Day 1 at the Mae Tao Clinic

Aung San Suu Kyi

In the midst of all the leaving-London mess, I hadn’t really thought about what I would be doing for my once-a-week placement at the Mae Tao Clinic.[1] And so my first day there was a daunting one.

The clinic is a sprawling, plant-filled complex of one-story buildings located just off the Asia highway, outside the center of Mae Sot. I was dropped at the entrance by a tuk tuk and jumped off the back in my grey hospital skirt outside a row of dark, shed-like food stalls with roofs made out of corrugated iron and dried leaves.

I instantly felt inappropriately dressed – although the skirt was knee-length (as per advice from the ‘Volunteer Orientation Manual’) almost everyone else was wearing a longyi. Tugging self-consciously at my waistline, I wandered in and around and tried to figure out how to find the ‘RH OPD’ (Reproductive Health Outpatient Department). This was only piece of information on ‘where to go’ I had discovered on trawling through my inbox the night before.

I followed some dusty signs with uterus drawings on them, passed an open-air delivery ward where a baby’s slick black head was crowning, tentatively stepped into a large room filled with pregnant-looking women, and introduced myself to someone sitting in a small office who seemed to vaguely register who I was. She sent me into another room where I was adopted by one of the health workers and sat down with a jolt for row after row of consults in the antenatal clinic.

Having no real O+G experience aside from medical school, I had to concentrate hard to remember/pretend to remember how to take an antenatal history, measure a fundal height, feel a cervical os, and determine estimated date of delivery (EDD) with that cardboard wheel-calendar thing. The health worker – a very patient, slender, seemingly sweat-proof woman in a clean, light-coloured shirt – seemed to figure out quickly that I was essentially useless, and relieved the awkwardness of the situation by both acting as a translator and telling me what to write in the notes. She was very good-natured about it, smiling and twittering quietly in clear but broken English in response to my frequent questions. The patients seemed bemused whenever I spoke directly to them – this was a bit disconcerting. 

MTC fanThe room was sticky with heat and I tried to position my plastic chair directly under the fan. Embarrassing moments included not being to find the fetal heartbeat 3 times in a row, then being asked to interpret a bedside ultrasound (I could barely make out the gestational sac in that swamp of inscrutable grey lines). And as the day went on I felt more and more uncomfortable, partly because I was dehydrated from all the sweating, and partly because of the pressing question: what is the point of me being here when I don’t speak Karen or Burmese, don’t know anything about O+G, and am only going to float in, ill-equipped, saddled with a mild but ridiculous white-saviour complex, for one random day per week?

I was relieved to be sent out for a break. I bought a longyi – a sarong-like tube of material that goes down to the ankles – from a makeshift hospital store that was dark, dank and covered in dust. For lunch I had a fluorescent orange chunk of fried chicken thigh, a small plastic bag full of noodles and some water from a flimsy bottle that tasted like chemicals. I swallowed it all in front of two expectant dogs, then stood under the shade of a large tree in the middle of the main passageway holding a green apple, feeling faint and staring blankly into the heavy air. Lost in a blur of human activity.

The Mae Tao Clinic was started by Dr Cynthia Maung when she was a young doctor fleeing the brutal repression by the Burmese military in the wake of the 1988 student uprising. From its beginnings in a small, run-down shack, it now provides an extensive range of free health and social services to an estimated 150,000 refugees, migrant workers and other displaced groups living on the border. Around half travel to the clinic from the Burmese side, where healthcare is essentially non-existent. Many belong to ethnic minorities (mostly Karen).

As I stood there eating the apple, I thought about how it was less sterile here compared to other hospitals I’ve been in – both literally and metaphorically.

MTC sinkThe toilets have splintered wooden doors with rusted locks and a plastic bucket floating in a dark pool of water for a flush. There are dregs of rice blocking the sinks, and cracked eggshells in the gutters. The soap is diluted. Gloves are scarce. But people seem more connected – less alienated and scared – with healthcare being this intertwined with everyday life. As per the website, the MTC is “not just a workplace…it is also a home” – there is an on-site orphanage, and 95% of the staff have themselves been displaced from Burma.

I went back to the RH OPD after lunch less naïve and more reluctant. The afternoon session was much the same, except the health worker wasn’t there anymore and none of the others paid me much attention. I spent some time taking blood pressure and walking in and out of different rooms, and attempted to communicate with staff and patients but didn’t get very far without intensive help. And when my longyi fell down while listening in vain for another fetal heartbeat, I decided to give up.

I left early, back on a tuk tuk through the searing afternoon heat. At the guesthouse I collapsed under my anti-mosquito tent and fell asleep in the dark with the air-con on.

I’m strongly attracted to the MTC, the buzzing humanity of the place – but one day a week won’t be enough to get the hang of things, let alone contribute anything. And I should probably ask to be moved somewhere other than the RH OPD (or anywhere else RH-related).

I remember now reading something about the problem with short-term overseas volunteering, but I didn’t pay much attention at the time. It suddenly seems very clear: I am here asking the MTC for help, rather than the other way round.

[1] The rest of the week will be spent working at a community-based women’s organization


3 thoughts on “Day 1 at the Mae Tao Clinic

  1. I agree with the sweat-proof lady comment, it was a fun bit. And the dogs bit was also pretty visual. I love how you
    describe things!
    As for the rest, Ok it sounds pretty challenging, but Day One is challenging even at the local pub!you just need time to learn some basic vocabulary and figure out how the hospital even have a longyi now!
    big hug!

    • Tx C, big sweaty hug to you too! Don’t worry I have a strategy in place to overcome dilemma – today I assisted with hernia operations in theatre wearing the longyi and thongs (flip flops). Like a Boss. Not really.

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