At around 10 am the midwife came to the Operating theatre where we had just started todays list after completing the morning patient rounds: Mostly minor cases, incision of abscesses, dressing changes. Now, a 19-year old pregnant woman had presented with continuous heavy vaginal bleeding. According to the midwife there was no fetal heart activity. According to the woman, she was in week 33. We did not have access to ultrasound. She needed a Cesarean section. With no obstetrician employed, this is the job of the surgeon.
10 minutes later the woman was in the operating theatre and we prepared for the Cesarean section. Probably a placenta previa I thought. I opened the uterus and I still remember the subsequent moments of confusion and disbelief when I removed handful after handful of what looked like small white eggs. There was no child inside. Instead this was a molar pregnancy, which the woman had carried undetected into the 33rd week due to the lack of access to pre-natal counseling in the remote are where she lived. I removed the mola and closed the uterus. She was 19. She would be able to have more children.
However, the postoperative course was complicated, she kept bleeding. Was this perhaps an invasive mola? We will never know exactly. I had to perform an emergency hysterectomy, but the vaginal bleeding persisted, however by now it was slowly diminishing. Was there perhaps also an element of coagulopathy? Possibly, but without adequate testing modalities, no way to know for certain and in any case no treatment would be available. After a few more days on the ward she was ready for discharge.
How does the future look, in this relatively remote part of the country, for a 19-year old woman, just married and not able to have kids?
Not necessarily bad, I was told. In many such cases a childless couple would raise the children of other family members, such as her sister, as their own.
Obviously with access to appropriate prenatal care, the condition would have been detected far earlier and probably could have been treated.
Once in Yangon, I simply booked a flight to Sittwe, the capital of Rakhine, an uneventful 50 min flight away. Arriving after midday in Sittwe, I walked through a lazy sea-side town, where various hotel staff tried to charge me 150 dollars for a private boat or car to Mrauk U, the remote temple sight and main touristic draw of the Rakhine State.
I politely declined, walked to the bus station, and arrived in Mrauk U after 5-hour drive in the back of a local pickup, crammed with locals who eagerly touched my skin, impressed with how white it was. In fact, all the markets are crammed with all sorts of skin whitening products.
Mrauk U is the name of both a village with about 50.000 inhabitants and a wide-spread temple. Still off the beaten track, being occasionally deemed off limits to tourists depending on the political situation in Rakhine, and with locals still living between the ruins as they did 40 years ago in Bagan.
There are no Rohingyas here, I was told. They are all up by the Bangladesh border. There is no trouble here. Considering that I had read that the Rohingyas of Mrauk U had been expelled to a camp approximately 8 km south of town, I silently wondered but left the subject. I traveled by boat up the river and visited remote Chin villages, only accessible by water, where the elderly women still wear the characteristic facial tattoos, a practice abolished 50 years ago.
However, upon insisting, I was also told by my boat-guide that there was indeed a Rohingya camp located 8 km south of Mrauk U, but ”it is more like a village, they are fine, they live just like us with markets and everything. No problems”. On the contrary ”the problem is the Rohingya who tried to cross the border from Bangladesh to Myanmar, because Myanmar is a richer country than Bangladesh”. The rural villages I passed in Northern Rakhine state were by any standards very poor though.
I then travelled by bus from Mrauk U to Kyaukpadang (1 hour from Bagan), an overland route only opened for foreigners within the last year. Another uneventful overland travel in Rakhine State. To the ordinary tourist in this area the Rohingya are invisible and those locals involved in tourism tries their best to make them stay that way, knowing well that travel restrictions to this part of Rakhine State will severely impact their business.
I first visited Myanmar in December 1996. We spent Christmas Day on the atmospheric and quiet Inle Lake. In Bagan we road bikes through empty, dirt roads and met few tourists at the (not yet ”restaured) temples. We passed through landshapes where people lived as in the European middle ages. All seemed to follow the same itinerary during the allowed 14 days visit: Yangon-Mandalay-Bagan-Inle Lake-Yangon. I remember it as one of the most special countries I ever visited.
In 2017, I mainly returned to see those parts of the country, which were not open to tourists in 1996: Mrauk U and surroundings in Rakhine. Hsipaw (and the hill tribes) as well as walking from Kalaw to Inle Lake. As always, I travel independently without guide and make arrangements as I go.
Day 1: Arrive Yangon, visit Schwedagon Pagoda.
Schwedagon pagoda is timeless and had lost nothing in the past 20 years. Still the most impressive pagoda I have ever seen and should clearly be nominated a UNESCO world heritage site.
Day 2: Walk around Yangon
Considering all tourists spend at least a day here, Yangon seems relatively free from tourists. The somewhat touristy Bogyoke Aung San marked is best avoided, but fabulously authentic markets and streetfoods are available on every corner. Of the major cities in South-East Asia Yangon is my favourite.
Day 3: Fly to Sittwe, local pickup (5 h) to Mrauk U
Day 4: Visit Mrauk U temples
Day 5: Boat trip to Shin villages
Day 6: Bus from Mrauk U to Kyaukpadang (1 h from Bagan)
The visit to Mrauk U and Rakhine was the highlight of the trip and described in a separate post
Day 7: Local pickup to Mt Popa and hitchhike down to Bagan
Day 9: Plane to Mandalay and visit Mandalay
Obviously the boat trip on the Irrawaddy is the way I´d recommend for traveling between Bagan and Mandalay. However I already did that in 1996, it takes 12 hour upstream and the plane took 20 minutes and cost less than 50 US dollars. Day 10: Visit Mandalay
Mandalay is as wide-spread as I remember it and the tourists do not seem to take up much space. The obvious thing to do is to visit Sagaing, Mingun and perhaps Innwa on a day-trip. Which I did in 1996 and did not feel like repeating.
Day 11: Shared taxi to Pyin Oo Lwin and visit to the Botanical Garden
Shared taxis are of great value: From Mandalay to Pyin Oo Lwin the price was 4,5 dollars, with pick-up and drop-off at your hotel. The attraction of Pyin Oo Lwin are the Botanical Gardens, special in the context of Myanmar but probably not otherwise a major sight.
Day 12: Train to Hsipaw
The 7 hour train ride to Hsipaw passes the famous Gokteik viaduct as well as seemingly untouched villages.
Day 14: Visit around Hsipaw village and the market
Although Hsipaw is now on the tourist trail, it is by no means overcrowded.
Day 15: Shared taxi to Lashio, visit market and plane to Heho, overnight in Pindaya
Lashio is very close to the Chinese border. Almost no English is spoken here, however a small bakery right next to the market served the best caffé latte I had on my entire trip.
Day 17: Pick-up to Kalaw and visit town
Kalaw village really is not much of a place to visit, the attractions are the hills outside town. Day 18: Kalaw-Inle Lake hike, stay overnight in village
Day 19: Kalaw-Inle Lake and stay in Nyaungschwe
Walking from Kalaw to Inle Lake was another highlight of the trip and described in a separate post.
Day 20: Visit Inle Lake and overnight in hotel on the lake Inle Lake has also developed into something of a tourist trap: Thousands of boats ply the lack, hundreds of craft-shops are set up for tourists around the lake and the former stilt-town of Nyaungschwe has developed into a nightmare of concrete and construction.
Day 21: Visit market and overnight in hotel on the lake At the far Southern end of Inle Lake, where fewer tourists come, more authentic villages may be visited. But the time is long gone where Inle Lake was an unspoilt destination.
Day 22: Plane to Ngapali Beach
The most developed beach resort in Myanmar. The beach itself is great, lined with small shops selling grilled fish as well as big resorts. Day 23: Ngapali Beach
Day 24: Plane to Yangon
Again, the plane takes less than 1 hour and costs less than 70 dollars. The bus takes more than 20 hours. Day 25: Yangon Day 26: Leave Myanmar
Open any Lonely Planet edition of Myanmar, or talk to any tourist or local you meet, and everyone will tell you that to hike in Myanmar you need a guide: Maps are non-existent and trails are unmarked. Nothing, however could be further from the truth: Myanmar is in fact a superb place to hike without a guide. But you´ll need a GPS. In fact, hiking may be a grand word for the trails commonly frequented by tourists, with hill-walking being a more appropriate term.
This is not the Himalaya, it is not even the foothills of the Himalaya, but the top walks of Myanmar are great cultural walks.
I walked in three areas: Around Hsipaw, around Pindaya and the multi-day Kalaw-Inle Lake. Entirely uncomplicated and all by myself. Several times I would meet other tourist with their guides on my way navigating the quaint paths traversing rice fields and cattle enclosures and they would ask with astonishment how I could possibly find the way? Then I would point to my GPS and say ”electronic guide”..
Hsipaw: There has presently been some unrest in the hills around Hsipaw and the walk most seem to do is from Hsipaw to the hillsite Pankam Village, and then return to Hsipaw by car. I downloaded this GPS track, and ended up walking both up to Pankam Village and back in one (though long) day: 32 km, 890 asc/desc. The entire walk, apart from the initial few km´s is along the gravel road between Hsipaw and Pankam Village, located well up in the mountains. Several traditional Shan villages are passed on the way and a man has even set up a Nepalese style lunch-place directly on the road. This is a trail where you almost do not even need a GPS, just follow the road. On the way down from Pankam I met several groups of tourists with guides on their way up, after their obligatory long lunch and morning coffee breaks. The land shape around Hsipaw is very beautiful but I imagine, in more peaceful times, that more interesting trails could be explored than than up (and down) this gravel road. However the villages right at the beginning of the track are fabulously atmospheric.
The most popular walk around Pindaya is a circular two-day walk from Pindaya up to the modern Shan village of Yazegyi and back. I downloaded this circular track and decided to follow it up and make my own way down, making it a day-walk. The first km out of Pindaya are on gravel road, but soon you follow paths between rice fields and in between mountains until you reach Yazegyi village, fabulously located in the middle of several hilltops and houses painted in bright colour. The nearby mount Yazegyi is clearly visible from the village, an estimated 3 hour return hike, which I estimated I would not have enough time to do. As Yazegui is app. 14 km from Pindaya I decided to follow my own way back down, aided by the GPS via various gravel trails on my way back to Pindaya. A total of 28 km, followed by a visit to the spectacular Pindaya Caves, a highlight of any visit to Myanmar.
I walked from Kalaw to Inle Lake from February 3-4, 2017. Solo and independently, ie. without a guide. You will however need a GPS, as this is not a standard marked hiking trail, rather a trail following foot-paths through pastures.
Kalaw-Inle Lake is the top walk in Myanmar and also the best of the ones I walked. Several trails are available for download on wikiloc, and to be on the safe side I downloaded several as I could not find any specific information about where to sleep, apart from info saying that a guide would be needed to communicate with villagers… Not true, in fact.
I finally ended up following this trailas a wikiloc commenter stated that he had walked it recently without problems. Being 51 km, and seeing that the land shape was only moderately hilly, I decided I would walk it in two days. Finally, I ended up walking 35 km the first day and 17 km the second day:
The trail is very beautiful, a superb cultural walk where fields, cattle and unspoilt villages are passed along the entire trail. The initial 5 km out of Kalaw is on gravel road, then enters into pine forest until you exit the forest and walk along a ridge with superb views passing chili-plucking women, and men guarding their cattle. After 17 km the descent to the road starts (some pass the night in the nearby village at this point), all the time passing villagers working in the fields. The road is reached at 20 km and I considered resting here, but it turned out only a handful of villages in the region are authorized to accommodate foreigners, and this was not one of them. As I was carrying a sleeping bag I was not really in any trouble. With temperatures not below 10 degrees at night I could easily sleep outside if I had to.
I continued to walk on, closely watching my GPS, criss-crossing in between rice fields and crops with many locals saying ”only one”, clearly not used to seeing someone walk entirely alone and without a guide. At around 5 pm I spotted a group of tourists with their guide at the other side of a rice field and I knew I must be close to a tourist-approved village, as the sun sets at 6 pm. Rightly so, and at 6 pm I entered what was a major stop-over village on the Kalaw-Inle Trek. I then found out, that all the guided tours do the Kalaw-Inle as a tree-day hike, choosing various villages for staying overnight the first night, but most staying at this village on night two, unless continuing 2 km to a large monastery.
As I entered the village I immediately knew that I had entered the tourist trail, as a group of 10 walkers yelled ”welcome, you made it” from a table where they were having beers. I walked further into the village, approached some villagers, made the sign for sleeping and was immediately pointed to the house right next to me. Mats on the floor upstairs, bucket shower, toilet, dinner with beer and breakfast: All 7000 Kyats. Incredibly friendly hosts, clearly used to having walkers stay overnight. Almost no English was spoken apart from ”son” ”grandson” ”daughter-in-law”. Family is important here.
The next day I was clearly on the tourist trail, meeting about 100 other walkers on the way down to Inle Lake. The trail I downloaded, stopped in a village with no road access close to the lake, where all the guided tourists take a boat to Nyaungschwe. I am sure I could have negotiated a boat as well, but I chose to walk back 2 km to the main road an negotiate a motor-bike to Nyaungschwe. So close (17 km) to Nyaungschwe and yet the villages on the Western shore of Inle lake are virtually untouched and the motorcycle driver and his mother clearly had not dealt with tourists before as they had no idea what to charge for the motorbike ride to Nyaungschwe.