Medical Action Myanmar
Medical services in a city of extremes
Medical Action Myanmar provide vital medical services to some of the poorest suburbs on the outskirts of Yangon. Services range from sexual and reproductive health, HIV testing and treatment, to treatment of malaria and tuberculosis (TB), all packed into four small but very efficient and effective clinics. The original and largest clinic in Hlaing Tha Yar township, which has been operational since 1994 and originally set up by Médecins Sans Frontières (MSF), serves a population of about 400,000 people and they typically see 300 clients a day.
What struck me most was the many pragmatic and common sense approaches they took to looking at the patient in the broadest sense. The efficacy of treating HIV is restricted if the patient is lacking in basic nutrition, as is so often the case in clients who discover they are HIV positive at the clinic. The clinic has a feeding centre which provides a balanced diet for a six month period for malnourished children. The centre is a fun place for the children to play and be monitored, thereby making feeding a more positive experience. MAM also provide what is called “Dry Rations” to patients on ART or TB medication that have dietary needs.
MAM provide assistance with transport fees for some HIV positive patients to ensure they can attend clinic regularly. The clinic has an outreach programme to encourage sex workers to attend the clinic for regular screenings for STIs including HIV. This includes a dedicated waiting area which is comfortably set up with coffee and noodles are served. This makes for a positive experience for anyone attending and provides a space to relax, chill out and share time with each other. The aim is to “make it their home” so they visit regularly, ideally every month. They have a trained peer educator who used to be a sex worker and she overseas the outreach programme. This also includes making a payment to women who recruit new patients and bring them to the clinic.
The clinic provides TB services, but unfortunately the government won’t allow patients to stay over night as it is not a hospital, so all patients have to go home. MAM now has a separate patient house for those that have to travel a long way to the clinic.
Each adherence team is made up of a doctor, a counsellor and an Outreach Adherence Supporter (OAS) who meet every two weeks. They consider sex workers, MSM, HIV positive and tuberculosis patients. The OAS regularly visits patients in their home to provide support and if there are any problems for the patient taking their regular medication.
I met many patients who were very open to be photographed and included in the work. It was a real privilege to hear their stories and see first hand how they are being helped by MAM, which they hold in very high esteem.