MTC week 3 + 4 - Reproductive Health

Sitting at an overpriced cafe in the airport during transit, sipping very slowly on my one drink to ensure I can continue to sit at their table for a time period far extending the time it takes to drink an ice tea and having internet-ed myself out by checking all my regular bookmarks, I figure what better time then to post my last few weeks at the MTC? Well actually I thought it might be nice to finish the series of posts for those of you still with me. 

Happy mum and chubby healthy baby (she was about to be discharged)

I had a pretty amazing last two weeks at the MTC with the reproductive health inpatient department (RH-IPD). There was an American OBGYN there which was nice, but to be honest the midwives there do such an amazing job and have a good command of English so it was fun anyways. The difference between the RH IPD at the  MTC and a maternity ward at home was that they look after obstetrics, gynae and neonatal (newborn babies up to 4 weeks) cases. They even have their own version of a neonatal ICU; theirs is an enclosed room which has phototherapy lights and humicribs to keep the babies warm, the room is okay for ward rounds in the morning but if you pop in in the afternoon it's a sauna. There are three humicribs and given the younger age of the mothers there is an increased risk of premature births, so sometimes two babies are put sideways in the humicribs which works just fine. 

Tiny twins, whose combined birthweight was that of a normal term baby

Burmese women in general are very stoic. There is no pain medication during labour or during evacuation of miscarried fetuses. The delivery room shares a wall with the main ward and even in the middle of the day when everyone is napping in the heat, you still can't hear the labouring women because they grin and bare it. 

As a medical student we are taught the steps of breaking bad news, you initially start with a warning shot i.e. did you bring anyone with you today? You might want to take a seat etc, which is generally followed by the bad news and a grief reaction. At the MTC it can be difficult to gauge whether or not the woman is aware of her situation (miscarriage or interuterine fetal death) as they do not have the typical Western grief reaction. Sadly enoughthere is a tradition amongst Burmese people that they do not name their newborn for the first 7 days in case it does not reach 7 days of age. Although many cultures observe similar traditions, rooted in the fact that historically not all newborns survived, the traditions are observed as a part of history rather than for an actually statistical reason. It is not uncommon to see women with a history of 9 pregnancies but only 3 live children.

Another difference is that the Burmese women all breastfeed and the clinic only provides milk powder to orphaned babies, women with HIV or multiple children. Breastfeeding is not taboo at all as it is in most Western countries and women will happily breastfeed in front of a room full of men and women whilst holding a conversation with you. It ensures a supply of food for the newborn, basically for free and conveys immunity to the child as well. 

Another cute baby in a handmade beanie (yay they fit) - if the baby looks yellow to you (yellow jaundice not yellow like an asian baby then you would be correct)

 Actually I remember one day the lab had run out of supplies to test bilirubin levels to check if a neonate was jaundiced so we had to eyeball it and actually suggested to the mothers to walk around outside for a bit with their baby to let them get natural sunlight. Just to be clear it is not recommended that you leave your baby out in the sun if they are jaundiced, they have tests and special lights to treat jaundice, but with no testing and not wanting to subject small babies to unnecessary treatment, 15 minutes of natural sun is perfectly fine. 

Cute baby with unknown cause of low haemoglobin

The experience at the MTC was amazing, and it was equally amazing to meet all the different volunteers in Mae Sot. There are at least 50 different NGOs working in Mae Sot and pretty much all the foreigners living there are volunteering and doing something worthwhile and amazing with their lives, it's actually quite an inspiring place to be. 

There's a facebook group what's happening in Mae Sot which is really helpful if you are going to be there for any amount of time. There are people selling bikes/ furniture as they move on to different places, important announcements such as the time the power was scheduled to go out and helpful long termers who are happy to answer all kinds of questions like where to find a good English speaking dentist etc. And there are all kinds of invitations to events happening in the small town of Mae Sot. One of those was for a Christmas Eve pot luck dinner at one of the local orphanages. The grassroots orphanage also rents out rooms for people who want to help out but can't afford to donate more,the cost of accommodation include a donation.

The children's playroom has had indoor hammocks and tyre swings, basically a child's dream. 

As I mentioned on my facebook page I generally feel quite awkward whipping out my point + shoot camera to take photos, so I did the next best thing and handed it over to one of the children and got some amazing shots, including this one of the mischievous photographer Charlotte. 

And with all kids the squeal of delight at the gift of candy was equally high pitched and excited.
 

I'll always value my time at Mae Tao Clinic for opening my eyes to those less fortunate and teaching me that working with less does not mean a lower standard of care, it just requires more creative in the medical approach. I'm equally grateful for the friends I made and the people I was able to meet who  opened my eyes to the plight of their causes and how much the world need more people like those who dedicate their lives to international development and the developing world.

Happy Crafting! and Happy Belated New Year.

Mel