‘If Patients Need Medicine, Sometimes We Health Workers Buy It for Them’: Ko Kya, Karen IDP Medic in KNU 5th Brigade

[U Wee Klo].

I was born in Hee Poe Der, [KNU] Brigade No. 5. I was living in my village until I was 11 years old. After that, I moved to many places. Sometimes I had to move due to conflict, and sometimes I migrated for education. When I was 11, I moved to Papun to study, and I studied there from grade 1 to grade 4. After that, I moved to Toe Thay Der and continued studying there from grade 5 to grade 7. I grew up with my family before moving to Papun. [After that] I rarely stayed with my family.

Going to government school was more expensive. I had to pay for school fee, dormitory fee, and uniform fee. I also had to buy books, pens, and pencils. According to the education system, in Burma all my teachers used the rote learning system, and they did not have activities in class. We had to memorize the whole book. If we could not memorize, we would be punished by our teachers immediately. The teachers used physical punishment. I was beaten at least three times per day when studying in a government school. I also faced the same thing when I studied at Toe Thay Der School in Karen State, because most of the teachers were from Burma [not ethnic area].

Later on, I moved to Mae La Oon refugee camp. I studied there from grade 8 to 10. My village is not that far away from Mae La Oon. It takes one day on foot. I could visit my village very often. After finishing grade 10 in Mae La Oon, I came back to Ei Tu Hta and studied at a post-ten school there. [Unlike Burma government schools], studying on borderline areas was free. I did not need to pay anything for it. While I was studying on the borderline, my teachers used the international teaching system. They had activities in class. They also used a student-centered teaching system. It is important to maintain this kind of education system, which is used on the border.

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Remembering Burma Army oppression: “I was always worried and afraid of the Burmese military when I was a child.”

I experienced the Burmese military’s oppression during my childhood. I was always worried and afraid of the Burmese military when I was a child. I had to flee very often, too. Once, the clash happened between the Burmese military and Karen army [KNLA] next to my village. Some Burmese soldiers got injured, and they asked villagers to carry those injured soldiers. Moreover, they even tortured the villagers because they thought that villagers were spies and were working with Karen army. Sometimes, we had to flee and hide in the jungle when the Burmese military were coming to our village. By doing so, we could not attend school regularly.

I remember one time my friends and I went to Mae La Oon. We were all arrested by the Burmese military when we got to Ei Tu Hta. They brought us to their camp, Pa Kay Kyo, and we had to stay with them for one week. After that, the local leaders talked to them and told them that we were students who would go and study in Mae La Oon camp. Later on, they released us. We were 19 people and we had to eat from one pot at the same time just like pigs. It was really hard for me. We were not allowed to take a bath for one week. We had no chance to go out. [When] we became free, we went directly to Mae La Oon.

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Becoming a medic and working in U Wee Klo: “I made a plan to become a medic in order to help patients as much as I could.”

I was sick very often during my childhood, and my mother went and called the medics to come and cure me, but most of the time the medics were not available to come and treat me. Many people in my village faced the same thing that I did too. For this reason, I made a plan to become a medic in order to help patients as much as I could. That is why I am a medic now. After post-ten school [in 2007], I attended the training of Community Health Worker (CHW) for 6 months, then I continued another medical training called General Medical Officer (GMO) for 3 years in Ei Tu Hta. Finally, in 2012 I moved to U Wee Klo, and I have been working as a medic in U Wee Klo clinic until now.

There are two medics [here]. Normally, there are over 100 patients per month. Sometimes, there are around 250 patients per month. Most of the diseases are flu, diarrhea, pneumonia, brain disease, itchy skin and dengue fever. Sometimes injured people come too. There are many kinds of diseases, however, diarrhea is most prevalent disease here. It usually happens twice a year. It usually happens in early summer [hot season], and it also happens between the hot and rainy season. The most difficult one for me to treat is brain disease like swollen brain. It is not easy to find medicine for this kind of disease.

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Lack of medicine: “If patients need medicine, sometimes we health workers buy it for them when we are able to buy.”

The main challenge is inadequate medicine. Sometimes, we already know how to cure patients with certain kind of medicine, but we do not have the medicine that we need. It has been for 4 years that we have not had enough medicine. We are struggling to find donors, but I have not found any donor so far. In 2013, all support for the clinic was cut. However, we can still run health services. If patients need medicine, sometimes we health workers buy it for them when we are able to buy. We also ask them to buy it by themselves if they can. We have not gotten medicine [regularly] for 4 years. Some people can afford to buy it, but some people cannot. Therefore, we hope that donors will help us about it. We will be very happy if donors are able to help us. If we have adequate medicine we can cure the patients here, and they do not need to go other places and spend their money for the transport cost too.

I sometimes run out of medicine, and I cannot do anything for the patients when they come to me. It is also not easy to find medicine around here even if you have money to buy it. Here it is hard to find medicine for serious cases who get meningitis disease, because there is no medicine for meningitis disease [here]. Those who get this kind of disease need to be treated quickly; otherwise, they will become abnormal. Last month, there was a patient who had a problem with the obstructive uropathy. He came to me for treatment, but I could not help me him because I did not have any medicine.

We deliver babies the traditional way. Some babies are born easily, and some are not. If we cannot take responsibility for them, we send them to other places. We usually send them to Ei Tu Hta [main section].

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Funding Cuts: “Consequently, we have to buy not only medicine but also rice.”

Previously, some local leaders here went and had meeting in Ei Tu Hta. They said that we would get food support until the end of December 2017 [NOTE: Support was cut in October 2017]. They also said that the TBC [The Border Consortium] has a financial problem to support for food. And if we needed support, we had to go and get it from the Burmese government in Papun area.  Most people do not dare to go there and take food because they do not trust the government. Few people probably would go and get support from the Burmese government [anyway], but they would not be allowed by the Karen leaders, because there is no firm trust between the Karen leaders and the Burmese government yet. Some people have already returned, and some have not. If all food support is cut, those who are staying here have to find their own job for their livelihood. They can stay here and do farming for their livelihood too.

If we do not get rice, we have to start doing farming. Most places that are good for crops are under the control of the Burmese military; therefore, we dare not do farming there because we are afraid of the Burmese military.  We can access only poor land, so we cannot get food supplies for sure. Consequently, we have to buy not only medicine but also rice.

There is not enough support, so they also had to reduce the level of school [in Ei Tu Hta sections 1-5] from grade 12 to 8.  The parents of the students could not afford to support their children if they studied there. Therefore, they just reduce the level of school and let their children go and study in Mae La Oon [instead]. I am not happy about it, but I cannot do anything. It is because of a financial problem.

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Peace Process in Burma: “To have a meaningful peace process, I think all the Burmese military who are staying in the frontline need to return and withdraw their camps from our areas.”

If the peace process is the truth and the right way, it will definitively be useful for us. However, if the Burmese military just lies to us, the peace process cannot be successful and meaningful for sure. We do not really trust the Burmese military. We are worried that they will do the same thing that they did to the Kachin people. Previously, the Burmese military government had ceasefire with Kachin for 17 years, but it failed later on. After that, they have been fighting again until now. To have a meaningful peace process, I think all the Burmese military who are staying in the frontline need to return and withdraw their camps from our areas. We also feel free and independent if they all go back to cities and do not stay in our territory.

I will return to my village for sure if the peace process between the KNU and the Burmese military is successful. Currently, we cannot go back yet. We are in uncertain situation. Therefore, it will be the best for us if the donors can still support at least rice for us.

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Everyday Life: “In my future I will try my best to be a good and caring medic wherever I go and live.”

I have been staying here for 6 years, and I am staying here with my family. I have two children. One is 4 years old, and one is 2 years old. I want my children to grow up free without suffering from bad situations like me.

If the food support is cut, I am planning to do small farming to grow some food.  I have not started farming yet. I am planning to grow rice, pumpkins, cabbages and other vegetables on a farm. I do not have any special place for farming like flat and good places. I have to do farming in a mountainous area. I do not think those places are good for crops, but I must do it if the food support is cut. I have no other option.

In my future I will try my best to be a good and caring medic wherever I go and live. I will keep on working as a medic here. I just work as volunteer. I do not have any income. Whenever I have free time, I go to the forest and find the elephant foot yams. Then, I sell them and I can get a bit of income by doing so. It [elephant foot yam] can only be traded during the rainy season. It is 1 kilo for 4 baht [USD 0.125]. I [also] make money by producing thatch. My wife also will work together with me as a medic. I cannot work only as a medic because the villagers cannot support me, so I have to do farming to get food too.

I sometimes buy medicine for patients, and I do not mind whether they can pay me back or not. The reason is because most of the patients are poor, and they do not have money at all as far as I know. I hope we will get medical support. It will benefit for all of us who lives here.

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Ko Kya’s story is based on two interviews conducted in March and October 2017. Some information has been omitted and the English translation has been edited for clarity and flow.

NOTES: U Wee Klo is section 6 of Ei Tu Hta IDP camp. The main camp (sections 1-5) is located around 20 minutes downstream the Salween River. All sections were cut off international food support in October 2017. The context are different, however, as the sections’ surroundings and other support structures are different. For more information about Ei Tu Hta, download Burma Link’s infographic briefer.