Meet Our Patients (22): A New Born Baby’s Story

A newborn baby is an 11 days old boy. In his village, there is no clinic but there are a number of health workers providing primary health care. The baby was delivered by unskilled traditional birth attendants (TBA) with health workers in the village. When the baby was born, he has a congenital head defect (Myelomeningocele).

“We genuinely hope that Mae Tao Clinic can help us to get our baby treated,” said the parents during the interview.

 

A newborn (the parents haven’t named him yet) baby is 11 days old boy. His family lives in a small village near Hpa An area,[1] Karen State, Burma/Myanmar together with 5 family members. Among them, his dad works alone and makes around 5,000 Myanmar Kwat (USD 3.70)[2] per day. There are around 400 households and there is only one middle school in the village. While only a few students who want to pursue the further education after the middle school to study in different areas, a majority of youth finish their education at middle school as their parents cannot afford the further education.

In the village, there is no clinic but there are a number of health workers — local health workers of ethnic health organizations. If some have a serious disease they normally go to Hpa An General hospital. In case of a minor injury or a disease, villagers get treatment from the health workers or use traditional medicine.[3]

A number of health organizations used to come to the village to conduct medical activities, providing medical treatment and health education until 2 years ago, but they stopped their activities. Recently, new organizations began their medical activities in the village, providing immunization and reproductive health education.

Before the baby was delivered, the parents were seeing the health worker monthly to receive the antenatal care. The baby was delivered by unskilled traditional birth attendants[4] (TBA) with health workers in the village. When the baby was born, he has a congenital head defect (Myelomeningocele)[5]. The health worker sent them to Hpa An hospital and they stayed there for 2 days. After a number of tests, the doctor suggested them to go to the Yangon hospital for the better treatment. Nevertheless, the family could not follow the doctor’s suggestion since they could not afford medical expenses.

They called their relatives who live in Mae Sot for help and they were recommended to visit Mae Tao Clinic (MTC). Although it took one day to arrive at MTC, they came to seek the treatment for their baby. Unfortunately, MTC medic told them the baby cannot be treated at MTC but should be referred to the advanced medical facility. Following the MTC referral procedures, the staff discussed the case with partner organizations whether a case of the baby can be supported. While the family has been waiting for the answer from the staff, the baby was admitted to the MTC Reproductive Health In-Patient Department (RHIPD) in the past 1 week. The parents are heartbroken due to the baby’s health condition.

“We genuinely hope Mae Tao Clinic can help us to get our baby treated,” said the parents during the interview. “We appreciate MTC and its staff to continuously look after our baby, show us kindness and help us whatever we need.”

 

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While our numbers of consultations and admissions were slightly down compared to previous years, the bed occupancy rate increased as did the length of stay of our patients. There are more basic primary health care facilities opening up in Eastern Burma and MTC is part of the Health Systems Strengthening project to support these clinics. Our data shows us that we are seeing more complicated cases coming to our clinic as these patients are not able to be treated in Burma. 10,705 children under five were treated at Mae Tao Clinic in 2016. This is 20% of the total client load. 19,319 were women of reproductive age which is 35 % of the total client load (54,521).


[1] Hpa An is a capital city of Karen State, eastern Burma, that shares the border with Thailand.

[2] Currency rate: US$ 1 = MMK 1351,35 [4 Jan, 2018]

[3] For instance, during the interview with a number of patients, we found that many believe that when one has diarrhoea taking curry powder has a curative effect.

[4] A traditional birth attendant (TBA), also known as a traditional midwife, community midwife or lay midwife, is a pregnancy and childbirth care provider. Traditional birth attendants provide the majority of primary maternity care in many developing countries, and may function within specific communities in developed countries. [https://en.wikipedia.org/wiki/Traditional_birth_attendant] Mae Tao Clinic has been providing two levels of training: a 6-month Community Health Worker (CHW) Training and a 2-year Health Assistant (HA) Training to health workers from numerous health organizations both in Thailand and eastern Burma. In the curriculum of the training, Laboratory Training and Traditional Birth Attendant (TBA) training is included.

[5] Spina Bifida, which literally means “cleft spine,” is characterized by the incomplete development of the brain, spinal cord, and/or meninges (the protective covering around the brain and spinal cord).  Spina Bifida happens when a baby is in the womb and the spinal column does not close all of the way.  Surgery may be required to correct the spinal defect. Additional treatments may depend on the type and degree of complications. For example, patients may suffer from nerve damage that causes co-occurring urinary incontinence. These patients may require catheterization. Two types of Spina Bifida are:

  • Myelomeningocele is the most serious type of Spina Bifida. With this condition, a sac of fluid comes through an opening in the baby’s back. Part of the spinal cord and nerves are in this sac and are damaged. This type of Spina Bifida causes moderate to severe disabilities, such as problems affecting how the person goes to the bathroom, loss of feeling in the person’s legs or feet, and not being able to move the legs. [Burma Children Medical Fund: http://burmachildren.com/who-we-are/conditions-we-treat/neurological-conditions/]