2
Finance and human resource effecting
Myanmars healthcare sector
HTOO THANT
T
hailand which is Myanmars
immediate neighbour, yearly earns
millions of foreign currency from
overseas patients by providing them with
international standard treatments and its
state-of-the-art medical facilities where as
Myanmar due to lack of human resources and
finance makes it is difficult even to cover the
local healthcare sector.
According to the ASEAN healthcare
communiqu, some ASEAN member
countries receive assistance to provide
international standard healthcare compared
to some western nations so health services
are even much cheaper. Therefore, these
countries yearly receive millions of dollars
from overseas patients who come for
medical treatment.
Thailands medical tourism earns US$ 2
billion per year which is about 40 percent of
other ASEAN counties health tourism sector.
Although questions were raised at
Hluttaw sessions regarding healthcare, reply
from the concerned ministry was that not to
mention medical tourism, at present even to
cover healthcare for the citizens are unable
due to constraints of financial and human
resource, meaning healthcare workers.
Currently, even expanding township level
hospitals to provide medical cover to the
rural populace are difficult, hospitals in
towns and cities are also facing difficulties
to appoint sufficient amount of doctors
says Dr. Myint Htwe, Union Minister for
Health and Sports.
Construction of new hospitals,
extending and renovating existing hospitals,
constructing service apartments and building
new 16-bed sub township hospitals all depend
on the budget allocated. In this process
approximately about 40 sub township
hospitals can be constructed during a
financial year, Dr. Myint Htwe, Union
Minister for Health and Sports explained
to the Pyithu Hlauttaw session on June 5.
Doctors who have to serve in far-flung areas
such as border areas face difficulties for
dwelling, so the cost of
building living
quarters
The Yangon Childrens Hospital (YCH) is a major public hospital in Yangon.
for them have to also be added in the
budget, the Union Minister added.
Hluttaw MPs usually raise questions based
on the difficulties that their constituencies
are facing such as to extend rural medical
centers, to appoint more midwives and nurses
and also to provide sufficient amount of
doctors, medicines and medical equipment
to towns. Even in Yamethin, the nearest
township to Nay Pyi Taw does not have a sub
township hospital so people who dwell in
rural areas face much difficulties in receiving
medical treatment and even lose their lives
said U Tun Tun Win, Hluttaw MP of Yamethin
township.
U Zone Teint, another Pyithu Hlauttaw
MP from Chi Phwe township in Kachin
State said that although there is a 500 bed
hospital in Myitkyina for the whole state,
there are no specialists to treat patients
so people feel very sad and in times of
emergency, they always have to travel to
either Mandalay or Yangon for medical
treatment which cost them a fortune.
For instance, there are no specialists
such as neurologists, cardiologists,
gastroenterologists and urologists in this
hospital, so patients have to travel either to
Mandalay or Yangon for treatment but as
travel expense, hospital fees etc..are so high
some even cannot afford to go and have to
give up their lives said a native who had
experienced this kind of situation.
The Union Minister said that there are still
many difficulties to fulfill the health services
of the states and regions. If I have to be
straightforward, when a state or region request
for a 500 bed hospital another state or region
also raises the same request. Therefore due to
the actual situation, when a 500 bed hospital is
provided, together with the hospital, medicines
and medical equipment can be provided.
However, it is impossible to provide human
resource such as doctors, technicians to that
hospital immediately. Although the situation is
obvious it is difficult to fulfill it.
Therefore the Ministry is nurturing more
specialists. For this year 2017, there are
plans to nurture 642 specialists, 820 in
2018 and 767 in 2019. Although previously
there were plans to increase the human
resource such as specialist, this plan was
not implemented.
Nevertheless, plans have been
drawn up for the years 2018-
2021.
Emergency assistance provided to a patient in an ambulance. Photos: Zarni Phyo
At present, there are five 200 bed region
and state level hospitals, 10 central level
hospitals and 30 specialist hospitals. There
are also 1123 township and sub township
hospitals in Myanmar. Although the WHO
indicates that it is necessary to have three
beds for every 1000 patients, it is still
unclear that how many beds are there for
patients in a country like Myanmar with a
population of about 51 million.
According the 2015 statistics of the WHO,
in countries that are low in development,
fundamental healthcare and prevention
for a person is approximately US$60 but in
Myanmar the allocation for the Ministry of
Health and Sports is only just K1000 billion
says Dr. San Shwe Win, Pyithu Hluttaw
MP of Yekyi Township in the Ayeyarwaddy
Region.
So if calculated with the allocated budget,
the health expenditure for a person would
only be US$20.
However, since the fiscal year 2011-
2012, the government has increased the
expenditure of the healthcare sector.
According to the approved statistics
K86.581billion for 2011-2012, K381.254
billion for 2012-2013, K484.383
billion for 2013-2014,
K661.882
billion for 2014-2015, K840.976 billion for
2015-2016, K831.052 billion for 2016-2017
and for the current 2017-2018 financial year
K1077 billion has been allocated.
As for Malaysia, the healthcare
expenditure in 2013 was US$13.7 billion
and is expected to rise to US$22.9 billion
in 2018. In the case of Singapore in 2015,
11 percent of the GDP, which amounts to
S$76.9 billion, was allocated for the health
sector. Although the expenditure for the
health sector of those countries are much
higher than Myanmar, there are healthcare
tourism which support their health sectors.
During 2015, there were 600000 health
related tourists who visited Malaysia where
the country received millions of US dollars.
In the Philippines, the government and the
private sector are working to together as
Public-Private Partnership(PPP) to raise the
healthcare sector. Similarly in Myanmar, a
health insurance system should be set up to
relieve the burden of the public said Dr. San
Shwe Win.
Change in social-economic system,
increase of growth rate, occurrence in
new types of diseases, lack of healthcare
knowledge, scarce in health funds and lack
of medicines are factors that directly affect
the public. So when this kind of situation
arises people have to bare about 80 percent
of the total cost which is a burden for them.
Therefore, a system which can effectively
support the governments healthcare system
and provide necessary healthcare to the
public, some kind of a health insurance
scheme should be set up, he said.
Myanmars healthcare expenditure
is only five percent of the total budget
and is far more behind the expenditure
of other low-income countries where
their expenditure is nine percent. A lot
of fatalities happen due to unaffordable
treatment cost, says U Win Win, Hluttaw
MP of Ingapu Township in the Ayayarwaddy
Region who commented on the burden
people face in their daily lives regarding
health matters.
Translation by Khine Thazin Han,
Kyaw Soe Htet and Zar Zar Soe
 4
Myanmars health sector is still underdeveloped. The country needs to build capacity by adding
doctors and nurses to cope with the growing number of patients. In general, low income
patients continue to rely on state owned hospitals, particularly Yangon General Hospital.
To find out the latest situation at the citys most popular hospital, Myanmar Times reporter
Myint Kay Thi interviewed the hospitals Medical Superintendent Dr Aye Ko Ko about the
working conditions of its doctors and nurses, and the cost of drugs and medical equipment.

Interview with Dr Aye Ko Ko, Medical

Superintendent of Yangon General Hospital
MYINT KAY THI
Q: How many departments are
there in Yangon General Hospital
and what kinds of diseases are
treated there?
A: Yangon General Hospital was
upgraded in 2016 to a hospital
that can provide 2000 beds. Its
also a teaching hospital. As a
result of the upgrades, many new
departments were formed. They are
the tropical medicine department,
hormonal disease treatment
department, and hand surgery
department. The Pharmacology
Department previously had three
patient wards, but it has been
upgraded to four wards. There
are Doctors and nurses are also
assigned to these wards. Other
necessary equipment and drugs
have also been provided. Currently,
there are 27 departments. Besides
Obstetrics and Gynecology,
Yangon General Hospital has an
emergency department, injury
units, cancer center and other
health services.
Q: How large a staff is Yangon
General Hospital operating with?
And, can you talk about the full
payment, cost-sharing, and free-
of-charge health services?
A: If you add specialists and
assistant doctors, the number of
doctors are more than 400. With
the addition of assistant nurses,
there are more than 700 nurses.
More than 60 new assistant
nurses have been appointed. But
red-uniformed nurse, numbering
about 300, are currently idle. We
need more nurses, Currently the
number of patients are more than
the number of nurses. Drugs are
not under the cost-sharing system,
as basic medicine and emergency
department drugs are provided
free of charge. But, patients have
to bare the cost of some medicine
that have run out as there are
a lot of patients at the hospital.
For this year, Yangon General
Hospitals yearly drug expenditure
for the emergency department is
K5.3billion. Thats why, in the long
run, we cannot continue giving out
free drugs. There is also a plan
by the government to establish
a health insurance system. That
topic is being discussed in the
Hluttaw. If it is approved, there
might be changes in the drug
treatment system.
Q: Yangon General Hospital
seems to have become
overcrowded due to large number
of patients receiving treatment.
Are there any plans to expand
the wards?
A: The main reason is the cancer
patients. There have been a lot Dr. Aye Ko Ko, medical superintendent of Yangon General Hospital. Photo: Myint Kay Thi
more cancer patients lately. The
number of patients receiving Q: Can you tell us about the that are accidently chopped off department sees 500 patients
tube feeding and chemotherapy improvement of treatments and or cut can be reattached, if the a day. And the number of
has risen, so there is some medical equipment at the Yangon patient is brought in time to inpatients is 2000 to 2500. They
overcrowding. The construction General Hospital, and what can the hand surgery department. come from every region and state.
of a five-storey wing intended for patients expect when they come Furthermore, successful
cancer patients is near completion in for check-up? treatments can be provided Q: What programmes are
and will probably be finished around to patients at the emergency planned by Yangon General
November. Another new five-storey A: This hospital has all the department with a thoracis Hospital in the future?
building will be constructed by the modern equipment of a 2000- aortic aneurysm or rupture.
Ministry of Construction facing bed hospital, such as Positron Those with blocked bold vessels A: There are plans to open a new
Anawrahta Road. After those emission tomography, computed resulting in stroke will be given medical treatment department.
buildings are transferred to us, it tomography (PET-CT), and cancer clot-bursting medicine. Of Under a project planned by the
will be used as a patient treatment scanning device. Before, you had course the success of treatment Ministry of Health and Sports,
wards for sick patients. As soon to go to Bangkok or Singapore rate depends on the patients pharmacies will be reopened at
as weve completed all these to get PET-CT scans, but now age, the prevalence of the Central Hospitals, and canteens
tasks, patients will be able to stay you can do it at Yangon General disease, and the time taken to will be opened, with the aim of
comfortably at a spacious hospital. Hospital. Other necessary reach the hospital. providing patients with clean,
Also, the Neurology Department has equipment and devices have also The number of patients receiving affordable meals. Those are the
been relocated to North Okkalapa been installed, and we will try to treatment daily at Yangon current plans, which I believe will
Township, so patients can be install more new devices as they General Hospital is between be fulfilled by the end of 2017.
diagnosed there. become available. Also, fingers 300 to 400. The emergency Translation by Kyaw Soe Htet

HEALTH SUPPLEMENT 2017

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Myo Lwin Nay Aung, Htoo Thant, Aung Htay Hlaing, Tin Zaw Htway Winaung247@gmail.com
Hein Min Latt, Myint Kay Thi, Zarni Phyo,
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Win Aung Win Aung, Maung Zaw Nyan Zay Htet Shutterstock
Sub-editor: Layout design:
P Vijian Khin Zaw

Rural healthcare expectations
NAY AUNG
M
agwe region located in the
central part of Myanmar has
twenty five townships and
according to the 2014 census urban
population constitutes only fifteen
percent of the total region.
Therefore, eighty five percent of
the people live in rural areas. In spite
of its high population ratio, access to
healthcare is still weak in those rural
areas according to local residence.
The topography of the region
which is a combination of plains and
mountains makes it more difficult
to reach and rural residents on
mountain ranges often experience
barriers to healthcare that limit their
ability to obtain the care they need. So
most rural people are still reluctant
to rely upon sub-rural health centers
(SRHC) and they prefer traditional
and folk medicines, a health assistant
assigned in Taungdwingyi township said.
Regarding healthcare, a residence
in Min Hla Township said, For an
ordinary sickness, we just get the
injection from the woman (illegal
health practioner) in the village. That
woman is a native of this village.
She learnt while a health assistant
(HA) came to the village. Due to a
variety of access barriers, township
medical officials are unable to come
to the villages frequently. As for
aches and pains, villagers buy the
medicines advertised in the media
from the nearest shops. However if
the situation gets worse they just go
to that woman to take an injection.
Let alone health assistants, even
administrative authorities barely
visit the villages which are on the
mountain ranges so when the elderly
and children fall sick we have to
carry them on our shoulders to the
sub- rural health centers, but if the
situation deteriotates we have to take
them to the nearest clinic said village
administrator U Phone Naing from
Htaw Zar village, which is situated on
the mountain range west of Magwe
region.
In these areas, although civil
societies are helping out and
providing assistance in projects
such as anti-malaria campaign,
they still lack in providing basic
healthcare which is most important
for the villagers. An official from the
Myanmar Medical Association said
that transportation plays a vital role
in the health sector of rural areas.
Road connectivity is one of the
main difficulties for rural healthcare.
A walk through ascending and
descending parts to some villages on
the mountain range from the nearest
traffic road will take at least three to
four hours.
Just about two months ago a sad
event occurred due to difficulties in
transportation, where a midwife was
unable to arrive on time to deliver
the baby from a pregnant woman.
Although the child was born by the
help of the villagers it died about an
hour later.
Many residents from these villages
are still facing a situation where
women give birth while working
in the fields and then they have to
take home their newborn babies in
bamboo baskets.
When elderly people are ill or feel
week, I give them intravenous vitamin
injections and for normal fever I also
give them injections, which I learnt
from a midwife about three years ago
of the village track where I live, says
a woman who is providing healthcare
to the villagers.
Another danger which falls upon
the villagers in central Myanmar is
snakebites, especially a venomous
snake. When a person is bitten by a
snake, a rope is tied just above the
place where it is bitten and let him
swallow cowhage seeds, which is
the traditional medicine for the first
aid treatment for snake bites. Then
the patient is taken to the nearest
medical centre, said Mai Pan Yi, the
in-charge of the youth network of Nge
Pe township.
Although they say that there are
sufficient amount of antivenin in
township hospitals, there are only
four ampoules in each village track
medical centers, said a health official.
A nurse providing health assistance to villagers. Photo: Nay Aung
An anonymous person said that
one village track medical centre in
Taungtwingyi Township had to take
care of 13 village tracks which include
48 villages. So it is questionable
whether that village track medical
centre was able to handle snake bite
cases where there are so many snakes
in the central regions of Myanmar.
Previously there was no antivenin
in every village track health centre but
now they say that sufficient amount of
antivenin has been provided to all the
village tracks in the region.
Villagers from those village tracks
say that they have purchased
antivenin on a self-helped basis in
an attempt to save the lives of their
villagers.
However a health official said that
although these villages have purchased
antivenin in case of snake bites, nobody
has any training how to use or when
to give this antivenin injection when a
snake bite occurs.
5
Antivenin injection cannot be
given to the patient without having
any knowledge as side effects may
be severe. When a health official
inquires who injects the antivenin to
the patient, nobody has the answer
and it is difficult to stop them or give
advice from using antivenin without
any knowledge.
Due to lack of health services,
healthcare conditions are still
worrisome in villages in Magwe
Region. Although natives of this
region have been expecting for skillful
health assistants till to date they still
have to depend on their traditional
medical treatments to survive.
Therefore, people in rural areas
are still longing for the day when
professional health workers will
arrive to their villages and take care
of their health so as for them to carry
out their daily livelihood in peace of
mind.
Translation by Zaw Nyunt
 6
Why go abroad for medical treatment?
Most privileged class prefer foreign hospitals due to the treatment and services provided
Air ambulance service has become part of the package for taking treatment abroad. Photo: Bangkok Hospital
MYINT KAY THI
W
hen a person or if one of his family
members becomes ill, not to men-
tion chronic illness but just even a
minor illness, the first thing that comes into
that persons mind is anxiety. Therefore, as
soon as a person gets ill, he or she goes to a
nearest medical clinic or hospital to receives
medical treatment.
Improved health standards are included
as most important sectors of a country and
for good healthcare system not only the
government is responsible but also the private
healthcare sector which can play a vital role.
Due to change of time and improvement
in systems, many high grade hospitals have
opened up throughout the country, so patients
have many choices for their healthcare.
Then again as there are now services which
provide assistance for medical treatment
abroad, which has become popular among the
privileged class to travel overseas for medical
treatment.
Nowadays a lot of Myanmar people who can
afford travel to countries such as Thailand,
Singapore, Malaysia and India for medical
treatment. There are also representative
offices of those hospitals in Myanmar, so
these offices provide all necessary assistance
for a patient from Myanmar to travel to that
particular country for medical treatment.
The expense for treatment in hospitals of
those countries vary from one another as well
as expenses of package programmes differ
depending on the treatment. However before
travelling to a particular country for medical
treatment, the expenses for diagnosis of the
disease, treatment, and all necessary services
provided by that hospital can be discussed
thoroughly with the representative office
before hand so as the patient and his family
will have a clearer picture for the trip. These
representative offices can arrange everything
for the patient to arrive comfortably to
that hospital for treatment. There are also
package programmes from just general check-
ups to major operations. All these can be
discussed before travelling to the hospital, in
that particular country.
Most of the patients from Myanmar travel to
Bangkok for medical treatment and some travel
to Singapore, Malaysia, and India. Some even
travel to western countries for treatment. said
Dr. Theingi Win, business development director
of Global Assistant Travel Medical Services. She
also said that patients have begun to use the air
ambulance service.
In cases of emergency, and if the patient or
family request for air ambulance service, we
can provide this service which can transfer
the patient to that hospital in a particular
country within six hours. There are at least
one or two cases every month. These kinds
of patients are mostly from Yangon and
Mandalay and use this service to Bangkok and
sometimes to Singapore, said Dr. Theingi Win.
The lowest rate of the air ambulance service
can be aproximately about US$14500. If the
patient uses this services two assistants for the
patient, a medical team including a doctor and
a nurse will also accompany the patient for the
journey. Then when the patient arrives to that
country the hospital arranges everything for the
patient to be admitted on time.
There were also cases from the childrens
hospital, which were transferred by this
service. Then again there are patients who
use this service for medical checkups for
heart, bone, brain diseases and also for
nervous system. However some patients have
to travel by this service on the advice of the
doctor said Dr. Theingi Win.
Most of the patients who have experienced
medical treatment in overseas hospitals say
the doctors pay special attention and discuss
in detail with the patient and if necessary,
advanced medical equipment and special
devices are used when it comes to treatment,
so it is very satisfactory for the patient and
the family members who accompany the
patient says some people who have take
medical treatment in foreign hospitals.
There are so many different kinds of
advance medical equipment and devices
and as there are only about ten to fifteen
patients, the doctors can pay more attention
to explain about the disease to the patient
and the patient also has an advantage of
raising questions about the disease in detail,
says Ko Phyo Thu who had the experience
of taking medical treatment in Malaysia. He
had to travel to Malaysia to have an operation
for sinusitis at the Sunway Hospital and the
total expanse for this operation was about
K2000000 in local currency he said.
I had to stay for a day in the hospital and
after the operation had to see the doctor
again. During that one day stay in the
hospital, the hospital provided three means,
morning, noon and night and also provided
in between meals like hot drinks such as
Ovaltine, Milo, biscuits and cookies, so it was
about five meals within a day. Here in our
country Nasal endoscopy is performed but as
there are so many patients, the doctor cannot
pay attention to each and every patient said
Ko Phyo Thu who shared his experience of
receiving treatment here.
I took my mother to Singapore for medical
checkup and she had checkups for her heart,
kidney, liver, and also for diabetes and the
total cost was about K700000 to K1000000 but
the service was satisfactory. If the doctor finds
a disease he explains what kind of treatment
will be the best for the disease, what kind
of drugs should be given and what kind of
precautions should be taken. He is also very
patient and answers all the questions that the
patient and accompanying family members
would like to know. said Ma Zarchi, who took
her mother to Singapore for medical checkup.
After being admitted to hospital, patients
need not worry where or which department
should they go for a checkup as staff
personally take the patient to the concerned
department. There at that department
patients dont have to wait for its turn and
there are also interpreters provided for
those who are unable to communicate in
Thai or English language. Here the patient
has to find the right department for the
checkup and also have to bribe them. When
a patient inquires about something there
is nobody to explain to the patient. Thats
why we decided to go overseas to have the
medical checkup, said Ma Cho Cho, who
went with her husband to Bangkok for a
general checkup.
My husband and I went to Bangkok for
general checkup. As my age is over 50 the
total cost for the checkup was Baht19000
and my husband who is over 40 the cost
was just over Baht15000. Being a promotion
period, we got the checkup with a special
discount rate. The checkup took only about
half a day and soon after checkup the doctor
explained the results. Both of us were each
given about half an hour to consult with the
doctor. Then within three to four days the
full set of results of the checkup was issued.
However, if the patient is unable to stay for
that period in Bangkok, can return here and
get the full results from the representative
office of that hospital, which is very
convenient, said another couple who went to
Bangkok for medical checkup.
Most of the people in our country who
can afford prefer to have their medical
checkups with specialists, state-of-the-art
medical equipment and advance medical
treatment so they travel abroad for treatment
said Dr. May Myat Zaw, an official from the
Malaysia Healthcare Travel Council (MHTC)
representative here in Yangon. Most travel
to Malaysia for treatment in heart disease,
In vitro fertilization (IVF), liver diseases and
Gastro intestinal illnesses. It is said that in
Malaysia, the success of In vitro fertilization
(IVF) is about 65 to 68percent.
In 2011, there were only about 5600
Myanmar citizens who went to Malaysia for
medical treatment but it has increased and
now there are about 11000. The Malaysia
Healthcare Travel Council (MHTC) expects
that in the coming year there will be a rise
of 30 to 40percent of patients to Malaysia.
Each and every country has its own rules and
regulations concerning healthcare systems
so the expenses on medical treatment differ
from one country to another. However, in
Malaysia due to the strict rules for hospitals,
charges cannot exceed than the limits
prescribed by the Ministry of Health, said Dr.
May Myat Zaw.
To have a medical checkup in Malaysia
the lowest average rate can be US$100 and
it differs according to the package of the
checkup. For Cardiac surgery approximately
the rate will be US$10000 to 15000, for In vitro
fertilization (IVF) is from US$ 5000 to 6000,
Surgery for Spinal cord and nervous systems
can cost about US$17000 to 19000 and for
thigh surgery can be from US$12000 to 13000.
Therefore, if somebody is planning to travel
overseas to have medical treatment should first
consult with the doctors from the hospital that
the patient has chosen. If that hospital has a
representative office in Myanmar it would be
very convenient for the patient and that office
will explain the treatment and expense and
whatever the patient would like to know, said
Dr. May Myat Zaw.
As an old saying goes that prevention is
better than cure, one should eat healthy
meals, take daily exercises and live a healthy
lifestyle so as to be strong and live a long and
happy life.
Translation by Win Thaw Tar,
Kyaw Soe Htet and Zaw Nyunt
 8

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 10
Its the birthright of
a child to receive full
vaccination
The Ministry of Health and Sports
conducts monthly immunization
programmes for people to be
MYINT KAY THI
V
accination is an effective method to
keep an eye on the publics health;
when a sufficiently large percentage
of a population, whether an adult or a child
has been vaccinated, they become protected
from infectious diseases that occur regularly
or occasionally. Therefore, every child should
complete the routine vaccination of childhood
on a normal schedule and by this way disease
and mortality rate of children in a nation, un-
der the age of 5 can be significantly reduced,
says health experts.
As polio vaccine was discovered, this
crippling and potentially deadly infectious
disease was eradicated. Children who were
vaccinated by this vaccine were protected
from polio and it was a further step of
improvement regarding the childrens health
condition.
Vaccination process taking place at a school.
vaccinated
In Myanmar the government provides every
individual child with ten types of vaccines
free of charge. Furthermore, the Ministry of
Health and Sports is striving to include three
new types of vaccines for diseases such as
Japanese encephalitis, diarrhea and cervix
cancer within a period of three years.
In regard to the whole country,
approximately 80 to 90 percent of the
population is covered by vaccination.
Although the vaccinated percentage of the
population can be seen as satisfactory, there
are still about10 to 20 percent of children
who do not receive the full yearly vaccination
scheme or losing the opportunity to be
vaccinated.
The children who do not receive regular
vaccination can be categorized into two
groups: The first group consists of children
from far-flung areas of the nation or places
encountering conflicts and the second group
are children from suburban areas that move
around with their vagabond groups, according
to officials from the Ministry of Health and
Sports.
Professor U Saw Win, a pediatrician
commented that It is impossible for the
maternal nurses to vaccinate the children of
parents who wander around. So, if these kinds
of people miss the process, it is their duty to
get to the nearest vaccination station to be
vaccinated. I strongly advice these kind of
parents to try their best so that their children
will not miss this opportunity.
Being vaccinated is the birthright of
every child. Therefore, both the government
and respective officials from the concerned
ministry are trying their best to fulfill this
task. Vaccines are safe because they are
produced only after international tests.
Every child should be fully entitled to every
vaccination provided by the government and
Nurse preparing a vaccine.
they should get full coverage of immunization
every time they are vaccinated, so that the
immunization can fully provide protection
against diseases, said Professor U Saw Win.
The National Vaccination Program which
is under the Ministry of Health and Sports,
monthly perform the operations of the
immunization programme which is conducted
by staffs from the health department and
people can also get vaccinated at government
clinics and hospitals.
Furthermore in an attempt that the
immunization programme covers all children
and for those who have missed this routine
operation, ninety eight hospitals with a
total of 100-beds each, which are under the
Ministry of Health and Sports have opened
up immunization centers around the country,
to ensure that the immunization programme
covers all children and to easily get vaccines.
The governments immunization program

which is free of charge covers 10 types of
vaccines; such as BCG, 5-in-1(diphtheria,
pertussis (whooping cough), tetanus, hepatitis
B and encephalitis), polio, pneumonia,
measles and rubella for children from infants
to 18 months.
The government provides 10 types of
vaccines free of charge with the assistance
of international organizations. So parents
should not miss this great opportunity which
is provided for their children, said Professor
Saw Win.
During the launching ceremony of hospital-
based immunization programme which was
held in May, Union Minister for Health and
Sports Dr. Myint Htwe in his speech said that
immunization process is a basic foundation
for universal healthcare coverage and
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Myanmars initial healthcare project. The
Union Minister also added that vaccines are
the first healthcare service for newly born
infants to stay healthy throughout their lives,
Vaccines will be effective only if they
are fully dosed. If they are not completely
vaccinated, the diseases cannot be prevented
perfectly. Some vaccines cannot prevent the
disease with only one dose. It is not dangerous
if the vaccines are over limits. In some
developing countries, there are about 17 types
of vaccines which are vaccinated to a child.
Myanmar is also now vaccinating about 10
types of vaccines than other more than some
South East Asian countries. Vaccines can
change the lives of people. They can cure the
diseases and also for polio. Therefore, vaccines
are the most effective way for the healthcare
Township health official collecting data for vaccination in a school. Photos: Naing Wynn Htoon
of the public, said Professor U Saw Win.
Centers have been opened where these
vaccines can be taken and also educational
programme for parents regarding these
vaccines. We explain to the parents that there
are ten types of vaccines being vaccinated to
children. These vaccines not only cure deadly
diseases but also make children grow healthy
and intelligent, said Dr Htar Htar Linn.
In some cases there are children who
are brought to hospital but have not taken
any vaccination yet. Therefore, we have to
vaccinate them when they reach here. The
services of hospitals are not only to cure
illnesses but also fulfill the needs of children.
Therefore, we decided to open clinics where
children could be vaccinated, said Dr Htar
Htar Lin, Deputy Director of Expanded
11
Programme on Immunization (EPI) under the
Department of Public Health.
I regularly vaccinate my children at the
ward dispensary. I take my children there
because doctors there vaccinate the required
vaccines. If the children are sick, they suffer
and on the parents side not only have to spend
a lot but also have to worry, said Daw Soe Soe
Htet, who is a mother of three children.
To vaccinate ten types of vaccines to a child
cost about US$50. International organizations
such as GAVI and UNICEF are providing
assistance for these vaccines. In the fiscal year
2016-2017 the cost for each child for these
vaccines was US$6.7 and donors provided the
cost for the expenses.
Translation by Kyaw Soe Htet, Zar Zar Soe and
Khine Thazin Han
 12
Organic
Organic fruits. Photo: Shutterstock
Organic food that play a
HEIN MIN LATT
I
n our country, there are some people who live in constant
fear. They worry about everything, no matter how unreal
the perceived threat seems to be.
These people always fear about power outbreaks, water
shortage or even the rise in cost of living then there are some
who although have the own car, take a taxi to go about during
raining season in fear that their car might break down on a in
flooded road.
Some even fear they might not get a space to park their car
so they place a stool or an object in front of their house or
apartment just to reserve a parking spot for their vehicle.
Some people fear a damaged power cable might fall on them
while walking in the street so they constantly look above, at
the power lines.
There are some who worry they might fall in to the drain
and always look down while walking. Still, there are others
who imagine that while they are walking on the road, aloaded
logging truck may spill the load of logs and crush on to
them.Some even worry about being snatched when they go
out at night times. So dont these worries seem ridiculous?
Yes, each and every human being has the right to be worried
or be afraid about any matter. There is nothing wrong about
being worried or being afraid.
However there is one thing that people should really
worry and fear. These are pesticides and other poisonous
chemicals used in growing fruit and vegetables that can be
putting people at risk of developing cancer in their later life.
There are also the soft drinks,which have become a part
of the younger generations everyday life. Carbon dioxide is
responsible for the tangy taste, sparkle and preservation of
the soft drink, but is a harmful substance which can cause
severe cell damage in our body.
According to scientists, chemical fertilizers reduce the
soils beneficial organism population and interfere with the
plant growth and these artificial fertilizers have been used
since early 18thcentury. Ammonia which was invented in
Germany in 1920s adds nitrogen which can support plants
to grow. Later on chemical pesticides were invented.
Among the pesticides are the chemical pesticide, plant-
pesticide and bio-pesticide. Only plant-pesticide and bio-
pesticide should be used. Then again,chemical pesticides
can also be dangerous.
Experts found that chemical pesticides can seriously
damage the consumers health and they have educated
farmers and cultivators not to overuse pesticides. They also
talked about the adverse effects of chemical pesticides.
Some farmers and cultivators use chemical pesticides
abundantly as they see these chemical pesticides can
eradicate pests quickly.
However these chemical pesticides can be absorbed in the
fruits or vegetables that they grow and can cause danger
to the human body once these contaminated fruits or
vegetables are consumed.
If large amount of chemical pesticide is consumed, it
will cause dizziness, headache, stomach ache and nausea.
Furthermore red rashes could occur on the skin and, in
some cases, could claim the lives of the consumer. Chemical
pesticide consumed in small amount may not show

which will
overcome fear
vital role in our daily lives
symptoms but as the time goes by it can damage the nerve
and respiratory system.
In recent years there have been rumours that chemical
pesticides and fertilizers are being excessively used
in growing vegetables and fruits. There is also news
spreading within the public that food producers are
using chemicals to make the colour of the fruits more
attractive.
There are reports about food producers using Shellac
on apples to restore the fruits natural wax and gives a
shiny coating; people preserving bean curd by soaking
in Formalin; placing plastic water bottles in hot boiling
cooking oil and when the plastic is absorb in the oil,
potatoes are fried in this oil to make them more crispy.
There were even reports that dyes are used not only in
shrimp paste but in producing dry prawns and pickled tea
leaves to make their colour more attractive.
As so much news have emerged the concerned
associations are also taking these reports seriously and
have begun to examine all the fresh produce as well
as checking food processing plants and factories in an
attempt to prevent these kinds of harmful foods from
circulating in the markets.
Consumers are becoming more aware of these kinds
of foods and they are paying more attention on organic
foods, which remove the dangers or at least the fear they
are facing in their daily lives.
All kinds of foods produced by organic fertilizers do not
pose dangers to consumers.Organic fertilizers are derived
from animal matter, animal excreta (manure), human
excreta, and vegetable matter, such as compost and crop
residues.
Naturallyoccurring organic fertilizers include animal
wastes from meat processing, peat, manure, slurry, and
guano.Organic fertilizers have been used in agriculture for
generations and its products are most safe for those who
consume it.
In organic planting, natural fertilizer and natural
insecticides are used. Growing vegetables planting fruits are
carried out in a natural way so they are able to stand natural
13
disasters and bad weathers.
More importantly, organic planting does not use chemical
pesticides and fertilizers in growing vegetables and fruits.
Organic fruits may not have beautiful colours and may not
be large in size, but they can give the real taste of a natural
fruit. They do not have chemical smell and they are safe for
consumers.
In foreign countries shopping centers and super markets,
organic fruits are sold on separate counters. Also here in
Myanmar in super markets like Market Place, organic fruits
are displayed on separate counters and their prices are usually
more expensive than other fruits.
So people who live in compounds and have spare land can
plant their own organic fruits and grow organic vegetables
using natural fertilizer and natural insecticides.
Just one last good advice to all who are health-conscious:
make sure to consumeorganic fruits and vegetableswhich can
make you healthier and free from fear.
Translation by Win Thaw Tar and Khine Thazin Han
 14
How to live
a healthy
lifestyle
Although it may not be easy to
commit, healthy lifestyle is most
important for humans life
WIN AUNG
I
n a lifetime of human beings,
health is the most important
physical and mental condi-
tion which is happiness free from
diseases and illnesses. However, as
all human beings are not the same,
the temperament also differs from
one another.
If one may inquire which is most
important and prefer between
health and wealth, the prompt
reply of the majority will be wealth
and only then comes health.
Right, although wealth is essential
in human life, obviously, health
is more important than wealth
which is the same concept as mine.
Wealth cannot buy health despite
having the ability to acquire the best
medication in the world. One may
be wealthy but if health is affected
how can he or she be able to enjoy
the wealth possessed and all this
wealth will be no more significant to
their lives.
A person, whose health is affected,
will not be able to enjoy the pleasures
of life like others. For instance, when
an unhealthy person sees people
in good health enjoying life, the
Girls participate in health exercise on the banks of Kandawgyi lake.
immediate desire that comes to his
or her mind is to be like those who
are healthy or even give up all their
possessions to be healthy.
There is also the preaching by
Lord Buddha regarding health where
it says health is the greatest gift,
contentment the greatest wealth,
faithfulness the best relationship.
Therefore, it is most important for
everybody to be knowledgeable to live
a healthy life. People, young or old
unnecessarily die every day due to
lack of health knowledge. Therefore it
plays a vital part in having a healthy
life.
So what is this healthy lifestyle
and why so important to us and how
can we gain this greatest gift of life?
Many believe, a healthy lifestyle
implies looking good and feeling good.
Most people say that they want to be
healthy but do they really imply to
gain a healthy lifestyle? To become
a healthy person, it is important to
avoid smoking, drinking excessively,
avoid using drugs, and avoid eating
unhealthy food, to exercising
regularly and having a balance
weight.
Then again a healthy diet also
plays an important part in a healthy
lifestyle. However, only by following
these rules it would not be enough
to gain a healthy lifestyle.
In todays fast changing world,
technology has become so advanced
that there are TV games, Internet,
cell phones etc which most of
the younger generation especially
schooling age are addicted too. Not
only in our country but around the
world in each and every country, the
younger generation have become
so addicted that they spend many
hours a day on the Internet, playing
TV games, chatting on cell phones
and giving too much of their time
even shortening their resting hours.
At the same time todays
younger generation are consuming
unhealthy food which is dangerous
for their health in the long run.
To make the matter even worse,
there are alcohol, drugs which are
the most dangerous for a persons
health.
Nowadays, most of the teenagers
to adults consume alcohol and
drugs which can shorten their
life span. When a child or adult
becomes addicted to one of these
habits, they lose interest to take up
sports or exercise and will never
Early morning exercise for elderly persons. Photos: The Myanmar Times
become a healthy person for the
rest of their lives.
Every human being has so many
things to do in their lives, maybe for
themselves or obligations in work
places and for matters relating to
family and friends. Therefore a
healthy lifestyle may not be easy to
commit to.
When a person is unable to fulfill
these obligations, tension rises and
becomes stressed which can hinder
a persons health. When a person is
stressed he or she becomes fatigued
and later on it affects the health.
That is why one should not stress for
each and every small matter or things
that comes across his or her daily life.
Priority should be given to obligations
and solved each at a time where
stress can be reduced.
Most people think that regular
medical checkups are essential to
have a healthy life. Yes, it might
be right for those who are wealthy
and can afford to go to hospitals,
especially to special clinics for
regular checkups. But that is only
for a few privileged. However not
everybody are in the same situation.
One may even argue that taking
medical checkup need to go to
hospitals, special medical clinics
and consulting and receiving
medical treatment from medical
practitioners but here the financial
matter comes in.
So what should we do to become
healthy persons? That is why by
following the mentioned steps
such as avoid smoking, drinking
excessively, eating unhealthy
food, using drugs, which are most
dangerous for health, giving too
much time on the computer and
other modern gadgets, and trying
to avoid in stressing for every little
matter that comes across in daily life.
But these steps are not sufficient to
make a person healthy.
The best way to have a healthy
life is to exercise regularly. For
instance people, who live in homes
with compounds, doing sports and
even gardening at home, can make
a person healthy. However, city
dwellers living in apartments where
they are unable to do these kinds of
activities, another option is trying
going to the nearest gymnasium and
taking up exercise lessons.
Even then if that situation
does not permit due to financial
constraint, try to take a daily walk
for at least half an hour which is
the bestideal for people of all ages
and fitness levels for those who
want to be more active. According
to medical reports, regular brisk
walking has shown to reduce risk
of chronic illnesses, such as heart
disease, diabetes, asthma, stroke,
high blood pressure, osteoporosis
and even some kind of cancers.
One last advice to live a healthy
lifestyle is to have self-confidence
which is extremely important in
almost every aspect of our lives.
If we look at our own lives
and those around us, we will see
that in searching for happiness
we spend most of our time and
energy, our external conditions
such as increasing our wealth
and possessions, enhancing our
reputation and finding better
partners. Though we may succed in
acquiring these external conditions,
we will never enjoy the lasting
happiness that we desire if we dont
have self confidence. Without self-
confidence, we will never be able
to avoid the evil doings which may
affect our lives that will end up in
damaging our health.
So lets practice this healthy
lifestyle by staying away from
unhealthy habits, avoiding
unhealthy food, doing exercise
regularly, having enough sleep,
reducing stress, and last but not
least having self confidence which
will make us healthy and happy
throughout our lives.

A layout of healthy and delicious home-made dishes. Photo: The Myanmar Times
Consuming well-balanced healthy food provides
most vitamins a human body needs
WIN AUNG
C
hoosing foods each day that are rich in vitamins and
minerals is the best way your body is receiving what
needs to be healthy. Supplements can be beneficial, but
the key to vitamin and mineral success is by comsuming a
balanced diet.
Vitamins are organic compounds necessary for the healthy
functioning of our bodies. We need vitamins to help us grow,
to make out bones, muscles, skin and organs strong as well as
to protect from infections. Deficiencies in vitamins can become
serious problems to our bodies. The best way to receive
enough vitamins for a normal growth and development comes
from the fresh foods that we consume daily.
Vitamins are classified as either water-soluble or fat-soluble.
In human beings, there are thirteen vitamins: four fat-soluble
(A, D, E, and K) and nine water-soluble (eight B vitamins and
vitamin C). Water-soluble vitamins dissolve easily in water
and, in general, are readily excreted from the body. Therefore,
vitamin consumption can be indicated by urine output. Many
types of water-soluble vitamins are produced by bacteria. Fat-
soluble vitamins are absorbed through the intestinal tract with
the help of fats.
The best way to get enough vitamins is to eat a balanced
diet with a variety of healthy foods. In some cases, one may
need to take vitamin as supplements. However it should bear
in mind that sometimes high doses of vitamins can cause
health problems.
Vitamin A, from the fat-soluble category can be obtained
by consuming liver, fish, orange, ripe yellow fruits, leafy
Food
and
vitamins
vegetables, carrots, pumpkin, squash, spinach, soya milk,
milk products such as butter and cheese. Vitamin A, not only
prevents night blindness but also lower the mortality rate of
cancer.
Another fat-soluble vitamin is Vitamin D, which can be
obtained from fish, eggs, liver, mushrooms, cod liver oil, oily
fish, fish roe, Sardine, Tilapia, Tuna , Cereals, Tofu, low fat
fruit yogurt, and various kinds of milks. Vitamin D increases
intestinal absorption of calcium, iron, magnesium, phosphate,
and zinc. Vitamin D can prevent heart disease, diabetes,
obesity, muscle weakness to name a few.
Vitamin E can prevent cancer, heart diseases, eye disorder
and prevent or slow the decline of mental function such as
Alzheimers disease. A variety of foods such as vegetable oils
like safflower oils and soybean oils, Nuts, such as peanuts,
hazelnuts, and, almonds and seeds like sunflower seeds, green
vegetables, which are spinach and broccoli, fruits like mangoes
and Papayas are also among the best sources of vitamin E.
Vitamin K, which is also a fat-soluble vitamin helps to
prevent calcification of arteries which is one of the
leading causes of heart attacks. It works by carrying
calcium out of the arteries and not allowing it to form
hard plaques within the arteries. It also increases the
amount of protein required to maintain bone calcium,
reducing the risk of osteoporosis.
Vitamin K is also effective in reducing the risk of prostate,
colon, stomach, nasal, and oral cancers. Vitamin K is found
plentiful in green vegetables such as spinach, swiss chard,
lettuce, cabbage, kale, cauliflower, broccoli, and brussels
sprouts and some fruits such as avocado, kiwifruit and grapes,
15
which are also high in vitamin K.
In the category of water-soluble vitamins there are Vitamin
B and Vitamin C. Vitamin B play important roles in cell
metabolism. There are eight types of vitamin Bs. B vitamins
are particularly concentrated in meat such as turkey, tuna and
liver. Other sources for B vitamins include pulses or beans,
whole grains, potatoes, bananas, chili, peppers, nutritional
yeast, brewers yeast, and molasses.
Another water-soluble vitamin, which is Vitamin C is found
in food and used as a dietary supplement. Vitamin C helps to
repair and regenerate tissues, protect against heart disease,
decrease bad cholesterol and common cold. Vitamin C is
important in the treatment of rheumatoid arthritis.
As many fruits and vegetables contain vitamin C, it is
easy to obtain through foods. Apples, asparagus, berries,
broccoli, cabbage, melon (cantaloupe, honeydew, watermelon),
cauliflower, citrus fruits (lemons, limes, oranges), kiwi,
fortified foods (breads, grains, cereal), dark leafy greens (kale,
spinach),peppers (especially red bell peppers, which have
among the highest per-serving vitamin C content.
However, if one consumes healthy and well-balanced food,
vitamins would not be necessary. A well-constructed diet
supplies not only provide the vitamins which are needed
daily, but also other important non-nutrients that are lack in
vitamins.
Therefore, it is possible to conclude that vitamins are really
good, because they help us keep our body in shape providing it
with lacking elements but by consuming a balance diet we will
be able to get sufficient amount of vitamins and minerals the
natural way.
 16
Unknown mixed medicines still on demand
Although dangerous, unknown mixed medicines are still a common
source of healthcare among the grassroots
An elderly lady preparing unknown mixed medicine for her ill family member. Photos: Aung Htay Hlaing
KHIN SU WAI
D
aw A Nge Lay said her elderly mother
has to take some unknown mixed
medicines for common ailments. She
added that these unidentified mixed medicines
are usually taken to alleviate headache and flu
symptoms as they are cheap, effective and eas-
ily available from local drugstores.
They are not to treat serious illness. If I feel
ill, I just take some mixed medicines sold in my
ward. The bad thing is I dont know what types
of medicines are mixed together. I dont even
know if these medicines are expired or whether
I am allergic to it. The good thing is I can buy
them easily, she said.
It has been more than a decade-long habit of
the people of Myanmar to take some unknown
mixed medicines prescribed by small shop and
stores in the neighbourhood to treat common
cold and cough, for temporary or long-term.
Some combined medicines are branded as
Myanmar traditional medicines and sold on the
market. Some are found to contain oral steroids
in powder form. The combined medicines are
cost effective, easily available and are widely
used as most ill-informed people are reluctant
to go to the clinics or hospitals unless they have
some deadly disease.
The combined medicines alleviate symptoms
of disease temporarily without addressing
the underlying causes. Most people used the
combined medicines because they think they
are cured as the symptoms disappear.
The combined medicines are very dangerous.
Although they are bad, people are still taking
them because they are cheap, easily bought, and
fast to relieve the symptoms. People are aware
that combined medicines are bad, but they still
dont want to see the doctors because of sparing
too much time in clinics. It is also difficult to
see a doctor as doctors are usually busy with
hospital duties, resident Dr Soe Naing Win from
Tagaung Township hospital branch told the
Myanmar Times.
He remarked that during his residency in
rural areas, 5 out of 10 patients he treated were
taking or had taken the mixed medicines. He
added that he had treated a 56 year old patient
from Lat Lote village in Depeyin Township of
Sagaing District, who went blind by taking some
combined medicines for over a year believing
that it would cure his knee pain.
Due to the compounded medicines, the most
common side effects are that the people suffer
stiffness in the nape and their faces become
puffy but they think they are getting fat due to a
good rest. It is most common at my clinic.
Therefore, I make them stop taking
compounded medicines. Some people oblige to
my advice. The main point is that we have to
educate the public and also control the people
selling compounded medicines. These are the
duties of the authority. We have to say is that
it is dangerous to take these medicines. They
come to us with a pack of medicines, which are
all compounded medicines, said Dr Soe Naing
Win.
At the second regular meeting of the
first Pyithu Hluttaw, the Minister for Health
answered about the danger of compound
medicines and that they are prohibited.
According to the National Law section 16,
nobody is allowed to sell, store or distribute
medicines or raw materials without licenses
but due to the weakness of regular checks, the
situation still prevails.
The Health Department had issued notice
of not to take compounded medicines. For
example, in 2016, announcements were made
about the dangers of these medicines and to
avoid them. However, due to lack of knowledge,
most people in rural areas still depend on
compound medicines.
Most of the people who come to me are
farmers. As they have worked in the fields all
day long, they use compounded medicines for
their stiff muscles and for arthritis of limbs and
swelling joints. They also use it in an attempt
to prevent from catching cough, cold, and
headache. As they cannot afford to have healthy
food, they take these medicines. They presume
that these medicines can provide them with all the
health they need. Most who are lack of knowledge
about medicines think that they look good when
they are chubby and rely on these medicines to
gain apatite so as to gain weight. They take these
medicines to cure swollen joints and from losing
appetite. Most of these kinds of people not only
take these medicines by themselves but also advice
others to take them, he said.
When they have to see a doctor, the cost
is high and also have to listen to the doctors
advice of the danger of these medicines.
Therefore, to avoid all these, they rather depend
on compounded medicines, he said.
The compounded medicines are still in
circulation and need time to be eradicated.
Success can only come when the population
fully accepts the danger of these mixed
medicines. Then again persuasion plays a vital
role to reduce the dangers of mixed medicines,
he said.
Translation by Swe Zin Moe
and Khine Thazin Han