|
MYAWADDY,
Myanmar—The bustle on the main road of this border town
halts at the sound of powerful engines. Residents stare as
half a dozen olive trucks from Mae Sot, Thailand, rumble
across the 300 square meter-long friendship bridge.
The
vehicles are waved through customs and immigration
checkpoints. The convoy is bound for the Irrawady Delta,
300 kilometers west of this town, where an estimated
million folk await relief goods and medical care.
A man
spits and mutters. Friends shush him.
“He is
stupid,” our trishaw driver translates. “Asking for storm
so we also get free food.”
Asked
which part of the statement is stupid, the driver who asks
to be called Leh says, both. “He thinks people will
receive the food,” the 30-year old father of two shakes
his head, “only the Army is important.”
Conscription
Leh left
his parents in
Rangoon more than 10 years ago to avoid recruitment in
Myanmar’s
Army. The Karen Human Rights Group (KRHG), in its April
2008 report on children of a militarized state, cites the
Human Rights Watch October 2007 estimate on child soldiers
comprising 70,000 of the state’s 350,000-strong armed
forces. Rebel groups also recruit children.
Leh
avoided conscription by volunteering to help soldiers load
supplies as he made his way to the Karen state bordering
Thailand’s northwest. He recalls days of marching nonstop
for 14 hours. His goal: to continue his education past the
fourth standard (grade), which is the limit for free
schooling.
Tuition
here for the higher grades is half that of Rangoon but
still beyond the means of most families. Free is also a
euphemism; enrollment comes usually only after an exchange
of cash—5,000 kyat (around 50 baht) in the provinces and a
minimum of 10,000 kyat (100 baht) in urban areas.
For years
Leh worked five days a week and used the remaining two
days to attend free adult classes taught by a
nongovernment group in Mae Sot, across the Moei River. A
decade hence, Leh needs three more standards to graduate,
though he speaks better English than most of his peers. On
the steps of the Kyauk Lone Gyi temple, which gives a
panoramic view of lush Thai farms, he admits graduation is
now just a dream. He is married to a local woman—he calls
her “my lady.” Their priority is feeding a daughter, aged
5, and a two-year-old son.
Inflation
It is a
struggle. Soldiers get first crack at the local farm
produce. Thirty percent of
Myanmar’s Armed Forces, the equivalent of 273 infantry and
light infantry battalions, are based on the eastern Karen,
Karenni, Shan and Mon states and the Tennaserim division.
The Thai
Burma Border Consortium (TBBC), which monitors
displacement of civilians in the authoritarian nation,
estimates that 30,000 people have fled villages to evade
forced confiscation of foodstuff or conscription to farms
for the army’s use. More than 40,000 others evacuated last
year to avoid armed conflict or were forcibly relocated by
an army determined to deny guerrilla groups their mass
base.
There are
no gun battles in this town. But residents suffer from
having the best crops taken by soldiers and then paying
more for food trucked from Thailand.
Also,
Myanmar’s junta, which sports the unwieldy name of State
Peace and Development Council, doubled the price of petrol
and diesel products last year and jacked up the price of
natural gas five times from 2006 levels.
Soaring
food prices led to rallies in the capital of Rangoon,
provoking a bloody backlash that killed hundreds of
protesters and saw thousands more thrown into rural jails
or, in the case of monks, to remote monasteries.
The
upheaval did not affect this town save for a few monks and
activists taking shelter before crossing into Thailand.
But folk feel the same anger.
A meal for
a family now costs 4,000 kyat (40 baht), up from 2,000
kyat. Leh earns an average of 8,000 kyat daily. He and his
wife sacrifice the day’s third meal for the children.
Malaise
The
cyclone that devastated
Myanmar’s
agricultural heartland earlier in the month did not hit
this town or the rest of the Karen state.
Neglect
and corruption, and a brutal counterinsurgency campaign
are enough to mire citizens in poverty.
Past the
highway there is little economic activity. On a Friday,
mid-morning, idle folk throng the streets and dirt
sidewalks. Groups of men huddle over coffee or squat in
pairs, chewing betel nut. The busy ones bend over Singer
sewing machines of ’70s vintage; or they hammer at steel
and solder scraps into strange hybrids of tractors and
trailers and pickups.
A few
women balance baskets of fruits or vegetables on their
head; many more just stare from windows. Children run
around barefoot while their mothers chat. A baby screams
and flails her thin limbs; the snout of a huge black sow
travels up and down her legs. Women ignore the child’s
cries.
At a
village market, they also ignore the big flies that buzz
and crawl across pork and chicken parts. A dog comes up to
lick scraps from a plate beside the meat products; the
vendor just stares at it.
People are
lethargic. Children sport the distended bellies of the
chronically malnourished. Karaoke joints, at a ratio of
one per block, are the most animated places in the
community. Leh shrugs: “Nothing else to do.”
Contrasts
Most homes
here are shacks with outdoor toilets; people lug pails of
water across steep slopes. Yet, there are also a number of
two-story concrete homes and a smattering of four-wheeled
drives. Some residences sport a satellite dish; open
kitchen doors display gleaming new appliances.
“Boss,”
Leh says by way of explaining the bigger structures. It is
a word that translates into local government cronies. They
get second crack at everything after the military.
As we head
for the temple, Leh and other trishaw drivers swerve to
halt as trucks of soldiers clear traffic for a parade of
late-model pickups, sports-utility vehicles and one luxury
sedan. Most vehicle windows are down; the occupants are
all men, fair and clean shaved, natty in uniforms. Leh
says they are Thai and Myanmar officers. Cops wave us away
from a bend that was open two days earlier. Buildings down
that road are now being used to store food supplies that
await transport to Irrawady typhoon victims.
After
talks between Thai Prime Minister Samak Sundarvej and
Myanmar’s generals, some Thai medics have been allowed
access to disaster zones.
But
distribution of food supplies remain the sole turf of the
Army though the junta has promised to let foreign-aid
workers in, weeks after the typhoon left more than 100,000
dead and the country’s rice basket flooded.
Robbing
the poor
Leh is
apolitical and doesn’t care for any of the Karen rebel
groups. He can’t even bear to see an animal hurt and
rescues a butterfly from getting trampled.
Lack of
education, however, hasn’t made him ignorant. In the air,
his finger sketches a diagram showing the Army on top,
followed by civilian allies, with an X at the bottom to
show the rest of the citizens don’t matter.
The KRHG
report notes that the expansion of Myanmar’s army, the
country’s economic stagnation and “the military’s tendency
to concentrate wealth, power and resources at the highest
levels, leaving field personnel under-resourced,” has
strengthened local commands’ penchant to “live off the
land”—using guns to wrest free labor, food, money and
other supplies from local populations.
This has
created a scale of tragedy rivaled only by that in
war-torn African nations. Despite areas with agriculture
yields higher than Thailand, five million people are
considered chronically hungry. The dropout rate for
education is 50 percent, higher in the eastern states.
In the
border areas, a third of the children have chronic
malnutrition. The TBBC says 9.5 percent of all children
have acute malnutrition, higher than the national mean of
7.4 percent.
And don’t
even think of health services. Myanmar reserves 40 percent
of its national budget for the military. Education and
health allocation combined is less than $1 per capita.
Doctors on
the run
For free
and compassionate medical care, folk have to cross the
Moei River and head for Mae Sot, where Ramon Magsaysay
awardee for community leadership Dr. Cynthia Maung heads
the Mae Tao clinic.
It is a
compound of bedraggled buildings. Rows and rows of
patients and their kin sleep on mats. A youth with a
gunshot wound is carried in. A man cradles an unconscious,
emaciated child. A few minutes later a couple straggles
in, the man propping up a woman with a face so yellow it
matches the shade of a lemon. The woman has malaria. It is
endemic in the Thai-Myanmar border communities and last
year the clinic recorded more than 5,200 patients with the
disease. Some had infections from two or three of the more
drug-resistant species and 73 percent suffered from the
aggressive and often lethal type that attacks the brain.
The day
before, another severe malaria case came in. The
10-year-old boy’s body was wracked with shakes. An arm
constantly thumped his chest. Crying, he repeated a plea
again and again. A clinic staff, Saw Aung Than Wai, gave a
whispered translation: “He is saying, kill me now.”
At the
sight of a camera, the newcomers cower. They are
terrified, Maung says. Such is the fate of people who live
daily with institutionalized or whimsical violence where a
whispered word or a slip of paper could lead to death.
Maung and 12 companions who fled after the 1988 crackdown
on student activists launched the clinic in 1989. There
are five regular doctors and a 120-strong cadre of
volunteers—Burmese and Thai, Americans and a few
Europeans. They treat from 300 to 600 patients daily. The
numbers climb during monsoon season. Maung says around
half of these patients, some “from deep into Burma,”
comprise a quarter of the estimated 1,000 folk that
illegally cross into Thailand daily.
The
dangers of a border crossing means people come already
with advanced stages of a disease. Sometimes, the rest of
the family comes, too, fearing reprisal should authorities
learn they have sought help from someone the junta calls a
terrorist.
It is hard
to match Maung’s tired, smiling face with the junta’s
description of a bomber-assassin-drug lord. She knows
things are getting worse across the border because of the
growth in caseload: from 98,979 patients in 2005 to
107,137 in 2006 and 114,842 last year.
Admissions
increased from 8,319 in 2005 to 9,066 in 2007. Hardly
anybody is turned away except for a few critical surgery
referrals to the government-run Mae Sot hospital.
Health
vacuum
Gastric
diseases, acute respiratory infections are the least
serious medical cases. The clinic also provides simple
surgical procedures, more than 9,000 last year, mostly for
wounds and abscesses.
Severe
anemia, malaria, tuberculosis and HIV/AIDs are the most
serious ailments and Maung says
Myanmar
residents suffering from the last three outnumber migrants
in Thailand.
Of the 262
new HIV cases diagnosed last year, 55 percent came from
across the border. The median is 29, with roughly equal
male and female cases.
Maung says
1.5 percent of pregnant women who come in for antenatal
care are diagnosed with HIV. Detection allows the clinic
to enroll these women in a program that aims to prevent
mother-to-child transmission. It is, by all accounts a
successful program. Of last year’s 21 babies of mothers
with HIV, only one turned out to be HIV-positive.
The clinic
is overcrowded. Some HIV/AIDS patients live outside the
compound in makeshift housing with no electricity, running
water or sanitary facilities. Volunteers risk arrest to
carry medicines for those who live across the border.
Whether in
Myanmar or
Thailand,
counselors are careful to mask health visits because of
the social stigma that comes with the disease.
More
troubling is tuberculosis. The clinic recorded 220 cases
last year. Most patients, except for those whose TB are an
offshoot of HIV/AIDS, are not in a state to merit
admission.
Maung says
unless these manage to find temporary housing in Thailand,
they cannot receive the full course, which comes with a
protocol involving daily visits and monitoring by health
workers. Unsupervised medication could lead to a more
drug-resistant strain of TB. Daily crossings by volunteers
are just too risky. The clinic has tried to refer patients
to health-service organizations inside Myanmar, but these
also have limited access to populations on the eastern
border and “face particular severe restrictions in the
Karen area.”
Outside of
actual health aid, the clinic trains volunteers who then
go back to the eastern states as backpack doctors to fill
up the vacuum caused by the state’s policy to deny social
services to perceived insurgent supporters.
Detection
could lead to imprisonment or, even then, death. But in
many of Myanmar’s rural villages, these volunteers offer
the only medical aid folk will see in their lifetime.
Exiles
The
clinic’s operations are not perfect. An American volunteer
grumbles at what he calls a disorganized system. The
volunteer, a surgeon, says he could treat more patients if
procedures were streamlined.
But Maung
and her staff treat the problems of the psyche with the
same importance they give to physical ailments. Their
patients are poor, unschooled and often traumatized from
the dangerous crossing. Getting the case histories of
people used to the notion that talk is dangerous requires
long sessions of coaxing.
Dangerous
isn’t a word that fits the first impression of the border
here. Immigration cops act like guest relation
officers—friendly, with good English, the better to air
warnings about not photographing anything and anyone
official. Citizens with permits to work and trade cross
the bridge daily; some are ferried in rafts of huge rubber
tires.
But with
typical
Myanmar
government paranoia, the sick are accosted because they
give the exiled opposition propaganda ammunition. Thai
soldiers also stand guard for illegal crossings. So
patients are often smuggled at night by boats to points on
a 580-km stretch of waterway and then brought by land to
the clinic.
It has
been almost decades of work for Maung and her friends. She
still dreams of a homecoming but has stopped wondering
about the when.
“I never
thought that I would stay in Thailand this long,” she
confesses.
Like many
of her patients, Maung would rather be home. For now,
however, return is synonymous with death. |
