Radcliffe Travelling Fellowship Travel Grant report – Reuben Dennison (2019, Medicine)

I had the opportunity to spend my elective at the Mae Tao Clinic in Thailand, situated just a couple of kilometres from the Thai-Myanmar border. Its main function was to serve the health needs of undocumented Burmese refugees who were not able to access healthcare either in Thailand or in Myanmar due to the ongoing military coup. As such, it was a multi-department clinic, and though fairly low in resource, provided a whole new perspective for me on the critical need for these humanitarian charities.

During my time with the clinic, I was able to rotate through all the departments. I spent time in the reproductive wards, both inpatient and outpatient, as well as time in the adult medical inpatient ward, the adult medical outpatient clinic department, the makeshift emergency room, as well as some time in child inpatient and outpatient. I felt completely  immersed and integrated within the teams I worked with and genuinely had a fascinating experience overall.

From my time in the reproductive wards, I saw hundreds of women come through the doors, being given access to antenatal and post-natal care, with high-throughput ultrasound rooms and donation-funded medications to ensure the safety of their pregnancies. Very sadly, it was not uncommon to discover intra-uterine fetal deaths via ultrasound, often speculated to be the product of a self-induced terminations with various herbal remedies. Some of the women told us they had tried to terminate their pregnancies because they would not have been able to afford the childcare, or that they could not bring a child into a world so cruel. While in the inpatient department, I saw many live births and largely to the contrast of the UK system, the mothers gave birth without pain relief, high-risk pregnancies would still be delivered vaginally, and the rates of death were much higher. Despite this, the clinic ran an extremely inspiring department that ushered through many babies each week, providing early post-natal care such as vaccinations and G6PD deficiency testing. I was able to improve at many family planning procedures too, learning how to insert and remove Implanon implants and administer IM depot injections.

My time in the inpatient ward was very illuminating and in fact, very useful clinically for me to understand and examine patients with very advanced illnesses. There were many cases of long-term conditions such as diabetes (which, due to the inability to have insulin at the clinic, tended to be poorly controlled), advanced viral hepatitides, various cases of encephalitis and some tropical diseases such as leptospirosis, MDR tuberculosis and malaria. The deterioration of the government in Myanmar and uprising of the military coup with subsequent conflict has catalysed a new influx of disease across the border into the clinic and it was fascinating to see first-hand how these diseases presented (rather than reading  about them in a textbook). At other times, it was challenging to see patients being “under-treated” due to the lack of resources; I spoke to and examined a middle-aged man with very advanced leukaemia who only had access to the clinic pharmacy, being given multi-vitamins as his mainstay of treatment. It was experiences like these that emphasise the intertwined yet fragile relationship between health and politics.

As I grew in confidence, I was able to fully run my own clinics in the medical outpatient department – which acted as a centre for mostly primary care needs, with the occasional  patient requiring admission to the inpatient ward. In these clinics, I was able to fully take the medical history from patients (with the help of a translator), perform medical examinations and document the findings, with a collaborative discussion on how to manage the patient with the supporting medical staff. It was during these clinics that I leant the importance of communication, verbal and non-verbal, and the limitations (and mitigations) I had with such a language barrier.

The clinic also had a makeshift emergency department – something of a trial before they build a dedicated building; though funding cuts from the US have stalled this process and may postpone the development of an X-ray-equipped department. While sometimes quiet, it was here where I saw the most revealing evidence of conflict and oppression from the other side of the border. Patients were rushed in via truck with gunshot or blast injuries, with staff performing extremely effective makeshift blood bags and wound care. In the UK, I’ve often felt shielded from witnessing the brutality that goes on in the world, but seeing these things really demonstrated the catastrophic impact people can have on each other’s lives and wellbeing.

The whole elective experience at the clinic was completely transformative for me; from witnessing and being involved in the creativity of clinical practice under such low resource conditions, to broadening and refining my fundamental diagnostic skills. I felt the elective really deepened my understanding of global health inequalities and illustrated the collective experience of the necessity of healthcare. I am extremely thankful to the Radcliffe Travelling Fellowship Fund for allowing this elective to happen and I know I will bring many of the lessons I learnt into my own developing clinical practice.

Published: 21 August 2026

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