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
Myanmar is the largest country in mainland South-East Asia 14 States and Regions 67 Districts 330 Townships 64 Sub-townships 2891 Wards 13698 Village tracts 64817 Villages
Shwedagon Pagoda Population 59.13millions Growth Rate 1.29 70% in Rural Areas 135 National groups 100 Languages 90 % Buddhists 0~14 32% 15~59 59% 60~>60 9% 98.89M/100F
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
Total No. of doctors 26435 Total No. of Nurses 25644 Total No. of MW+LHV 22900 Royal Boat
Public Hospitals 924 Per Capita (public) Health Expenditure (2009-2010) 1082.4 (Kyats) [1.35 (US $)] (880 Kyats = 1 USD $)
Medical University and Number of Students 1. University of Medicine (1), Yangon 4327 2. University of Medicine, Mandalay 3956 3. University of Medicine (2), Yangon 3706 4. University of Medicine, Magway 3141
Health in Myanmar 2009 Morbidity Mortality
HMIS Reports for 2007 & 2008 Year 2007 2008 Reporting Status 96 % 97 % Cases/Deaths of Transport Injury 37644 / 1085 43917 / 1316 Cases/Deaths of Occupational Injury 39845 / 302 46096 / 358 Cases/Deaths of Poisoning 2435 / 196 2538 / 243 Cases/Deaths of Fall from Height 10617 / 394 10196 / 355 Cases/Deaths of Burns / scalds 14571 / 148 15544 /138 Cases/Deaths of Drowning 2599 / 1484 13083 / 7625 Cases/Deaths of Suicide 1275 / 557 1518 / 564 Cases/Deaths of Assaults 24826 / 405 28569 / 467
Cyclone Nargis Formed 27/4/2008 Dissipate 3/5/2008 Winds Tides 135 mph (215 km/h) 12 to14 foot high storm surge
Cyclone Nargis 2/5/2008 3:00pm 3/5/2008 9:00am Winds 135mph (215 km/h) Tides 12~20 foot high storm surge
Started at 11pm Ended at 7am In Yangon
The Official said 150,000 Deaths 57,000 Missing 100,000 Injured.
Dr James Han Boon Kong ( RACS )
ROYAL AUSTRALASIAN COLLEGE OF SURGEONS Primary Trauma Care in Myanmar
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
PTC Training Since March 2009 Supervisors 14 Instructors 189 Providers 861
2011-2012 Changes in Myanmar: The Lady was out She was elected! The doors of Myanmar began to open.
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
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.
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.
1896 1500 bedded YangonGeneral Hospital
Entry to ED, YGH
ACLS room
Trauma receiving area
Emergency X-rays
In Myanmar YGH is the only center that has an A&E. There is no AMBULANCE SYSTEM. There is no EMERGENCY MEDICINE training.
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.
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.
Courtesy Call in MOH 9 December 2011
To develop Emergency Medicine specialty & service in Myanmar To organize National Level Workshop on Emergency Medicine Development in Myanmar
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
DEPUTY MINISTER OF HEALTH PRESIDENT OF MYANMAR MEDICAL ASSOCIATION
Professor David AK Watters Dr Tai Wai Wong Professor Peter Cameron Dr James HB Kong
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
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
Letter of Intent
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
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
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
HE Professor Dr Pe Thet Khin AusAID & First Secretary Shaanti Sekhon
Myanmar Emergency Medicine Introductory Course (MEMIC) International Faculties and Students
HE Ms Bronte Moules
ASSET Course, 7~11 September 2012
Plan ATLS 13 20 /11/2012 ELSi 2/2013 EM visit to Hong Kong & US ED 13 21 /4/2013 MIMMS 6/2013 APLS Burn 7/2013 Toxicology 9/2013 Examination 10/2013
Bagan Thank you very much for your help to Myanmar People.