Medical Treatment at a Yangon Clinic

It’s our final day in the pagoda and stupa marvel of Bagan. Jo started the morning with a 10km run, then we lounged by the palm shaded pool of a resort next to Bagan Golf Club and in the late afternoon Jo walked the 3km to a watchtower to view the sunset. I said I’d give it a miss and meet her at Wetherspoons for dinner (not the UK pub chain you might imagine – the owner uses the name as a clever and successful marketing ploy). After dinner it’s back to the hotel for an 8pm pickup for the overnight bus to Yangon where we plan to arrange transport to the town of Mawlamyine in the South East of the country. So it’s been another fine day and all is well.

Then wham! It all goes wrong. The bus stops at 1am for a scheduled toilet break and Jo has difficulty getting out of her seat. She struggles to step off the bus. I’m telling her – come on Jo stretch those legs. She looks at me in despair and says – you don’t understand, I can’t move.

Over the next few hours Jo’s joints seize up. She is unable to effectively move her knee joints, her wrists and two fingers of her right hand, and they are all extremely painful to touch. We think back on her exertions of the previous day and our first reaction is that she’s overdone it and the cramped conditions of the bus have caused a temporary stiffness. It will pass.

Waiting for the bus to Mawamyine which we should not have taken.

The Club Class lounge at Mawlamyine Airport.

But when the bus pulls into Yangon, nine hours later at 6am, it has not passed. To raise her out of a seating position we cannot use hands, we have to interlock arms and heave. We’re not going to Mawlamyine today, Jo is too weak so we grab a taxi for a downtown hotel, and whilst Jo rests I scour the web for some answers. I discover that the general condition she’s got is called arthralgia – acute pain in multiple joints without swelling. There are a multitude of causes for this condition but Rheumatic Fever seems to tick all the boxes. Aspirin and paracetamol are needed to control the symptoms which now include, I think, a high temperature. We need aspirin and a thermometer.

I leave Jo and go in search of a pharmacy. It’s the hottest time of the day and I’m anxious. Rheumatic Fever can get complicated and recovery can take some time – we may need to fly home. Suddenly my mood is uncharacteristically bleak and the streets are an oppressive swarming malevolent freak show, the stinking filth and rot, the hideously deformed mendicants and pathetic begging children are all I see. I’m blind to the excitement, beauty and charm. After a sweltering fifteen minute waIk east I locate a small pharmacy – they have aspirin but only 85 mg tablets. The recommended daily dose for a fever is 3 to 4 grams so Jo would need to swallow between 40 and 50 of the things. Don’t you sell higher doses? I ask. No he says. Try the clinic on 49th street. He points west. Half an hour later I arrive with what feels like a fever myself – I’m sodden with sweat. I walk down 49th but there is no pharmacy so I cut across to 48th where there is one. No! Pharmacy closed, says the woman sitting outside. One across the road. Down there. She points. This one is open and more formidable. It’s next to a scruffy clinic. Standing behind the counter are six assistants, each about fifteen years old. No they only do 80mg aspirin. Don’t you have anything stronger? I ask. She shows me a pack of 81mg tabs and I laugh a bit hysterically. I buy a load and a thermometer. As an afterthought I ask if they have any penicillin. One of the youngsters presents a jar with penicillin written in felt tip on the lid. They could be anything. How many you want? Small wonder that there’s a global antibiotic crisis if they’re ladling them out – no questions asked. I buy fourteen.

Back at the hotel I take Jo’s temperature – 38 degrees. Not good. She downs a load of aspirin and paracetamol and an hour later when she’s enjoying a brief respite we make a big mistake. The hotel is not comfortable; it’s dark, dirty and noisy. I have to get out of here, says Jo; Let’s go to Mawlamyine and find a hotel with a garden and pool. And I want to take the boat ride on the river to Hpa-An. Sure, I say, better to recuperate there than in this place. 

Jo has an uncomfortable and fitful night but the following day at noon we board the bus for the six hour journey to Mawlamyine. And as we do so there is this nagging thought at the back of my mind that this is madness. We don’t know what Jo is suffering from, we don’t know what course her illness will take and we’re leaving the one place where we might get some medical help or a flight out. Jo sleeps throughout the journey as we rattle past the flat open paddy fields, lakes and rivers of south eastern Myanmar. We check into yet another hotel which seems to be empty. Jo manages a little of a bowl of vegetable soup but now she looks desperately tired, her eyes are puffy and swollen, her fingers crippled. Even though she slept all afternoon, she will sleep all night. 

The next morning I quickly decide that we’re in the wrong place and I tell Jo that we are going back to Yangon to a clinic I’ve discovered on the net. She looks at me in disbelief, total exhaustion and despair. I can’t face another six hour bus ride, she says. So I check with hotel reception the cost of a taxi. It ain’t cheap but then Jo says she can’t face that either. Is there a flight? I go online and we have a remarkable stroke of luck,  There are two flights a week from Mawlamyine to Yangon, one on a Monday and one on a Thursday. Today is Monday and there are a few seats available. Instead of a six hour bus ride it’s just a 30 minute flight. I book two tickets for the 1pm departure and we enjoy a few moments of relief.

Mawlamyine Air Traffic Control

One of the Two a Week Flights to Yangon

Mawlamyine airport is a relic from World War Two. Built in 1941 it was used by the RAF and the American Flying Tigers. It still has the original, now obsolete control tower decaying above the terminal building which comprises a waiting room, a wooden counter, some baggage scales and an X-ray machine. Jo sleeps for an hour on a bench in the waiting till the turboprop plane shatters the rustic tranquility. In just over an hour we are in a Yangon taxi heading for International SOS.

The rule in Myanmar is that at all costs you must avoid going into hospital. Flee the country for health care in Thailand. Myanmar’s medical facilities are shocking and you’re very likely to come out of one with more problems than you went in with. There are however some private clinics that have high standards of cleanliness and competence. International SOS is one of them. It’s located within the complex of the Inya Lake Hotel in the centre of Yangon. Whilst waiting for Jo to be admitted I cheer myself up with that fancy that it is International Rescue, not SOS, that is going to save Jo and that Brains and Scott Tracy are going to pull off one of their brilliant last minute stunts. 

Within ten minutes of registering, Jo is in a treatment room for an initial consultation with a nurse who immediately suggests the possibility of dengue fever or chikungunya virus. Chicken what? I ask. Google it, she says. It’s a virus introduced by a mosquito bite and Jo’s symptoms match. The mosquito bites during the day (Jo is assiduous about covering up and spraying herself with repellant in the evening) and is prevalent during and immediately after the rainy season in remote parts of the country, so she was a ripe target.

International SOS. A First Class Medical Facility

Jo undergoing tests

Half an hour later the doctor is with us. He’s friendly, informative  and very considerate. Jo is tested for flu virus (swab through the nose right to the back of the throat) and dengue fever (blood test). Both tests are negative so Doc reckons it’s chikungunya or Zika virus, probably the former. It’s a relief to get a diagnosis. Doc says it’s a nasty virus and Jo will be unwell for the next week with extreme tiredness, swelling painful joints and nausea. He prescribes medication to control the swelling, and tells Jo she must rest. The whole positive experience at International SOS is over in about three hours.

We have six full days before we leave Myanmar for the Philippines and there is nothing to do but hole up in a half decent hotel and wait for Jo to recover. With the flight to Yangon and the Thunderbirds bill our budget has taken a bit of a hit but it’s not the disaster I thought It might have been. Jo will make a full recovery and we’ll be back on the road.