Mike Ives shares his experience of being on the road with an ambulance crew in Myanmar's biggest city.
Zaw Sai is sitting on a wicker mat, wearing a bright orange jumpsuit, when his mobile phone buzzes in his pocket. He brings it to his ear and speaks softly into the receiver. Then he rises to his feet – a thin silhouette under a car park streetlamp – and shouts: “Childbirth!”
Three men standing nearby, also in orange jumpsuits, follow Zaw Sai into a nearby ambulance. One slides behind the wheel, flicks on a blue-and-red flashing light, and turns onto an adjacent four-lane road. Within seconds they are speeding at 80 km per hour through Yangon, Myanmar’s largest city.
Many car drivers refuse to move out of their way, but Zaw Sai says that’s understandable. “Some of them don’t know about ambulances,” he explains.
The ambulance is a free, dusk-to-dawn service operated by the Free Funeral Service Society, a Yangon charity. Funded entirely by donations, the society began as a funeral service in 2001 and expanded into ambulatory work when it became clear that too many people were dying because they couldn't reach doctors fast enough. Daw Ayeyar Mg Mg, a senior administrator at the society, tells me it has a monthly budget of about 500 million Myanmar kyat (nearly half a million US dollars) to run four clinics and a squadron of free hearses and ambulances. It also spends a portion of that money on subsidies for ailing public health facilities.
The society is one of many ad-hoc responses to chronic shortcomings in Myanmar’s health sector. Its five ambulances are all second-hand; four are Japanese, and the one Zaw Sai usually rides in is South Korean.
“Government officials accept our help reluctantly,” says Daw Ayeyar Mg Mg. “They worry that people will think their government can’t provide for them.”
Yangon, a riverside city of 5 million, is a study in contrasts. Majestic, but weathered, buildings from the British colonial era line downtown avenues. Tourists flock here, partly because the city is an aesthetic throwback to colonial times.
But Yangon is modernising in a hurry. Serviced apartments are going up in and around downtown. Trendy bars are rubbing shoulders with rickety tea stalls and pungent-smelling fruit markets. And a wave of new cars is flooding the streets as Yangon’s urban planners race to build new roads and overpasses: at rush hour, the city’s main arteries are clogged with cars, bikes, buses and pedestrians. Its colonial charm seems like an increasingly distant memory.
“There are a lot of accidents here,” Zaw Sai, the volunteer medic, tells me, sitting on a blue leather bench in the ambulance’s back cabin. “I’ve seen a lot of dead bodies.”
© David Maurice Smith/Oculi
Tonight the ambulance team is racing to pick up a heavily pregnant woman and bring her to a delivery room. The problem is that the woman lives nearly 12 miles away, on the very edge of this sprawling city. And even though it is after 9pm, Yangon’s downtown traffic is heavy.
When the ambulance hits a particularly congested patch of gridlock, its driver, Zaw Myint, swerves across the road’s centre line and – with sirens blaring and lights flashing – heads the wrong way in the opposite lane. Zaw Myint’s driving is making me nervous. But Zaw Sai sits calmly beside me, with a broad smile on his face. He’s done this many times.
Eventually, the traffic eases up, and after nearly half an hour of driving the ambulance turns down a narrow road at about 30 km per hour. The asphalt turns to gravel as Zaw Myint pulls up to a row of one-storey homes. A crowd of people is waiting outside one of them.
The pregnant woman, who is 26, emerges wearing a white blouse and a red Manchester United jacket that barely covers her bulging belly. Zaw Sai jumps out, helps her through the ambulance’s open doors and lays her down gently on a stretcher. She doesn’t speak. I see beads of sweat forming on her forehead.
As the ambulance starts again, Zaw Sai wedges himself between a stretcher and some cabinets that hold vials of clear liquid. He puts on a pair of white gloves and takes the woman’s temperature and blood pressure, then holds the stretcher firmly as the vehicle’s chassis lumbers over the uneven and potholed road.
The woman is breathing heavily, and she winces at every bump. But her vital signs are normal.
Twenty minutes later, the ambulance passes through the entrance gate of a Yangon hospital. A crowd of people is milling around under some streetlamps as we pull up beside a maternity ward.
Zaw Sai jumps out again, gently brings the stretcher to the ground, and helps to push it through a hospital corridor toward a delivery room. Then he walks back into the Yangon night, still smiling, and waits for his mobile phone to ring again.
“Tired?” I ask. He isn’t getting paid for any of this.
“Not tired,” he says. “Always fresh.”