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  • Hospital Days—Observations of a Micro-Cosmos of Myanmar Society
  • Jella Fink (bio)

Spending time in a Myanmar hospital was certainly not at the top of my bucket list. Being in the ward as involuntarily as everyone else, I came in as an uninformed friend. As a member of the group of caregivers, I automatically became a participant observer of Myanmar's hospital culture (anthropological habits die hard), and tried to collect as much intelligence as possible to support my friend's recovery.

The ward we ended up in after a hazardous journey to several physicians is a typical ward of a government-funded hospital in Myanmar. Basic services are available for free, whilst additional costs for medicine, some laboratory tests and food must be borne by the patient. Private hospitals are available but remain unaffordable for most people. And while basic health insurance has recently become available, it only covers a period of one year, and the available budget per client is limited. Overall, most health-related costs are covered by individuals and their families. If the money runs out, the patient's recovery is put at stake.

"We Will Wait and See"

"We will wait and see" is a frequently repeated credo in the hospital setting in Myanmar, which expresses the attitude of physicians, [End Page 646] patients and their families. The patience and acceptance of fate of Myanmar nationals seem to shimmer through. No matter how bad a patient's condition is, all processes run quietly here. New patients are settled into their beds, awaiting the physician's initial checkup. The noise level is surprisingly low considering the number of people. Every once in a while, however, the quiet is disrupted by the sharp squeaking of the wheels of oxygen tanks being moved back and forth by caregivers. The caregivers are not healthcare professionals, they are the patient's relatives (rarely, friends), who are present twenty-four hours a day.

In this hospital there are many young physicians. They move slowly from patient to patient, not as hurried as I observed at another hospital in Myanmar. The daily examination is followed by a conversation about the patient's health status amongst physician, patient and caregivers. The physicians are very engaged in determining the patient's condition. But at times information gets lost, as there is an unspoken consensus amongst caregivers and patients that information that is not asked for specifically will also not be given—and this can include additional symptoms, for example. Those are then communicated to their relatives, who will decide if that information should be shared with the physicians.

The group of caregivers—the relatives—deserves special attention. It is they who do much of the work, which I—as a Westerner—had only ever witnessed being executed by physicians and nurses. To my understanding, visiting a patient includes bringing flowers and being entertaining company at the cafeteria. But this is not the case at a hospital in Myanmar. Instead, there is a twenty-four-hour shift for caregivers. Most of the time, these caregivers are relatives, either one or two people (husband and child or adult children and their offspring, for example), who spend day and night at the hospital. Their tasks include organizational, logistical and nursing-related activities.

Joking between the members of different families is a way to lighten the mood and pass some time. Discussing the prices of [End Page 647] the fruit seller, as well as the offers at different teashops, are the most frequent topics. Medical conditions are not a focal point of discussions.


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Figure 1.

A patient busies herself with a smartphone.

Waiting and seeing is also covered by extensive smartphone usage. Sometimes, pictures of the hospitalized are taken and shared on social media platforms, like Facebook. This is another example of the differences in understandings of privacy on the one hand and good intentions on the other. By sharing this image the patient may be able to receive positive thoughts/energy from other friends, so-called "metta", which will support the recovery. Besides this, using phones to watch music videos or playing games is particularly popular—as long as...

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