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Ratana Metta Clinic: offering free Anti Retroviral Virus treatment
By Ma Thanegi
A group of college chums, both men and women, who first met each other in 1958 atYangon University, and by now all retired from stressful high level positions, cametogether in 2004 to form a local NGO, the Ratana Metta Organisation (RMO). By now,with a network of around 200 friends, this group dedicated to People Living with HIV(PLHIV) has even more stressful work they are committed to wholeheartedly.
“We just wanted to do something, health-wise, and started with a free clinic in 2005manned by one of our mates who acted as volunteer doctor, “ said U Myint Swe, presidentof the Ratana Metta Organisation. “Now we three full time doctors as well as nurses butwe cannot pay them what they are worth; even then, these wonderful people donate back aportion of their salaries towards the clinic.”The executive board members volunteer their time, and every month chip in necessaryfunds from their own pockets.
“Until last year we could only treat what is called Opportunistic Infections for HIVinfected patients such as diarrhoea, pneumonia, herpes etc.” he continued, “but in 2008we obtained permission from the Ministry of Health to give out free Anti Retroviral Virusmedication. It started with only enough for ten patients. At our clinic the registered numberof patients doubled every year since its opening, so by now we have over 1500 patients,and from that 500 who need ARV, but we could only give it to a hundred at present.”
The head office is in two small rooms on the ground floor of the Shinthamanay DhammaBeikman off Arzarni Road, while the clinic is tucked away on a narrow strip of land nextto the Shwegyin Dhammayone or the prayer hall of Shwegyin Township, situated onShwedagon Pagoda Road. Inside the clinic patients are treated by doctors in curtained-offbeds. Clean baths and toilets are at the back.
Upstairs are the offices for the finance and administration departments, which are tablespushed against each other in a narrow space. Both the head office and the clinic are ratherrun down if clean and neat; every kyat is needed for the patients. The clinic does not evenhave a blood testing lab yet but has to send patients to another place. The probabilityof having an in-patient department, out patient clinic plus administrative offices andlaboratory in one place are virtually zero. Those who needed hospitalisation are sent toWaybargi Infectious Diseases Hospital.
“We work closely with the doctors there,” U Myint Swe explained. “We give financialsupport to these who need to be hospitalised. Should they pass away we also support their
families with funeral costs.”
“The worse thing for an HIV infected person is that as soon as he or she knows the result,panic and then depression sets in. Sometimes it is so bad that they attempt suicide. AsMyanmar is a Buddhist majority country, we give counselling according to Buddhistconcepts. However it does not mean we are missionaries; people of other faiths are alsowelcomed. You see, according to Buddhist thought, everything is impermanent: everyonemust die sooner or later. A healthy person can get run over by a truck anytime, and anHIV infected person can live a full long life. The Buddhists way of life is to focus onthe present and be aware of what we are doing. Being aware like this means we are ablelive in the best way we could, i.e., to do the best we could for both ourselves and others,without obsessing about the past or worrying about the future. This is based on Vipassanameditation which also brings peace of mind. We also educate about taking precautions notto spread the disease: to have no concern about giving HIV to others is like breaking thefirst Buddhist precept…indeed, it’s a sin in all religions…. not to kill.”
“We have trained many volunteer home care personnel paying regular monthly homevisits, checking on the patients and their home environment. These volunteers are mostlypeers of People Living with HIV (PLHIV) and at present there are 78 of them, each doingtheir work with dedication. We send them out to their own communities so that it creates asense of ease. Ten more peer volunteers and two supervisors are now being trained for thisprogram. At the same time, a friendly gathering of PLHIV is held every two months, tocreate an atmosphere of friendship, goodwill and understanding among them.
If necessary we also give support to the families such as for the children’s education orcapital for income generating projects, because if we care only for their health while theyare starving, it makes no sense.”
In various villages or neighbourhoods where they have patients, RMO has set up localcommittees with members of both sexes. RMO works together with them, not in a verticaladministrative manner but in a lateral and democratic way.
“They know their neighbours better than we do,” U Myint Swe said, “and I find them trulyinspired and dedicated towards helping their communities. Since we also work for the careof orphaned and abandoned children with UNICEF, local volunteers are also involved inthis.”
U Myint Swe has a Drop Off Centre for street kids on the ground floor of his residence at58, Bogyoke Aung San Road, Pazundaunbg Township, next to a fee clinic for over 60s,with both places managed by Mrs Myint Swe.
The executive committee of Ratana Metta, all volunteers, meet once a month to go overthe accounts and to follow up on projects began the previous month.
“We have experienced accountants and we also have internal and external auditors,”U Myint Swe said. “As we are also dealing with funds from internal organisations andINGOs, we are very strict about our accounts. We are committed to having transparencyand accountability in our organisation.”
Apart from revealing the name of the patients, all donors on request are given a detailedaccount of used funds. However they need more funds, especially from local donorsbut the stigma of being a sexually transmitted disease meant that donations do not comeas easily for this HIV project. However, the majority of patients at the Ratana MettaFree Clinic are women, infected by their husbands, as well as children infected from themothers.
U Myint Swe said that since the clinic first opened, the number of patients have doubledannually. The cost of a month’s worth of ARV medication for a patient is around Kyat25,000 and therefore a year’s worth would be about Kyat 300,000. Since the pills have tobe taken twice a day for life, the burden of costs is no small matter. At least good qualityARV is available in Myanmar but the high cost of a lifetime supply for each patient is thebiggest stumbling block that Ratana Metta is facing.
Due to lack of funds they unfortunately had to stop accepting new patients since the end oflast year.
In conclusion, U Myint Swe said,“We get support from international organisations but its not nearly enough. In the wholeof Myanmar according to of the Ministry of Health statistics for 2007, there are about240,000 infected with HIV and out of that number there are 70,000 to 80,000 who MUSTget on the ARV regime, or else they would probably not be alive in two years’ time orless. But on the whole, our country gets support to give ARV for only about 20% of thatnumber, so you can imagine the disparity in requirement and fulfilment. We need morelocal donors, whatever amount they want to give; we cannot be depending solely onoutside support. ARV for 20% of 70,000 is a very tiny drop in the ocean.”
Head Office:Shintharmanay Dhamma BeikmanArzarni RoadNear the Eastern walkway of the Shwedagon PagodaBahan TownshipYangonPh: 095-1-375 345Email;
Free ClinicShwegyin Dhammayon compound,Shwedagon Pagoda RoadDagon Township,YangonPh: 095-1-241 830
Hours: 8.30 am to 4.30 pmDays: Monday to Friday(Not closed on public holidays)
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