Loi Tai Leng Clinic

Loi Tai Leng Clinic interview transcript with Head Medic Paw Shar Gay, February 2010

How many medics do you have here?

Here we have two medics, and the other people is me, Ba Tay is finished from Dr. Cynthia's clinic and then the other is finished the Siesta Blue training. Siesta Blue training Community Health Worker. Total staff at the clinic is 22 people.

How many patients do you get here per day?

One day is maybe 20, sometimes 30.

Are they mostly from Loi Tai Leng, or from inside Burma too?

Some people is from outside, some people is from here. But mostly IPD (In-Patient Department) is outside.

Loi Tai Leng's problem is ARI (acute respiratory infection), also skin infection is high. And rainy season is rain all the time, four months no sun. Sometimes is maybe one week or two week sun is come out. You know, our dress we make the fire wood and the fire make dry. The sun cannot make dry. And then UTI (urinary tract infection) is become high.

What do you do to help people prevent it?

Every year we plan to prevent it. Our clinic do like the home visit. One month we will going to section and home by home, give education. And then give information and vitamin A.

Do you see vitamin A deficiency here?

Sometimes we see like one year maybe one case or two case.

Do you always have enough medicine?

Enough medicine? Yeah is enough. Before the medicine did not enough and then we ask more money to buy the medicine. And the Partner did not came in here and also backpack, FBR (Free Burma Rangers) did not come in here. From outside, we take medicine here to outside and go and give the people who live outside Loi Tai Leng, like mobile team, and then our medicine did not enough.

The donor says 'Paw Shar Gay, you say every year medicine did not enough. How about this year, this is enough?' Last year he come back. And then I said, 'yes, before medicine did not enough, but this year enough.'

And then he laughing and said 'why medicine did enough this year?'

'Backpack is coming here, and then FBR is coming here and go outside outside, and same the Partner group is outside and then our medicine we use here not outside.' So here is enough for me.

Are there any backpack medics here?

Backpack medics is four, five people. Yes, sometimes if they come back from inside they coming here. If he going inside maybe two months or one month he will come back here.

Are people's gardens here big enough that their nutrition is good?

Yeah, we see now better than years before. And then we can get vegetables. Big garden (in reference to the sponsored one in the valley) but the vegetables is not enough. Some the shopping go down to Burma part and buy vegetable. Because you know here we can plant in the rainy season. This season no water. We can't plant, we have to buy outside. But in the rainy season is enough. We can buy here and sell here, in the garden. It's like, how do you say, save the money for us. But in the dry season is cannot save the money.

Do you have a computer?

Yeah. One computer is not so good. Internet if we going to the leader's house and check the Internet. But our computer is maybe five years. Is working very very slowly.

Do you see health here looks better now than when you began as a medic 14 years ago?

When I arrived here in 1999, no clinic. In 2000 one clinic. The people, the leader here is building the one clinic, like small like this, this room. We treat the villager, also the military. We treat both. And then clinic is very small, in Section 3.

At that time the people is not know about health. Not health education, they did not know about this so much. They did not know about the family planning. You know in the year 2000 we delivered 120 babies. At that time population is maybe 1,000. And now population is 2,600. More people here but the people know about the education and then they can provide and think. And this year is 42 babies delivered. Very different.

Then you know about the vaccine? Before two year, three year they don't want to receive the vaccine immunization, because the people said if they get the immunization her children is become sick and then is painful, cannot sleeping enough for the night time, because the baby is crying. Very painful, they don't want to come. The health worker is work hard, like go down and give education like this. Because immunization is very very important. But many people they also tell me, 'before we did not receive, we never receive vaccine. But we alive until now. We did not get other disease like you say.'

They ask me and then I answer, 'before is like the before. Before is the disease is not like this. So your baby, how do you say? Like, you is very old, and then you will dead. Your baby is growing and then in the future you will not see. Your baby, maybe your baby can get some anything you did not know about. If you receive the vaccine maybe the vaccine can help like the infection is coming less. Not 100 per cent. Maybe 50 per cent. Explain the parent about the vaccine. And then now, if we looking in the register book the vaccine is become improved. And many children is receive the full course of the vaccine, immunization. For me I think is improved.

And then the last one is education about diarrhoea. We need to boiling the water and then drinking. If you boiling the water, water will be safe for our life. Cannot get the disease easy like the diarrhoea, something like that. Washing the hands for you going to toilet, but if after you finish the toilet after you come back wash your hands before eating.

One man is very old, and then he ask me, because we give toilets, we have the budget for building the toilets. We ask to building the toilets and one man he ask me, 'Sa Mah,' they call me Sa Mah, 'I never believe about this because now my age is 70 and I never boiling the water and drinking the water because if you boiling the water, the water is not sweet. If you go to taking in the river and then drink, is sweet. And then sometimes we did not go in the toilet, we go in the forest. Sometimes we going pass stool in the river,' he said like this.

And then I'm about this question thinking, because I cannot answer yet. I thinking, and then I remember my Sir tell me that if you go in the community you will get many many problems. The people will ask you many questions. And then I remember. I ask that man, 'OK, you say is true. The water you carry from the river is sweet. If you boiling then is not so sweet, right, true. But at that time,' I call him uncle, 'Uncle, at that time how many household at that village?'

And then he answer me 'not so much.'

'And then you see now, many people in this village. And then if the one people going to pass stool at the river, and another people is going to pass, it will put a lot of things in the water. It will be clouding. If only Uncle you going to pass in the river maybe the river will pass stool with the river, but many people not so good.

And the pig, they did not make the pen, they did not have a pen for a pig, they will free for the pig. And then maybe that pig will go pass stool at the river. And then maybe the rabbit, some rabbit is move down to the river. And then this water is sweet. So then uncle is drinking some stool from the river, so become sweet. So that uncle not believe me. Only uncle can pass in the river, but for the other people I think it's not so good if you go down to pass in the river or in the forest. You need to build the toilet. The toilet it will save the stool and then not so smell.

Bay Da

We arrived in Loi Kaw Wan in the afternoon. Once we came through town to the medic compound, we stood and looked around at things. Suddenly a tall young man running at full tilt leapt onto Dr. Semkuley and hugged him with his arms and legs. That's the most emotional reunion I've ever seen between two men. The man was Bay Da, whom everyone knows has the biggest smile since Eddie Murphy, and much nicer than Murphy's. Especially since the corners of Bay Da's mouth curve up, even when he stops smiling, which he eventually did. He smiled so much those first few days anyone would think he was the happiest man in the borderlands. Of course, his smile fell into disrepair over the next two weeks. It began with slow fractures, changing from joy at having Myron back, to worry, nervous smiling. Beaten dog smiling. Shorter smiles, frowning in between, right in front of us. It took two weeks for Bay Da to stop being formally gracious, open up, and say enough for me. Two weeks to say something to me that could make me cry. When the woman watching her mother die of AIDS in the clinic down the road only made me angry. Bay Da climbed down from the frame he and the others spent all day building to hold these mega big solar panels, so the clinic will finally have night light. We sat on the grass together and he took off his Chinese army boots, inside which his feet had stewed all day without socks. Man what a stink! Like grade C ham left under the deck for a week. I moved to sit up wind and we joked about the smell. He said I should write about how people in Loi Kaw Wan are too poor for soap so donors would send some for his feet. Then we headed off to bring the tools someplace for safe keeping.


“Sometimes when we walked in the forest for four or five...or seven days, very difficult to get clean. No soap and got very dirty.” “You mean you were in the forest for that long?” “Yes” “What were you doing in the forest for seven days?” “Hiding, from Burmese soldiers.” “Oh. You were one of those people.” “Yes.” “What would happen if they caught you?” “They want to make us porters. Porters carry their weapons and food, and big bombs. A big bomb... They burned my father.” My skin crawled. “They took cigarettes, pressed on his face. You know when cigarettes burn, and the end is red? They burned on his face, here,” he traced his finger along his cheeks, “here.” “They tortured.” “Yes, tortured. I was seven...or six. I never forget that in all my life.” Earlier we had also joked about how he would like to be president. The things he would do, notably enact litter laws. Bay Da is an environmentalist, dislikes litter, and takes the decimation of the local teak forests by the SPDC personally. As he should, the SPDC are raping his people in order to rape his land. Anyway, his president talk ends with a smile and he says “in my next life.” “I want to have some coffee.” “I want my freedom.” “And what will you do with your freedom?” “I will travel, and present about Burma's politics and the environment.”


I didn't expect him to have an answer so ready. After we put the tools away, and after he told me about his father's torture and I tried to keep my head tilted up so tears wouldn't fall out of my eyes and perhaps he was doing the same thing, he told me more. “I will tell you my real dream. This is real, what I wish. I want to go to a small village and teach English. Have maybe 50? students. I teach English and improve my English. At my home town we have waterfall,” he showed with his hands, “a beautiful waterfall. And land is flat and soil is very...good.” “It's no good here?” “No. Very hilly, and difficult to bring water.” The Shan aren't a mountain people. They are traditional farmers who are used to rich plains where they can grow just about anything. This place is Akha land. The Akha like the rugged land, but they had to move aside here to make room for the Shan refugees. 


“I want to have a house, and around the house, trees, because I like the environment. I would have trees. That is my real dream.” “Do you want this in Shan, or Thailand?” “Shan. If I can, I don't like in Thailand.” 


The whole time, his nervous smile would flicker by. It's surprising how a face constructed to fall so naturally into a wide grin can drop into such exhausted despair. He'd mentioned even on the first day that he doesn't think about worrying things because it would just make him depressed. But I knew when he said that, even though I didn't know him, that he must think about those things all the time.

Kang Hseng

Within three days of arriving in Loi Kaw Wan, we all had a Kang Hseng crush, and he knew it. Kang is hot to begin with, but being one of the few city boys in Loi Kaw Wan, he possesses unusual charisma. This is what he said: Kang was born and raised in the capital city of Shan state: Taunggyi (Dong-chi). He has two older sisters, both of whom have been to college and now have relatively good jobs in retail. His father was an opium addict for 25 years. He paid for his habit by dealing. It's a little fuzzy, but he may have been a bootlegger too. The work put Kang's family squarely in Taunggyi's middle class. When it was evident Kang was on the verge of growing up, he had to decide what to do with his life. He's Shan, but because they lived in the city and his father had a mind for business they never felt threatened by the Burmese. 


At first Kang wanted to be an engineer, but he fell 5 per cent short on the entrance exam. His uncle in Singapore offered him a job. “Come work for me in Singapore. I'll set you up with a position and you can make a good living here,” his uncle told him. No. Another uncle is a monk in San Francisco, but Kang didn't want to be there either. A third uncle told him about the rebel Shan State Army, which he knew nothing of before, and the medics who bring aid to the Shan huddled along the border. 


That was the job 19-year-old Kang took. When Kang first told me this I thought “well you're a good guy Kang, but you're the only one here who can go home anytime you want. It doesn't have to be a serious thing for you.” Then I realized how much it meant. He could have chosen so many other lives. He was one of the rare ones; safe, comfortable, educated. He chose to go in when the others ran out. Almost three years later. He likes Loi Kaw Wan. He's a good medic and when the supplies hold he's the town dentist. He'll only leave if he wins a spot in the Mae Sot training clinic. And after that he would come back. Plus, he's staying because he's fallen in love with a 20-year-old student down the hill. He's a clothes horse with a choker of black beads like the surfers wear, and a black motorcycle jacket. His motorbike lust is strong, but with the honorarium salary he gets it will take him years to save up for one. He has an elfish face, likes to smile and show-off. His anime haircut makes him look like Bruce Lee and he loves it when people tell him that. 


He has no desire to be a soldier, but he calls the SSA “our organization.” Many Shan change their names when they escape or become rebels. Kang didn't change his, because he wants people to know it's him doing these things. Dangerous. He has his own private house; a bamboo and thatch hut the size of a backyard tool shed, with a dirt floor. There's a bare light bulb in the thatch that works for the two hours a night the generator's running. Between the bamboo cot and the rest of the house is a rack of clothes that acts as a wall. The door hangs onto the upper corner of its frame literally by a thread. He loves his house, because it's his only private place. In a few months he and the other two single male medics will be moved into a dorm, and he's not looking forward to it. 


Early every morning he took Cody and Sanjeev down to the clinic yard to teach them kung fu. Now and then he'd find one of the medics' guitars and play, which he was good at, and sing, which he needs to brush up on. Every night when all the others went to bed, Kang and I stayed up together to talk. We would play cards and tease and flirt. He told me all his secret gripes about how the Commander runs the town when there are no strangers to see it. Talked about politics and the genocide in Shan and how it's all going to end. And what happens after the end. He reminds me so much of another friend.

Interview with medic Bay Da, Shan State, February 2010

From an interview with 27-year-old medic Bay Da, Loi Kaw Wan, Burma, February 2010

What is Loi Kaw Wan?

Loi Kaw Wan is one of the IDP camp. People move from inside Shan State to live here. 

What year did Loi Kaw Wan begin?

Since 2000. During I am here, I didn't hear any problems around here.

We're still in Burma. Why is this place safer than further inside Shan State?

Because how to say that, we have like SSA (rebel Shan State Army) around here to protect this village.

If you're in Burma, in Shan State, how do people get to the IDP camps?

Very difficult. Walking, mostly.

Are you in the SSA?

Yes, I'm medic.

Do all the men have to be in the SSA, or they can choose?

They can choose. Not all. Depend on their mind.

Can they pay their soldiers?

No—which one?

Can the SSA pay?

Yes.

A lot of money?

No. I don't know about that. Not so much.

Do medics get paid good money?

Not so much, in the middle. 1,500 baht. (Per month. =$50)

That's enough?

Not enough.

Is there any way to make money here?

Yes, like, we have to go and pick tea leaves, in Thailand. And then sometimes we farm by ourself. Rice, pig, some rice farm.

Why do the Shan people need medics? Are there no doctors here?

No. Like inside Shan State? Most of the people there get sick, but no doctor, no health worker there. Nobody, like, very few medics.

How many medics are there here in Loi Kaw Wan now?

All of the medics here, 30. But all of them not here.

Where do they go?

Backpack inside. They go inside Shan State and look, take care of the patient inside.

Is it dangerous?

Yes, dangerous. Maybe sometime they're—I don't know, about the SPDC (the Burmese government and army). We have to be careful.

You're only giving medicine. What's wrong with that?

They don't like.

Why not?

They think that we are against them.

Are you?

Yes.

What does the SPDC want to do to the Shan?

They want, like, how to say? They want the Shan all, the Shan people, like no any, like, how to say? They want to do ethnic clean, cleansing. They want Shans to disappear.

But there are eight million Shans.

Yes. They try to control. They make us can't do anything. Like in Shan State they don't allow Shan people to study our language, like that. Like, sometime we study our language in a small village or monastery, temple.

In secret?

Yes.

So do they want you to become like the Burmese, or to disappear?

Maybe both.

How many ethnic groups are in Shan State?

Oh, about 20 ethnic. Shan, Palong, Wa, Kogank, Lahu, Akha, and Chinese. Pa'o, Kayin, many many, but I can't remember. Biggest group is Shan.

Do they want them to disappear too?

Yes, also the same. Everybody in Shan State.

Are there things in Shan State that the Burmese government wants?

Yes, things like natural resources. Wood. How to say, silver. The mines. Mining. No oil. Like gold. Diamond, yes they need a lot. Teak. They don't care about environment.

Do you want to go back to Shan State if you can?

Yes, but if the situation doesn't change it's not safe for me to go back.

What do you think could happen to you?

The SPDC they know from here, they will catch me and torture and they will kill me maybe. I don't know.

Have you seen them torture people before?

Yes.

Who?

My dad. When I was young, about eight or 10 years. They came and took my dad to be a porter and they torture him with cigarette and burn him, burn his cheek.

What did you do?

At that time I'm just children, I don't know. I can't do anything. And my mom only crying.

How long did the SPDC stay with you?

About one or two days. In my village they come from the city.

Did they tell you why?

I don't know. I can't speak their language. I don't know, I don't know. I just see. Make me sad.

Do they do this many times?

Many many times in my village.

Do you know now why they came?

I don't know.

When the SPDC comes to the Shan villages are they all soldiers, or other kinds?

All soldier.

They make you do porter work—

Yes. When I was young I used to go and build house for them.

You built their house?

Yes. Build, and dig. Dig the ground for their fighting.

But they're fighting the Shan.

Yes, but they force us to go to do for them.

So they force you to build their barracks to fight you. Are you angry?

Very angry.

You said they came when you were eight, that was almost 20 years ago. Are they doing the same thing today?

Worse than that. Like last year, they burn the house inside Shan State. They burn the village.

Have you been interviewed before?

Yes, I think two or three times.

Do you think it's helping when you tell your story?

Yes, I think it helps.

Does it make you tired, or sad though?

Yes, makes me sad but, also make me strong.

Can you still contact your family in Shan State?

Yes, by telephone. Sometimes, maybe once a year.

Why not more?

If they don't call me I cannot call them, because they are very far from the town. They come to the town and call me. Give me bad news.

What is the news they gave you this week?

I lost my nephew.

How old was he?

About four years.

How did he die?

From disease. Some disease but I don't know. They don't know. I also ask them, but they don't know.

Didn't he go to a hospital?

No, no hospital there. Just wait and see. Sometimes a little bit herbal medicine from the forest, but not help very much. I lost three younger brother and one sister and one nephew. Five of them, from different diseases.

Do you think about the election anymore?

I don't think the election will be fair. I don't think.

Do you know when it will be?

I don't know. They won't tell. I have no idea about that. Nobody knows.

Can you vote in the election?

No. Most of them, most of the Shan people that live in the small village outside the town they don't have ID, how can they vote? To get ID we have to pay a lot of money.