Case Study from MyanmarProfessor Zaw Wai Soe

Rector University of Medicine #1, Yangon

Strengthening Health Care Systems

1927...

Burma – Myanmar change,

Emergency Medicine

Our Case

Myanmar

is the largest

country in mainland

South-East Asia15 States & Regions74 Districts

330 Townships64 Sub-townships

2891 Wards13698 Village tracts

64817 Villages

Surgery &

Anaesthesia

in Myanmar

today

Shwedagon Pagoda

Population51.49

m

Growth Rate 0.8

in Rural Areas

70%

National Groups

135

Languages 100

Buddhists 90%

Age Groups

0 – 14 32%

15 – 59 59%

> 60 9%

93 M : 100 F

Mandalay

Inlay Lake

Adult Literacy Rate

89.5%

IMR 62

U5MR 72

MMR 1.44

Life expectancy

Urban 72.1

Rural 65.5

Medical Universities

Total # students

Intake

University of Medicine(1) Yangon

3454 400

University of Medicine, Mandalay

2881 300

University of Medicine(2)Yangon

2945 300

University of Medicine, Magway

1984 200

University of Medicine, Taunggyi

100

Total

1,300

2013~2014

Total No. of doctors

31542

Total No. of Nurses

29532

Total No. of MW+LHV

24902

Changes in Myanmar

The Lady was out,

She was elected...

The doors of Myanmar begin to open... 2011-12

Prof. David AK Watters

Dr. Tai Wai Wong

Prof. Peter Cameron

Mr. James HB Kong

DEVELOPMENT OF

EMERGENCY MEDICINE

IN MYANMAR

Dr Zaw Wai SoeMBBS, MMedSc(Ortho), FRCS(Glasgow), DrMedSc(Ortho)

Dip in Med Education

Professor of Orthopaedics & TraumatologyUniversity of Medicine 1, Yangon

Yangon General & Yangon Orthopaedic Hospital(s)

Emergency Medicine Development in MyanmarPhase I Diploma Course &

EM Departments in Major Cities

Phase II Masters in EMEM Department in State &

Division

Phase III EM Department in UniversitiesLocal MMedSc (EM)

Dip of EM NursingEMT & Paramedics

Training

Total injury

morbidity –

11.5 % is

HIGHEST in

2012 !

Total injury

mortality– 8.1

%

is HIGHEST

in 2012 !

Burden of Injury in Myanmar

1st leading cause of Hospitalization

11.5%

1st leading cause of DEATH 8.1%

only 1 ’National’ Blood Bank !?

Health Expenditure (1998–2015)

1988 2008 2011 2013 20150

4000

8000

12000

16000Kyats per Capita

1000 Kyats = $1 USD

National Seminar on development

of EMS in Myanmar

EMS Plan Advocacy meetings – regional & departmental

National Seminar on development of EMS in Myanmar

Submission to National Health Committee

Pilot projects

Implementation by Phases...

Resource collection

Central 31

97

Emergency Physician

10

State & Divisional

37 Neurosurgeon 11

District 29 Ortho & Trauma 208

Township 352 General Surgeon 323

Station 552 Ob-Gyn 358

Total100

1Anaesthetists 201

Population 51 million1,111

Doctors per 100,000 population 2.2

Hospitals & Manpower (2013-14)

MMed Sc at Central level

• 2 months courses to Gen Surgeons from State & Divisional H’s• 4 X 3 X 6 = 72 will start in March 2015-6• 20 sets of neuro instruments & CTs in State & Divisional H’s

Emergency Medicine 0 25 2015

Neurosurgery 0 5 2016

Orthopaedics 20 60 2015

General Surgery 30 68 2015

Obstetrics & Gynaecology

30 65 2015

Anesthesiology 30 60 2015

URGENT

Need of Neurosurgeo

ns

planned at Primary Level

Primary Emergency Care Adult & (Paediatrics)

Emergency Anaesthesiology

Emergency Obstretics & Gynaecology• 1 year Curriculum• In State & Divisional Hospitals• Focus Emergency Care

Select from & serve in State & Divisional...

5 X 20 = 100 per year

Diploma in ...

Limited Facilities

How do to do this ??

Phase I

Phase II

Phase III

Phase IV

Yangon General Hospital (c 1906)

Thank you for your support & kindness to Myanmar