Health care in Myanmar, also known as Burma, depends upon donated resources. I just returned from the interior after evaluating strategies for medical and humanitarian service. Last week’s column reviewed the dire status of health care in this developing nation. Still ruled by a military junta, it is among the poorest on the globe. The meager national budget prioritizes spending on defense, which leaves negligible funding for health care and medical education.
Leading causes of death today include malnutrition, malaria, tuberculosis, dysentery and AIDS. Government hospitals are few and far between. They are staffed with physicians trained in general practice who must resort to performing emergency surgery for appendicitis, gall bladder disease, bowel obstruction, tubal pregnancies and bleeding ulcers because there are not enough trained surgeons. Outcomes are poor. Physicians are paid roughly $100 per month and, given the opportunity, often seek employment outside the country.
To fill the gap in care, regional efforts on the part of village chiefs and local monasteries seek to raise funds and secure professional resources and materiel to support both hospitals and schools. During my recent trip, I began to work with the Jivitadana Hospital in the interior of the country northwest of Mandalay on the banks of the Irrawaddy River. Its funding comes primarily from the nearby Kyaswa Monastery. The medical director is a volunteer, retired government physician who supervises three other doctors for outpatient care. An Australian ophthalmology group travels there several times per year to perform cataract and retinal surgery, while an Italian general surgeon comes periodically to perform laparoscopic surgery for hernias and non-emergent gall bladder disease. A Japanese pediatric heart surgeon also flies out on a regular basis to repair birth defects of the heart.
A prominent traditional Burmese medical practitioner works at the hospital and collaborates with acupuncturists from Hawaii, England and the Netherlands. Traditional Burmese medicine is especially important as it does much more than fill a gap in conventional care. It helps to preserve and perpetuate the cultural fabric in Burma and represents health care that the Burmese people trust and understand. Foreign acupuncturists are received in much the same way.
Our family has a tradition of integrating medical service when we travel. Alia Zunin, my wife and co-founder of Manakai o Malama, has offered acupuncture services for Tibetan refugees on a trip to India. When I offered to return with her and hold a joint clinic that would combine acupuncture with conventional outpatient management of musculoskeletal problems, the chief administrator responded, "Thank you. All Burmese people have pain problems."
In addition, we have begun to evaluate the viability of facilitating intermittent trips by additional foreign surgical teams for regional needs that are as yet unmet.
The hospital administration is also currently seeking five dental chairs to replace old ones, surgical instruments for cataract surgery, a fiber-optic scope to evaluate the stomach and laboratory testing equipment.
To contribute resources, visit vipassanahawaii.org/mettadana.
Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
