PUB's Founders - Cathy and David

History of PUB's Work

History of Burma

The Karen People


Essay on Dr. Cynthia Maung, Founder of the Mae Tao Clinic

Reflections by Dr. David Downham

September 12 1945 - a memorable date for the end of World War II in the Pacific. The young men, aged
by war, began to come home. Returning from the war in Burma was a new teacher for us in history and political thought, previously Major, and then Mr. John Royds. Shortly after he arrived, he made this statement in a class with us.

“Gentlemen you have to understand, it is ideas, not people that matter'.

To us, he was a hero, but the remark puzzled me for a long time. Much later realizing, this was a young man trying to come to terms with the carnage of which he had so recently been a witness and likely too an unhappy participant. That war was over but the carnage has continued in Burma, so sadly, without much interruption to the present day.

If you go out west for about a mile from the Ban Thai guest house in Mae Sot towards the border on the Inthrakeeree Road, you come to the rusty gates of the Mae Tao Clinic. Going through them, Dr. Cynthia's old house is on the right, and then on the left an even more dilapidated building.

When we first went there in 1999, she took us into it. The ceiling was low and we could not stand up properly, the floor was earth. The place stank of urine and the smells of delivery. Babies were crying and mothers grunting in childbirth. I was very glad to get out, straighten up and breathe fresh air. We felt as though we had just walked out of a Hogarth Picture.

Then she took us to the medical department. There was a young man dying of cerebral malaria, his IV run out, flies in his eyes, and deeply unconscious, no one paying him much attention. Dr. Cynthia also seemed unperturbed. Accepting. It was Fateful though for if we had not seen him – it is quite possible, we would not be talking to you here today.

I want to try to tell you a bit about Dr. Cynthia Maung.

She is a Karen by birth. She had just got through medical school, when the uprising broke in 1988. Like many others, she fled to the border.

A Thai monk arranged for her to rent the Clinic's land. She used the primitive buildings already there as a place to bring and treat the injured, as she traveled backwards and forwards across the border. It was a converted cow-barn.

In 1988, she thought what she was doing was temporary. ‘Temporary' has gone on and on, and she is still there. In the meantime the Clinic has changed out of all recognition. Then -She had no idea that she was to become an icon, the winner of multiple Humanitarian International awards and tipped for the Nobel Peace Prize, and that she would manage one of the most fragile and complex organisations that could be found anywhere.

When I started to write this – I put down a whole lot about Dr. Cynthia’s achievements; in the Clinic and with the numerous projects she has across the border – I read it to Cathy and she was bored stiff, as a matter of fact so was I – her advice – don't do facts, do feelings and she is quite right – you can find out all you want to know by looking up the Clinic Website at

Cynthia is actually a very shy person, who has at the same time, an extraordinary authority. Most comfortable speaking Karen of course, then Burmese and then English a long way last. And of course most comfortable with people in race in the same order.

About once a month we get called to ‘All Department Meetings' – I get asked too and I go because it is polite – but they are in rapid Karen. Occasionally I can sit next to someone who will whisper English translations of some of it in my deaf ears – I can get some idea of what is happening – then there is the “Naw”.

I have never seen her anxious, occasionally firm but never angry, and always calm which can sometimes be slightly unnerving.

Two years ago, we were very short of cash and we were worried. To her it was simply another testing time and she just giggled and said someone should give her another award. All her award money goes straight back into the clinic.

As you know a lot of right-minded people can be very determinedly wrong. NGO's are great – we could not do without them – but sometimes they can be a total pain in the neck. I have seen Cynthia wrestling with the payments for food, electricity and water, while we are drowning in a sea of hyperdermic syringes.

Sometime ago, there was a real crisis with very little available in funds and the rumour began to circulate among some respected members of the NGO circle in Mae Sot that she was incompetent and maybe corrupt too – it was a very uncomfortable time and I began to have doubts as well – so I talked to Law Kwa, my chief medic in Trauma, someone I love and respect very much, and he looked at me for a long time and then he said very seriously:

“Pou Pou , I do not think just I heard what you just said”.

So I said: “Law Kwa, do not worry, for I said nothing” and so we smiled together and got on with the rest of the day.

There was, of course, no incompetence and no corruption – just another big funder had suddenly decided some other cause needed a greater attention.

Sometimes I am upset that things are for her not what they used to be. We are hoping to give her an emblematic stethoscope to try to persuade her to spend less time administrating and more with us. I remember her coming on rounds with us and we showed her a young woman with abdominal pain who was a real puzzle. She sat down and talked to her for a long time and it was clear that she and the young woman had gone somewhere else together. At last she had finished. The woman's pain seemed to have gone.

Later I heard she had been raped in her village by the soldiers. Her husband then nor the people in the village would have anything to do with her. She was outcast and starving. In desperation she had crossed the border and for a while had earned her living as a prostitute before coming to the Clinic for help – she had cried out her torment in terms we had not understood – but Cynthia had and rescued her.

I remember another time. A young man was brought in. He had stepped on a mine ten days before. He was septic and very sick. What was left of the foot was infected and gangrenous. He was brought in by his Uncle. For some reason, his parents were not able to come with him. We treated him with fluids and antibiotics to the point at which it was safe to remove what was left of the foot – and we explained to his Uncle and his Aunt that this was what had to be done. Our patient was glad of that – but the Uncle and Aunt would not take the responsibility. They said he had to be taken back across the border, see his parents again, be treated by a traditional healer. We told them that if they did that, he would die. My Karen friends argued for a day with them, eventually giving up. It was his Karma they decided and so he was put back in the truck to go home. I could not stand it and ran and got in front of the truck and shouted for Dr. Cynthia to be found. It was all very unseemly and I believe I suffered a huge loss of face that day. Eventually they found her. I sat around while she talked to the relatives for well over an hour. She finished and walked away. I had to catch up with her. ‘So what has happened I asked; “ Oh, he will have the operation,” she said, and walked on. And so he did, and so today he is alive, or so I hope, and Cynthia as usual forgets, I am too deaf and too old to learn Karen.

Clearly both ideas and people matter. Indeed what would the Karen do, what would the Burmese do and for that matter what would the World do without people like Dr. Cynthia who change the world, with their ideas, so much for the better.