Thai clinic heals neighbours

Athey, an ethnic Karen, lost his foot to a landmine in the Myanmar jungle and was taken to the Mae Tao Clinic Thailand for free treatment.

Mae Sot, Thailand // Cutting down trees for timber deep in the jungles of Myanmar can be a dangerous place to make a living. Not only do workers need to watch for falling trees, but also landmines in the area. Athey, a 38-year-old ethnic Karen, was one of dozens of men working in the dense bush to support his family when he stepped on one of the mines that blew off his left leg.

"I walked into the forest to cut trees for a new monastery," Athey said. "The monks hired me to get wood. They said they would pay me 200 kyat [Dh110] per day. "I am very poor. I don't have any chance to make a living there." After the blast he found himself torn and bleeding, riding in a car bound for Dr Cynthia Maung's Mae Tao Clinic, two hours away in Mae Sot, Thailand. He could not afford to pay for a trip to a Myanmar hospital and, as an ethnic Karen - a group that has been targeted by the country's military junta in a long-running conflict - he feared persecution in the state hospital.

Although the clinic itself could not perform the surgery he needed, they paid for his treatment at a hospital across town and now, two weeks after his accident, Karen craftsmen at the Mae Tao Clinic are fitting Athey with a prosthetic limb. Dr Maung, also a Karen, is well-known among the ethnic group in the border region. Her clinic pays for schools in Karen worker communities and boarding houses for orphaned children, and the clinic staff visit villages throughout the region.

Each year the clinic trains hundreds of medical staff as medics, specialised technicians capable of returning to their villages and saving lives by treating the most common illnesses. The clinic employs hundreds of Karen who might otherwise be out of work. The clinic, which treats between 200 and 400 patients a day, is open to anyone, though almost half the patients are from Myanmar. Dr Maung opened the clinic in 1989 as a single building on the outskirts of Mae Sot, almost within sight of the Myanmar border. She fled her country in 1988 after the notorious 8888 uprising, a national civilian protest demanding democracy that left thousands dead. Although she left her country, she vowed to continue to help her people through her clinic.

Her work has won her international praise. Over the past decade Dr Maung has won half a dozen international awards, including the Ramon Magsaysay Award, considered Asia's Nobel Prize, and she was listed in 2003 as one of Time magazine's Asian Heroes. Even so, the doctor can usually be found working at the clinic. Except this week. This week Dr Maung is dealing with another emergency. It is donor conference week and the clinic is strapped for cash.

"We can say that for the clinic we need to increase funding by 10 to 20 per cent every year because caseloads increase and the number of staff we need to train increases," she said. As the situation in Myanmar, formerly known as Burma, worsens across the border, trauma cases have become more frequent. "For us, the situation inside Burma is getting worse and worse," Dr Maung said. "The poverty and the human rights abuses are all getting worse, so people are coming to Thailand, but Thailand doesn't provide enough job opportunities or social services to immigrants."

She estimates about 250,000 Karen live in Mae Sot and most are illegal, which means they cannot get affordable health care in Thailand. Without her clinic, few of her patients would have any other access to medicine. "If you budget for 80 malaria cases but 100 cases come, what will you say?" she said. "Will you say, 'no, we won't treat them?' " She receives annual support from the US and Canadian governments as well as a few other large donors, but a lot of her funding is piecemeal.

She said about 40 per cent of the clinic's funding is assured. "Sometimes we have to wait until September before we know how much we'll receive." She said her clinic and all its subsidiary activities can operate on about 80 million bhat (Dh8.5m) a year, but Dr Maung said she was hoping to increase her budget to rehabilitate some of the ageing facilities and to help more patients with the cost of surgery and referral.

The rising price of food has also added to the clinic's costs. A food shortage in Asia drove up the price of rice and the clinic, which feeds more than 5,000 people a day, had a chunk of its budget disappear within weeks. "Since the food prices have increased it's become a big challenge this year," she said. Yet she is hopeful. In its first decade the clinic has become a focal point for a community and Dr Maung is determined to keep her clinic going.

"This clinic has become a community network for strengthening the co-ordination within the Karen community," she said. "We also train people to work and go back into their own communities. We provide assistance to the needy people but it's also an opportunity for people to learn medicine and skills to help their communities." [e-mail]