11 May 2021
UK health institutions have supported clinical development in Myanmar for many years, but the coup of February 1st provides our partnerships with their biggest challenge.
Since the beginning of February, we have witnessed a rapid and complex health system deterioration in Myanmar. In response to the coup, most of the doctors and nurses collaborating with our organisations have refused to work in hospitals as part of a countrywide ‘civil disobedience movement’ (CDM). As a result, these hospitals, which form the bulk of the country’s inpatient provision, have stopped functioning, leading to a very significant fall in admissions.
In addition, we have seen intimidation of health staff and a deliberate attempt by the military to reduce internet service provision.
Despite this, healthcare is being provided in a patchwork of pop-up and private clinics, many of which have waived their fees. The fragmented nature of this means it is not possible to access guidelines and ask for a specialist opinion and lives are being lost as a result.
Thanks to the convening power of THET we have been able to come together as a health community and develop a low bandwidth website with simple clinical guidelines for common conditions. The conditions are provided in list form and there are simple flow charts for people to follow. Despite only being up for a few weeks, the website currently has more than 1,000 active users.
The health system fragmentation, leading to a collapse in the already fragile referral network, means many doctors and nurses are struggling to access specialist advice.
We have therefore been offering daily Zoom calls with UK-based Burmese-speaking clinical specialists which are open to any doctor or nurse working in Myanmar who wants advice. Within this, we are also offering mental health first aid support for the clinicians.
The deliberate internet flow restrictions mean it is very hard currently for clinicians to access this service. We can see them try to log onto the call before the call quickly falls away again. Before the coup, online events we ran would often have more than 100 participants.
Supporting Trauma care
Aside from trying to maintain the health system, our colleagues are also having to deal with a huge increase in cases of trauma. There is a whole generation of doctors and nurses who have never dealt with gunshot wounds and trauma on this scale and so we worked with colleagues at the University of Southampton Hospital and Cambridge University Hospital to record social media-friendly videos which can be shared via phone and online.
This rapid support provides a foundation on which to build wider and broader work as the situation evolves. We understand the significant challenges that this crisis presents to our work and partnerships, but we also see the enormous need and the vital importance of this work in supporting the medical staff in Myanmar and the populations they serve.