healthcare and history in the land that the world forgot-Myanmar

 

MINGALABA!!

This is the common greeting for friends and strangers in Myanmar. The direct translation is, ” it is a blessing” which has dual meaning for hello and goodbye. It also has a wonderful subtext as an offering of ‘ auspicious blessings”. What nicer way could there be to greet and part with someone, than by offering them a blessing.

Traveling to the other side of the world is no euphemism here… I  spent more than 25+ hours in air ravel, approximately 9,856 miles from my home in Atlanta, Georgia to Officially arrive in the Republic of the Union of Myanmar (formally the Republic of Burma). Logistically, it  has been quite the  undertaking to prepare for months gone from your home and outside of the country. Thankfully, I have a village preparing me for my time away, all who have conspired to help me be successful and given me the peace of mind that everything both professionally and personally is under-control while I am serving as a Global Health Fellow. To each and everyone of them… I am grateful!

It is both and honor and a privilege to have the opportunity to represent Pfizer as a Global Fellow and partner with PSI, all while being a first hand eye witness of a country introducing itself to the world and on the precipice of evolution and expansion. Myanmar is a country where access to the outside world had been all but criminalized for more than 4 decades. Trade, communication, innovation and medical advances had been halted for more than 50 years. The world marched on while the population of Myanmar was all but frozen in time. Imagine a country where Coca-Cola was considered contraband until just a few years ago, a place where they skipped right over the concept of black and white TV and were instantly catapulted into color tv, cable television, facebook and cell phones. A good majority of the population in the rural provinces still has little idea of the advancements the world has been making.

The military lead government (junta) was officially dissolved following a 2010 general election and a sparse civilian government was installed. Although the military retains enormous authority it has taken steps toward relinquishing control of the government back to the people. Myanmar is a country that is unquestionably on the verge of growth and modernization, the change in government constraints has allowed forward progress in the country’s foreign relations and has led the way for improvement in trade with Europe and the United States. The upcoming general election in 2015 will definitely be telling for the future of democracy in this country.

At this moment, Myanmar is one of Asia’s poorest countries. When the World Health Organization (WHO) ranked Myanmar against its global counterparts, the country was ranked last out of 190 countries with respect to what the WHO calls “overall health system performance.” %. Myanmar’s government spends the least percentage of its GDP on health care of any country in the world, it spend roughly 2% on healthcare; whereas impoverished Laos spends 4.5%, and Cambodia 5.6% of its GDP on healthcare.

The general state of health care in Myanmar (Burma) is poor. I recently read that Myanmar has barely 61 oncologists in the entire country and a meager 3 radiation machines in all of Yangon. Cardiovascular diagnostic capabilities barely exist anywhere in the country.

A bit of perspective on health care costs in Myanmar, currently it is mostly a private pay system. The average estimated patient’s out of pocket contribution accounts about 92 % of total health care expenses. Today, person in Myanmar needs medical attention, the vast majority will go to a private-pay clinic or monastery where for a small fee, they can receive very basic primary care services. If medicine is prescribed, the individual knows they will have to pay 100% of the costs out of pocket. The net of this is that today’s healthcare consumers in Myanmar are accustomed to taking nearly full responsibility for their individual healthcare costs.

Luckily for Myanmar, the demand for healthcare services, pharmaceutical products and medical innovations will go hand in hand with the economic development and increasing income of the Myanmar people. As Myanmar continues its economic growth, the demand for quality healthcare will undoubtedly increase, as will the demand for access to better more advanced procedures and treatment options.

I will be excited to learn more about this country , its customs, cultures and most importantly its people. As for now, I say to you…

MINGALABA!!

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