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Thursday, 9 September 2010

Jo, Myanmar (Burma) - Building a sustainable healthcare system

Going over notes after a day in the field

I have now been in Myanmar (Burma) for a month and have seen and done so many things for the first time in my life, that it really feels as though I have been here for at least a year!

I arrived in Yangon, the capital, on the 30th July and had to spend the next four days waiting for my travel authority so that I could go down to the Delta region, where I am working.  After four days in Yangon I left for Pyapon, the town where I am living and working.  The drive from Pyapon alternated between no miles an hour (as the car negotiated some gigantic pot holes) and careering at breakneck speed when there were short stretches of relatively good tarmac.

My first impressions when I arrived at the office were that I was never going to get the hang of peoples’ names.  How am I ever going to learn to say Hlaing Yu Maw let alone remember it? So I started by bonding with 2 nurses called Doris and Diana and gradually the other names started to sound more familiar as I got used to them.

Making a house a home while on a healthcare mission

The expat house is old fashioned but has a certain charm, at first sight it seemed very basic compared to the lovely comfortable airy house in Yangon.  I quickly got used to no running water or reliable electricity and I am enjoying the bucket showers and living by candle light.

It is a wooden building, completely unlined, which makes it terribly noisy.  Every sound that is made outside in the street can be heard clearly from inside the house. When the dogs howl outside my bedroom window, it sounds as though they are in my bed with me.

There is also a lot of uninvited livestock trying to share it with me. I really don’t mind the little frog about the size of my thumb; it is sweet and comes into the shower with me. But the mice, the huge hairy spider and the bats will definitely remain uninvited guests.

My mission

My job title is health advisor.  The Doctors of the World programme covers 131 villages in the Pyapon Township (a township is an administrative district similar to an English county) and by the time I had been here a few days I was really beginning to see how my mission is going to pan out.

The programme was first implemented in January last year to strengthen existing (or barely existing) primary health care in this township following the devastation of Cyclone Nargis 2 years ago. The project has reached a stage where it needs to move on and become more sustainable and advice is needed about how the training and supervision can best be organized to achieve this.

All my conversations with the local people are done through an interpreter, it really isn’t very easy, because the interpreter and I hardly understand each other. The language sounds half English and half Burmese, which is a tonal language and SO different. They don’t seem to use consonants at the end of  words and so they  actually find that very difficult to do. I am beginning to get used to interpreting things like “chah” as meaning “child”. When the logistician assigned my bike to me, he told me that it was “Nuh Zeh Nah”. It took me a while to realize that my bike was “Number zero nine”!

The commute to work

I cycle to work each day.  It is the rainy season at the moment – and it really knows how to rain here!  I haven’t yet mastered the technique of riding one handed holding an umbrella. The roads are so bad, that I need both hands to cling on for dear life, so I have borrowed a poncho, and I am going to try not to worry about the torrential rain. The route is quite flat and takes about 10 minutes. The morning ride in is during the rush hour and the road is packed with bikes and rickshaws. It’s chaotic with all traffic going in different directions and none of it complying with any sort of road rule that I am familiar with. At the moment I am the only European in town, so I am very obvious as I negotiate my way through the traffic with my very white hair.  I am beginning to see people that I recognize and we wave at each other.  I’m almost a local!

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