By May L. Ling BSN
Member, MNA Diversity Committee

"Where?" That's usually the first question people asked when they heard we were going to Myanmar. "And why are you going there?" was the second question. Myanmar was called Burma in its colonial days. Our friend Rev. Paul Chang, Director of Christian National Evangelism Commission in Southeast Asia (CNECSEA) headquartered in Singapore, has been insisting for years that we should consider a trip to Myanmar where CNEC is actively involved in a number of ministries. Because of its proximity to China, there is a large Chinese population centering in Lashio, less than 100 miles from the border. Both my husband and I speak Mandarin Chinese. After much prayer, we decided to go last September for an "exploratory trip" to see exactly how we may be of service there. Thus began an adventure that transformed our outlook on life.

Foreigners must enter Myanmar by way of its capital Yangon. Our flight landed Sept. 18 and we caught a 6 a.m. flight the next morning for Mandalay, the last capital of the Myanmar kingdoms before the colonial days. Then we took a taxi to Lashio on the Burma-China Highway of WWII fame. The road has not seen much improvement since its construction over half a century ago. The same Bailey bridges are still in use, perhaps missing a few bolts here and there, permitting only one-way traffic. Overloaded trucks have to be off loaded onto pickup trucks to cross. Lashio is about 160 miles from Mandalay and about 3,000 ft. above sea level. Part of the road is very steep and narrow, with lots of hairpin turns. We reached Lashio some six hours later with our hearts in our throats. CNEC supports a number of orphanages and Christian schools in Lashio. Its regional office is in Grace Haven, home to 150 orphans ages 8 to 14. Its director, Pastor Cha, and his staff were waiting for us as we pulled into the courtyard.

CNEC also provides training to lay believers who are pastors in mountain villages. The entire pastoral training program runs from September to December for three years. There were about 45 trainees, most in their twenties. Some had to walk two to three days to get to a train or bus for Lashio. Another CNEC sponsored institution is the Holy Light Christian School with an enrollment of about 1,400 from first to ninth grades. Classes are held only in the morning. Some teachers themselves attend Burmese high schools in the afternoon. We were asked to teach the 8th and 9th graders. There were about 40 students in each class. Most of the students were clean and well dressed. At the start and end of each class they all rise and bow to the teacher as the teacher enters and exits the room. Each class is forty minutes long. The students are used to being spoon-fed and are very shy. I talked to them about dental care, simple first aid, and transmission of diseases in the public areas, hepatitis, allergic reactions and general hygiene. In the afternoon I was to teach the pastoral trainees and four "bare-foot doctors." I went into more details with the pastoral trainees, adding medication calculations and how to give medications. And with the four barefoot doctors we went through wound care with their limited supplies. Since hepatitis A & B are so prevalent there, we discussed simple anatomy and physiology of the liver, types of hepatitis and prevention, liver cirrhosis and nutrition. We also talked about leprosy that continues to be a problem in the area where one of the students lived.

One afternoon a lay pastor student had high fever with chills. She arrived from the border near China only a few days before. The orphanage nurse did not have a thermometer. So I took her temperature with mine and it was over 104 degrees. We eliminated Malaria because the incubation period is about seven days and she had not been there that long. She also insisted that she never had malaria before. The nurse gave her Tylenol and locally available antibiotic and sent her to bed. The next morning she continued to have high fever, chills and headache. She was sent to a local clinic and was diagnosed with malaria. She was treated accordingly and got well. Malaria is very prevalent here. It is not only transmitted by mosquitoes, but also by injection or transfusion of blood of infected persons or by use of contaminated needles and syringes. A small brook near the school is filled with garbage. The water is stagnant during the dry season, a perfect breeding ground for mosquitoes. There is no garbage collection in this area. The perishables are used as composts and everything else is thrown on the street and eventually finds its way into nearby streams.

The pastoral trainees regularly go on visitation on Saturday afternoons. We went with the orphanage nurse and seven pastoral trainees and visited twelve families. We talked with the family members about their concerns and prayed with them. One family was concerned about hepatitis, another thyroid, stroke or TB. The nurse told me that burn injury is very common as many houses are made of bamboo or wood. Candles and oil lamps are the common means of lighting and present great fire hazard. Not many people have electric service, which is sporadic at best. Telephone service is very limited and mail service is unreliable. The military government has a tight control on Internet access. So the people we come in contact with were all very eager for outside information.

The nurse mentioned that newborn babies were quite jaundiced and some times even has convulsions. Most babies were breast-fed. According to local costume, the mother and newborn were kept inside the house for at least one month before venturing outside. Since Rh factor is most likely not a problem. I suggested maybe stop breast-feeding for a couple of days or take the baby outside for a few minutes of daylight might help to alleviate the jaundice problem. As we walked into one courtyard, two children came running out calling "teacher, teacher, please come in." They were my students from the Christian school. Their father makes water pipe for smoking. Drug addiction is a serious health concern. This area is within the infamous Golden Triangle, where opium is grown and processed. I was told that over half of the heroin sold on the streets in the U.S. is from this area.

We also visited a new orphanage Sunday afternoon. Ten orphans live in a house owned by a Christian. Six boys share a bed with a bamboo mat. Their only table is made of rough wood slats. One little boy about 8 years old was very thin, pale and jaundiced. He had ascites and generalized edema. His father had deserted him because the father could not take care of him. Pastor Cha took him to the hospital and was informed that there was nothing more they could do besides palliative care. We were heartbroken for him. Everyone was in tears when we prayed for him.

There is only one government owned hospital in the city. But there are several privately owned clinics. It was strange to me to see doors into the hospital were always locked. I had an opportunity to go in when a pastor with ulcer was admitted. There was no elevator. In order to get a simple blood test, the patient, no matter how sick, must walk down the stairs and go to another building where the laboratory is located.

There is no privacy in the hospital wards, no curtains on the windows and no doors. Each cubicle has four or more beds, either made of wood or of metal. Patients have to bring their own mattress, sheets and blankets. The only other piece of furniture is a bedside stand. On top of the stand are medicines that the patient bought from commercial pharmacies, with prescriptions written by the hospital doctors. I was told that nurses are in charge of the ward. Resident doctors are present only a few hours a week. The hospital is not open to tourists. I was warned strictly not to take any photographs.

Our eight days in Lashio were quite an eye opener. Although I have been working in a hospital as a medical-surgical nurse for almost twenty years. My limited knowledge and my ability to handle the unexpected were put to the test. This unusual experience gave me incentive to grow personally as well as professionally. Towards the end of our stay, Pastor Cha repeatedly asked us to return. God willing, we will return in November this year.

May L. Ling is a member of the MNA Diversity Committee and a medical surgical nurse at Brockton Hospital. She is one of the founders of the Chinese American Nurses Association of New England.