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Our Eye Clinic renews the sight of hundreds of people every year who, without our help, would lead incredibly difficult lives in Burma.
The eye care department began modestly in a bamboo shed in 1995 with three eye medics doing exams, treating basic eye diseases and refracting and dispensing donated eyeglasses after being trained by a border eye program. By the end of 1996, the medics were able to see 30 patients a day and started an outreach program in the Karen state (this was later discontinued due to security reasons).
In 1997, with the support of Karen Aid, and under the auspices of the IRC, a surgical team from the United Kingdom began facilitating on-site eye surgery. Initially there was just one annual visit, in which approximately 10 surgeries were performed. Nowadays, the team comes three times a year, performing 400 to 500 eye surgeries.The patients come from nearby factories and refugee camps, as well as from inside Burma, sometimes as far as Mandalay. Most have cataracts or glaucoma; others are victims of landmines, or suffer from infections or inappropriate application of traditional medicines.
The department is currently staffed by twelve full time eye medics: one eye clinic program manager, one clinical supervisor, one optometrist and several community health workers and volunteers. In the last decade the clinic has grow to offer a variety of different services:
- Facilitation of eye surgery for cataracts and glaucoma
- Eye screening and eye health training for teachers in migrant schools
- Treatment of eye infections such as trachoma (the leading infectious cause of blindness in the world)
- Overseeing and running a mobile eye-clinic outreach service in the Mae-La district
- Facilitation of eye health training for teachers, interns, nurses, health assistants, backpack medics and community health workers
Although the surgeries are provided free to patients, financial difficulties are still present for patients and their families who, in most cases, have to borrow money or sell livestock to pay for transportation and expenses incurred in getting to the clinic. High transportation costs, the risk of arrest, and the inability of family to accompany them makes it difficult for some patients to access the clinic. These difficulties also make it hard for the clinic to carry out follow up care and assess long-term success. In recent years, the clinic has received a large number of patients and their families; this causes overcrowding of the clinic’s halls, rooms and any possible space under the shade of a tree.
There are still only basic instruments, a limited supply of eyeglasses and lack of space to treat large amounts of patients. Unfortunately, some of the patients must leave disappointed.
The Dental Clinic serves as not only a treatment space, but also helps patients by educating them on what kinds of foods to eat to avoid dental problems, as well as prmoting oral hygiene.
The MTC Dental Clinic opened in 2001, operating three days a week as an adjunct part of the surgery department. At first the clinic had limited resources, with just a couple of dental mirrors and tools for extraction. The surgical medics that attended dental training in Bili Htoo saw three to five patients a day.
Over the years the clinic has received help and support from generous volunteers, including Dr Michael Travis from the United States, who has visited the clinic since 2004 and has donated much of the equipment; and Dr Bo-Im from South Korea, who trained the medics to perform root canals in 2008.
Today the dental clinic is an independent department with a staff of 11. It has new facilities with three donated chairs and high speed pneumatic dental drills. The specially trained staff see 20 to 30 patients each day.
For impoverished patients, it is common to delay treatment until an infection rages out of control. Patients are forced to spend their savings on one visit to the doctor in Burma, making prevention and early treatment impossible. The medics recall the sad story of a 9 year old girl whose father brought her to the clinic from Burma with a fever and swollen face caused by an infected tooth. The dental medics wanted to admit her to the pediatric ward, but her father had to return to Burma for work. They gave the family antibiotics and asked them to come back for a follow-up. By the time the girl returned, the bacteria had spread to her bloodstream. They sent her to Mae Sot hospital but it was too late; she died of septicemia.
Almost all the patients seeking dental care at MTC have never before visited a dentist. In addition to their primary complaint, eight out of 10 patients also have cavities they aren’t aware of. The problem, dental medics say, is that most patients have little education and don’t understand the importance of oral hygiene.
“Dental care is very important,” says one medic. “It is a part of health. Before, people didn’t understand. They only [associate] malaria and diseases like that with health. [A tooth infection] starts because of lack of knowledge about how to clean and take care of the mouth. It gets worse, sometimes turning into an abscess if you do not get appropriate treatment. Lots of suffering, pain, fever. It can cause osteomyelitis, an infection of the bone.”
The staff know that prevention is the best treatment, and they try to improve oral health through activities for the children, teaching them how to brush their teeth; our new Child Recreation Centre is now able to help with this kind of education, turning learning about oral hygiene into fun games for the children at MTC. Through the school health program, which operates in 58 migrant schools, the medics from the dental clinic use didactic tools to demonstrate the difference between good and bad food and the importance of dental care. They also warn children not to chew betel nut, which is very popular amongst the Burmese population, because this increases the risk of oral cancer. The clinic diagnoses many cases of oral cancer, but due to the lack of resources staff can only help with pain medication.
Challenges and Looking to the Future
For some time, the dental department has had a shortage of instruments, as they are not available for purchase locally, thus they must be ordered from Bangkok, which means they can take a long time to arrive at the Clinic.
The dental medics dream of being able to offer x-rays and dentures some day. In the short term they hope to acquire small dental instruments, a copy of Color Atlas Endodontics and a dental surgery book.