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Myanmar in Transition: Primary Care and Public Health

Organiser:

Dr Xin Hui Chan
University of Oxford
xinhui.chan@gmail.com

Chair:

Prof Valerie Wass
Royal College of General Practitioners

Valerie Wass is a general practitioner who over the years has become increasingly involved in the international development of the field of family medicine. She studied for an interprofessional Masters and PhD in Health Professional Education in Maastricht in the Netherlands. She is currently Head of the School of Medicine at Keele University as well as Chair of the International Committee and International Development Advisor for South Asia at the Royal College of General Practitioners.

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Roundtable Abstract

The Myanmar healthcare system faces significant challenges after decades of underfunding and neglect.

Health indicators are poor: life expectancy is 65 years, the mortality rate for children aged 5 years and younger is 62 per 1000 livebirths compared to the global average of 51, around 40% of Burmese children aged <=5 years are moderately stunted, and the prevalence of tuberculosis and incidence of malaria are respectively three times and two times global and regional averages with increasing reports of drug resistance and counterfeit medication. Healthcare is chronically underresourced: the country has 5 physicians per 10,000 population with the bulk of primary care in rural areas being provided by midwives and non-medical staff, 81% of health expenditure is out of the patient’s pocket and only 10% from government expenditure, and of total government expenditure healthcare receives 3% compared to 20% for the military. These statistics, themselves based on data of mixed quality, gloss over inequalities between cities and villages, between rich and poor in a country where 50 million live below the poverty line, and between central Burmans and their ethnic minorities in the borderlands.

Against this backdrop, there is a growing recognition of the importance of further financial and human resource investment into the Myanmar healthcare system. The Myanmar government has augmented healthcare spending in 2013, and increased medical school student numbers. There is also a real openness from Burmese doctors to learn and improve standards of care and training. As the government healthcare sector develops, there remains a pressing need not just for support in the form of funding and expertise but for more effective coordination among agencies and individuals involved with healthcare. This roundtable brings together doctors, nurses and other healthcare professionals with an interest in developing healthcare in Myanmar to encourage collaboration and exchange of best practice.

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Themes

  • Development of primary care as a specialty, including its introduction into the undergraduate curriculum, supporting continuing professional development, and ensuring these and other initiatives are accessible and applicable to all general practitioners
  • Models of care in rural settings, including the role of midwives
  • The role of traditional medicine and its practitioners in healthcare provision
  • The role of voluntary/religious organisations and how to collaborate with them
  • Supporting medical education, including online teaching
  • Development and dissemination of online resources, including guidelines

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Participants

  • Dr Caroline Nixon
    Myanmar Family Medicine Project & Royal College of General Practitioners
    Caroline Nixon is a general practitioner and medical educator in Oxfordshire who has worked as a volunteer in Cambodia, Bangladesh, and Myanmar. She is currently involved as a Royal College of General Practitioners International Representative in a project to support the development of a faculty of family medicine in Myanmar.
  • Dr Eleanor Vogel
    Myanmar Family Medicine Project & Royal College of General Practitioners
    Eleanor Vogel is a general practitioner in Didcot, Oxfordshire, completing her GP training in Oxford in 2007. She has been involved in international projects in both primary and secondary care for over 10 years. Eleanor became Thames Valley Faculty International Lead for the Royal College of General Practitioners in 2012, and initiated the twinning project between Thames Valley Faculty and Myanmar colleagues.
  • Dr Myint Oo
    Myanmar Medical Association General Practitioners’ Society
    Myint Oo is a general practitioner in Yangon who is secretary of the Ethics Committee of the Myanmar Medical Association General Practitioners’ Society. He has published widely on family medicine, health policy, and human rights.
  • Dr Thinn Thinn Hlaing
    Brighter Future Foundation
    Thinn Thinn Laing is a metabolic medicine registrar at Addenbrooke’s Hospital, Cambridge where she has been working with the Addenbrookes Abroad team to develop a health partnership link between Cambridge University Hospitals and Yangon General Hospital specifically in supporting laboratory and orthopaedic services. She is a trustee of the Brighter Future Foundation.
  • Dr Aung Aung Lwin
    Brighter Future Foundation
    Aung Aung Lwin is a consultant intensivist and acute physician in Chelmsford. A graduate of the Institute of Medicine 1 in Yangon, Myanmar, he is a trustee of the Brighter Future Foundation.
  • Dr Khin Swe Myint
    Brighter Future Foundation
    Khin Swe Myint is a consultant endocrinologist and honorary senior lecturer at Norfolk and Norwich University Hospitals. She is the current chair of the board of trustees of the Brighter Future Foundation.
  • Dr Nwe Thein
    Mind to Mind Foundation
    Nwe Thein works as a consultant psychiatrist in Shropshire, and contributes to the mental health sector in Myanmar through her young charity Mind to Mind.
  • Dr Andrew Murray
    Health and Hope
    Andrew Murray is a general practitioner who trained in Oxford and is currently chair of the board of trustees of Health and Hope UK.
  • Ms May Tha Hla & Dr Jon Wilkinson
    Helping the Burmese Delta
    Jon Wilkinson and May Tha Hla are founders of the charity Helping the Burmese Delta. He completed a DPhil in Chemistry but followed a business career in Unilever and WPP. She was born and brought up in Yangon, but spent her working life in the UK – and latterly in Burma – in market research.