Now is the Time
My name is Naw Zu Zae Nar. I am a Physician Associate, Patient Care Leader, and Vaccine Coordinator for Earth Mission’s Teaching Hospital program. This is my story.
Barriers to Education
I was born in a village near a larger township in Myanmar, where I grew up with my two brothers and one sister. My parents are Christians. They looked in the Bible and found my beautiful name, Zu Zae Nar (Susanna). They farmed rice and beans and also raised cows and chickens.
I started going to school in my village for grades 1 to 4, and then had to walk 30 minutes to another village to study grades 5 to 8. For grade 9, my uncle invited me to stay with his family in Yangon. But the following year my parents’ crops were damaged by floods and they didn’t have enough money for me to study further in Yangon.
I went to do grade 10 in a dormitory and failed the final exams. I had difficulties understanding some subjects. My teacher invited me to stay with her and study grade 10 a second time and I passed.
Looking for a Future
After finishing high school, I went back to my village to stay with my parents. The village didn’t have enough teachers, so they asked me to teach science and history to grades 5 and 6. I liked my job, but I felt like I didn’t have enough experience to teach them well.
During that time, one of my friends heard about Earth Mission’s Physician Associate training program and asked me to apply with him. I didn’t get a great high score to go to the University when I finished high school, and I could not speak English, so I thought maybe I could not be in this program either.
A month after the interviews, one of my village teachers came and told me that I was accepted! I felt happy for the opportunity.
I ask them, “Do you want to deliver at home or at the clinic?” If they want to deliver at the clinic, we tell them, “Come early”. We deliver babies at the IPD (inpatient department). When a woman comes in to give birth, she sleeps on the bamboo floor, and there is a piece of cloth around to protect people from seeing her. If she needs assistance, we put her on the table to do delivery. If we need to do an episiotomy, we give the mother an antibiotic to prevent infection, use a sterile blade from the autoclave, and give medicine to clean the wound.
Calling to Action
If Earth Mission went away, it would be difficult for us, because Earth Mission has been taking care of the Karen people and delivering a lot of PA students. But if Earth Mission was no longer here, we would figure it out. I will go on cleaning, taking care of patients, and helping teach medical students. This is because with Earth Mission, we are developing the education, experience, and confidence to change the future of our people.
I thank God that he made a way for me to find Earth Mission. I want to encourage all the young people from our community to join Earth Mission. This is a great opportunity and a time to make a difference and to help our people.
We don't know what will happen tomorrow, but we will always need people who can take care of our community and provide healthcare in any situation. Don’t postpone what you can do today. Now is the time to get an education that will improve our community.
How Earth Mission selects high-quality students:
Young adults from remote communities are nominated by their local healthcare leaders.
Candidates take placement exams in English, writing, and mathematics.
Candidates undergo health screenings for clearance to live in a harsh environment.
Candidates are interviewed for character, attitude, and desire to serve as a medical professional in resource-limited areas as their calling and career.
Candidates are tested in mental resilience, physical strength, teamwork skills, work ethic, positivity, patience, and compassion during a 4-week boot camp.
In my village, we had about 300 households and only 1 medic who could provide first aid assistance and basic medicine. If someone was really sick, they had to walk 1 hour to reach the nearest hospital. I decided to join the Physician Associate program because I wanted to help my Karen people receive the healthcare they need.
Stepping into the Future
Because of the coup, everyone in my village had to run away from their homes. Now, my family stays at the refugee camp. I cannot go back to my village. It affected my life. It affected everybody’s life, because now the children cannot go to school for education.
With only 7-13% of the World Health Organization’s recommended ratio of healthcare professionals, southeast Myanmar is experiencing some of the worst health outcomes in the world. Earth Mission trains and deploys Physician Associates to remote jungle communities where help is needed most.
I graduated from the Physician Associate program’s second cohort. Today, I work as Patient Care Leader and Vaccine Coordinator at Earth Mission’s Teaching Hospital program.
As the Patient Care Leader, I ask the patient what they need and educate them on care plans and procedures. When the doctors refer patients to another hospital, I ride there with them. I also check that vaccines stay at 2 to 8 degrees Celsius and monitor expiration dates. When supply is almost gone, I report to the doctors, and they order for me.
The vaccines we give the most are ATT (tetanus), hepatitis, and rabies. We do not see tetanus often, but we give the vaccine when people come with injuries. Tetanus is better to prevent than to treat. Another is hepatitis B. We see a lot of hepatitis B in the Karen, especially newborn babies. If the mother has hepatitis B, the children have a chance of getting it also. It is transmitted easily, so we get a lot of patients with hepatitis B.
I live 6 hours by motorbike from my home village area. Where I work is very different from my village closer to larger cities. There, we could get anything for food, and we could travel anywhere, even during rainy season, because the transportation was good.
But in the jungle areas where healthcare is most needed, it is difficult. Even if we have money, there is nothing to buy or sell. The roads are bad here. In the rainy season, it’s very difficult to go visit patients because roads are lost in flooding and it is dangerous to travel to the villages. But I serve here because it is where I can help my people the most.
Why develop a teaching hospital and campus in the jungle?
Earth Mission aims to make healthcare accessible between 1-2 hours away
Training remote people in their local context makes them the most effective in accessing, educating, and serving their people’s unique needs in jungle conditions.
Training people in best medical practices reduces malpractice, which exacerbates child and maternal mortality rates in these remote areas.
Improving Health through Education
I think it’s important to help develop remote villages and improve healthcare and education. They do not have much healthcare knowledge. Some traditional practices are good, but certainly not all. Animism negatively affects healthcare outcomes a lot.
For instance, when mothers give birth, midwives in remote villages tell them, “We need to stay near a fire. We don’t need to take a shower.” Some pregnant women don’t want to come and deliver at the clinic because they were told, “They will not push there, they don’t let us in there with a fire. You will get a cold and have to pay a lot.” They have the wrong understanding. We have seen women lose their babies because of midwives pushing on their abdomens to make the baby come out.
At first, when the clinic was starting, we saw a lot of that kind of problem. Now it happens less, because if they come for prenatal care, we educate them on labor and delivery.
“Don't postpone what you can do today. Now is the time to get an education that will improve our community.”
I also want to tell my Karen people that they don’t have to stay quiet when problems arise. If what you want to say is true, say it. If you see or hear something wrong, say it. Because we are shy and quiet, we are always behind everybody else and development and improvements are slowed down. We need to encourage each other to speak out and to be brave. We don't need to be afraid. We need to try to go forward together, to improve our community.