Burma - Four

Working to ease
the burden...

A former monk...

THEY WERE TRAPPED in Chogali. Traveling to Noh Poe would be pointless. We were stuck, yet my mind was still restless, searching. The scenarios were endless, each worse than the next, but I scrolled through them anyway under the delusion that what I worry about won't happen since I always tend to worry about the wrong things.

The girls could starve. After the Burmese soldiers captured Chogali, they confiscated villagers' rice and sold it back at exorbitant rates.

The girls could be used as human mine sweeps, in front of Burmese soldiers, to trigger the traps laid by Karen guerrillas.

The girls could be kidnapped and sold into prostitution. Thai brothels would pay a premium, more than the usual $40, because customers believe young rural girls are less likely to carry the AIDS virus.

The girls could die from malaria. It would not take much: a single bite from an infected female Anopheles mosquito, the type most active in this area. The mosquito breeds in stagnant water and rice fields and prefers to suck blood between dusk and dawn. Its saliva leaves behind parasites that migrate to the liver, where they invade red blood cells and multiply until the cells explode.

Under a microscope, the deadliest type of malaria parasite, Plasmodium falciparum, looks like tiny grains of sand floating on the surface of a small pond. The grains of sand are the parasite; the pond is the blood cell. The more you look at the pond, the more sand you see. Magnified a thousand times, an exploded blood cell looks like a million specks of dust.

I once spent an afternoon talking about malaria with a Karen man who is a fisheries expert, air-conditioner repairman, springboard diver and explosives technician. Since he had lived with so much danger, blowing up enemy bridges and helicopters, I thought he would shrug off malaria as a sort of macho man's flu. He did not.

Malaria starts with aches and tremors, he said, especially at the elbows and knees. Then comes a big thirst and wracking hot and cold shivers. Even two or three blankets can't warm you. Later, the left side of your torso gets so heavy you can't stand straight. Your liver swells. Even if it's summer in the jungle, your teeth chatter, your body trembles, you collapse on a bed of teak leaves. Your friends press against you to stop the shaking, they try to warm you with high-calorie dog meat. They worry you will have seizures, fall into a coma and die. But there is little they can do if they do not have the right medicine.

To choose the right medicine, a medic needs to know which malaria parasite the mosquito carried. Mosquitoes have been around 40 times longer than humans, and in the past 20 years the parasites they carry have become resistant to drug after drug. To identify which parasite, to choose the correct drug, a medic must have a microscope.

Last year in Chogali, the only microscope within a six-hour walk had presided over Dr. Cynthia's field clinic, on a laminated vinyl table. It was an angular hunk of black and beige metal that reflected sunshine off a small mirror to magnify the malaria parasite to 1,000 times its actual size. It saved many lives.

When my friend Paw Ruth Say fled the village, she took that microscope. She was afraid the Burmese soldiers would smash it. She was afraid to let the enemy have it. She was afraid she'd need it later. She was just afraid.

When Dr. Cynthia heard the Burmese military's No. 2 general would fly into Chogali by helicopter, she said, "We want to tell the general: Please bring one microscope. If there is not a microscope or enough medicine, even the soldiers will die."

Perhaps, Dr. Cynthia suggested, the people of Chogali would become angry if the soldiers didn't maintain the village's medical care, nursery school and water system. "Now, they know what they need," she said. "Before, they didn't."

Dr. Cynthia's war is a struggle to preserve community. A village falls. Families collapse. Everybody depends on everybody else, or everything breaks apart.

You can't improve the health of the people without improving their community, she says. If the people aren't educated, if they don't have jobs, if they're depressed, they won't be able to care for themselves or their children. They will starve, get sick, have accidents. Their daughters will enter brothels and their sons will join the army. They will have no choice.

Someone asked Dr. Cynthia how she felt knowing Chogali had been captured.

"What does it feel like to be a human being?" she replied.




Working to ease the burden... A former monk...		THEY WERE TRAPPED in Chogali. Traveling to Noh Poe would be pointless. We were stuck, yet my mind was still restless, searching. The scenarios were endless, each worse than the next, but I scrolled through them anyway under the delusion that what I worry about won't happen since I always tend to worry about the wrong things. The girls could starve. After the Burmese soldiers captured Chogali, they confiscated villagers' rice and sold it back at exorbitant rates. The girls could be used as human mine sweeps, in front of Burmese soldiers, to trigger the traps laid by Karen guerrillas. The girls could be kidnapped and sold into prostitution. Thai brothels would pay a premium, more than the usual $40, because customers believe young rural girls are less likely to carry the AIDS virus. The girls could die from malaria. It would not take much: a single bite from an infected female Anopheles mosquito, the type most active in this area. The mosquito breeds in stagnant water and rice fields and prefers to suck blood between dusk and dawn. Its saliva leaves behind parasites that migrate to the liver, where they invade red blood cells and multiply until the cells explode. Under a microscope, the deadliest type of malaria parasite, Plasmodium falciparum, looks like tiny grains of sand floating on the surface of a small pond. The grains of sand are the parasite; the pond is the blood cell. The more you look at the pond, the more sand you see. Magnified a thousand times, an exploded blood cell looks like a million specks of dust. I once spent an afternoon talking about malaria with a Karen man who is a fisheries expert, air-conditioner repairman, springboard diver and explosives technician. Since he had lived with so much danger, blowing up enemy bridges and helicopters, I thought he would shrug off malaria as a sort of macho man's flu. He did not. Malaria starts with aches and tremors, he said, especially at the elbows and knees. Then comes a big thirst and wracking hot and cold shivers. Even two or three blankets can't warm you. Later, the left side of your torso gets so heavy you can't stand straight. Your liver swells. Even if it's summer in the jungle, your teeth chatter, your body trembles, you collapse on a bed of teak leaves. Your friends press against you to stop the shaking, they try to warm you with high-calorie dog meat. They worry you will have seizures, fall into a coma and die. But there is little they can do if they do not have the right medicine. To choose the right medicine, a medic needs to know which malaria parasite the mosquito carried. Mosquitoes have been around 40 times longer than humans, and in the past 20 years the parasites they carry have become resistant to drug after drug. To identify which parasite, to choose the correct drug, a medic must have a microscope. Last year in Chogali, the only microscope within a six-hour walk had presided over Dr. Cynthia's field clinic, on a laminated vinyl table. It was an angular hunk of black and beige metal that reflected sunshine off a small mirror to magnify the malaria parasite to 1,000 times its actual size. It saved many lives. When my friend Paw Ruth Say fled the village, she took that microscope. She was afraid the Burmese soldiers would smash it. She was afraid to let the enemy have it. She was afraid she'd need it later. She was just afraid. When Dr. Cynthia heard the Burmese military's No. 2 general would fly into Chogali by helicopter, she said, "We want to tell the general: Please bring one microscope. If there is not a microscope or enough medicine, even the soldiers will die." Perhaps, Dr. Cynthia suggested, the people of Chogali would become angry if the soldiers didn't maintain the village's medical care, nursery school and water system. "Now, they know what they need," she said. "Before, they didn't." Dr. Cynthia's war is a struggle to preserve community. A village falls. Families collapse. Everybody depends on everybody else, or everything breaks apart. You can't improve the health of the people without improving their community, she says. If the people aren't educated, if they don't have jobs, if they're depressed, they won't be able to care for themselves or their children. They will starve, get sick, have accidents. Their daughters will enter brothels and their sons will join the army. They will have no choice. Someone asked Dr. Cynthia how she felt knowing Chogali had been captured. "What does it feel like to be a human being?" she replied.