Thursday, April 9, 2020

Medicine in the mountains

High up in the Naga Hills, James Fable receives a frosty reception and learns of an initiative to provide local communities with healthcare. Photos by Médecins Sans Frontières.

Perched over 1,000 meters up in the Naga Hills of northern Sagaing State, Lahe is as beautiful as it is remote. The only route up is from Hkamti via a rugged mountain road that takes five hours by jeep, and the area has poor Internet and phone connection. Despite these logistical challenges, international medical charity Médecins Sans Frontières (MSF) set up base here 18 months ago and have been working with local Naga communities to improve healthcare across the mountainous, self-administered region.

Jeep in the midst of crossing a stream.

Lahe sits on a picturesque mountainside and boasts sweeping views of the leafy valley below. Misty mornings force everyone to wrap up well; most locals wear coats, a few don distinctive red and black Naga blankets interwoven with stylistic animal designs. Some of the older women have chin tattoos of four evenly spaced vertical lines going down from the bottom lip, and many wear colourful beaded necklaces. As the sun rises, the morning gloom disperses and dusty trails weaving elegantly round the mountains become visible. They lead to remote Naga villages, where MSF does most of its work.

One of these villages is San Htun, which I had been encouraged to visit. When I reached the brow of the hill leading there, thatched roofs reflecting the morning rays came into view. Bamboo huts lay sprawled over a dusty hillside sparsely scattered with skeletal tree trunks and verdant treetops. The women had chubbier faces and wider mouths than Bamar women, and the girls sported stylish ginger streaks in their black hair. Every child ran away as I passed, and every baby cried.

This I was used to in rural Myanmar. What I wasn’t used to were the unwelcoming stares and parents hiding their children from me. It was eerie, and I felt the most isolated I have during my entire travels. One guy in a lime longyi and grey jacket eventually began talking to me, but that was only once I had reached the far end of the village. Photos were a definite no.

Two young men squatting on the grass. (Photo by James Fable)

As I headed back down the hill, a guy offered to sell me a traditional cone-shaped hat for 50,000 kyats, but to my estimates it was worth ten times less. While we talked, a procession of 20-30 weeping women wrapped in blankets strode past in single file, imitating the wails of their elderly leader. Many were genuinely crying and those who weren’t held blankets over their eyes to make it look as though they were.

I had managed to hitch a lift to San Htun with an acquaintance; but to return to Lahe I’d have to arrange a motorbike taxi. I got talking to a villager in a navy sports jacket who was smoking an enormous bamboo bong. He invited me into his place, where bull skulls hung on the walls. A fireplace sat on a raised bamboo platform, the ceiling had been blackened by smoke, and dust particles spiralled through shafts of light penetrating the thatched walls.

Offering me yay-nway-jan, he called his friend over and they priced the 45-minute ride to Lahe at a steep 30,000 kyats, to which I offered half. They then discussed in Burmese (which they knew I partly understood) how they could bleed my wallet. With no other means of returning, we agreed on 20,000 kyats, still double the fare, I later learned.

My experience in San Htun was similar to Michael’s, the only other tourist in Lahe. He had been introduced to the community by Lahe monastery’s sayardaw, who lived in the village. But unless Michael paid them, no one would talk to him.

Initially I suspected the hostile reception was due to the village’s isolated location, but traditionally every Naga village identifies as an independent republic, and so outside involvement has historically been met with resistance.

The MSF team of national and international staff, however, have been more readily accepted by the communities.

“It’s been very nice to see how the Naga population is welcoming us and supporting us through their acceptance,” Dr Andrea Incerti, the medical coordinator of MSF Swizz, told me. “They see us as somebody that can help.”

Two men struggling to go across a fallen tree.

The team has faced challenges including the transport of generators, drugs, fridges and other materials, during the six months they’ve been operating, he said, but has been helped by the Ministry of Health and Sports (MoHS) and people in the region.

They focus on those lacking access to health care or in emergency situations and have been in Myanmar since 1992, with current projects in  Nagaland, Tanintharyi Region, Shan State, Kachin State and Yangon. Of all these locations, Lahe may be the least accessible.

The Hkamti-Lahe road has improved, but “there are still so many isolated villages to which there are no roads,” said Dr Incerti. “We may have to walk for a couple of days to reach a completely isolated population, where there is no communication means.”

Each Naga village has its own dialect, but despite these challenges, Dr Incerti is pleased with MSF’s progress, their main goals being to create a sustainable regional healthcare system that the MoHS can take over and to boost health awareness among the locals.

James Fable
James Fable is a travel writer, children’s author and novelist from the UK. After moving to Myanmar in 2016, he travelled around the country as a freelance travel journalist and this culminated in the publication of "In Search of Myanmar: Travels through a Changing Land", an entertaining account of his nine-month journey round Myanmar. James now lives in Heidelberg, Germany, and is currently working on a magical realism novel. Find his latest book about Myanmar here https://www.amazon.co.uk/dp/B07WFPTZ2J/ref=sr_1_1?keywords=in+search+of+myanmar&qid=1565804282&s=gateway&sr=8-1

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