Meet Our Patients (54): 1 month old Nan Tha Zin

24 years old, a mother of a one-month-old daughter, Paing Mu started working as a babysitter or house cleaner in Bangkok from an early age instead of studying at school. She came back to her hometown before the due date as she could not afford the medical bill in Bangkok as she doesn’t have a health insurance. During and after the delivery, there were no complications but Paing Mu had to bring her daughter to the clinic again because her daughter has been coughing and feverish for a couple of days…

 

Paing Mu is 24 years old. She delivered her first child at Mae Tao clinic a month ago. She is originally from Myawaddy[1], Burma, until the delivery she has lived in Bangkok, Thailand. There are around 100 households in her village; most of them are subsistence farmers and daily workers. Since there is only one school providing education up to grade 7, some children who want to pursue their study should attend the school in a city, which is costly as their parents need to pay not only the tuition fees but also the accommodation and extra. For this reason, after the primary school, many starts working to support the family.

Among the villagers, some come to Thailand in search of better job opportunities, including Paing Mu. She never attended school. Instead, she started working as a babysitter or house cleaner in Bangkok from an early age. At her last job, she received THB 9,000 while her husband makes THB 10,000 at an oil factory per month respectively. She wanted to stay and deliver her baby in Bangkok if possible but realistically it was impossible due to the high cost of medical bills.

“I attended antenatal visit at a clinic in Bangkok twice and each time I had to pay around 700 to 1,000 Thai Baht because I have no health insurance,” said Paing Mu. “I didn’t think I could deliver my baby in Bangkok as I cannot afford the medical bills. That’s why I came back to my hometown.”

She delivered her first daughter a month ago in Reproductive Health In-patient Department (RHIPD) at Mae Tao clinic. Her daughter received the first-round of vaccinations and had no health issues after the delivery. Nevertheless, they came back to the clinic because for a few days her daughter has been feverish and coughed.

“Many villagers have been coughing a lot these days and I also started coughing. I wonder if my baby is weakened and being sick because of me.”

RHIPD staff provided her and her daughter medication. She was also provided a useful health education on how to prevent respiratory disease and promote child nutrition. Her daughter seems to get much better during the 3 days of stay in the clinic.

“I cannot thank enough Mae Tao clinic and donors for providing the maternal and child health services. Food, accommodation, and medical bills were all free before and after the delivery at the clinic. If I delivered my baby in Bangkok, I have no doubt that we would have been deep in debt. In about 3 months, we will go back to Bangkok to continue working and will take good care of my baby.”


 

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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] 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: https://en.wikipedia.org/wiki/Myawaddy]

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