During MTC’s advocacy trip in Taiwan, our former medical volunteer, Tseng Po-Chang, shared his personal experience at MTC that has highly influenced his choice of career and view on life with us and an audience of NGO workers. In his presentation he clearly elaborates on what MTC has been often facing.
“This girl from Burma, who injured her brain falling down a closet, has neither Thai citizenship nor Thai health insurance coverage, it might take hundreds and thousands of Thai baht or even a million. […] The doctor who took care of this little girl told me that it is a tough decision that whether they are going to support this girl to receive surgery with the budget from Mae Tao Clinic, because with the same amount of the funding, they might be able to support many more people to receive other simple but lifesaving surgery like C-section.”
My name is Tseng, Po-Chang. I graduated from Kaohsiung Medical University. I once worked at Taiwan medical mission in Burkina Faso. After this, I obtained Diploma in Tropical medicine from Liverpool School of Tropical Medicine and I will study MSc Global Mental Health at London School of Hygiene and Tropical Medicine for the following year.
When I just graduated from medical school, I made an application for a placement at Mae Tao Clinic, which has great influence on my later decision for my career and my view of life.
Firstly, I would like to talk about how I knew Mae Tao clinic. This is because of the book Mr. Sam Lai wrote, Our story on the Thai-Burma border for 2000 days. When reading this book, I come to know that many people suffer from war, poverty, and they are forced to leave home, cross the dangerous forest, river and those conflict areas scattered with landmines. They risk their lives to cross the border, and enter a country that they are unfamiliar with. Mae Tao Clinic and the story of Dr Cynthia are also mentioned in this book. From their stories, I found that I have so limited understanding about the role as a medical worker and how naive I was. I became more eager for exploring the other side of the world and how I can help people as a doctor. Especially, nowadays, refugee has become one of the most important global issues.
I would like to share with you about my experience and thoughts as a junior doctor, facing the medical dilemma on the border of Thailand and Burma. When I visited mae tao clinic, I just graduated from medical school, about the same age as Dr Cynthia when she arrived Mae Sot. I mat a little girl, who came from Myawadddy. In Burma, there is no well-established health insurance and healthcare system yet. As a result, people have to pay a huge amount of money for medical treatment, which is not affordable for common Burma citizen. This is why many people risk to cross the border and travel to Mae Tao Clinic, which provides free medical care to everyone.
The mother of this little girl left her and her father went to work in a far-away city, hence she stayed with her aunt. According to her aunt, she fell from a high closet and had some head injury. She probably needed some brain surgery, otherwise her life might be endangered.
So far, Mae Tao Clinic has developed into a great medical institute, a medical centre on Thai-Burma border. They have well organised departments, including medical, surgical, ob-gyn, paediatric departments. Many people for remote rural village also come to learn medical techniques, they undergo training to be probably the only medical profession in their own community. However, Mae Tao Clinic still has limited budget, because it relies greatly on donation. Some complicated cases such as those who need brain operation need to be referred to Thai hospital.
For this girl, from Burma, without Thai citizenship, without Thai health insurance coverage, it might take several hundreds and thousands of Thai baht or even a million. This is also one of the main issues of the healthcare for the displaced people: they don’t have a reliable party, such as a health insurance institute, providing easy access to medical care for all people. The doctor who took care of this little girl told me that it is a tough decision that whether they are going to support this girl to receive surgery with the budget from Mae Tao Clinic, because with the same amount of the funding, they might be able to support many more people to receive other simple but lifesaving surgery like C-section.
The following part of this story was sad, the aunt of the girl left secretly without leaving any words and she never came back. I think this might also be a heart-breaking decision for her, because this girl has become a great burden for the family. In many places in the world, for seeking medical help, people have to sell out all their properties and put the whole family in the risk of homeless and displacement.
I actually don’t know what happened to this girl in the end, by the day I left Mae Tao Clinic, she still lays on the bed unconscious. However, I often think of her, just like many other patients I met at Mae Tao Clinic. Just like a young woman I met at out-patient department. We did a test for her and I told her that she is pregnant. I still often think of her face, with a mixture of joy and some unexplainable sorrow, given the tough situation on the border for people to be pregnant. Although, I stayed at Mae Tao Clinic for a very shorty period, only a month, the stories of the people on the border, are like a mysterious call for me, to start my never imagined journey on my medical career, to explore more about the healthcare in resource limited settings.
I later decided to study tropical medicine in the UK, because I would like to gain better understanding and clinical skills for working as a doctor in the deprived regions. Sometimes people ask me: how do I feel for my delay on my original training pathway in Taiwan medical system due to my decision to receive alternative training in tropical medicine? Indeed, I have some complicated feelings since many my peers already went on further ahead of me in terms of the medical training stage in Taiwan. However, I would like to say: it is my experience at Thai-Burma border that changed my point of view for medical career and for life. I finally knew that in the world, life does not always follow a straight-forward pathway, many people, their lives are changed dramatically by war, by displacement. My story is nothing compared to them.
Besides me is an honourable person, Dr Cynthia. She also made a life changing decision, shortly after her graduation from medical school and she stayed on Thai-Burma border ever since, providing invaluable help for the displaced and poor people. Without doubt, she must have faced much more dilemmas, must have been forced to make much more tough decisions, in her lifetime.
(This article is originally from the presentation of our former medical volunteer, Tseng, Po-Chang, on August 23, 2017 during MTC’s advocacy trip. We highly appreciate Tseng, Po-Chang for his time and consent to the publication of his experience on our website.)