Meet Our Patients (53): Nay Min Htet’s Story — Newborn baby

Than Than Soe, together with her husband, used to work as porters, carrying and loading cargo into trucks. While the job was very tough and challenging, the income was low and unstable so they decided to move to Thailand in search of better jobs.

“I delivered my first child at home by Traditional Birth Attendant (TBA) as I had no money nor any access to a health facility in Burma. Even in Thailand we cannot afford health insurance as it’s beyond our affordability as we live from hand to mouth. But now I cannot express how happy I am to be able to access to this quality health care service at Mae Tao Clinic without concern over money.”

 

Nay Min Htet is the newborn son of Than Than Soe, who is 25 years old. Than Than Soe has two sons including the newborn. She is originally from Bago region[1], Burma. She, together with her husband, used to work as porters, carrying and loading cargo into trucks. While the job was very tough and challenging, the income was low and unstable. She and her husband decided to move to Thailand in search of better jobs, and moved to Mae Sot area[2] at the beginning of 2018. Than Than Soe’s mother stays with them in an accommodation provided by their employer. They make a living by tenant farming, planting and harvesting rice, sugar cane and corn. She and her husband make THB 150 (USD 4.5) and THB 200 (USD 6) per day, respectively. However, the income is intermittent. For instance, now they have no work because it’s not yet the time for harvesting sugarcane. Both of them have no legal documents to stay and work in Thailand.

“If we had a work permit or residence permit, we can receive insurance for health care service and we don’t need to be afraid of Thai authorities to arrest or deport us. Nevertheless, we cannot afford it as it costs around THB 4,000 (USD 122) per person, including travel cost. As you can imagine, it’s beyond our affordability as we live from hand to mouth.”

 

Than Than Soe attended antenatal care twice and delivered a healthy baby at Mae Tao Clinic yesterday. There were no complications during and after the delivery. Reproductive Health Inpatient Department (RHIPD) staff provided her with multi-vitamin and analgesic tablets. Her newborn son received the 1st round of vaccinations.

“When I was attending antenatal care, Reproductive Health Outpatient Department staff gave me contact information. So, when I started feeling contractions I contacted the number and the clinic driver came to pick me up. It would have cost around THB 600 (USD 18) if I took a taxi. It was really nice of the staff to support the transportation,” said Than Than Soe.

“RHIPD staff are patient, kind and have taken good care of me and my baby. When I was living in Burma, I delivered my first child at home by Traditional Birth Attendant (TBA)[3] as I had no money nor any access to a health facility. But now I cannot express how happy I am to be able to access to this quality health care service, including ANC visit and delivery without concern over money.”

Than Than Soe will go to register the birth of her baby 4 days later with the help of MTC staff.


 

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In recent years, the proportion of complex cases in need of higher level care has increased, while the number of women attending our reproductive health clinic for normal delivery has decreased, which is likely due to improvements in services along the border. Our reproductive health team provides care to women through multiple services:

Antenatal care: Women are encouraged to come for at least four antenatal visits over the course of their pregnancy. Pregnant women are assessed following our protocol, which is regularly reviewed. Over half of women who were admitted at MTC for delivery came the recommended 4 times for ANC.

Family planning: We offer emergency, short, and long-acting reversible contraception (LARC) family planning options. Most women prefer contraceptive injections and need to attend the clinic every 3 months. The reproductive health team is trying to advocate for more LARC contraception methods such as implants or intrauterine devices (IUDs). Over the past 3 years, approximately 10% of women visiting for family planning received LARC.

Delivery: We aim to ensure specific training for our midwives, improved clinical supervision and improved infection control in the delivery room. We regularly review the patients we refer and monitor our referral outcomes. Of 2,327 admissions, 179 women (7.7%) were referred to Mae Sot General Hospital for advanced emergency obstetric care.

Neonatal care: We continue to face challenges in the management of premature babies and low birth weight babies, due to our limited resources. However, through improved staff training and parent education on monitoring of new-borns, we can achieve better outcomes.


[1] Bago is a city and the capital of the Bago Regionin Myanmar. It is located 91 kilometres (57 miles) north-east of Yangon (Capital of Burma/Myanmar). [Wikipedia: https://en.wikipedia.org/wiki/Bago,_Myanmar]

[2] Mae Sot is a city in western Thailand that shares a border with Burma to the west. It is notable as a trade hub and for its substantial population of Burmese migrants and refugees. Mae Tao Clinic is located in Mae Sot [Wikipedia: https://en.wikipedia.org/wiki/Mae_Sot]

[3] Traditional birth attendant: 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.

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