Doctors from Canada and Burma exchange lessons on refugee health care

There was reverence in her voice when Dr. Hillary Lawson introduced Dr. Cynthia Maung and medic Aung Than Wai to her Ottawa colleagues. Six years had passed since Hillary volunteered at the Mae Tao Clinic in Thailand, working alongside Dr. Cynthia and Aung Than Wai. She could not have known that six years later she would be working with Burmese refugees in Ottawa, people who had left the refugee camps in Thailand to begin new lives in Canada.

Hillary, a physician at Ottawa’s Centretown Community Health Centre, works with recently arrived Karen refugees, many of whom had received health services through Dr. Cynthia’s Mae Tao Clinic in Thailand. The Clinic was established by Dr. Cynthia, herself a refugee, and operated by a number of committed people who have fled to Thailand to escape the scorched-earth campaigns conducted by the Burmese military junta. Aware of the impact on local social service organizations of the resettlement of thousands of refugees from Burma, Inter Pares organized a gathering in September 2009 between our colleagues from Burma and the Community Health Centre. There was much to share about the intersections of poverty, conflict, and the conditions that affect the health of people that both the Mae Tao Clinic and the Community Health Centre serve.

Leaders from the Karen community, who knew Dr. Cynthia, were also there. They had supported the Community Health Centre to re-envision and restructure its model of primary health care so that it could better serve immigrant and refugee families. The Community Health Centre struck a committee in an effort to develop a holistic program that would address the many determinants of health in an interdisciplinary manner, while supporting people to improve the health of their community.

Inter Pares also arranged for members of the Burma delegation to meet with the International Development Research Centre (IDRC) to discuss how, in contexts of profound inequality and conflict, community-based health systems can be developed and supported. The experience of the Mae Tao Clinic provided IDRC staff with a concrete model. Dr. Cynthia Maung and Aung Than Wai, along with Dr. Chris Beyrer, Director of the Center for Public Health and Human Rights at Johns Hopkins University, shared some of the challenges and successes in providing health care in conflict situations. IDRC staff found the presentation to be an especially relevant example of how community health workers can collect and analyze data that directly informs the development of health services. As Sue Godt from IDRC noted, “Dr. Maung and her colleagues have built an impressive integrated health service that not only responds to immediate needs of people caught up in a war setting. By building social capital and designing and implementing information and delivery systems, the foundation is being laid for a comprehensive national health service that can be scaled up once peace is achieved.

Through these exchanges with IDRC and the Centretown Community Health Centre, our counterparts were able to share their years of experience and their insights with their peers. Inter Pares acted as a convener – connecting people who are developing and strengthening community-led health care systems.