BANGKOK (AlertNet) – Under Nan Than Than Oo’s care, no mother has died during or shortly after a pregnancy – a feat very few midwives have been able to achieve in Myanmar where the government spends less than three percent of its gross domestic product on healthcare and where one in 10 infants will not live to celebrate their fifth birthday.
So what’s her secret?
“I’ve always been interested in this work, I have good intentions and I try and put myself in their shoes,” said Oo, a veteran midwife who has worked in some of the most remote locations in Shan State in eastern Myanmar.
“And as a Buddhist, I told myself that it’s not only when you build a stage and offer alms or give to charity that you gain merits, you can gain merits by taking care of other people,” she added, speaking at the sidelines of the Second Global Forum on Human Resources for Health in Bangkok, where she has been recognised for her work in improving health in rural and hardship areas.
“I go and look at my patients at night too if they need me. If I don’t have a torch light, I use a burning torch.”
From her first posting in 1982 in Mogok Township, where it took her hours of walking up and down numerous hills to visit the furthest village, to her current workplace near the Thai-Myanmar border where she looks after nine villages, the 50-year-old has thrown herself into the job.
The people she looks after are almost always poor and the areas hilly and often inaccessible. And she is the only midwife in the clinic.
“There was nothing at my first posting – no car, no motorbikes, so you just wall up and you just walk down,” said Oo, who has been at Lwe-Satone sub-rural health centre since 2000, and now has a motorbike.
“At Lwe-Satone, the roads can be really bad, especially during monsoon when the streams are flooded. Then I have to wait until the water level goes down and the rain stops,” she recounted.
When it’s the wet season, and all else fails, she walks just like she used to.
MAKING DO WITH WHAT'S THERE
Oo has used her underskirt and the curtains at her house to wrap babies when patients gave birth in remote towns or en route to the health care centre, been woken up at five in the morning to help despairing wives find wayward husbands and donated blood 19 times when a suitable donor could not be found.
She is understandably proud of her “zero maternal mortality” achievement but is even prouder of the relationship she has formed with her patients.
She recounted a case in 2007 when a pregnant woman with intermittent fever refused to go to the hospital. “She told me, ‘I’m not going to the hospital even if I die’,” Oo said.
After Oo delivered the baby, the mother suffered post-partum bleeding as expected. Oo asked the husband to find a motorcycle attached with a carriage to carry his wife to the hospital, who had lost so much blood by the time they arrived that the midwife donated her blood. The mother survived.
“When I manage to save a mother’s life or a child’s life because of my actions, that’s when I’m most satisfied,” Oo said.
Many of the people she looks after are afraid of hospitals due to language barriers and social beliefs.
Every year, she looks after around 130 pregnant women and immunises over 200 children under the age of one.
When she is not looking after mothers and babies, she travels across the hills on her motorbike, visiting each village twice a month, to do home visits, train auxiliary midwives and provide health education on topics like how to prevent HIV/AIDS transmission from mother to child.
She also looks after malaria and dengue patients – both diseases are endemic in the area – and tuberculosis patients, many of whom are migrants or move about between areas.
“We have to make sure they take their medicines to prevent drug resistance. If they’re not taking medicines, you have to find out why and then do your best to resolve the problems,” she said.
After 28 years in the job and numerous accolades later, Oo, who said she had wanted to be a midwife since childhood after seeing the ladies in their crisp white-and-red uniforms taking care of people, has kept her initial enthusiasm for her work.
“As long as my health is fine, I want to continue doing this work till I turn 60,” she said. “And if I’m still well enough to work after that, then I’ll join a non-governmental organisation.”
Despite being born and raised in the bustling trade town of Taunggyi, the capital of Shan state, Oo says she loves rural areas the most.
“Townsfolk can get to the hospital easily, they don’t face many challenges,” she said. “The people in the hills are poor, lives far from the hospital and have more need for me.”