Meet Our Patients (48): Eh Ken Ler’s Story – Bowel Malrotation

In the last 5 months 3 years old Eh Ken Ler’s health condition has gotten worse. When she arrived at Mae Tao Clinic, she had a number of symptoms, including vomiting, thirst, sunken eyes, fatigue and very skinny but swollen tummy. Child Inpatient Department staff examined her and detected holes in her big bowels. She was diagnosed with Intestinal obstruction and perforation


After the operation and continuous treatment, Eh Ken Ler’s health condition is getting better

3 years old Eh Ken Ler is a daughter of Ma Aung, who is 48 years old. Ma Aung has five children: 3 daughters and 2 sons, from 3 years old to 31years old. Her eldest son has already married. Apart from one of her daughter, who studies in the village, both parents and the other four children cannot read or write because they have never studied at school.

Ma Aung’s family lives in Myawaddy[1], Karen state, Burma. Her family members are subsistence farmers, working in their rice field on the mountain. Sometimes, especially during the rainy season, she together with her husband is working for their neighbours’ or villagers’ rice fields to make extra money — they make up to 10,000 Myanmar kyat (USD 6.9) for each time.

Her youngest daughter Eh Ken Ler got sick in the past five months.  She sends her daughter to Myawaddy hospital for the treatment. The doctor could not help her daughter and suggested that she should go to advanced level hospitals in bigger cities. She, however, didn’t go, more likely, she couldn’t go because the medical bill is beyond their affordability.

Her daughter condition was getting worse. So she decided to come to Mae Tao Clinic as she knew about the clinic from villagers. It was the first time that she visited the clinic. She came to the clinic by car and it cost 740 Thai Baht (USD 22) only for the one-way trip.

She arrived at the clinic in the evening. Her daughter, Ma Aung, has a number of symptoms, including vomiting, thirst, sunken eyes, fatigue and very skinny but swollen tummy. Child Inpatient Department staff examined her with ultrasound and detected holes in her big bowels. Medics and consultant doctor diagnosed her as Intestinal obstruction and perforation and provide antibiotics and Intravenous fluids to disinfect and stop her from vomiting. Child IPD staff carefully monitored her condition and referred her immediately to Mae Sot General Hospital (MSGH). Mae Tao Clinic provided a part of the referral cost. She was showing symptoms of bowel malrotation so she was operated at the hospital.

After the operation, Eh Ken Ler came back to Mae Tao Clinic, receiving treatment while waiting for the follow-up visit to MSGH.  Her mother really wants to go home as for the farming work but medics at the clinic strongly suggested that her daughter should stay and be monitored until her condition gets better. Thanks to the operation and Child IPD staff’s intensive care, Eh Ken Ler has gained weight and her condition is getting better.

Our patient, Eh Ken Ler and her older sister in the Child IPD ward

“I cannot thank enough to Mae Tao Clinic and all staff who have taken good care of my daughter, especially their prompt diagnosis and referral. If I didn’t come to the clinic, the only option that was left to me was to just look after her at home and pray to get better. Mae Tao Clinic saved my daughter’s life, so I really thank you all.”

Mae Tao Clinic sees an increase in patient caseload with non-communicable diseases (NCD), with the top-5 of most common diagnoses making up for 80% of the cases diagnosed. 

Most common non-communicable diseases (2017)

Diagnosis # of Patient % of total NCD
Diabetes 299 29.6%
Hypertension 226 22.4%
Thyroid 102 10.1%
Asthma 96 9.5%
Epilepsy 86 8.8%
Other 202 20%
Total 1,011 100%

Mae Tao Clinic has referred 64 patients with chronic non-communicable diseases patients to different government facilities in Burma for continuation of life-long regular treatment. Patients can decide where to go and Mae Tao Clinic facilitates the referral. However, some patients cannot bear the costs associated with government treatment and return to Mae Tao Clinic. We also need to further develop the feedback system between MTC and referral facilities.

[1] Myawaddy is a town in southeastern Myanmar, in Kayin (Karen) State, close to the border with Thailand. Separated from the Thai border town of Mae Sot by the Moei River (Thaung Yinn River). [Wikipedia: