Relief Work in Myanmar

On 2nd May 2008, Cyclone Nargis struck the delta region of Myanmar (formerly Burma) causing major flooding and terrible damage with winds peaking at about 135 miles per hour. The devastation was unimaginable and the world initially turned in sympathy to provide aid. But the problems of dealing with the Government in Myanmar and subsequent other natural disasters (like the earthquake in China) resulted in Cyclone Nargis being largely forgotten by the wider world. At the time of writing, it's over fourteen months since Cyclone Nargis struck but the need for relief is still pressing. The low-lying Delta area of Myanmar was worst affected, as it became inundated by the sea during the cyclone.

During my first trip to Myanmar, I had learned about the educational and medical charitable work sponsored by Orient Express staff on the ship 'Road to Mandalay' and supported by former passengers from a number of countries. Within days of the cyclone, Doctor Hla Tun from 'Road to Manadalay' travelled to the Delta to operate a mobile clinic in the more remote areas. Dr. Hla Tun has continued to make visits to the Delta and has provided the information below. For my earlier report on the cyclone and its aftermath go to Cyclone Nargis

(Photographs are by courtesy of the relief teams involved).

1st Trip

The first trip was from the 10th to the 16th May 2008. 599 patients were treated.

2nd Trip

The second trip was from the 29th May to the 1st June 2008. 491 patients were treated, bringing the total to 1,090.

3rd Trip

The third trip was from the 13th to the 20th June 2008. 868 patients were treated, bringing the total to 1,958.

4th Trip

The fourth trip was from the 16th to the 24th July 2008. After an early start, Doctor Hla Tun arrived in Bogalay Township in the Delta where he hired a boat to carry medicine and surgical materials to 8 different villages. One day was spent in each village and one day in Bogalay Township, treating around 100 patients each day. 951 patients were treated, bringing the total to 2,909.

In addition, medicine was donated to the Township Hospital where essential items were running short. Pressure on the Hospital was so great that some beds were shared by two patients. The relief team donated clothing to some patients and two ready-made noodle packs, provided by other donors, were distributed to all patients. Many people had lost loved ones, pets, houses and possessions and were struggling for food. In addition to the medical problems caused by poor nutrition, some suffered from post traumatic stress.

5th Trip

The fifth trip was from the 20th to the 28th August 2008. The mobile clinic operated in 9 different villages treating 909 patients, bringing the total to 3,818.

In addition, a total of 648 young people studying in temporary tents in various villages each received a pencil and notebook. Just over 100 U.S. Dollars made 648 young people very happy. Most of the population had been engaged in farming and since their fields were flooded with salty water and their cows and buffaloes died during the cyclone, they are currently dependent on outside help.

6th Trip

The sixth trip was from the 10th to the 16th September 2008. 666 patients were treated, bringing the total to 4,484.

On this trip, Doctor Hla Tun was accompanied by a former passenger on 'Road to Mandalay' and Associate Professor of Rheumatology Leila Magaro. The mobile clinic operated in four different villages within Bogalay Township, but patients from around 15 neighbouring villages attending the clinics. A further donation of medicines was made to Bogalay Township Hospital, at the request of Township Medical Officer. T-shirts, notebooks and pencils were distributed to over 300 students. 20 patients were referred to the Township and Division Hospital and a contribution was made towards transportation, investigation and treatment.

7th Trip

The seventh trip was from the 26th September to the 2nd October 2008. On this trip 307 patients were treated, bringing the total to 4,791.

8th Trip

The eighth trip was from the 10th to the 13th September 2008. 294 patients were treated. The total number of patients treated is 5,085.

9th Trip

The ninth trip was from the 26th September 2008. 288 patients were treated, bringing the total to 5,373.

10th Trip

The tenth trip was from the 21st to 26th November 2008. 507 patients were treated at two villages, bringing the total to 5,880.

In addition, pencils and notebooks were given to 285 students in two schools.

11th Trip

Doctor Hla Tun went to Pet Pyel Village in the Delta on 13th December 2008, returning on 17th December 2008. Pet Pyel village had a population of of 1,755 at the time of the visit but the clinic also dealt with patients from the nearby village of Toe Hla (population 377). It's believed that 350 people from these two villages lost their lives in the cyclone. These villages are remote, involving a two-and-a-half hour journey from Bogalay Township against the current of the river, using a small boat with a ten horse-power engine. There was no electricity in the villages, so the doctor had to use a small petrol generator donated by a Township Association and costing about 90 U.S. Dollars. On the first day, the clinic remained open until after midnight and on the second day, didn't finish until even later - 1.40 a.m.! Petrol for the generator is a significant overhead at around 3.50 U.S. Dollars per day.

The mobile clinic was open for three days, treating 71 patients on the first day, 131 on the second and 77 on the third. Number of patients treated over the three days was 279, bringing the overall total to 6,159.

In addition, a book and pencil were distributed to 418 students in the school there. There are 288 students in the Primary School (1st - 5th grade) and 130 students in the Middle School (6th - 9th grade).

Snacks, milk powder and clothing were also distributed to some poor patients. Food is also still being provided by the United Nations.

Doctors from the Health Ministry treat patients at large villages by using a ship but this cannot pass along the streams to the smaller villages.

Patients most commonly suffer from peptic ulcers, hypertension, chest infection and aching of the muscle and joints caused by hard, physical labour. Psychological trauma is common. Diarrhoea and dysentery has not been a problem at about 30 villages in Bogale Township because they collected clean water from rain during the rainy season. Although many reservoirs were inundated with salt water during the cyclone, some still provide reasonably clean water but the situation could deteriorate.

Most farmers have now harvested the rice crops in their paddy fields but yields vary from 30% to 80% of normal. Yield depends on the location, time of sowing, resistance of the seeds to the salt water which inundated the fields during the cyclone and availability of replacements for the buffaloes, sickles, spades and small plants from the nursery. Different planting methods have also been used when aid was received late from Government or NGOs. Instead of planting the small plants transferred from nursery to the paddy field, sometimes seeds have been sown directly. In places, shortage of buffaloes for ploughing has resulted in tractor ploughing being employed but this needs trained drivers and a supply of fuel. An attempt has been made to use buffaloes brought from Arakhine State in the South East of Myanmar, but problems have occurred due to the Myanmar Language having a different accent from that spoken by the Arakhine Tribe.

12th Trip

Doctor Hla Tun went to the Delta on 29th December 2008 for 3 days, opening a mobile clinic in 3 different places. 229 patients were treated, bringing the total to 6,388. On 31st December, the small boat used to access these remote villages grounded in the mud because of low water and it was necessary to wait four hours for sufficient water to proceed. During the enforced wait, 22 patients were treated in a temporary tent in a paddy field which has replaced a stronger one destroyed during the cyclone. The patients showed their gratitude by serving lunch to the relief team, after which the boat got under way to the village of Pet Pyel where a further 145 patients were treated.

Clothing and shoes were also donated to the patients.

13th Trip

Dr. Hla Tun travelled again to the Delta on 12-Jan-2009, returning 16-Jan-2009. This time, a boat with a 16 h.p. engine took two and half hours from the Bogalay Township with the boat of engine 16HP to reach the area of Ah Pyin Pa De Kone Village and Tha Maung Stream Village. On the first day 59 patients were treated, on the second 85 and on the last day 73, a total of 217 treatments, bringing the total to 6,605.

During the cyclone, over 2400 villagers perished in Ah Pyin Pa De Kone, leaving around 600 survivors. The number of dead is not accurately known because, on the day of the cyclone, there were two wedding ceremonies and many relatives and friends were visiting Ah Pyin Pa De Kone. The population has now swelled to around 1000 because of survivors migrating from smaller neighbouring villages.

The headmistress explained that about 65 students are expected to enrol this academic year compared with 215 students last year. Currently, there are 121 students in the primary school. Some are just starting school at age 5 and some are migrants from neighbouring small villages. Two teachers are taking all the classes this year. The headmistress estimated that more than 140 students died during the cyclone.

Of the 485 houses in Ah Pyin Pa De Kone, only 3 were left standing after the cyclone. There were 41 monks in the local monastery and all survived the cyclone, except for one who had gone to a relative's house in the village. The monastery itself was badly damaged but the monks ascribe their survival to the protection afforded by the trees which surrounded the monastery.

Treatments were also carried out at Tha Maung Stream Village which is a 45 minute drive from Ah Pyin Pa De Kone. Only one monastery here survived the cyclone. Because this visit was made during winter and the villages are near the sea, it was cold and windy.

14th Trip

Once again, Dr. Hla Tun went to the Delta for 4 days on 26th January 2009, reaching 2 villages which he'd not previously visited. A boat with a 16 h.p. engine took two hours and 40 minutes from the Bogalay Township to reach Pyin Boe Gyi. This village and A Se Gyi village are opposite Main Ma Hla Island.

The daily patient numbers were 43, 128, 70 and 83: a total of 324, bringing the total to 6,929.

Milk powder was distributed to some of the patients. In addition, 448 pencils and 348 books were distributed to 144 students in Pyin Boe Gyi Middle School and 371 students in A Se Gyi Monastic High school. The chief monk of A Se Gyi Village is a graduate who teaches 28 students in 10th and 11th grades at the High School. This is the only functioning High School education found during relief work in over 30 locations. In addition, there are 233 students in the primary school and 110 students in the middle school. There is a plan by a military attache from the Japanese Embassy to construct a new school in time for the next academic year.

The name Main Ma Hla Island means 'Beautiful Girl Island'. It's a free zone of 34779 acres, where there are crocodile breeding camps but all the crocodiles escaped during the cyclone.

During the cyclone, 374 villagers from Pyin Boe Gyi died out of a total population of 680. Due to migration, the present population is 804.

At A Se Gyi a levee reduced the force of the water during the cyclone. Over 50 villagers died out of a population of around 1300. Again, due to migration from outlying villages, the present population is has increased to 1564.

15th Trip

This was a 5-day trip to the Delta starting on 19th February 2009, operating at three villages, only one of which had been previously visited. The daily patient numbers were 57, 103, 126, 115 and 62: a total of 463. One of the villages is fairly close to the sea, taking a 10 h.p. boat about 20 minutes.

Dr. Hla Tun has treated 7,392 patients at this stage, with help from a local doctor on the first trip and the assistance of Dr. Leila Magaro on the 6th trip.

16th Trip

This visit to the Delta starting on 15th March 2009 and treated 282 patients in 2 different villages, the Robbers' Village and the Betel Nut Village. The Robbers' Village is very close to Thar Yay Kone village and the combined population is 1065. More than 100 villagers died during the cyclone. 147 patients were treated. There are 1350 villagers in the Betel Nut Village at the moment. Over 605 villagers died during the cyclone. A total of 7,674 patients have now been treated.

17th Trip

On 27th March 2009, Dr. Hla Tun undertook another trip to the Delta, treating 302 patients in 3 different villages (one village not previously visited). A total of 7,976 patients have now been treated.

18th Trip

This trip started on 20th April 2009, treating 230 patients over 3 days, bringing the total number of patients treated to 8,206.

Clean drinking water remains a problem in many of the affected communities. On this trip, Dr. Hla Tun organised a new Tube Well, 430 feet in depth for Lawine Island Village. He also organised the raising of the boundaries on the reservoir for Tha Maung Chaung Village. These boundaries are about 6 feet wide and 320 feet in length. The height is being raised around 3 feet at a cost of 650 U.S. Dollars. During summer, 35 villages rely upon this reservoir for drinking water.

19th Trip

This 3-day trip started on 8th May 2009 and treated 264 patients, bringing the total number of patients treated to 8,470.

20th Trip

256 patients were treated, bringing the total to 8,726.

21st Trip

Dr. Hla Tun went to the Delta on 17th June 2009, treating 272 patients in total during 3 days. The total number of patients treated is now 8,998 patients since Cyclone Nargis.

22nd Trip

This trip to the Delta started on 1st July 2009 and treated 274 patients in 3 different villages over a period of 3 days. This brings the total number of patients treated since the cyclone to 9,272.

On this trip, Dr. Hla Tun handed over medicines and his group of three assistants to a 74-year old native health assistant with a lot of experience. Dr. Hla Tun intends to follow up their activities on subsequent visits to the Delta so as to evaluate the cost and effectiveness of their activities. The health assistant had previously worked with Dr. Hla Tun on the first three visits to the Delta.

Details of later relief work can be found here.

[Statistics amended 15-May-2012].

Boulogne

My first trip abroad was a day trip by ferry to Boulogne with my mother when I was ten. The photograph above was taken by my mother from the ferry ('Maid of Orleans', I think) as it docked at Boulogne. The picture shows a diesel railcar waiting to speed passengers away. We stayed in Boulogne looking at the town and the docks. We had lunch at a small restaurant in the town, sitting at one of the outside tables - this idea of eating outside struck me as very continental.

Later, we returned to the docks for our return sailing where I watched the Paris express being marshalled by one of the exotic-looking '231' Nord Pacifics. I'm sure my mother took a photograph of the '231' but I'm afraid I've not been able to find it.

I spoke no French, but my interest in railways must have been apparent because at one point one of the shunters suddenly lifted me up into a baggage car where I sat on the floor as the train disappeared towards the station throat. My mother did not at first realise that this was only a shunting move and envisaged me ending up in Paris! She was relieved when the train stopped and reversed into an adjacent platform where we were reunited. That was my first trip on a French train. At the time, I found it perfectly natural to be suddenly given a short ride on a train in a foreign country - it's only looking back now that it seems remarkable.