Threads of Resilience
We are sharing a series of journal entries that the author, JH, contributed following an invitation from Insight Myanmar for publication on our website. She includes the following message: The following entries from my journal along the Burma-Thai border were first shared more than 18 years ago. On the advice of a respected teacher, they were distributed only on paper, so as to protect involved parties while raising awareness. Later, when the Internet became available, many of us still hoped in our hearts that these descriptions would soon become obsolete. Finally, I offer these words here in realizing that certain details remain far too accurate. May they bring benefit. Please forgive my youthful ignorance and arrogance. Errors are my own.
“She likes my nose. She is interested in how straight it is and its narrowness at the nostrils. Her nostrils are more round and the cartilage surrounding them flared.”
Burma Border Journals #12
“Don’t forget vitamin A and worm infection prevention.” So says the laminated sign over the medication table in Child OPD. Unlike yesterday, one of two busy weekly vaccination mornings, there are no drop-in families waiting on the mat. Today is Thursday, no big deal on a universal scale, but here it is the day the Thai police happen to do their checking for papers along the road between the clinic and one of the fields where migrants farm. This basically means that walking to work I passed a huddle of about twenty people; some men dressed in well-fitted black uniforms and shiny shoes were patting down each person gruffly, herding them with batons into a mini-bus with bars for windows. These were probably our patients. Sometimes they get caught two blocks before entering the compound after spending all their money just to travel to the clinic. Other times they emerge carrying long sought after medicine, only to have it confiscated.
Even on the other six days in the week, the journey has its price. Yesterday, we saw a sixteen- year-old male with malaria resistant to outpatient treatment. We wanted to admit him, but he said he could not stay. He had nothing left and felt that above else he needed to go back to where he came from. But with poor health, no food, no bus money, he was rather stuck. The clinic dipped into a small pool in its budget dedicated to such circumstances and found him a ride in the back of someone’s truck.
My eyes fell to the Mefloquine on the table. I asked one of the medics who specializes in malaria, if they encounter patients with Mefloquine-induced psychosis, a known side effect of the drug. I ask because I have not seen anti-psychotics on the donation-limited formulary. “Oh yes,” he replied, “they have to drink very much fruit juice all better.”
As impressive as the packed child immunization clinic, which employs the same schedule used by my own pediatrician, plus Japanese encephalitis and tuberculosis prevention, is the HIV outreach program. I amble over to discuss outreach efforts to factories aimed at detection and prevention of the stigmatized disease referred to here as “442.” The following day we will visit one of the many orphanages and its school. In particular, we will see a site caring for children whose mothers have been kicked out of the house by husbands in denial of AIDS.
When I eventually do speak with one of the mothers, she is lying on a cot by the door, an emaciated pin-up for African starvation. One provider from the malaria institute, who trained in an impoverished village on that continent so much more famous for malnutrition than Asia, says that even though the doctors here live more comfortably it ‘feels worse because the people they serve are not free.’ The women in this home can receive much sought-after treatment with donated antiretrovirals but only when they develop full-blown AIDS, as in the case of this woman first encountered, her skin covered with various opportunistic processes I have never imagined. At the clinic, they only get the medicines if found by MSF to have concurrent TB. So in a sense, it’s useful if the patients there can catch TB. She looks up from where her limp arm dangles, fingers grazing the floor, and glares me straight in the face; her first words are “You afraid of me.” “No,” I said. “No, I’m not.” She softens in surprise and gratitude. I take her hand, and she warns me, “People no touch me they fear.” I cannot say fear does not arise, or that precautions are not employed. After one of the children, separated from family and too sick to attend school, drools and chews lovingly on my hat string, I throw it in the dumpster and rub my hands with a giant dollop of the cleanser I carry with me. The woman feels like the hatstring.
On the way to plan for the morrow’s outing, I run into my favorite medic. There is a grounded warmth in her manner, not demanding of speech for connection, just present. Why did she want to learn medicine asked another student. She didn’t actually, but her community needed someone to do it. That was years ago, and now they need her to teach it. So, she teaches. She adopted a disabled boy this year, one who everybody thought would die. When he could only lie there, it was next to her that his little body lay for as long as he needed. The boy walks now. My friend sleeps less well with son at her side but says she doesn’t feel tired. She and I bonded the week before while she instructed me in traditional midwifery skills. There being a dearth of patients in her department today too, she drinks a cup of something and is actually on the verge of sitting down. It turns out the mug contains just boiled hot water. Why, because she ate something too spicy; her mouth is burning up. She explains that traditionally one fights hot with hot; if one is cold, one bathes in ice-cold mountain water. For fatigue, the treatment is to carry a heavy load, slowly. She likes my nose. She is interested in how straight it is and its narrowness at the nostrils. Her nostrils are more round and the cartilage surrounding them flared. I imagine our skulls without the noses, our teeth flapping and tattering, that friendly sense of affection somewhere; where exactly is the difference? Her approach is functional, suiting her affable yet practical personality. She met an African once and considers her nose between mine and his in shape, attributing the evolution of such variation to regional weather, how the hot air carries more moisture, how the smells carried differ with climate.
This talk of temperatures reminds me of what I learned last night, that in Burma the mother wakes up early to cook a spicy dish. It is eaten then for breakfast by the entire family, packed cold in boxes for lunch. What remains is consumed for the evening meal as well; they only re- heat dinner if serving Westerners. Yes, that is how it is, she confirms, but this, like a number of customs, has been imported from India. She begins to list the other activities, and when she gets to chewing betel nut, I interrupt to inquire about cheroot smoking. No, those are Burmese. The conversation switches to tobacco. She draws me a picture of the blossom; it is white or sometimes yellow with a single, sizeable seed. It grows by the river in the rainy season; she thinks it’s pretty. Yes, I too have seen it in my explorations. We happily discover a mutual fondness of flowering plants. Then she draws another flower. This one grows in the high country, Shan or Kachin territory. “Cold season it likes. Whole field color, very beautiful. Many tiny seed, tasty in cake. Old medicine use the root only, even if very strong, no danger, no poison, good medicine. Now gun make farmers grow for drug, use liquid inside.” Poppy.
May this writing heighten awareness about the plight and great beauty of the people from all parts once called Burma. May it bring benefit to all who are described herein and to all who read it. May you be truly happy.