Development of Emergency Medicine in Myanmar

Transcription

1 Development of Emergency Medicine in Myanmar Dr Zaw Wai Soe MBBS, MMedSc(Ortho), FRCS(Glasgow), DrMedSc(Ortho) Dip in Med Education Professor of Orthopaedics & Traumatology University of Medicine I Yangon Yangon General Hospital & Yangon Orthopaedic Hospital

2 Myanmar is the largest country in mainland South-East Asia 14 States and Regions 67 Districts 330 Townships 64 Sub-townships 2891 Wards Village tracts Villages

3 Shwedagon Pagoda Population 59.13millions Growth Rate % in Rural Areas 135 National groups 100 Languages 90 % Buddhists 0~14 32% 15~59 59% 60~>60 9% 98.89M/100F

4 Mandalay Adult literacy rate 94.1% IMR(R) 30 IMR(U) 28.2 MMR(R) 1.57 MMR(U) 1.23 Inlay Lake Life Expectancy Urban Male 65.1 Female 70.5 Rural Male 63.9 Female 67.4

5 Total No. of doctors Total No. of Nurses Total No. of MW+LHV Royal Boat

6 Public Hospitals 924 Per Capita (public) Health Expenditure ( ) (Kyats) [1.35 (US $)] (880 Kyats = 1 USD $)

7 Medical University and Number of Students 1. University of Medicine (1), Yangon University of Medicine, Mandalay University of Medicine (2), Yangon University of Medicine, Magway 3141

8 Health in Myanmar 2009 Morbidity Mortality

9 HMIS Reports for 2007 & 2008 Year Reporting Status 96 % 97 % Cases/Deaths of Transport Injury / / 1316 Cases/Deaths of Occupational Injury / / 358 Cases/Deaths of Poisoning 2435 / / 243 Cases/Deaths of Fall from Height / / 355 Cases/Deaths of Burns / scalds / /138 Cases/Deaths of Drowning 2599 / / 7625 Cases/Deaths of Suicide 1275 / / 564 Cases/Deaths of Assaults / / 467

10 Cyclone Nargis Formed 27/4/2008 Dissipate 3/5/2008 Winds Tides 135 mph (215 km/h) 12 to14 foot high storm surge

11 Cyclone Nargis 2/5/2008 3:00pm 3/5/2008 9:00am Winds 135mph (215 km/h) Tides 12~20 foot high storm surge

12 Started at 11pm Ended at 7am In Yangon

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14 The Official said 150,000 Deaths 57,000 Missing 100,000 Injured.

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16 Dr James Han Boon Kong ( RACS )

17 ROYAL AUSTRALASIAN COLLEGE OF SURGEONS Primary Trauma Care in Myanmar

18 RACS & ACEM Mrs Daliah Moss Dr Georgina Phillips Dr Sydney Chung Dr Anthony Ho Dr Antony Chenhall Dr James HB Kong Dr Lee Tsun Woon Dr Eric Vreede Dr Wong Tai Wai Dr Stephen Swallow Dr Michael Holland Dr Hadyn Perndt Dr Max Esser Dr Kou Sio Kei

19 PTC Training Since March 2009 Supervisors 14 Instructors 189 Providers 861

20 Changes in Myanmar: The Lady was out She was elected! The doors of Myanmar began to open.

21 SEA Games (11 ~ 22 December, 2013) 11 countries 10,000 Athletes & Officials 40,000 Supporters & Spectators 17 events in NayPyiTaw 14 events in Yangon 1 in Chaungthar

22 We are Preparing for medical care in SEA game Minor illness Minor injury Major illness Major injury Outbreak Disaster The last SEA game in Myanmar was in 1969.

23 RACS SURGEONS INTERNATIONAL AWARD (13~26 November 2011) Jointly funded by ACEM I would like to find the way to develop the A&E services in Myanmar by looking and learning during my visit to Australia.

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28 bedded YangonGeneral Hospital

29 Entry to ED, YGH

30 ACLS room

31 Trauma receiving area

32 Emergency X-rays

33 In Myanmar YGH is the only center that has an A&E. There is no AMBULANCE SYSTEM. There is no EMERGENCY MEDICINE training.

34 Back from Australia I wrote a report of my visit to Minister of Health. I went and met him in Nay Pyi Taw, the new capital. I advocated him about the importance of the development of A&E in our health care system.

35 2 weeks after He accepted and received the courtesy call of the PTC international faculties;- Dr James HB Kong, Dr Georgina Phillips, Dr T W Lee and myself at the Ministry of Health on 9 December, 2011.

36 Courtesy Call in MOH 9 December 2011

37 To develop Emergency Medicine specialty & service in Myanmar To organize National Level Workshop on Emergency Medicine Development in Myanmar

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39 Deputy Minister of Health, President - MMA, International Faculties, DGs, Rectors of UM, MS of Teaching Hospitals, Professor & Head of Departments, Directors from DOH and DMS

40 DEPUTY MINISTER OF HEALTH PRESIDENT OF MYANMAR MEDICAL ASSOCIATION

41 Professor David AK Watters Dr Tai Wai Wong Professor Peter Cameron Dr James HB Kong

42 Myanmar the future A plan to upskill existing specialists (surgeons, anaesthetists or physicians) A specialist training program for doctors (eg Masters in Emergency Medicine) A diploma or certificate for Rural Family Physicians A trauma system embedded in the curriculum? Align training with International standards Better reception and initial treatment of all emergencies presenting to hospital, including women and children

43 Progress Recommendations and Proposals were send to MOH (30/1/2012) Agenda of EC meeting in Ministry (23/3/2012) EM Development Committee (29/3/2012) Discussion in Postgraduate Training Meeting (30/3/2012) Letter of Intent between Department of Medical Science / Department of Health and RACS/ACEM/IFEM

44 Letter of Intent

45 Emergency Medicine Development in Myanmar Phase I Phase II Phase III Diploma Course & EM Departments in Major Cities Masters in EM EM Department in State & Division EM Department in Universities Local MMedSc (EM) Dip of EM Nursing EMT & Paramedics School

46 PHASE I Diploma of EM for Junior Specialist Board of Study (2/4/2012) Curriculum (23/4/2012) From 1/6/2012 to 12/2013

47 Diploma in EM MMedSc in Medicine / Surgery / Paediatrics /Anaesthesia / Ortho 45 and <45 4 May 2012 last date 8 May 2012 Interview Selected 18 Candidates 2~8 June 2012 Myanmar Emergency Medicine Introductory Course (MEMIC) 2 months Clinical Rotations in each Specialty Emergency

48 HE Professor Dr Pe Thet Khin AusAID & First Secretary Shaanti Sekhon

49 Myanmar Emergency Medicine Introductory Course (MEMIC) International Faculties and Students

50 HE Ms Bronte Moules

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52 ASSET Course, 7~11 September 2012

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54 Plan ATLS /11/2012 ELSi 2/2013 EM visit to Hong Kong & US ED /4/2013 MIMMS 6/2013 APLS Burn 7/2013 Toxicology 9/2013 Examination 10/2013

55 Bagan Thank you very much for your help to Myanmar People.