28, mother
ETHNICITY: Burman
BIRTHPLACE: Pyinmana, Burma
INTERVIEWED IN: Mae Sot, Thailand
Naw Moe Wai spoke to us on a bench outside the Mae Tao Clinic in the bustling border town of Mae Sot, Thailand. Her three-year-old daughter, Phyu Phyu, ran around laughing and shrieking gleefully as we chatted. The two had traveled over 450 kilometers from their home near Burma’s new capital, Naypyidaw, to seek medical care. Medical assistance is inaccessible to many living in Burma due to the high costs of treatment and lack of options for the poor. According to the World Health Organization, in 2000, Burma’s healthcare system ranked 190th out of 191. The Mae Tao Clinic serves Thailand’s population of Burmese migrant laborers and refugees as well as many who live inside Burma.
I gave birth to my second daughter Phyu Phyu in 2007. Two days after I gave birth to her at home, I realized that she couldn’t defecate. I had noticed that she had the shape of an anus but there was a small round ball attached to it, so I thought the doctors at the hospital would be able to remove that successfully in a short amount of time.
Many village people in my area believe that a mother must not leave the house during the first five to seven days after delivery. Since I could not go out, my elder sister took my newborn daughter to a few clinics. She had to pay 3,000 kyats to each clinic for the doctor’s examination,11 but none of them could solve my daughter’s problem—they said she was born without an anus.22
My sister and her husband took Phyu Phyu to the Naypyidaw Hospital that same day.33 I didn’t have money to cure her, so some people lent money to me so that she could be treated.
My sister’s husband came back at four in the morning and said my sister had to stay at the hospital with Phyu Phyu. The doctors had to do a colostomy on the side of Phyu Phyu’s stomach instead of on her buttocks, so now she passes stool through a hole in her abdomen.44 This was because the baby had the shape of an anus, but not the canal that joins it with the lower intestine. The surgery cost 100,000 kyats.55
My father told me I should cut off my attachment to my baby, because my husband and I didn’t have money to cure her. My mother went to the hospital, but she didn’t take me along because she was worried that my attachment to my baby would grow when I saw her again. They tried to give her up for adoption to someone who had money, but no one adopted her.
I feel very sorry for my daughter because she was born like this and no one loves her; the relatives from my husband’s side don’t love her. But ever since I delivered her, I’d become attached to her and felt responsible for taking care of her—I couldn’t abandon her.
When I arrived at the hospital in Naypyidaw, I felt so sorry for my baby I didn’t know what to say. I asked the nurse why the doctors could not make the anus on the buttocks, and she replied that they’d tried their best to do this, but the baby’s intestine was too short to reach her buttocks. The doctors needed to do an X-ray to figure out how to treat my daughter further, but the hospital was not big enough to have an X-ray machine.
Cleaning my baby’s surgical wound was very complicated, but after three days, the nurses wanted me to do this without their help. I had to buy the materials to dress the wound, and I had to pay for the baby’s medicine at a pharmacy. Every morning the nurses came and collected fees for cleaning and for use of the bathroom.
I experienced discrimination at Naypyidaw Hospital. I wanted the nurses to take care of my baby and explain things to me, but they would not answer my questions. They weren’t friendly. They only answered my questions if I bought them apples or tea leaf salad as a bribe.66 They don’t treat the patients equally. If a patient has money, for example a military official, they care for the patient very well, but they don’t do that for poor families. I just wanted my baby’s wound to heal quickly, and I wanted to leave the hospital as soon as possible because I didn’t have enough money to stay there for a long time.
After five days, a doctor came around to check the patients and she told me that the baby was well. She said that if I could take responsibility to clean the baby’s wound, then we could be discharged from the hospital. I didn’t get any further explanation.
In order to open up my baby’s anus and reverse the colostomy done in Naypyidaw, we had to seek advanced medical treatment in either Rangoon or Mandalay. I don’t know why the hospital in Burma’s capital city is so poorly developed. I tried to find out the cost, but I knew I wouldn’t be able to afford it. I even had to borrow money to pay for my trip to Naypyidaw—how could I afford the surgery? Then people told me it would cost 2 million kyats.77 I thought, Please don’t say that! I’ll never have that amount. We tried to ask for donations from other people, but it was too much; we couldn’t get it.
I ended up coming back home with my baby. I just regarded her condition as misfortune.
I STILL WANTED HER TO HAVE TREATMENT
I fought with my husband. I wanted my baby to have medical treatment, but I only made 1,400 kyats for a whole day’s work selling rice and corn.88 It wasn’t enough, because I had to spend 700 kyats for basic daily needs. Also, daily work was sometimes not available. So my husband and I agreed to play the two- and three-digit lottery, but then we became addicted—it was a big problem.
The most I ever spent on lottery tickets was 200 kyats, but my husband would spend thousands of kyats.99 This was one reason we started to have problems between us. I was hoping that if we won, I would be able to buy cotton and the other materials for my baby’s wound. I ended up in some debt, but not very much.
One day, a woman who had gone to work in Mae Sot, Thailand told me she could take my daughter to get medical treatment there. My husband told me not to go all the way to Mae Sot, but I was already planning to go. He asked for my ID card and all of the child’s medical records, but I didn’t give them to him because he would have burned them to stop me from going. I told him and my parents that if I didn’t go to Thailand, the child would never become a normal human being. It’s hard for me to talk about how my husband acted.
I was really happy thinking that my daughter would get medical treatment. I had always wanted to find someone to help her—if a person could help, I would do whatever that person asked. I would do it for my daughter.
I got all of my daughter’s medical records and my ID card, and I followed the woman to Mae Sot. I had never heard about the clinic and the organizations there, so I thought at first that the woman was paying to cure my daughter—I thought maybe she was very rich. I didn’t know that the clinic and the organizations were helping people by giving free treatment.
When I arrived in Thailand, my daughter was two years and four months old.
I WANTED TO HELP THEM, BECAUSE THEY ARE CURING MY CHILD
At the Mae Tao Clinic, there were lots of patients whose illnesses were more serious than my daughter’s. I found there was no discrimination in how people treated each other there. From the Mae Tao Clinic, my daughter was sent to the Mae Sot Hospital. They examined her, but they didn’t tell me anything. While we were there, a translator asked me, “Why did you come to get medical treatment here? Naypyidaw is very developed and Than Shwe is very rich—he celebrated his daughter’s wedding so splendidly, with diamonds.1010 Won’t he be able to cure your baby?”
The Mae Tao Clinic connected us with the BCMF—Burma Children Medical Fund—who sent us to Chiang Mai with an interpreter.1111 When we first arrived in Chiang Mai, I thought my daughter would immediately get surgery and recover very soon—but then I found out it could take years. But the BCMF actually provided us with accommodation and food, and they gave my daughter and me some clothes as well. Everybody was so friendly. At the hospital in Chiang Mai, I became friendly with the nurses. Here in Thailand, if a nurse or medic asks you to do something, they say “thanks” to you after you help them; it is very surprising to be treated with respect. I stayed in Chiang Mai for a month and a half. I was very happy because I could help cook, clean, and wash clothes for other patients. I wanted to help them, because they are curing my child.
Right now we have to stay at the Mae Tao Clinic in Mae Sot until Phyu Phyu can have the surgery, and then we will have to go to Chiang Mai again.
Here in Thailand babies undergo the anus operation by the time they are seven months old and they recover completely by the time they are a year and a half. But my child is now three years old and she hasn’t had the medical treatment. If I had known earlier, I would have come here.
I DON’T WANT TO GO BACK
I miss my village, because it is where I grew up. But the standard of living is high here in Thailand—people here use electricity switches and they cook with automatic rice cookers. We can also get free medical treatment here through the Mae Tao Clinic, and it doesn’t feel like people discriminate against each other.1212 I never saw that when I lived in my village, so I want to tell my parents about it.
Even though I miss my family in the village, it’s better for me to stay here to improve my daughter’s condition. I miss my parents and my elder daughter, who is nine years old. I left her in Burma with my mother and father. My husband went back to his village, so he is living there.
When we lived in Burma, the other children wouldn’t play with my daughter and she didn’t talk much, but now she is very confident—she plays and talks a lot.
I don’t want to go back to Burma. I found out from other people that children can study English, Thai, and Karen languages here, and they don’t have to pay a tuition fee at schools for migrant children. I will look for a job, and then I will send money to my parents so they can send my older daughter here—I want her to get an education. In Burma, I could only send my child through grade four because the primary school in our village only goes that high. After that, parents have to send their children to town to continue school, but I would not be able to afford that, and my daughter would end up doing work like the people in the village. I want my daughters to become educated people, because if they have an education they can choose what to do and they can help those in need.
1 Approximately US$3.
2 Imperforate anus is a birth defect where the rectum is malformed. It occurs in about 1 out of 5,000 infants.
3 Naypyidaw is 200 miles north of Rangoon, and has been Burma’s new capital since March 2006, when the government built it specifically to serve as the capital.
4 A colostomy is a surgical operation in which a piece of the colon or large intestine is diverted to an artificial opening in the abdominal wall in order to bypass a damaged part of the colon.
5 Approximately US$100.
6 Tea leaf salad, or laphet thote, is an integral part of Burmese culture. It serves a multitude of purposes, including as a palate cleanser and to welcome guests. Its flavor is colored by the use of fermented tea leaves, shrimp, peanuts and an assortment of sauces and spices.
7 Approximately US$2,000.
8 Approximately US$1.40.
9 Approximately US$0.20.
10 General Than Shwe serves as Commander-in-Chief of the Myanmar Armed Forces and chairman of the State Peace and Development Council (SPDC). He also heads the Union Solidarity and Development Association (USDA)—a mass organization that coordinates government at the local level. The amalgamation of positions means that Than Shwe is the effective leader of Burma’s ruling military junta.
11 Mae Tao Clinic does not send patients to Chiang Mai. This is done through the Burma Children Medical Fund (BCMF) or Burma Adults Medical Fund (BAMF). When patients get sent to Mae Sot hospital and get a referral letter to Chiang Mai for treatment, they go back to the Mae Tao Clinic and then get referred to the Burma Children Medical Fund program, which is independent of the Clinic. It funds the accommodation, transport, surgery and other costs involved.
12 Burmese migrants receive free medical treatment at the Mae Tao Clinic, which is located on the Thailand side of the Thailand–Burma border. However, migrants are not treated for free in Thai hospitals.