Do not get ill in Myanmar!

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This pretty much sums up the advice guidebooks give about getting ill in Myanmar. The Lonely Planet states outright 'local medical care is dismal and local hospitals should only be used out of desperation.' Having spent a fair bit of time in hospitals over the last few days I think that is a dramatic exaggeration and quite frankly insulting to the doctors here (the ones I met at least.) This said, being ill is never pleasant, contracting a tropical disease thousands of miles away from home where no-one speaks much English is very unpleasant.

Travellers are advised to bring a complete supply of medication from home, including antibiotics if possible. Well, trying to march into a GP surgery in the UK and saying you want a bunch of drugs even though you're not ill is never going to get the desired result, so we came without.

Not that standard drugs would have done much for the delight that is dengue fever. Yup, less than a month in the country and paranoid about bites and I manage to catch dengue. Actually, considering the incubation period, it is entirely possible I managed to get infected in my first week here. If you're going to do something, you might as well do it to extremes! Quite ridiculous having spent the past four years living in another malaria-and-dengue-prone country without the slightest problem.

I've always been the food du jour of mosquitos, but Myanmar may beat every other country hands down for the sheer number of cheeky little beggars. Repellant, clothing repellant, mosquito coils - nothing works, English blood is apparently Michelin starred for Burmese mosquitos (see photo). And this is out of monsoon season!

Tuesday started with vomiting, fever, headache and joint pain. Apparently dengue used to be called 'break-bone fever' and it most certainly feels like it. Having written it off as bad 'flu and intending on self-medicating and sleeping it off, the first couple of days passed - especially considering our boss' claims that 'only children get dengue' so it can't possibly be that. And then the rash appeared and it got worse.

So we went to the hospital. Me, the driver from the school, and one of the assistants who, apparently, speaks the best English. She is officially the sweetest person in the world, but not so sure about the language. Amazingly the doctor did speak some English - apparently doctors and vets here tend to speak English for the simple reason that medical text books are usually written in English. Thank goodness for small favours.

First impression of the hospital (doctors only seem to work out of hospitals or hotels, not individual practices) was that it was ridiculously calm. Admittedly I have (fortunately) never had to spend much time in hospitals in my life, but this one was calm, quiet and more or less organised. I still don't understand the Burmese medical system but there is apparently no emergency department, and you only go to hospital if you have an appointment. I didn't initially believe this (what do you do if you have a broken leg?!) but it certainly seemed that way once we got past the guard. Everyone sat and waited patiently, no outward signs of anyone being ill, no blood, broken limbs or vomiting. I looked the worst of everyone there frankly.

The doctor seemed remarkably unconcerned at the sight of a foreign woman collapsed in a little puddle on his floor and proceeded to have a (mostly one-sided) conversation about how he'd always wanted to visit England and have I managed to do much sight-seeing since being here (er...no.) He was also quite fond of stating facts without giving much explanation. For example, telling me 'your liver is palpable' (or maybe 'not palpable' - I wasn't understanding much at this point) without any explanation as to what that meant. Is that good or bad? Positive sign that I'm recovering or are my internal organs about to break down leaving me to die in gooey agony?

At least he was a little more forthcoming in terms of diagnosis. Initially going with the 'only children get dengue' line, he changed this once my blood tests came back positive to 'children and some tourists...though usually just teenagers.'

Equally helpful was, 'you can be admitted to hospital for a few days.' Er... I know I can but do I need to be admitted? I'm rather more used to doctors telling me what to do in no uncertain terms. He seemed to take my question as I didn't want to go to hospital and offered that I could be treated at home before putting me on an IV and letting me sleep for a few hours before cheerfully telling me to come back in a couple of days to see if the drugs have worked. Fortunately drugs plus rehydration and two weeks of solidly sleeping 18 hours a day seemed to help, not withstanding the sudden drops in blood pressure over the next couple of months that resulted in vomiting or fainting without warning (not fun.)

All in all, despite still having no idea what you would do in an emergency or without someone to translate, I was pleasantly surprised with the standard of the hospital. This was only reinforced when I got back to the UK under instructions to have blood tests to confirm that the platelet and white blood cell count was back to normal, only to be told by my GP that I couldn't just request 'unnecessary treatment' when I was obviously fine. Myanmar 1 - NHS 0.

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Comments

[Home and Away]

Sorry to hear about your bout of dengue...
but pleased that you received good care and that you are fully recovered per the NHS. I also had dengue when I was 17...I lived in Thailand. As you say...NOT fun! Never got malaria, but my wife did.