A life less ordinary
source: SMH (25-07-01)
Rebecca Foxton had it all as a well-paid doctor in a cosmopolitan city. So why did she give it up to work in a dirt-floored clinic on the Thai-Burmese border? Phil Thornton reports.
They are half-carried from the cramped back of a ute - father, mother, aunt and two small daughters. Dots of blood, red against the mud, trail the family into the clinic. Inside, two plastic fans chop at the hot air. Bandaged patients stare as medics lay the wounded on lino-covered wooded beds. Checking their injuries, Rebecca Foxton reassures the family by touching, talking and drawing word pictures.
The appalling injuries were caused when the father stepped on a landmine laid by Burmese troops. "He's lost one foot, but will probably end up losing both," says the volunteer Australian doctor. "His wife got metal fragments in her abdomen and chest and has internal bleeding. Her sister has a piece of metal resting on her heart, causing blood to collect around her lungs. One of the daughters' ring finger is blown off and the five-year-old got metal through her femur, shattering it."
It's another long day for Foxton, 28, who runs the trauma unit at the Mae Tao Clinic in north-west Thailand, in the conflict zone on the Thai-Burmese border. She plans to stay a year to help the many thousands of people who cannot afford medical treatment.
Nearly 30,000 people came to the clinic last year for treatment of malaria, tuberculosis, gastrointestinal disease, malnutrition, HIV/AIDS, respiratory infections, accidental injuries - and gunshot and landmine wounds from the fighting between local people and the Burmese army.
It's all a long way from Foxton's last job in an orthopedic surgery in a fashionable suburb of Melbourne. "Friends thought I was ruining my career when I said I was taking a year off to do this," she says. "Out here I earn about $430 a month. Back home I'd get twice that in half a day, and we had the best resources money could buy."
Foxton says her decision to work as a volunteer doctor at the Mae Tao Clinic was a spontaneous, impulsive one. "I am still relatively young. I felt I wanted to give something back before settling down to a full-time career." Foxton says she's fortunate to be able to share her knowledge, help people who need it and have a whole new experience on life that she wasn't getting in Australia. "For me that's far more valuable than money."
Besides giving up her high salary to work in Thailand, Foxton missed out on being bridesmaid at the wedding of her friend Lisa Weekes, the Olympic gold-winning water polo goalkeeper. The pair played together for Australia for five years.
"I'd love to have gone, but I couldn't take the time away from the clinic - it's understaffed and under-resourced as it is. I would have felt bad spending all that money flying back to Australia for a couple of days."
The clinic, between the town of Mae Sot and the Moei River that separates Thailand from Burma, provides free medical services to Burmese migrant workers, refugees, people crossing the border and local Thais, as well as those injured in the bitter local conflicts.
At the cash-strapped clinic, even basic necessities like sterilised bottles and medical handbooks are regarded as luxuries. Instead, plastic soft drink bottles are recycled and used to store saline solution, and Foxton makes her own wooden footstools for leg injuries. Handwritten signs at local guesthouses beg tourists to donate their unwanted holiday medicines.The clinic is a cluster of rambling sheds fenced in by rusty barbed wire and connected by a dusty track that churns to mud when it rains. The trauma ward is a breeze-block construction on a bare concrete slab. Its tin roof catches the fierce heat that reaches as high as 42C in summer, and it leaks in the wet season. Flies and insects buzz through the glassless windows. A small cubicle has been sectioned off from the main ward so new patients can be assessed and treated. Beds are roughly built wooden platforms without mattresses or sheets, covered in lino for easy washing.
A list of ailments written on a white board nailed to the bare wall tells the daily story of the care provided by clinic staff. Today it includes kneebone destruction - landmine injury; forearm medial damage; gunshot - burns to baby's face and head; abscess - post-landmine injury; foot injuries, blood transfusion and gunshots to face.
Foxton moves through the ward on bare feet, the nails on her tanned toes painted pink. A pile of thongs and plastic sandals lies discarded at the door. Plastic bags hold the patients' few belongings. A mother fans her sleeping baby and a young man shakes and bites his lip as a medic tries to inject him with a local anaesthetic.She stops next to a small woman and her baby, removing a large pus-soaked plaster from the crying infant's head. The mother puts the baby on her milk-swollen breast and the silence is immediate. Foxton cleans the baby's wounds, explaining to the mother through an interpreter to cut the baby's nails and keep the sores clean by using boiled water.
"The baby was only 26 days old when she was burnt," she says. "The mother left her for a minute and a candle fell and burnt her face and head. It's hard to stop it getting infected with all the flies, and that'll get worse now the wet season is here."Foxton is worried the mother will have difficulty caring for herself and the baby. "I want her to stay at the clinic - she has breast abscesses that worry me. We need to watch her and the baby's burns until they're both healed."
The mother shakes her head and says she has to go back to Burma. "If she goes, she'll want to see her traditional healer and if that happens anything from cow dung to tree fungus will be used on the burns. We've had some horrific infections from wounds treated like that."Foxton loses the argument with the young woman, but strikes a bargain that she promises to return to the clinic in two days.
Foxton says she's no saint, and that many of the young medics who work with her are the ones who deserve praise for risking reprisals from the Burmese military for helping at the clinic. "Many of the staff had to flee here for their own safety," she says.
"They don't even know if their families in Burma are still alive. By working at the clinic they endanger their families. We've had visits from spies - you never really know who you're dealing with."
Undercover Burmese agents are not the only dangers the staff at Mae Tao Clinic have to worry about. "Somebody came into the clinic and attached a grenade to a window and the pin to a doorhandle so it would explode when the door opened," she says. Luckily one of the patients saw a suspicious-looking person and reported it to the staff. "They investigated and found the grenade before anyone was hurt, but it was a close call."
Foxton and her team of seven medics operate an outpatient program, manage in-patients and run a dental clinic two days a week. The trauma unit alone performed 2,624 medical procedures last year.After a day spent trying to mend broken bones, counsel sex assault victims, stitch ripped flesh and avoid booby traps, Foxton admits there are times when she misses the normality of life in Australia.
"Sometimes I just don't want to see any more landmine victims or people who are under constant suppression. I miss little things like not being able to get in my car and go some place without having to think of the ramifications."
And occasionally she needs to take time out to get some perspective back. "Sometimes I get pissed off with the lack of resources, but the problem's mine - my expectations are too high. You accumulate months and months of kids crying, people having fits on you in the back of trucks, being covered in blood and trying desperately to save dying babies. At the end of the day, you have to know when you've had enough."
Compared with the hardships her colleagues and patients have to endure, Foxton considers herself lucky. "I thank God I've grown up in a society where my safety is guaranteed," she says. "I know it will never, ever be like this."