Point Reyes Light - November 11, 1999

Point Reyes Station doctor aids Burmese refugees

Point Reyes Medical Clinic's Dr. Ben Brown spends his "vacations" near a war zone halfway around the globe. He left this week for a month's visit to Myanmar's troubled border with Thailand, where he's spent the past decade treating victims of Myanmar's civil war.

"It's like a 'Wild West' film," he said, referring to the Myanmar (formerly Burma) frontier, which is governed by reckless soldiers who corral refugees with gunfire and plant land-mines in rice fields.

But the biggest menace in the borderlands may be the lowly mosquito. "Malaria is the worst problem there, because the types of malaria parasites found there are the worst in the world," he said.

Refugees afflicted with malaria are difficult to treat, mostly because they often don't see a doctor until it's too late. "The problem is that they'll keep working in the rice fields, even when they're sick, because for them quitting work means starvation. So, many of them come to the clinic in a coma," Brown explained.

The malaria parasite doesn't always attack the brain. Sometimes it spreads to other parts of the body, causing kidney or liver failure. Brown offered that folks are "lucky" if their suffering is limited to fevers, chills, and uncontrollable shaking.

Known for his upbeat, attentive manner, Brown, who lives in Sebastopol, works at as a family physician alongside Dr. Mike Witte in Point Reyes Station.

He has delivered many of West Marin's babies. In Marin and Sonoma, he said, babies are generally healthy and the infant mortality rate is low, about 0.5 percent.

By contrast, he said, the infant mortality rate among Burmese refugees is about 50 percent. Brown treats most of his Burmese patients at a refugee medical clinic near the border in Mae Sot, Thailand, northwest of Bangkok.

The clinic was established in 1988 by Dr. Cynthia Maung, who fled from Burma when the military began to gun down students, merchants, doctors, monks, and other civilians in an attempt to curb their rallies for democracy.

The country has been a military dictatorship since 1962, although democratic leadership has received widespread civilian support. In 1990, the National League for Democracy (NLD) won 80 percent of the votes in a nationwide election. The military nullified the results and began arresting and imprisoning NLD-party members.

The founder, general secretary, and leader of the NLD party, Aung San Suu Kyi, won the Nobel Peace Prize in 1991 while under house arrest. Although she was released in 1995, she was not allowed to rejoin her political party (more recently, she was told she could visit her dying husband in England but could not return to her country; she chose to stay home).

Nevertheless, she continues to promote democracy and human-rights, despite the surveillance of government's ruling party, the State Peace and Development Council.

Burmese dissenters have been tortured and relocated. Also unsettled by the violence are some of Burma's 67 ethnic groups, all with their own languages and customs, who live in remote hillsides and jungles.

An estimated 500,000 Burmese have crossed the border to live in Thailand, and only one-fifth of these are documented refugees, Brown said. An additional 50,000 reportedly move back-and-forth between the two countries, he said.

Brown calls Dr. Maung, the founder of clinic where he works, "eastern Burma's Mother Theresa." The clinic serves up to 20,000 patients per year. The majority are women and children suffering from malaria, cholera, measles epidemics, malnutrition, typhoid fever, respiratory infections, and severe diarrhea, he said.

Mothers there often feel helpless, he said. "Moms are moms everywhere. All these people want to do is to grow their rice and raise their kids. But they're totally broken up. We see a lot of moms hysterical over their kids' illnesses."

Then there's stuff that makes no sense at all. Brown recalled treating an eight-year-old Burmese girl who, while walking to her grandparents house, stepped on mine in a rice field. It blew apart her leg.

"Here's this little kid who doesn't know anything about politics, and her life is drastically changed. And she's just one of thousands," he said. "She looked like someone who could be in a kindergarten class here. She was so sweet, so simple."

In addition to helping people who come to Mae Sot, the clinic has a "mobile medic" team that reaches across the border to Burmese villages, some of which are only accessible by foot and bamboo raft, Brown explained.

Most of the medics are Burmese, who come to the clinic for training, and return to their villages with backpacks full of medicine. "Their work is very important. They're motivated people who want to find a way to help their people," he said, adding that becoming a doctor is a non-violent means of fighting military repression.

Hoping to further the efforts of Dr. Maung and her clinic staff, Dr. Brown established the Burmese Refugee Care Project (BRCP), a non-profit organization that provides financial support, medical supplies, medic training, lab equipment, food, and other items.

Once a "converted barn with one book and dirt floors," the clinic has now developed into a small village, with an inpatient hospital, a medical library, a lab, an orphanage, a nursery school, and an outpatient clinic, where medics give immunizations and offer health-education sessions, Brown said.

"There's a huge need for health education," he said. "AIDS is a big problem, but people need to be taught how to prevent even the simple stuff, like diarrhea." For example, he said, some villagers treat diarrhea by drinking a brew of bat guano and kerosene.

"In another village, they were treating diarrhea with fluid restriction," he said, shaking his head. "This was during a cholera outbreak, and a third of the population was wiped out."

When earnest medical advice fails, Dr. Brown resorts to drama. He and his colleagues once put on a few "stool skits" to teach villagers how to avoid the trots. One skit featured a medic playing the role of an infectious turd that made the other actors convulse with diarrhea-like symptoms (complete with sound effects); the group then built a latrine to trap the turd, and all regained their health.

The audience, he said, erupted in laughter, and got the message. (And his colleague earned "the first Academy Award for most convincing stool.")

Brown entertains kids with juggling acts and magic tricks, said Janet Wells, a Sonoma County journalist who visited the Burmese clinic last March. "He's really willing to look stupid and funny, and the kids really like him," Wells said, adding that Brown always carries toys along with his medical bags.

"He comes up with creative ways to help people," she said. "People really feel valued when he's around because he's encouraging and responsive. He's highly regarded there."

Just about anyone - not just doctors - can make a difference on the Thai-Burmese border, Brown said. "Really, an individual can make things better, simply by finding a need and filling it. And there's plenty to do there besides offering medical care. One of my friends taught kids art. Others have helped out at the nursery school, or at the orphanage."

Has he learned anything there that helps him better serve his patients here in West Marin?

"That's a big question for me, and I could ramble on and on about how Burma has shaped me as a doctor," he said. "The bottom line is that it's kept [the reasons] why I became a doctor alive. I've seen what matters: caring, listening, developing clinical intuition, and having a strong knowledge base... It's so critical that we not be mediocre in the way we practice medicine."

Those wishing to help Dr. Brown's work can send donations to the Burmese Refugee Care Project, Box 1774, Sebastopol 95473. Those with questions about BRCP can call (707)522-9701. The project's Internet address is www.burmacare.org

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