Case Study from Myanmar Professor Zaw Wai Soe Rector University of Medicine #1, Yangon Strengthening Health Care Systems

Burma – Myanmar change, Emergency Medicine Our Case

Myanmar is the largest country in mainland South-East Asia 15 States & Regions 74 Districts 330 Townships 64 Sub-townships 2891 Wards Village tracts Villages

Surgery & Anaesthes ia in Myanmar today Surgery & Anaesthes ia in Myanmar today

Shwedagon PagodaPopulation m Growth Rate 0.8 in Rural Areas 70% National Groups 135 Languages100 Buddhists90% Age Groups 0 – 14 32% 15 – – 5959% > 60 9% 93 M : 100 F

Mandalay Inlay Lake Adult Literacy Rate89.5% IMR62 U5MR72 MMR1.44 Life expectancy Urban72.1 Rural65.5

Medical Universities Total # studentsIntake University of Medicine(1) Yangon University of Medicine, Mandalay University of Medicine(2)Yangon University of Medicine, Magway University of Medicine, Taunggyi 100 Total 1,30 0

2013~2014 Total No. of doctors Total No. of Nurses Total No. of MW+LHV 24902

Changes in Myanmar The Lady was out, She was elected... The doors of Myanmar begin to open

Prof. David AK Watters Dr. Tai Wai Wong Prof. Peter Cameron Mr. James HB Kong

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 1, Yangon Yangon General & Yangon Orthopaedic Hospital(s)

Emergency Medicine Development in Myanmar Phase I Diploma Course & EM Departments in Major Cities Phase II Masters in EM EM Department in State & Division Phase III EM Department in Universities Local MMedSc (EM) Dip of EM Nursing EMT & 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 1 st leading cause of Hospitalization11.5% 1 st leading cause of DEATH8.1% only 1 ’National’ Blood Bank !?

Health Expenditure (1998– 2015) 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

Central31 97 Emergency Physician 10 State & Divisional 37Neurosurgeon11 District29Ortho & Trauma208 Township352General Surgeon323 Station552Ob-Gyn358 Total1001Anaesthetists201 Population 51 million 1,11 1 Doctors per 100,000 population 2.2 Hospitals & Manpower ( )

MMed Sc at Central level 2 months courses to Gen Surgeons from State & Divisional H’s 2 months courses to Gen Surgeons from State & Divisional H’s 4 X 3 X 6 = 72 will start in March X 3 X 6 = 72 will start in March sets of neuro instruments & CTs in State & Divisional H’s 20 sets of neuro instruments & CTs in State & Divisional H’s Emergency Medicine Neurosurgery Orthopaedics General Surgery Obstetrics & Gynaecology Anesthesiology 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