My Public Health Work in Mongton

Dr Maung Maung Nyo

Preamble

I was posted to Mongton only for a year and yet I did a lot of things there as I fell in love with the place and people. It’s not that I liked to be popular or pro-Shan ( I'm married to a Shan), it’s just that I had to do what I could do as I was the only medical doctor in the area at the time in 1962 and 1963. I did only my professional works and I did not indulge in romantic or sexual ventures.

(A Beautiful Cherry Tree Seen in the Shan State)

I was very idealistic at the time and my heroes were medical missionaries and stalwarts like Walter Reid, Albert Schweitzer, Gordon Seagrave etc. In fact the fictional hero Andrew Mason of the A.J. Cronin’s novel “The Citadel” was my most admired hero. He was so determined, so courageous, so selfless and dedicated to uplift the health conditions of the people, the downtrodden poor ones. So, what I did in Mongton was based upon their models and ideals.

Prevention of Malaria

(World Map Showing the Malaria Endemic Areas of the World in Red)

Malaria was rampant in Mongon as it was in other parts of the Shan State. Many fever cases were due to it and the diagnosis was made by clinical picture and confirmed by the therapeutic measures. If any one of them was referred to the Base Military Hospital the laboratory investigation confirmed it. Malaria affected both the army and civilian personnel.

(Female Anopheles Mosquito Biting Human and Transmitting Malaria Parasites)

For the army personnel and their families there were appropriate instructions being issued together with prophylactic medicine to be taken. Even the Army Rum contained some quinine n the beginning.

(Malaria Parasite Cycle: Plasmodium Falciparum)

For the civilian population in Mongton:

1. Minimize or avoid mosquito bites by wearing long sleeve shirts or jackets in the dark

places and at dawn and dusk.

2. Sleep under the mosquito nets.

3. Burn incense or tumeric roots to repel mosquitoes.

4. Drain the logged water of collected waters in the home and back yards. Make water

flow in the stream and its connected ducts and ditches.

4. Cut the grasses and weeds in the house compounds and shop yards.

5. Let Health Department spray DDT powder occasionally. We’re still using DDT then.

6. Take two Chlorophos (chloroquine phosphate) tablets once a week. It was cheap and

easily available in those days and malaria parasites were not resistant to it.

7. Report to the army hospital any case of fever for immediate diagnosis and treatment to prevent spread of the disease by mosquito bites.

(I myself took to two tablets of pyrimethamine once a week throughout my stay in Mongton.)

School Health

(A Primary School in the Southern Shan State Near Thai-Burma Border)

There was only a primary school in Mongton attended by about 20 or 30 school children. Captain Ko Lay’s wife Khin Than Myint was a teacher there. There was another teacher too. I used to go there either with Major Tin Shwe or Captain Ko Lay. I talked about healthy eating habits and good nutrition. I also did quick physical examination (mostly inspection) and took the ill or malnourished children to my hospital and gave them multivitamins and tonic like malt extract. Children liked the malt extract as it was sweet.

I gave the children DTPP injection as I had enough vaccines in the beginning.

(Map of Burma Showing States and Divisions)

Maternal and Child Health Association

I told the Station Commander of Mongton, first Major Tin Shwe and later Colonel Mya Din, to organize a Maternal and Child Health Association as it would help the organization of the people to be on the side of the army and for their own good. They were reluctant at first as it was a civilian matter, but they agreed to form it when the Chairman of the Eastern Shan State BSPP came to Mongton. The wife of the Mongton Myosa and mother-in-law of Captain Ko Lay as well as Khin Than Myint were leaders in the Executive Committee.

(The Military Barracks in Mongton)

I gave them advice on women health, prenatal care and nutrition. I told them Mongon lacked fresh fruits and vegetables and people suffered from nutritional deficiencies due to lack of nutritious foods. I asked them to grow tomatoes, lady fingers, Chinpaung (Rosalle0, egg plants, chilly, water cress (Kazunywet) etc for home consumption and for selling if there was a surplus. The naturally growing Dayingauk Ywet ( A tendril plant) was good for nutrition as it was green and fresh. I found it in Kuching, Sarawak, Malaysia in the 2000s as a delicacy and quite expensive. I was glad they grew the vegetables in the backyards later.

(Vegetables Sellers in the Shan State)

Health Education

As in the countryside in Burma people in Mongton were ignorant of health education and hygiene. I had to explain each of them the benefits of drinking boiled water, washing hands before and after eating as well as after visiting the toilets. The importance of fly-proof latrines was stressed.One good thing with the latrine system of Mongton was that they copied the Thai latrine system whereby a big trench was dug, connected to the latrine by big-bored bamboo (Wabo) and covered by earth. It was fly proof and auto-digestion of sewage took place automatically. I copied this system in my house in Parami Yeiktha, Yankin, Yangon, for the maids during the building of our house and it served well. In fact the Shan girls preferred that squatting latrine to the sitting commode of the European style.

(Map of Shan State Showing the Situation of Mongton, spelled as Mung Ton

in the map)

I also gave health education talk occasionally at all the meetings either at the 5^th Buregt Officers Mess or at the primary school. Captain Ko Lay or Maung Lu interpreted for Shan. Captain Ko Lay used to collect all the pamphlets distributed by the SSA (Shan State Army) and asked his wife to translate to Burmese for him. Once there was a love letter addressed to her that she refused to translate. Khin Than Myint had a lot of admirers before she married Captain Ko Lay. The remaining single teacher was also good looking and she had a bunch of admirers. She ultimately married my friend Captain Ivan Win Pe. They had two sons who are now in the UK.

Mongton Township Civil Hospital

(Recent Opening of a Modern Hospital in the Southern Shan State,

Yaungcha Village)

There was a civil hospital in Mongton, but no government doctor was sent there during my posting in Mongton. So, I looked after the civil patients too. Once I called the compounder (Hospital Pharmacist) to me and asked him what he needed for opening the OPD for patients. He said that the Civil Surgeon in Loilem was in charge of the Mongton Civil Hospital (a township hospital for 25 patients) and there was no doctor appointed to it until then. So he (Compounder) was the only person posted to look after it. There was a Staff Nurse or midwife for the Hospital that was attached to our hospital when she came to Mongton. Most of the time, they both were in Loilem or Nampan.

(An Operating Theatre in Yaungcha Hospital in Southern Shan State)

I offered to provide him with medicines and materials for opening the OPD. He asked for common oral and external medicines and bandages, but he came to me only twice and disappeared altogether. Then, I met Dr Maung Win of Monywa at the Bar of the Burma Medical Association in Rangoon and he told me he was posted to the Civil Hospital in Mongton in 1978 or 1979. I was glad that the Mongton people had a civilian hospital with doctor and nurses at long last. I had been complaining about this to the authorities concerned during my posting in Mongton and Lashio. I had been very vocal about it unnecessarily.

Health Education for the Border Outposts

Once I had an NCO with severe paralysis of the legs due to the injection abscess in the gluteal region (Buttock) and I had to operate it. He was later airlifted together with some patients suffering from peripheral neuritis and malnutrition that could have been prevented. I told this to the Commander of the 5^th Buregt and he asked me whether I could teach his medics the basic health needs and primary prevention and treatment of common disease like malaria, amoebiasis, typhoid, diarrhea and dysentery with food hygiene, nutrition and maintenance of health.

( A Burma Army Border Outpost Near Thai-Burma Border)

I agreed to teach them for about a month provided he sent two each from the border outposts the total not exceeding 20. He sent 16 corporals and nursing soldiers of the companies stationed at the military border outposts. My MA and nursing staff also attended the course held in my office cum lodging.

I remember teaching the following topics, two hours per session for a month:

1. Primary Management of Emergency Patients with

(A) Bleeding

(B) Burn

(C) Shock

(D) Gun Shot Wound

(E) Fever

2. Management and Types of Fever

(A) Acute Fever

(B) Continuous Fever

(C) Intermittent Fever

(D) Chronic Fever

(E) Subacute Fever

3. Management of Fractures

(A) Fractures of Upper Limb

(B) Fractures of Lower Limb

(C) Spinal Fractures

4. Care of the Medical Room

(A) Arrangement for Drugs and Instruments

(B) Sterilisation

(C) Washing of Hands

5. Prevention and Treatment of Common Disease

(A) Malaria

(B) Diarrhoea and Dysentery

(C) Enteric Fever

(D) Food Poisoning

(E) Abscess

(F) Allergy

(G) Fits

(H) Cough)

(I) Tuberculosis (TB)

(J) Venereal Disease

(K) Personal Hygiene and Protection

6. Vaccines

(A) TAB

(B) TT and ATS

(C) DTPP

(D) Cholera

(E) ARV and ARS

(F) BCG

(G) Small Pox Vaccination

7. Open Discussion

The trainees were very enthusiastic and they asked a lot of questions on the topics taught. I was teaching only the basics in Burmese and English. I used Burmese to talk about the general principles and clinical pictures but I wrote down in English on the black board treatment and drugs. It was very gratifying to know that they were interested in the teaching and that they said they gained a lot from my course.

Medical Articles and Stories

I’m interested in reading and writing since my middle school years and I was writing in Burmese in the 7^th standard. Later I was the editor of the BMF (Branch Medical Faculty) Wall Newspaper in Mandalay and Chief Editor of the BMF Annual Magazine in 1959/60. I have been writing articles in the Kyemon (Mirror) Newspaper Daily since then. I also started witimg short stories on common diseases in the Thwethauk (Comrade) Magazine in 1962. I asked my patients and friends to read my health education articles and short stories. They did and said that they liked them.

( A Health Education Book in Burmese Written by me, Dr Maung Maung Nyo,

Entitled "The Dangerous Diseases: Heart, Hypertension, Kidney,Stroke and Diabetes Mellitus")

Wife of Colonel Mya Din was a fan of my short stories and she was bewildered why I wrote about Mongton while my pseudonym was Maung Maung Nyo (Monywa). I explained to her that I was born in Monywa and hence I took that pen name, but I was serving at Mongton. Later I changed my pen name to Dr Maung Maung Nyo on the advice of Sayagyi Dr Ba Than and Dr Shwe Ban to represent my professional belonging and to dedicate my works to the whole of Burma.

Benefits of Being a Doctor in Mongton

I was welcome in every house in Mongton and they gave me discounts if I bought any article from them. I refused gifts from them. I was a strict follower of Sagaing U Pho Thin’s ethics that a public servant must not take gift from the public. My ideology at the time was to serve the people. I was never ambushed or attacked wherever I went around Mongton despite the presence of Shan rebels (SSA) in the vicinity. Once, the SSA attacked the Gate Sentries guarding the 5^th Buregt at night and shot into the air in the Mongton roads, but they did not even shoot a single bullet into my hospital when they passed by. Captain Ko Lay told me that they respected me and my Cetana (Good Intentions) to the Shan people. Dr Kanbawza Khin Hlaing enjoyed this favour in the Shan State as he treated all the Shan with Cetana. He is not a Shan, he is a pure Burman of Shwebo origin born in Kyaukme, Northern Shan State.

(Gokteik Viaduct Railway Bridge on the Road to Lashio from Mandalay)

I was also well known to the Shan rebels as they told me in 1964 that they had heard of my services to the Shan populace and they did not fire upon my ambulance whenever I drove out of Lashio. I met them in Mongkaung when there was a ceasefire between SSA and the Burma Army for peace negotiations in 1963/64. I remember their names, Colonel Kyaw Khin from Kyaukme and Major Myo Myint from Hsipaw. They belonged to the SSA Lashio Region. They were high school students when they first joined the SSA in the early 1960s. I pitied them as they left high school education for armed struggle. I did not discuss politics with them as politics was such a touchy topic.

Politics and Me

I was interested in politics and I did take part in student movements in the medical school and Rangoon University, but I never joined the political movement as I was determined to be an academician. But I have the habit of telling the truth and calling a spade a spade.

(A Panoramic View of Kengtung, Eastern Shan State)

One warm day in 1963, Colonel Kyaw Win, Chairman of the BSPP Organizing Committee for the Eastern Shan State came to Mongton from Kengtung, his Head Quarters. He assembled all the officers at 5^th Buregt Officers Mess and told us to join the BSPP Party as a priority during the organizing stage of the party (BSPP). He opened the forum for discussion.

(Discussion for Development in th Shan State)

I asked him whether soldiers could join a political party as it was not allowed by the existing government rules and whether army personnel could join any political party freely as there were other parties like NUF, AFPFL, Pyidaungsu Party etc. He replied that he did not know about permission to join other political parties, but they were allowed to join the BSPP in the early stage of party formation. He later asked Major Tin Shwe, my Station Commander, who I was and why I was asking about joining other political parties meaning that I might be an anti_BSPP. Major Tin Shwe told him I was a good medical doctor and university graduate and so naturally curious about political developments, but not an activist and not anti-army or anti-BSPP. No further enquiry ensued and I was left unharmed. Colonel Kyaw Win later became a Member of the Central Committee of the BSPP and a State Councilor of the Socialist Republic of Burma after 1974. He died in the 1980s.

(Hsipaw Town Centre, Northern Shan State)

Conclusion

I’m an idealist in medicine and I’m interested in all branches of medicine eager to do good to the public as most medical doctors are. I have great sympathy for the poor masses and I tried to be a good all round medical doctor in Mongton. I sometimes tended to be a social and hence political reformer, but it was based on my medical training and back ground. I was never a dissident or insurgent and for that matter never a politician.

(Lashio Manzu Pagoda Built by King's Minister U Paw U During the Reign

of Bodaw Phaya)

Dr Maung Maung Nyo

16.02.2009