Transformative Education
for Health Professionals

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The Burmese Medic

Don Pedersen, PhD, PA, Kathy Pedersen, MPAS, PA Doug Barker, PA, Verapan Santitamrongpan Editor: Nadia Cobb MS, PA-C

The Burma Medics attempt to provide care to nearly 500,000 of the estimated 2 million displaced Burmese minority ethnic groups (Karen, Karenni, Kachin, Mon, Shan, Burmese Muslims, and others) living along the border between Thailand and Burma. The use of Medics is an integral part of the health care system in the camps, border clinics and communities in Eastern Burma and Western Thailand. Because of the shortage of physicians, members of the refugee community receive training (typically 2 – 3 years) to become Medics who then treat patients in hospitals, clinics, villages, and in makeshift dwellings in the jungles along the Thai/Burma border.

Full project description: 

 

Dr. Cynthia Maung who is a Karen refugee herself and a 2002 Nobel Peace Prize nominee founded the Mae Tao Clinic in 1989. Dr. Maung fled Burma after a brutal crackdown by Myanmar government troops in 1988 (8/8/88) where many demonstrators (mostly students) were killed. Presently the clinic staff consists of a few physicians, 275 Medics and 225 support personnel. Every year about 100 new health workers receive training in areas such as medic training, nursing care, laboratory, maternal and child health, traditional birth attendant, basic eye care and computer use. English language classes are also a part of the training.

Medic training began at the Mae Tao Clinic in Mae Sot, Thailand, under Dr. Cynthia’s direction, in 1994. As of 2009 approximately 1,700 Medics have been trained. At the clinic there are inpatient and outpatient activities providing free health care for refugees, migrant workers, and other individuals who cross the border from Burma to Thailand, regardless of ethnic origin or religious status. Care to the approximately 150,000 patients per year at the Mae Tao Clinic is provided primarily by the Medics, including coverage of the adult and pediatric outpatient clinics and inpatient wards, the clinics for dental and eye care, the obstetric and surgical wards, the mental health clinic and the complementary medicine clinic. There is also a prosthetics department to care for victims of landmine injuries, staffed by landmine injury survivors. The lab processes upwards of 45,000 malaria slides per year. Only 1% of the annual patient census needs to be referred out to the local Thai hospital in Mae Sot.

Importantly, some of the Medics who are trained at Mae Tao Clinic work for Back Pack Health Worker Teams (BPHWT). The teams go into the armed conflict areas in Burma, and provide primary health care and education to displaced villagers who have no access to medical services. There are extreme risks for the teams to be in Burma including being imprisoned or shot by the Myanmar military and injured by landmines in the border area. Seven workers have lost their lives since the program started in 1998 (wwwbphwt.org).  There are currently 81 teams (consisting of 3 – 5 individuals) operating in Eastern Burma. There are approximately 300 Medics involved on the teams. The medics work with local village birth attendants (for whom they provide training) and village health volunteers. The teams remain in the conflict (or so-called “Black”) areas for approximately 6 months at a time and are periodically re-supplied by the village volunteers. Health education is conducted in the makeshift encampments including sanitation, first aid and malaria and HIV/AIDs prevention. Additionally, preventive medicine programs are initiated including Vitamin A and Iron distribution, de-worming mediations and Filariasis prevention activities. In some areas clean water systems are installed to promote health and wellness.

The Medics in the camps, the Back Pack Health Worker Team Medics, and the Medics at the Mae Tao Clinic operate very much like US Physician Assistants (PAs). They extend access to medical care to the vulnerable population of displaced persons. The Medics are educated to take patient histories, perform physical exams, diagnosis, and initiate treatment plans including the prescribing of medications and the performing of surgical procedures. Interestingly the Medic, as an officially recognized profession, does not exist in Thailand or in Burma, but only exists within the milieu of the vulnerable populations displaced by a brutal military Myanmar dictatorship. Health worker training begins with 6 months of education to become a Community Health Worker (CHW), then an additional 18 months to become a Medic. The Medics are then able to take additional training (3 – 6 months) in the areas of mental health, laboratory science, dentistry or ophthalmology. 

 

 

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Relevance: 
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Sustainability: 
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