. (Counterfeit drugs are very common in Asia and add an additional burden to already underfunded and overburdened healthcare systems.) Dr. David pays for medicine and his other projects (water collection, toilets, schools, and livestock-check out the website above) entirely through the donations of his volunteers. Fortunately, a relatively modest sum of US dollars buys a lot of medicine in Thailand. Clinics in the two villages were held in churches- competing Catholic and Evangelic missionaries have been active in the areas for years. Excuse my cynicism but these missionaries have built churches but have not built schools, wells, or healthcare facilities. They have even left small communities of no more than 30 families with TWO competing churches – one Catholic and one Evangelic. Well at least these churches provided an excellent space to run a health clinic and as soon as we rang the bell, the villagers hurried to our “clinic.” The villagers we saw were mainly suffering from gastritis, respiratory illnesses (cooking with open fire within their houses certainly must contribute to this) and poor nutrition (their rice based diet is low on vegetables and protein). Thankfully, because of Dr. David’s water and toilet projects, there were few diarrheal illnesses.
In addition, with the aid of his volunteers, Dr. David’s organization is currently funding the education of 50+ hill tribe children- including several nursing and midwifery students. We found our experience with Dr. David to be excellent and inspirational. His tireless advocacy and care of the hill tribe villagers has had an immense impact on their health and quality of their lives. We strongly recommend this volunteer opportunity – especially for medical students or physicians/NPs/PAs who want to volunteer along with their families.