Cottage Hospitals Go Without Doctors in Arakan State

By Admin 03 Jun 2023

Written By Min Tun

“He would not have died if the cottage hospital in our village had a doctor,” said Daw Ma Khin Thein, 55.

Her 63-year-old husband U Tin Aung Gyi was suddenly imperilled by hypertension, at around 4 p.m. on December 20, 2022. The man lapsed into unconsciousness after throwing up. There is a cottage hospital in their village, but there was no doctor, so Daw Ma Khin Thein arranged to send him to a public hospital in Minbya, 25 miles from their village. However, she was not able to hire a car until 6 p.m. that night.

They arrived in Minbya around 8 p.m., but it was too late. Her husband died about an hour later, said Daw Ma Khin Thein.

“There is no doctor in our village. So, we had to take him to the town. But he did not arrive in time, and he died,” she said.

Daw Ma Khin Thein lives in Kyin Inn Taung Village, part of Arakan State’s Myebon Township. The village is home to a population of more than 1,500 people and 326 households. The village also has a cottage hospital that was built at a cost of 600 million kyats (US$287,000).

There has been no doctor at the hospital since it was opened in December 2020. There are only four staff members at the hospital — three nurses including a senior nurse, and the watchman.

As a result, the hospital can only effectively treat mild illnesses, and lacks the capacity to take care of pregnant women, deliver babies, or treat patients who need emergency healthcare. Villagers seeking these medical services instead have to travel by road to receive treatment at Minbya Hospital, located some 25 miles from the village. The only other feasible option is to travel 18 miles by boat to a public hospital in Myebon town.

The cottage hospital in Kyin Inn Taung Village is the closest healthcare facility for some 40 villages in the surrounding area. But because the hospital lacks the resources to provide emergency treatment, locals suffer from a variety of inconveniences and hardship.

“The majority of the people in our region are rather poor. When someone is severely ill, they can’t receive treatment at the village hospital, and they need to be sent to the hospital in the town. In that case, family members have to hire a car and it costs us a lot of money to save a life,” said Daw Ma Khin Thein.

This problem is common, to varying degrees, across large swaths of rural Arakan State. There are cottage hospitals in Buthidaung, Rathedaung, Sittwe, Mrauk-U, Minbya, Ramree, Manaung, Ann and Taungup townships that also do not have doctors, making it difficult for those local populations to receive basic healthcare services.

Moese Island, in Rathedaung Township, is home to 28 villages. There are two cottage hospitals, respectively in Ugar and Kutaung villages, which are located at the centre of the island, but neither of the hospitals has a doctor.

Ugar cottage hospital was opened in 2020, and has since been run by a senior nurse alone. Kutaung cottage hospital also has not had a new doctor since the doctor there was transferred to another hospital in December of last year. 

“We have had troubles since the doctor left,” said U Oo Thein Aung from Kutaung Village.  “Nurses can’t provide the same treatment provided by a doctor.”

Local people on Moese Island are struggling to access public healthcare services and must go to Rathedaung and Sittwe to receive advanced medical treatment as the island’s hospitals are devoid of doctors. Making matters worse, when these villagers go to Rathedaung or Sittwe for treatment, they face difficulties on the way due to poor road connections.

If locals go from Ugar Village to Rathedaung town, they have to travel via a rough gravel road, and then must cross a river to Rathedaung town, which takes about half an hour by boat.

“The road is completely rocky, so it is not comfortable even for people in good health. There are concerns for patients travelling that road. The patients have to cross the river by boat, and their lives are in danger. If the wind is strong, people cannot cross the river,” he added.

DMG’s repeated phone calls to Arakan State Health Department officials seeking comment on the lack of doctors at rural hospitals in Arakan State went unanswered.

The Arakan State Health Department told DMG in December 2020 that among the 53 cottage hospitals in Arakan State, 23 did not have doctors. 

A commonly held belief is that the presence of cottage hospitals and lack of doctors to staff them is a symptom of poor management by successive governments.

“Building a rural hospital without a doctor is very confounding. From the time the hospital was built, the staff had to be appointed. There are cottage hospitals in rural areas, but there are no doctors,” said former Arakan State lawmaker U Pe Then.

“If there is a doctor at the health centre, even if you have to buy and use the medicine yourself, it is a support for your health. Now there are no doctors at all, and the rural hospitals are nothing but a joke,” said U Khaing Kaung San, director of the Wan Lark Rural Development Foundation.

Regime authorities cannot fill the vacancies, in part, because of the civil disobedience movement (CDM), local people say.

Residents are demanding the appointment of doctors as soon as possible as patients are facing life-threatening circumstances due to the physician shortfall among cottage hospitals.

Daw Ma Khin Thein from Kyin Inn Taung Village, Myebon Township, who lost her husband because there was no doctor at the local hospital, said she hopes her tale of woe can serve as a catalyst for change.

“I want the doctors to be appointed at rural hospitals in Arakan State so that others will not suffer like us,” she said. “It would be good if people in the rural areas could get medical treatment in a timely manner.”