When I first visited the Lin Young Chi (LYC) tuberculosis self-help group in Hlaing Tharyar, a township on the muddy outskirts of Yangon, the monsoon was in full swing. Rain and wind lashed the car as we pulled up. I was greeted by Daw Ma Ma U who hurried me under a newspaper into the small wooden clinic. A veteran nurse with 12 years experience treating TB in Myanmar, Daw Ma Ma U is the amazing woman who co-ordinates the group from a clinic and small farm set against a muddy and polluted channel on Hlaing Tharyar’s eastern edge. The group, which assists those who suffer from TB including mothers and their children, is largely run by specialist nurses and ex-patients who continue to volunteer for the programme.
Hlaing Tharyar is a densely populated, deeply impoverished township on the outskirts of Yangon. Most of its population of almost 700,000 moved to the area following Cyclone Nargis in 2008, their homes in the delta destroyed. Vast ramshackle squatter settlements with no formal sewerage system and rudimentary health services crowd the zone. TB thrives in these damp, cramped and crowded conditions. Here at their headquarters, Daw Ma Ma U introduced me first to new mother Ma Ei Li and her six month old child May Oo Li, both undergoing treatment for TB through LYC. She told me they had both contracted the disease days after their neighbour was diagnosed. LYC ensures that patients take their treatment correctly and provides sufferers with essential nutritional supplements. Both Ma Ei Li and May Oo Li receive weekly rations of rice, eggs and cereals from LYC; a poor diet can cause their treatment to fail. Daw Ma Ma U personally organises monthly community talks to educate the people of Hlaing Tharyar about TB prevention and how to identify symptoms.
Tuberculosis is the second most deadly infectious disease in the world. Myanmar has the fourth-highest TB prevalence rate, with 525 cases per 100,000. There are over 180,000 adults and children in the country that are infected with the disease, including 20,000 that are HIV positive. TB is a bacterial infection that can spread through the lymph nodes and bloodstream to any organ in the body; it is often found in the lungs, and patients tell of coughing up blood, and pain while breathing. TB is most deadly to young children, pregnant mothers and those who are HIV positive. In Myanmar Multi-Drug Resistant-TB is the key problem. It develops when patients are unable to complete their treatment course; are prescribed the wrong treatments; or if the supply of drugs is not available. MDR-TB can then be spread from person-to-person. While drug-sensitive TB can be cured with a six-month course of antibiotics, MDR-TB requires 24 months of highly toxic and costly medicines and injections.
Alongside their TB activities, LYC runs a nutritional support programme for mothers and children. According to UNICEF nearly half the deaths of children under five and pregnant mothers are associated with malnutrition. Hlaing Tharyar also lacks the basic healthcare facilities found in nearby Yangon, and there is a dearth of skilled care during delivery and the immediate post-natal period. LYC provides supplements to over 100 women and children, including eggs from the group’s chickens, mushrooms grown on-site, beans purchased locally, and rice. The group also distributes medication donated by hospitals in Yangon, which are critical in preventing postnatal infection.
To supplement assistance from international donors and expand their nutritional programmes, the group operates a small farming business on the land that it occupies. I was astounded by the professionalism of the staff and smooth operation of a chicken, vegetable and mushroom farm on such a modest parcel of land. A former beneficiary of the group, U Kyaw La, runs the farm and manages the business at the request of Daw Ma Ma U. He tells me that he sells the excess eggs and mushrooms at the local market and is particularly proud that all his produce is organic. He enthusiastically grabs a bunch of mushrooms, while exclaiming: “No chemicals!”
Here at The Angus McDonald Trust we are proud to support LYC's nutritional programme, and to fund its operational costs, ensuring that Daw Ma Ma U can continue to provide this critical care. Please sign up to our newsletter to receive regular updates about the programme.