Reaching out from the river

The rice farmer is 81 years old, and his back is bent from decades of work in the paddies. U Mya Oo can now barely climb up onto the examination table. His hands are shaking and he has |difficulty breathing. For weeks |he has been waiting, and suffering, for there are very few medical |doctors in the Irrawaddy Delta of Myanmar.

It often takes hours of travel to reach a doctor’s surgery. But in this case, the doctor has come to him – a medical services vessel has docked near Oo’s village.

“My daughter brought me here in a row-boat. Our village is a kilometre away,” he says. Since 2014, the Artemed Foundation of Germany has financed the vessel of the River Doctors with donations. The idea was born after Cyclone Nargis devastated the delta in the bitterly poor country in 2008, claiming 140,000 lives.

At the time a military regime was in power, and only reluctantly permitted outside helpers to enter the country.

“We also wanted to help out after that catastrophe,” says project director Aung Thein Myint. Since 2010 the ship has been in service, year in and year out. It can also reach villages during the rainy season, when roads and fields are under water.

Farmer Oo first gets an infusion to shore up his reserves. His daughter is watching through a screen door from outside, her face showing her worry. From a smartphone somewhere, pop music can be heard, while out on the river, a boat with a sputtering motor putters by. Its waves gently rock the former rice freighter now serving as a floating medical clinic.

The patients are desperately poor. Those who can might leave a few cents on board for the doctors. Nobody who needs medical attention is turned away. The ship operates throughout the year in the delta’s many branches. It can reach 12 villages a month. On board are a doctor, a dentist and three nurses.

“In the past we had to go to a hospital in the next town,” Oo’s daughter says. “With the row-boat that took three hours.” 

After five decades of military dictatorship, Myanmar’s health sector is hopelessly underfunded. Since 2011 the country has been slowly opening up to the outside, but all the same, in 2014 only 6.5 per cent of the budget went to health, compared with 30 per cent for the military. There are not enough doctors, health assistants and modern equipment.

“The situation is worse than in other countries in the region,” says Alyssa Davis, an adviser to the aid organisation Save the Children. The government has started now to put more money in the health system, she says, but it is far from enough.

The ship also has to get by on tight funding. Electrocardiogram testing equipment, some infusions, and a few medications is about all there is on it. The hygienic standards are far from satisfactory. Oo, the farmer, gets an asthma spray in his mouth, and after that, the nurse takes a piece of toilet paper to wipe off its mouthpiece before putting the spray back on the shelf. Doctor Chit Pe between carrying out an ECG and listening to Oo’s heart rhythm, is eating a salad.

Nikolaus Behr, a medical student from Hamburg doing a two-week internship on the vessel, comments about the hygiene: “The standards would shock the average German.” He makes the remark while removing some cooking oil-saturated bakery items lying right next to the cabinet with the medications. “Ants,” he says. “A hygienic catastrophe!”

The floating clinic of the River Doctors treats about 100 patients a day while at berth, or a total of 25,000 a year. Most people come with high blood pressure problems, asthma and heart ailments, Pe says. Because many people also eat rice that is rich in glucose, diabetes is also a problem. Oo the farmer must above all try to get his strength back.

“I’m doing better now,” he says after the infusion. “I am happy that I am finally getting some help.” Then he climbs onto his daughter’s row-boat for the ride back to his village.