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Hitting the Streets for Healthcare

By Kyi Wai

May 25, 2007—Many in Burma who need proper medical attention do not go to hospitals or clinics but seek relief for their ailments at small grocery stores or sidewalk betel nut vendors in their wards and townships. The owners of these shops and stands serve as their unofficial “physicians” and “pharmacists.”

Aye Maung is one such patient who depends on the modest services of Burma’s street doctors. The 54-year-old Yangon [Rangoon] Eastern University professor opts for the services of a small street vendor in his ward.

When he feels ill, he prescribes for himself an antibiotic drug called Amxil, which he buys at a small stand near his home. The drug comes with no instructions for use, and he has no prescription from a doctor saying the drug is appropriate for his symptoms.

The professor suffers from pneumonitis, an inflammation of lung tissue, and needs proper treatment from a hospital or clinic, according to Dr Myint Aung, a Rangoon-based physician familiar with the ailment.

Fear keeps Aye Maung away from proper healthcare providers—fear that treatment would take up his whole salary.

“I can’t go to any of [the hospitals] because I don’t have enough money,” Aye Maung, who preferred not to use his real name, told The Irrawaddy.

Aye Maung, who earns 140,000 kyat (about US $110) per month, estimates that he would spend 15,000 kyat (about US $12) per day if he were admitted to a hospital. Costs would be much higher at a private hospital, where the resources and quality of care are much higher than at public facilities such as Yangon General Hospital.

The frequent use of Amxil has made his body resistant to the antibiotic, and his pneumonitis is getting worse. A hospital remains his last alternative. But if left unchecked, his illness can lead to irreversible scarring of the lungs.

“It’s very difficult to treat patients with this problem [pneumonitis],” said Myint Aung. “To cure those who have been avoiding proper treatment will take longer than usual. And that means it will cost more.”

Aye Maung and thousands more like him in Rangoon and throughout Burma are forced by economic considerations to put their lives in the hands of vendors who know nothing about healthcare or the pharmaceuticals they sell.

Khaing Soe suffers from heart disease and, like Aye Maung, cannot afford a trip to the hospital. A senior staff member of Burma’s Ministry of Livestock, Khaing Soe requires medication that costs 12,000 kyat (nearly $10) for a five-day supply.

Khaing Soe chose to rely on traditional medicines that are relatively cheap but do nothing to ease his condition. After three months, he collapsed in exhaustion and had to be rushed to the hospital.

“Whenever I am sick, I worry about my family. When we have to spend so much money, it puts a burden on my wife,” said Khaing Soe, whose wife works as a teacher at a middle school in Hlaing township, Rangoon.

Khaing Soe and his wife earn 84,500 kyat ($68) per month, out of which they support their three children. They now owe the hospital 300,000 kyat ($240) for Khaing Soe’s recent visit.

According to vendors in Rangoon, more of Burma’s ailing citizens are turning to traditional medicines, in numbers that are estimated to be four or five times higher than in previous years.

Those who seek help from Burma’s street doctors often end up with improper prescriptions that further complicate, rather than ease, their illnesses, said Myint Aung.

The doctor added that many of the drugs available from small shops and stalls are low-quality remedies from China, Vietnam, Indonesia and Malaysia—or worse, cheap imitations that will ultimately do more harm than good.


 
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