Last Mango in Mae Sot

We can see the smokey hills of Burma from our balcony, but the heat has melted the color out of the sky.  Hot season is upon us in Mae Sot, a dry and weary 104′ F.

 Early this morning we pedaled across town to the bustling Burmese market, in search of purple orchids and golden mangoes!  The long, narrow lane is crowded with Burmese women in colorful sarongs, with faces painted with “thanaka”  (sandalwood paste), bargaining for veggies, chilies, fruit, and fresh fish on ice.  

Jaundiced chickens (plucked clean and dipped in turmeric) are piled next to basins of squirming frogs and eels.  Flowers, in a riot of color, are everywhere, and the heady scent of jasmine revives us.

Mae Sot is 60-70% Burmese, including the Karen, and only 30% Thai.  Most are Burmese migrants, who have no ID cards.

Ahhh…..we found some ripe golden mangoes–luscious, juicy, never stringy–they melt in your mouth.

We spoke our few words of Burmese, and received smiles in return.  Most vendors also understand our northern Thai.  We banter back and forth over piles of lemongrass, fragrant “holy basil”, cilantro, mint, stems of “pak bong” (morning glory leaves), and exotic-shaped mushrooms, bursting out of the market jungle.

We’re grateful to Partners for giving us an intro into Mae Sot, our home base, and especially to experience living in the village of Lay Tong Ku, which has been the heart of our medical and relational work here.

 

 

Meanwhile, back in Lay Tong Ku, we saw an older Karen woman walking slowly down the hill, puffing on her stubby bamboo pipe.  Turns out that she was K’Nyaw Say’s (one of our medics) Auntie from inside Burma.  She had heard a rumor that our Clinic was fitting eye-glasses, and she came to see for herself.  As she tried on different lenses, she suddenly exclaimed to her nephew, “Now your face looks more beautiful !”

Naw Yeh Mu had never seen a “galawa” (white woman) before, and there was a connection between us, perhaps because we’re the same age.  I gave her a bead necklace, which looked lovely on her woven Karen shirt.  Early the next morning, she returned to the Clinic and presented me with a tasseled Karen bag that she had woven herself.  We were friends!

 

 

Sunday mornings are joyful in Lay Tong Ku, as we walk up the dusty path, across a bamboo pole bridge, to the small bamboo church on a hill overlooking Burma.  About fifteen families gather together.  

The children love to sing songs of worship. As we close our eyes, we are transported by angels singing in the hills.

 

Paw Dae Du is always a peaceful presence at church.  He was the first Talako Karen man who asked to be baptized from this village, with his family, in 2008.  They were baptized in the river close by.  Eight years later, his face still reflects the sweet Spirit of Christ in him.

Our seven months here are drawing to a close.  Leaving is always bitter/sweet.  We leave part of ourselves behind.  We’ve been blessed by our friendships here.  God has stretched us, and expanded our hearts. 

We’ll miss the laughter of the Lay Tong Ku medics!

There is no word in Karen for “Goodbye.”  Only a word that means, “Grateful for you.”

 

Moving on from Lay Tong Ku…….

 

 

 

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“Expert Diarrhea Medics”

The jungle has been awake long before we rise, with raucous bird calls and cicadas greeting the day.  A slight chill is in the air, as we creep out from under our mosquito net.  

The medics rise early.  Soon we hear chopping of firewood with a machete, for the morning meal.  An aromatic resinous wood is used to start the fire, and the smell is like burning incense offered up to this new day.  

Here is our breakfast one morning, cooked with love by K’Nyaw Say, one of our medics.                                                                                  Jasmine rice, spicy pumpkin curry, potato         patties, stir-fried greens and carrots, and warm (ready to peel) red sweet potatoes, dug up from the jungle.

Most of our patients come from across the border.  Healthcare is non-existent in most of these border villages in Karen State.

“Pa Peh Ko,” a thin, quiet, 11 year-old boy, walked with his mother for over two hours over a mountain from his Talako Karen village in Burma.  His mother told us he had lost 2 kilos of weight in the past month.  A blood test showed that he is anemic, and probably has worms, as he had a distended abdomen, and complained of an “itchy stomach.”  Anemia and malnutrition are common in these conservative Talako Karen villages with rules dictating their diet.  They eat no eggs, no domesticated meat (only jungle animals that they hunt), and very few vegetables.  They can eat fish from the river, but they are scarce.  Pa Peh Ko has never attended school, as there is no school in his village. The medics treated him with worm pills and multi-vitamins, and will follow up with him in a month.

Pa Peh Ko, the boy with the sad eyes.

 Soon a worn-looking mother of five daughters walks down the hill, holding her youngest, who is suffering from persistent diarrhea and dehydration. The baby is lethargic.  The medics assessed her and started a slow IV drip into a vein in her foot.  Her rehydration took all day.  We entertained her sisters with bubbles!

Diarrhea became the afternoon teaching topic for the medics.  This is hot season, water is scarce (hygiene issues), bacteria rampant, and many babies and children are suffering from persistent diarrhea.  Paul taught how to identify severe dehydration;  giving ORS (Oral Rehydration Salts) first; and correctly starting IV’s if they cannot swallow. Rehydration literally saves lives!

“Infective diarrhea is a leading cause of death in the tropics.  80% are children under 2 years old.”

We were explaining what the word “expert” means to the medics, and called them “Expert Diarrhea Medics” amidst roars of laughter!  Our medics are a great bunch!  (And Tawni, a Partners’ volunteer English teacher.)

Village life is very slow.  Time stands still, especially in the heat of early afternoons, when a cloud of lethargy settles over the village, the clinic, and us.  We are honing our patience, and the practice of living in the present moment.  Out of our comfort zone, God has met us here.  

A walk to the thundering, incredible waterfall and plunging into the cool pools, is just the best to refresh our bodies and minds on a hot, humid afternoon!

A New Leg to Walk On

She looked like a broken lily among the old soldiers and rough farmers. Despite having no hair, her pale face radiated a serene beauty, but she did not smile.  Wearing a sarong disguised the loss of her left leg. I was drawn to her and asked to hear her story.

Unlike most of the men, young and old, at the Queen Mother’s Prosthesis workshop, who lost their limbs from stepping on a land mine inside Burma,  Mo They Pwue  (“Bountiful White Rain”), lost her left leg to bone cancer.  Only 21 years old, she walked with her right leg, with the support of a walker.  

“My life began in a small town deep inside Burma.  When I was very young, my father left us.  I don’t know why.  My mother could not support my sisters and me, because there were no jobs.  We left our home and made the long journey across the border into Mae Sot, joining other migrant families looking for work.  My mother heard about available jobs at the “Thai Sun” garment factory, outside of town.  She and my two sisters were trained to sew on the big industrial sewing machines.  We were given a small cement room to live in on the compound, alongside hundreds of other migrant workers.  It gets so hot in our room, because there are no windows.” 

“Six years ago, when I turned 15, I began my training to sew.  My starting wage was 100 Baht ( $3) per day, for a 13 hour day, 6 days a week.  I now sew sweaters and jackets for export, and earn 150 Baht ($4.50) for a very long day.  My mother is strong, and she worked her way up to be the factory cook.  She cooks good Burmese food.  We have short breaks for lunch and supper.”

“About six months ago, I felt sharp pain in my left leg.  As it got worse, I went to Mae Sot General hospital.  After waiting all day to be seen, the Doctor confirmed that I had bone cancer, and wanted to amputate my leg!  I cried!  I didn’t want to lose my leg, and we could not afford the surgery bill in Thailand.”

“The women I work with pooled money together for me to go by truck to Yangon Hospital in Burma.  They gave me 500,000 kyat (about $500).  The surgeon there had to cut off my leg just above the knee, and they put metal pins into my thigh bone.  It hurt so much!”

“Sadly, a month later, the pins fell out, because my thigh bone was crumbling.  I had to return to Yangon for a full amputation just below my pelvic bone.  This was the worst day of my life.  Then they gave me Chemo treatment, and all my hair fell out.  That was three months ago.  For the last 6 weeks, I’ve been back at work because I can sit down and sew.”

This was an amazing week in Umphang, a small border town south of Mae Sot.  Partners brought in over 50 amputees to join the 146 total people mostly from inside Burma, Karen, Shan, and Karenni, all wanting a new leg to walk on.  Sponsored by the Prosthesis Foundation of H.R.H. the Queen Mother of Thailand, a total of 231 legs were custom-made on site. (some got 2 legs, a “working leg,” and a “dress leg.”)  These are lightweight aluminum legs, with knee joints of steel on steel.  118 of these soldiers and farmers had lost legs to land mine injuries. Their old legs were worn-down heavy wooden legs, some even made from PVC pipe.  We had never seen so many amputees in one place!

With Mo They Pwue, we watched the master craftsman as he first wrapped her waist and hip in meters of saran wrap, then molding the plaster cast.  After the plaster dried, he cut it open in the front to make the plastic mold, which the aluminum leg would attach to.

Late on Day 2, her new leg was structurally completed and the girdle strapped around her waist.  She was reluctant to try to walk on it. She looked at the metal mechanical leg suspiciously, saying, “It looks like a robot leg!”  

A patient Physical Therapist coaxed her to walk slowly using the railed walkway for support.  Slowly, putting one foot in front of the other, one step at a time, she was learning to walk again.

Mo tired easily, and sat down on a chair to rest.  “I just want to go home and keep using my walker.  This is too hard!”  We encouraged her to not give up.  

The third day, the tide turned.  A prosthesis technician, that had lost his leg at the pelvis as well, walked in front of her as a model. She saw for herself if he could walk, so could she.  A young enthusiastic PT placed a full-length mirror at the end of the walkway, and coached her moves.  “Soon you can wiggle those hips!”  A few times she stumbled, as her knee joint gave way.  But she persevered.

Mo practiced walking steadily for two more days. On the Presentation Day, she was able to walk with her new shaped flesh-colored leg, dressed in her best sarong, in front of the Governor of Tak Province.  We all clapped for joy, and she smiled!!

“Here I am, back home at the garment factory.  That’s my Mom behind me.  Love my skinny jeans!!”

Heh Neh Htoo is a 7-year old Karen boy from Po Phat, a village right on the border.  He was born with a missing calf and foot.  His twin brother was born with both legs.  He is adept at using his wooden crutch like a leg, and loves to play soccer!  He loves to play, and his vitality is infectious.  He enjoys school and has learned some Thai, as well as his native Karen.   He was the youngest to receive his first leg, and won over all the technicians.  The challenge with Heh was to motivate him to walk on his new leg, without his crutch that had become his leg. 

 

 

 

 

 

 

 

 

 

 

We (Partners) will follow up with both Mo and Heh Neh Htoo with Physical Therapy sessions here in Mae Sot. They both are over-comers, and will not let their disability rob them of their future. What an inspiration they are!

231 legs were custom-made and given to amputees from both sides of the border.

Drama in the Spirit World

We awoke at dawn to the songs of jungle birds, with a cool breeze blowing in through the open windows and rippling our mosquito net.  Cool season at last.  Each time we’re in Lay Tong Ku, we experience another dimension of this tribe and their world.

Today was the Full Moon of November, an auspicious day.  In the early morning we walked through the village to the gathering at the Elephant Gate, their “holy place.”   Only men are allowed to enter, barefoot, through this gate to the spirit world.  Two huge, intricately-carved ivory elephant tusks dominated the open room, surrounded by small spirit houses and several black stone sitting Buddha rupas.  A mixture of animism and early Buddhism.  

The head priest, Pu Ta Ko, was sitting on a raised wooden platform, wearing a long white woven robe.  The village men would bow to him three times, and offer him an assortment of food.  He looked at us impassively, chewing his betel nut.  We introduce ourselves as medics come to help in the village Clinic.  He nodded his approval.

Soon a procession of younger men, their long hair rolled up in top knots, all in white robes, carried trays with candles, and rice and fruit offerings out to the huge gnarled trees at the edge of the jungle, to appease the spirits dwelling in them.  Upon their return, as a finale, they struck the Burmese brass gongs, each ringing and echoing deep into the forest.

The village women gathered on the floor of a separate pavilion, dressed in their best brightly-colored handwoven sarongs and Karen shirts.  The grannies were either smoking their cheroots, or chewing betel nut and spitting out the blood-red juice.  The young girls wore long white woven dresses with colored tassels. The children were wide-eyed and beautiful.

We wore our Karen clothes, but we did not blend in.  Eh Pho, our young Karen Partners’ co-worker, translated our questions into Karen.  We smiled at their answers and asked to take their portraits, to remember their dignity.  

The Talakone Karen believe and fear the spirit world of ghost tigers, white elephants, and tree spirits, to name a few.  Listening to them chanting ancient prayers, this seems a timeless place……nothing of the 21st century is visible.  

One of the pleasures of village life is the late afternoon splash bath.  Dipping from the large clay urn of cold water, we pour a stream over our hot sweaty bodies…..a shock that takes your breath away!  Feels so good that you don’t want to stop.  Cool and refreshed, we sit together on the wooden balcony and savor the sunset that paints the hills of Burma crimson, looking forward to another quiet cool night under our mosquito net.

However, life in this border village is unpredictable and raw.  As we were watching the huge yellow moon rise over the jungle, suddenly Eliya, our senior medic, and his wife, Kat, burst onto the verandah.  They had trekked with their motor bike up the deeply rutted road from their home village at the base of the three mountains.  Eliya, an ex-Karen army medic, pumped up on adrenaline and betel nut, exclaimed that we had to leave the village tonight!  Why?

Apparently, a red-eyed Talakone Karen man from inside Burma had appeared at the “holy place,” wielding several long knives.  He was threatening to decapitate any Thai Border patrol he could find.  The local villagers were frightened, and had sent word through Eliya to get the “galawa” (white people) out of the village for our safety.

Startled, we began to rapidly pack up our things for evacuation, realizing that our anticipated ten days of village serenity was  unraveling.

Just then, a distraught mother arrived, carrying her unconscious 4-year-old daughter, Paw Ku Say, “Silver Flower.”  She had run for over an hour from her Karen village on the border.  Paul and the two medics rushed over to assess her.  Low and irregular heart beat, and not moving air well.  Mother said she had complained of a bad headache. Abnormal fixed pupils, and she was posturing (stiff arms and legs). Could be cerebral malaria, meningitis, or possible ruptured brain aneurysm?

Our only real option, after starting an IV and giving steroids, was to transport mother and daughter down the mountain ASAP for advanced life support.  We radioed an ambulance to meet us down below.

Time was scarce.  After quickly loading the truck, we bounced and barreled down the deeply rutted track at high speed, with Eliya driving like a bat out of hell.  We were crammed in the backseat, next to mother, cradling her daughter’s head in my hand, with her IV hanging out the window.  As the truck lurched and crunched over large boulders and through rivers, in the inky dark, we prayed desperately that we would get there in time, without breaking an axle.

Once down the three mountains, we sped through the night, through Beung Kleung, and through the hills towards the No Po Clinic, where we met the ambulance, lights flashing, in the road.  Stopping the truck alongside, we lifted her limp body onto the gurney.  The two Thai paramedics started a “full core”……oxygen with ambu-bag and chest compressions.  We stood looking in the ambulance door, feeling helpless.  They worked on her for over an hour, to no avail.  She was gone.  Standing with her mother, who thought her daughter would still “wake up”, I put my arms around her.  She was cold and weary, wrapped in an old sarong for warmth, and stunned as she was told that her daughter had died.  She expressed her surprise that so many people had tried to save her daughter.   Eh Pho was by our side, witnessing her first death.

The paramedics wrapped her naked little body in a white sheet, knotting each end.  Silver Flower’s mother told us she could not bring her body home, as her village would not accept the malevolent spirits accompanying the corpse.

On the long, silent, midnight drive back to Eliya’s house in Beung Kleung, we were all grieving in our own way.  A child’s death is so unfair and broke our hearts.

Paw Ku Say’s mother

The next morning, before mother left to return to her village, Paul prayed for hope…..that she would know how much God loved her, and that she would be filled with the Holy Spirit.  She teared up, for the first time during this ordeal, and we felt the Presence of God, crossing all language barriers, comforting her spirit.

“For I am convinced that neither death nor life, neither angels nor demons, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.”        

                                                                                            Romans 8: 38-39       

 

 

 

 

 

 

Beyond a Smile……

Naw Ma Chaw Lay knew she would never marry.  She lived in the shadows of her village.  Her parents were both dead, so she lived with her sister’s family, cleaning, washing clothes, unable to smile or speak clearly because of her cleft palate and protruding teeth.  Her family did not have the money for her to attend school, and she is illiterate at age 26.  Young women her age are already married, with several children.  Her rejection was a constant raw ache in her heart.

Her Karen village is Pae Wah Tah, deep within Karen State, Burma.  Ma Chaw Lay had never left her village.  A few years ago, she heard about the free surgeries (Operation Smile) over the border in Thailand, for those like her.  But money was scarce, even for transportation.  

However, this year, her sister heard about the surgeries in Mae Sot, and that a group named Partners would reimburse travel money spent.  So she helped Ma Chaw Lay plan her 3-day journey.  The first day, walking 12 hours through the jungle; an all-day riverboat ride the second day; and a dusty ride in the back of a truck to the border town, Myawaddy, the third day, and then crossing the river over to Mae Sot. 

She shared the two-story Partners’ “patient house” with other Karen families from Burma, but entering the white, sparkling clean International hospital, with all the medical staff speaking Thai, not Karen, was scary for her.  She joined the other Karen patients sitting in a crowded room on mats on the floor.  We claimed a sleeping mat and a cotton blanket, and she sat down with her small bag of toiletries.  Even at age 26, Ma Chaw Lay enjoyed the coloring books and stickers we brought to pass the hours, content to color in animals and flowers with colored pencils.  Imagine a lost childhood in the village.

The Karen are a patient people.  Families were sitting with their children, waiting and waiting for their number to be called, but grateful for this unique opportunity that will bring a new smile to their child.

The next day, Ma Chaw Lay’s surgery lasted over two hours; three teeth were extracted and her cleft lip was cut, grafted, and repaired.  First- class Thai plastic surgeons from Bangkok volunteered their time, working in long shifts.  I sat waiting for her outside of the Recovery room.  Finally, she walked out with an aide, stunned, her eyes glazed from the anesthetic, and up to the second floor to rest in a room with wall to wall beds.  I held her hand to let her know that she was not alone.

The next afternoon we came for her discharge.  I saw her pull out a compact mirror to look at her face, and she looked disappointed.  Her lips were swollen and distorted, with a jagged line of black sutures.  Her affect was flat, as it hurt to move her mouth.  She still saw herself as “ugly”.  We tried to explain to her (in Karen) that it will take time for the swelling to subside, and for healing.  A surgeon can repair a cleft lip, but how do you repair a cleft heart?

Back at the patient house, we gave her rice soup, with ground pork and egg to eat.  (Partners provides accommodation, food, and transport for patient care.  At the Burmese wholesale market, we would purchase a cartful of vegetables, rice, and pork every few days for the 15+ patients and their caregivers.)

For the next week, our team visited her everyday.  We kept encouraging and praying for Ma Chaw Lay.  I really bonded with her, like a mother, in this time of her pain and fear.  Slowly, her swelling decreased and she was healing, both physically and emotionally.  After six days, Paul gently removed the tiny sutures from inside her nostril down to her upper lip. It still hurt to smile, but gradually her face was being transformed.

Soon she was preparing for the long journey back to her village.  The rice harvest was waiting.  We told her that she looked beautiful, and shyly, she was beginning to believe it.  Her quiet dignity as a woman was being restored from the shadows.  As a gift, I gave her a small silver angel necklace, to remind her that she is loved and protected.

 

 

 

 

 

 

 

 

After a big hug, and more photos, we shared our hope, God-willing,  to see her next February in her home village inside Karen State.  We waved as we left, but there is no word for “goodbye” in Karen, only “dahbleu,” meaning “grateful to know you.”

 

 

 

 

 

 

 

 

Road to Lay Tong Ku

After two weeks of transitioning into life in Mae Sot, at the tail-end of the monsoon rains, we’re building friendships with the Partners’ family, mostly Karen, who love to laugh, eat together, and help their people, on both sides of the border.

Last weekend, we set off with the medical team on an expedition to remote Karen villages, to follow-up on the cholera outbreak….a long day’s journey south, snaking along the Burmese border.

The following morning, we set off for Lay Tong Ku, three mountains away. We attempted to 4-wheel it up the first mountain….the dirt track was very deeply rutted with red mud, and soon the truck was high-ended and stuck. Barefoot in the sticky mud, the men got out to push, reversing to the side of the track.

So under the midday tropical Sun, sweating profusely, we reluctantly hoisted on our backpacks and prepared to hike over the next two mountains. The air is thick and humid, and the dense jungle is alive around us.  The butterflies are deep purple, with long tails, dancing in the sun. The jungle is deep green and lush, with wild bananas and a few towering hardwood trees, reaching up to the sky through the canopy.  Our squeaky-clean hiking shoes plunge into the warm red sticky mud.  We realize quickly that a long, sweaty uphill hike lies ahead.

But wait!  What do we suddenly hear behind us?  A rumbling diesel Toyota Helux, plowing through the mud, stacked high with goods and villagers.  Turns out the village truck has come to our rescue!  Two young Karen medics jump off the back and offer us (the two older ferang) their places.  Gratefully, we found ourselves squashed among cases of Mama noodles and crates of eggs, with no complaint!  The Talakone Karen driver grins, his long hair up in the traditional topknot, his amulets dangling around his neck.  The indomitable truck plunges through two rivers on the way up the two steep mountains.

At the end of the road lies the village of Lay Tong Ku, home to the Talakone Karen, with their own unique traditions and beliefs.  Entering the bamboo village was like stepping into the world of a lost tribe.  The men and women all wear handwoven cotton lungis and shirts; the men do not cut their hair, and wear it coiled in a topknot above their forehead.  Hunters and gatherers, they eat only wild meat from small deer, wild boar, python, and monkey.  They keep no domesticated pigs or chickens.

We settled into the large wooden verandah of the “sala”, next to the recently-built Clinic. We slept on mats on the floor under a blue mosquito net, with the melodious, rushing sound of the nearby dramatic waterfall lulling us to sleep.

The next morning, fortified after an early breakfast of rice and vegetables, and the indispensable “Birdie” (3 in 1 …..coffee, milk powder & sugar), the sick villagers were already waiting at the Clinic.  Malaria, pneumonia , and probable TB were the main medical problems of the morning.  The cholera was still across the river on the Burma side, a few kilometers away. This Clinic serves as a lifeline for these villages on both sides of the border.

A highlight for us was the Sunday morning service in the small open-air bamboo church on a hill, overlooking the mountains of Burma.  Most of the village remains Animist, but now about 30 families are followers of Christ.  Young girls wearing long white woven dresses, were like angels, singing in harmonies with a guitar.  A sweet fragrance of worship, and we could feel the Presence of God in that place.