Thirteen weeks in Myanmar…

This will be my 13th week in Myanmar where I have gradually adjusted to how utterly different every day experiences are – living here is endlessly fascinating, beautiful and can also be quite complex.

Shwebo (aka Shwebes) and work
Most of my time (Monday to Friday) is spent at my hospital base of Shwebo, with the weekends free for adventures. Shwebo is a town 3 hours north-west of Mandalay which is famous for ‘Thanaka’ – a pale, creamy yellow paste made from ground bark which many women and children in Myanmar wear on their faces in different shapes. It has been traditionally used in Myanmar for thousands of years as a sunblock, perfume and skincare.

Work is settling into a routine with daily ward rounds, 6 teaching sessions a week and supervising the junior Doctors in assessing and treating patients. The junior Doctors and nurses work several nights and 24 hour shifts a week, but despite such demanding shifts, they are enthusiastic, dedicated and a pleasure to work with. Our main project of teaching Emergency Paediatric care to hospital staff has involved delivering 5 day courses at different towns in the delta region for the last two weeks. It has been rewarding, but also pretty challenging at times – teaching simulation in near darkness because of frequent powercuts in the storms demands improvisation! iPhone lights are super helpful when demonstrating CPR…

Nature
Nature definitely has the upperhand in this geography and climate – before the storms, most of April and May was spent under a crushing heatwave upto 46C. It was pretty relentless but has finally cooled down now the rains have arrived. There has also been an earthquake and a cyclone in Myanmar which really made me realise the tangible and unstoppable forces of nature, especially for people whose homes are not built to withstand those threats.
Life on the road
We have done a fair bit of travelling on buses, which is a fascinating window into people living in rural villages and towns. In the delta, the homes are bamboo and wooden rickety structures on stilts interspersed by stretches and swathes of water. The homes are linked to each other or to the road by make-shift bridges and boats. Alot of the farming is with huge water buffalo, which are pretty bizzare to see as I open my phone to take a photo and find 3G signal. The area looks incredibly beautiful at sunset with the tall palm trees reflected in the contrast of the flats of water between bright green paddy fields.

Mini-adventures (without my mini)

We’ve been so lucky to have made lovely new friends in Myanmar who have shown us their beautiful country at the weekends. My favourite trip so far was to Pyin Oo Lwin – the flower city. We visited waterfalls and cave systems stretching for hundreds of metres full of shrines and buddha statues amongst the stalactites & stalacmites.

Another memorable trip was visiting an orphanage and nunnery with a friend from the UK who goes there weekly to play with the kids. We took six kilograms of homemade playdough which developed into a whole lot of colourful fun-filled chaos. It was a really special day, but the reality is that many of the children live at the orphanage because of fighting in their home region. It was pretty tough to walk away and say goodbye to them.

Myanmar celebrations

We are made to feel so welcome in Myanmar, and have been invited to attend birthdays and family weddings. Birthdays here are selfless and genorous celebrations, where there is traditionally a trip to the monastery or pagoda, with donations of food or money made to the monks.

Wedding are momentous events, with the finery of traditional Myanmar dress worn at its’ most beautiful. The outfits are intricately decorated and in so many different bright colours. During the ceremonies the couples hands are tied with cloth and then water is poured over to symbolize the marriage.
So that is some highlights of Myanmar so far. Today will be half way through my time here, and I can’t believe how quickly it is flying. Thankyou to all my lovely friends and family for keeping in contact – it makes being away from home much easier 🙂

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Myanmar adventures

I’m very lucky to have had some time to explore beautiful Myanmar. Last weekend we took a trip to Bagan which is a world heritage site with more than 2000 pagodas which are upto 1000 years old. We explored the maze of rusty ochre coloured structures on electric scooter riding through a jasmine scented hot breeze. The pagodas are linked by dirt tracks which feel like passages of ancient time, a contrast to the hilarious task of handling an electric scooter which swerves from under you at any hint of sand on the tracks. Climbing the steep, narrow and dark steps inside the pagodas is not for the faint hearted, but totally worth it for the views – fog settles deep and thick in the trees all the way to the horizon, with pagodas rising up everywhere, their shadows changing continually through sunrise and sunset. It’s kind of lucky as those times of day happen to be the only bearable times to go outside in the heat!

On my birthday we visited the Jade Market – an arrangement of ramshackle tin huts which can be described as something between a stock market and factory production line. Jade is mined heavily in Myanmar and bought to the market as huge watermelon sized chunks which are first quality checked by men sat around rickety tables studiously assessing their clarity with a special torch light. After haggling for a price, they are cut on site into jewellery before being cased in bright glass cabinets in more professional looking tin huts. The whole process is fascinating, but the story behind the country’s wider jade trade is full of ethical problems.

Politically, Myanmar is facing exciting times of change, with a new government cabinet starting this week after more than 50 years of military rule (though the military still hold 25% of seats). An example of the mindset which is ingrained here is that we discussed ‘rights’ in the context of ‘Children’s rights’ with a group of Doctors & Nurses. The concept of having ‘rights’ is a taboo subject, which our group remained uncomfortable to discuss.

There was a public holiday for the full moon last week, which involved a sunset trip to Mandalay hill with some new friends from the hospital. We are moving to our permanent hospitals next week, so will get to see some of the countryside.

Thanks for reading 🙂

Enjoy the photos 🙂

Yangon

Wow, Myanmar has definitely been a real cultural experience so far. I’ve been here for 12 days of my 6 month stay, and it feels as if I have moved planets, rather than just countries. Life is incredibly different here, but refreshingly so.

Looking out from the 11th floor of my hotel window in Yangon, the rainforest pushes back against the barrage of expanding buildings. The golden Shwedagon pagoda (the epitome of gilded!) rises above the city and takes on an ethereal glow at night. Downtown is made up of colonial buildings, which are in varying states of (almost charming) disrepair.

An exploration around town reveals some fun facts:
– Anger or stress don’t seem to be in existence
– Yangonites use clips on a string dangled into the street from their flat above in order to exchange goods and letters etc
– Stray dogs are everywhere – A pack of them live on the corner of the hotel
– Cars drive on the right of the road, but the driver side is also on the right
– Almost nothing is of recognisable branding to me
– You can find every type of international plug socket in the wall. I think no plug consensus has yet been decided

The work we have done so far has been learning a course and how to teach on emergency Paediatric medicine in Myanmar so that we can deliver the teaching at more locations across the country in May and June (similar to APLS/NLS/GIC). Simulation and ABCD assessments are relatively novel here so that has been interesting. The Doctors and Nurses we have been on the course with are some of the lovliest people who are incredibly polite and keen to learn – much more so than the UK! Doctors are paid around $250/month here.

The bank was an enlightening trip – the counter is an unprotected wall behind which sits around 10 workers. There are notes everywhere which are being counted frantically through the machines – all over the tables, floor. People draw their money in stacks and are given a plastic carrier bag to take away. On any one day, the bank may decide they are not exchanging your dollars that day, or that particular $100 dollar bill cannot be exchanged due to the tiniest stamp. Its pretty funny…as long as you dont actually need to perform a transaction.

I’ve been incredibly lucky to have met some amazing individuals, whose stories and contributions to Global Health are a true inspiration. I hope we can make them proud in the next 6 months and beyond.

We have just moved to Mandalay for several weeks of induction at the ‘550 bedded hospital’ where we hope to start some of our capacity building projects…I will update soon!

Thanks for reading!
Emma
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Myanmar

I am spending 6 months in Myanmar with the RCPCH (Royal College of Paediatrics and Child Health) on a Global Links Volunteer placement. With 4 other colleagues from the UK, we will work in different hospitals north west of Mandalay in the Paediatric departments working on the wards and also on capacity building projects.