building bridges - University of Sydneysydney.edu.au/health-sciences/building-bridges.pdf · Building Bridges, the title of this seminar, is most apt , given what is taking place

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3

“Building Bridges”

Seminar for Strengthening Collaboration and Building the

Collective Contribution of Overseas Burmese Health

Professionals to Maternal and Child Health in Myanmar

(Burma)

Organised by the Burmese Medical Association Australia (Sydney) in

collaboration with the University of Sydney and partly sponsored by AusAID,

on Tuesday 10th and Wednesday 11th April 2012 at New Law Faculty Building, University of Sydney

"The abstracts in the booklet and presentations are the ideas of the individual presenters and not that of Burmese Medical Association Australia."

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i

Union of Myanmar Administrative Divisions/States

ii

Union of Myanmar Key Demographic and Health Indicators

Indicators Values (Year) Source

Population and Vital Statistics

Total population (in millions) 58.38 (2008-09)) MHS

Sex ratio (males per 100 females) 98.91 (2008-09) MHS

Population under 15 years (%) 32.32 (2008-09) MHS

Population 60 years and above (%) 8.79 (2008-09) MHS

Population living in urban areas (%) 33 (2009) MHS

Crude Birth Rate (per 1,000 population) Urban Rural

18.4 (2007) 21.2 (2007)

MHS

Crude Death Rate (per 1,000 population) Urban Rural

5.3 (2007) 5.9 (2007)

MHS

Annual Population Growth Rate (%) 1.52 (2008-09) MHS

Health System Inputs

Hospital beds per 10,000 population 6 (2006) WHO

Physicians per 10,000 population 4.57 (2008) WHO

Nurses and Midwives per 10,000 population 8 (2008) WHO

Community Health Worker per 10,000 population 0.63 (2008) WHO

Total expenditure on health as a % of GDP 2 (2007) WHO

Government expenditure on health as a % of total government expenditure

0.8 (2009) WHO

Government expenditure on health as a % of total expenditure on health

9.7 (2009) WHO

Private expenditure on health as a % of total expenditure on health

90.3 (2009) WHO

Health Service Indicators

Births attended by skilled health personnel (%) 36.9 (2007) WHO

Measles (MCV) immunization coverage among 1-year-olds (%)

87 (2009) WHO

Antenatal care coverage - at least four visits (%) 43 (2007) WHO

Contraceptive prevalence (%) 41 (2007) WHO

Health Outcomes

Life expectancy at birth (years) 64 (2009) WHO

Neonatal mortality rate (per 1000 live births) 32 (2010) WHO

Infant Mortality Rate (per 1,000 live births) 50 (2010) WHO

U5 Mortality Rate (per 1,000 live births) 66 (2010) WHO

Maternal Mortality Ratio (per 100,000 live births) 240 (2008) WHO

Source: WHO – WHO Statistical Informational System (WHOSIS) http://www.who.int/whosis/en/ MHS – Myanmar Health Statistics 2010, Ministry of Health, Union of Myanmar

http://www.who.int/whosis/en/

iii

FOREWORD

I am honoured to be asked to write the foreword to this booklet, Building Bridges: Seminar on Maternal and Child Health in Burma/Myanmar

It is a first for Australia, made possible through the support of many, including the sponsorship of AusAID. I thank them, Ambassador H.E. Ms. Bronte Moules, and Counsellor Mr. Michael Hassett for supporting this seminar.

The presence of four very senior maternal and child health specialists and academics from Myanmar who attended the preceding international reunion of Burmese doctors and dentists, along with very senior Australian specialists, marks this seminar as special.

I want to single out the Burmese Medical Association Australia, notably Dr. Raymond Tint Way, Dr. Aye Aye Bartlett, Dr. Kyaw-Myint Malia and Dr. Khyne Nyunt for their dedication to good health for all – here in their adopted country and in their motherland of Burma, as it is affectionately known to Australians, and Myanmar as it is called officially.

The Burmese Medical Association Australia has introduced me to so many wonderful medical professionals from Myanmar and friendships have been formed. Some I now meet on each visit, and yes, there will be more. We have the most interesting discussions that provide me with further insight into Myanmar health systems and practices and Myanmar thinking and cultures.

It is pleasing that health professionals are joining hands to work to improve health outcomes for Myanmar women and children. Through the seminar I hope that new friendships are formed, new alliances built, and systems made stronger and more sustainable.

Health professionals were at the forefront of efforts after Cyclone Nargis, and they were determined to stay involved, working for changes in health policy, services and outcomes. Most of this valuable work is done quietly, some more noisily, but all is having an impact.

Myanmar’s Parliament has for the first time not only grappled with a national budget, but recommended an increase in health expenditure. It is only through the efforts and leadership of Myanmar people and their governments that real change will take root.

As a health advocate of some three decades, it is not surprising that I have a strong interest in maternal and child health. As an advocate of freedoms and human rights for a longer period and in particular for Burma’s many peoples for some two

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decades, it is not surprising that I have a strong interest in improving the health of all Burmese; especially women and children. If their health improves, so does that of their families, their village, their township, and so on.

It is well known that continued conflict creates trauma, and that Burmese society is marked by both, with political and military conflicts having run for decades.

There is however hope and cautious optimism with the current situation. I feel it is auspicious that I am writing this on the very day that significant by-elections are taking place in Burma, with everyone expectant for the future. Building Bridges, the title of this seminar, is most apt, given what is taking place in Myanmar right now.

I wish you a successful seminar and good health to all.

Warm regards

Janelle Saffin, MP Federal Member for Page NSW AUSTRALIA 1

st April 2012

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Message from daw Aung San SUu Kyi

I am delighted to hear that Burmese doctors have gathered together to discuss the improvement of maternal and child health. My mother had been involved in maternal and child care for many years. Since my childhood, I have been familiar with the terms maternal and child welfare and health. Since I was a child, I have seen and experienced the issues of maternal and child health in a developing country.

What is very sad is that, as all of you who are attending the conference are well aware, the development of maternal and child health is not developed as well as it should in Myanmar. The situation of maternal and child health in our country is still very weak. Things that needed to have happened have not happened. This situation has festered on for years. It is so encouraging to know that you are now focusing on maternal and child health.

Now that the National League for Democracy party has won some seats at the recent by-elections, we have started to implement activities that will be beneficial to the public. In implementing activities for the benefit of our people we want to prioritise the welfare and health of mothers and children.

In our endeavours, I ask doctors who are present here to help in any way you can. Doctors, who are abroad and have become very learned and experienced in the medical field, if you will help our people in any way you can, this will contribute towards the development of the country.

I would like to remind all learned doctors that, in our country, one cannot differentiate between development and politics. Some think that if we get development and business success, it is enough, and that politics is not important. In reality, if the political system is not right, one cannot maintain development in the long run. This is a lesson the world is learning on a daily basis.

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That’s why, my dear doctors, if you are serious about working for the health of mothers and children, you will need to help bring about genuine democracy. Unless mothers and children can learn to protect themselves and their health and know their rights, we cannot rest. It is not enough that people from outside help. That’s why, as you discuss the importance of how you would practically promote maternal and child health, please consider also how you would find opportunities for mothers and children to participate.

Before long I pray that we will meet again in Myanmar. Thank you. Daw Aung San Suu Kyi addressing delegates at the Building Bridges seminar at the

University of Sydney (video message).

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TABLE OF CONTENT s

Page

Map of Myanmar - Administrative Divisions/States i

Myanmar - Key Demographic and Health Indicators ii

Foreword iii

Message from Daw Aung San Suu Kyi v

Acknowledgements x

Preface xii

Background of the Seminar xiii

Part-1: Abstracts

1 Health in Under 5 Children of Myanmar, Prof. Samuel Kyaw Hla

1

2 The Functions of Maternal and Child Health Care in Myanmar Maternal and Child Welfare Association, Dr. Mon Mon Aung

2

3 Public Health in New South Wales regarding Maternal and Child Health, Dr. Joseph Pereira, AM

3

4 Delivery of Paediatric Cardiology Services in Resource Poor Countries, Dr. Philip Roberts

4

5 Mental Health Interventions: A Pathway to Maternal and Child Well-being, Dr. Raymond Tint Way

5

6 My Personal Experience of Maternal and Child Health in Myanmar, Dr. Joyce Conolly

6

7 Asia Pacific Community Mental Health Development Project A/ Prof. Chee Ng

7

8 General Practitioners’ Liaison Project between Myanmar and Malaysia, Prof. Kyaw Tin Hla

8

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Page

9 NGOs and their role in Health Care in Myanmar A/Prof. Bruce Conolly, AM

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10 A Perspective of Graceworks in the Promotion of General Wellbeing of Mothers and Children in Myanmar Mr. Peter Simmons

10

11 Can Research in Developing Countries be both Ethical and Responsive to those Countries’ Health Needs? A UNESCO Bioethics Approach A/ Prof. Russell D’Souza

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12 What would a reliable Pathology system mean for Maternal and Child Health in Myanmar? A/ Prof. John Aaskov

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13 Significance of LBW in Myanmar Prof. Aye Aye Thein

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14 The overview on Maternal Mortality in Myanmar Prof. Aye Aung

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15 High Risk Pregnancy and its management Dr. Miguel Marquez

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16 Antenatal Shared Care Dr. Aye Aye Bartlett

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17 Seeking Practical Benefits in Medicine from National Reconciliation in Myanmar Mr. Trevor Wilson

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18 The Importance of having an Integrated Emergency System to improve Healthcare Outcomes for Burma Prof. Peter Cameron

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19 Upcoming Challenges on MCH in Mon, Karen and Tanintharyi States/Division after Repatriation/Resettlement of Refugees from camps in Thailand Dr. Tun Aung Shwe

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20 Maternal & Child Health in Humanitarian Emergency Affairs Dr. Kyi Minn

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21 Establishing Paediatric Developmental Service in Myanmar Dr. Ohn Nyunt and Dr. Kyaw Myint Malia

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22 Emergency Obstetric Care (EmOC) and RH training provided to CHW along the Thai-Burma border Dr. Alice Khin Saw Win

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23 Saving the lives of Myanmar Women: The Way Forward Dr. Si Lay Khaing

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Page Part-2: List of Participants and University of Sydney’s Media Release

24 Participants of the Seminar 26

25 Media Release 30

Part-3: Photographic Section 32

Annex

Timetable of The Seminar 42

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ACKNOWLEDGMENTS

This book is a collection of abstracts of papers presented at a seminar on Maternal and Child Health in Myanmar, held at the University of Sydney on the 10

th and the

11th

of April, 2012. The initial idea of working collectively among overseas alumni of the Institutes of Medicine and Dentistry in Myanmar, to contribute to their Alma Mater and their homeland, germinated in the discussions that took place during the preparatory phase of the Burmese Medical and Dental Graduates Reunion in Sydney (6-9 April, 2012). A consultative meeting was held on the first day of the reunion, which was well received and many alumni who registered for the reunion sent their own ideas to be discussed at the meeting, and some personally presented their concept papers.

We were fortunate to be granted a partial sponsorship by AusAID to convene a two-day Maternal & Child Health seminar in collaboration with the University of Sydney immediately after the reunion. A Burmese delegation of four senior maternal and child health specialists and academics from Myanmar were able not only to join us at the reunion but also to participate in the post-reunion seminar, where a global network of Myanmar alumni was successfully set up.

We thank the Honourable Janelle Saffin, MP for her leading role at the seminar, the purpose of which was to engender close collaboration between Australia and Burma/Myanmar in medical research and exchange of knowledge in Maternal and Child Health (MCH).

Daw Aung San Suu Kyi had sent a video message of greetings to the delegates, in which she urged the doctors to apply themselves to finding ways to help improve the health status of mothers and children in Myanmar, the area that she highlighted as in urgent need of assistance. We were inspired by her words and we wish to acknowledge her for her important message.

The support of the Australian Ambassador to Burma, H.E. Ms. Bronte Moules, is greatly appreciated. We also wish to thank Professor John Hearn, Deputy Vice-Chancellor International, University of Sydney and his staff; Professor Heather Jeffrey, Chair of Maternal & Child Health, University of Sydney; Mr. Justin Baguley, Director of AusAID Programs in Burma and Mr. Trevor Wilson of ANU for their support of the seminar.

The papers presented at the seminar deal with a diverse range of topics encompassing clinical, socio-political and philosophical aspects of MCH issues relating to health service delivery. The presenters are also from various backgrounds, expertise and interests. The expert contribution of the Chair to each section made the discussion more interesting.

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I believe that this seminar has led to an increase in the knowledge of MCH, and a greater degree of collaboration between the Australian and the Burmese health care delivery services, with the support of the global fraternity of Burmese medical doctors.

We wish to express our appreciation to the Faculty of Health Sciences at the University of Sydney, Dr Gomathi Sitharthan and Hon. Prof Sitharthan Thiagarajan (Department of Psychiatry); AusAID and the participating worldwide Burmese alumni for the success of the seminar. We acknowledge the partial sponsorships of three pathology services, Laverty Pathology, Medlab Pathology and Moaven and Partners Pathology; and the generous donations by Dr Darryl Li of the Plumpton Medical Centre, Sydney.

We also would like to acknowledge the contributions of academics from the Universities of Sydney, New South Wales, Queensland and Melbourne, as well as from the Australian National University; and the enthusiastic participation of Graceworks Myanmar, known for its exemplary humanitarian work.

Finally, I thank all members of the Organising Committee for their untiring efforts to ensure the success of the reunion and the invaluable input given by Dr. Thane Oke Kyaw-Myint, a senior paediatrician with extensive knowledge in MCH in Myanmar. Many people contributed to the organisation of the MCH seminar, and I would like to record my gratitude to them, in particular Drs. Thomas Wong, Rose Wong, Ohn Nyunt, Theresa Wong and Tun Aung Shwe. We hope that this collection of abstracts will stimulate further discussion on MCH issues to the benefit of mothers and children in Myanmar.

Dr Raymond Tint Way BA MB BS (Rangoon) MM (Sydney) MRACMA FRANZCP President Burmese Medical Association Australia 12

th April 2012

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Preface

It is a rare and privileged opportunity to be part of an exceptional group of dedicated individuals who have one common goal; to provide their expertise to promote maternal and infant care in Myanmar (Burma). This is a unique gathering of clinicians, health service planners, academics, researchers, representatives from the Government, and officials (from Australia and Burma). What sets this group and their contributions apart is their genuine care and willingness to share their knowledge and skills to plan, collaborate, and execute pragmatic solutions.

The theme of this seminar fits with the Australian Government’s policy towards Burma, focusing on immediate medical and health needs to reduce unacceptably high maternal and infant mortality rates. It is a timely reminder that more needs to be done and more can be done.

Several people were involved in making this gathering possible. I am greatly indebted to the staff of the Office of the Deputy Vice-Chancellor-International, the University of Sydney; and the passionate members of the Burmese Medical Association Australia (BMAA). Their support and dedication for this project is incomparable. I have been very fortunate to be associated with the BMAA. Their generosity cannot be measured. On several occasions, long hours were spent in the planning of the seminar, preparation and fine-tuning the application, identifying key topics and expert speakers; and other logistics that are often taken for granted.

I am very grateful to the speakers who have travelled from other countries (and continents), as well as those from Australia, who have kindly agreed to share their expertise. I am aware that several colleagues from Australia have taken time from their busy schedules to contribute to the seminar, and I am very thankful.

This seminar is supported by AusAID and representatives from AusAID have kindly agreed to share their experiences supporting projects to make things happen.

I am confident the book of abstracts is just the beginning of a long and productive venture between all collaborators to engage in an exciting scientific, social and humanitarian journey.

Gomathi Sitharthan, PhD (U.Syd); M.Phil., M.A.(Hons)

Senior Lecturer in Psychology Faculty of Health Sciences The University of Sydney

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Background of the Seminar

Maternal and Child Health in Myanmar In Myanmar, immense effort has been put to improving maternal and child health (MCH) services through various programs. All sources agree that the under-five mortality rate, maternal mortality rate and infant mortality rate are improving. Although there have been significant improvements in the quality of MCH service delivery and community awareness, estimates indicate that the current maternal mortality rate has not achieved its target.

MDG Goal 4 and 5 Indicators Baseline (1990)

Current (2010)

Target (2015)

MMR per 100,000 live births 420 240* 50

IMR per 1,000 live births 79 50 28.3

U5MR per 1,000 live births 112 66 38.5

Births by skilled attendant (%) 46.3 63.9

1year-old children immunised for measles (%) 68 87ǂ

*2008 data 1991 data 2007 data ǂ2009 data

Data source: 1) http://mdgs.un.org/unsd/mdg/data.aspx 2) Myanmar Health Statistics 2010, Ministry of Health, Union of Myanmar

The Opportunity In early April 2012, Burmese Medical Association Australia (BMAA) hosted the Burmese Medical and Dental Global Reunion in Sydney and it was one of the largest gatherings of Burmese medical alumni from various parts of the world. The organising committee has taken this opportunity to convene an MCH seminar to promote networking among clinicians, researchers, academics, health policymakers and NGOs. Collaboration In collaboration with the University of Sydney, BMAA has obtained an AusAID grant in sponsoring four MCH specialists from Myanmar with a view to setting up linkages with health services between Australia and Burma. Objective It is to address the pressing medical need to reduce the unacceptably high maternal and infant mortality rate in Myanmar, in line with the United Nations Millennium Development Goals, in particular MDG-4 and MDG-5, and Australia’s AusAID strategic approach to aid in Myanmar. The seminar further aims to reduce morbidity and improve the quality of life of all mothers and children.

http://mdgs.un.org/unsd/mdg/data.aspx

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Part-1 Abstracts

BUILDING BRIDGES Seminar for Maternal and Child Health in Myanmar

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Health in Under 5 Children of Myanmar Prof. Samuel Kyaw Hla Amongst the 2009-2010 estimated population of 59.32 million in Myanmar, the 0-14yrs age group constituted 18.84 million and the under-5 population was estimated to be about 10 million.

The MCH development section of the Department of Health has been providing maternal, newborn, adolescent and child healthcare with continuum of care approach, developed in accordance with the national health plan. The strategic plan had been implemented since 2001 with the aim of achieving the millennium development goals, especially MDG-4.

The target of MDG-4 is to reduce the under-5 mortality rate by 2/3 between 1990 and 2015. Indicators are: U5MR<IMR and the proportion of one-year-old children immunized against measles.

U5 M in 1990 is 130/1000 LB whereas the target is 43.3

IMR in 1990 is 98/1000LB whereas the target is 32.7.

Measles vaccine coverage in 1990 is 72% and the target is 100%

For the effective implementation of reducing the U5 MR and IMR, knowledge and information of where and when these children are dying is essential.

Distribution of under-5 death by age in years revealed that about 70% die during the first year of life whereas 1/3 of those deaths occurred during the first month after birth. A high proportion of under-5 deaths (77%) took place in rural areas.

Leading causes of childrens’ deaths are ARI/pneumonia (27%), diarrhoeal diseases (18%), Malaria (8%) and measles (1%). The improvement in child mortality related to MDG-4 in Myanmar is going slowly though still on track.

Many challenges remain concerning health service delivery for under-5 children of Myanmar.

Professor Samuel Kyaw Hla B.A., M.B.,B.S., D.C.H.,

M.Med.Sc(Paed) FRCP(E) Head Of Dept of Child Health (Rtd) University of Medicine (2) Yangon.

Consultant Paediatrician (Rtd) North Oakalapa General Teaching Hospital.

Yangon [email protected]

http://m.med.sc/

mailto:[email protected]

Organised by BMAA and Sydney University 10th

& 11th

April 2012

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The Functions of Maternal and Child Health Care in Myanmar Maternal and Child Welfare Association Dr. Mon Mon Aung The Myanmar Maternal and Child Welfare Association (MMCWA) is a voluntary organization established in 1991 with headquarters in Nay Pyi Taw. It has more than 13 million members with branch office in 330 townships. The association is dedicated to serve the Myanmar society in promoting the health and wellbeing of mothers and children with the aim to improve the quality of life of the people. Objectives of the MMCWA are to carry out activities related to health, education, economic and social aspects of beneficiaries with priority to the grassroots level residing in wards and villages. MMCWA is working in partnership with government as well as non-governmental organizations and civil societies to provide support for women and children to enable them to become productive citizens.

President of Myanmar Maternal and Child Welfare Association

MBBS (Ygn) – 1987 M.Med.Sc (Public Health)

(Mdy) - 2003 Lecturer

Department of Preventive and Social Medicine, University of Medicine

(Mandalay) [email protected]

http://m.med.sc/



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Public Health in New South Wales regarding

Maternal and Child Health Dr. Joseph Pereira, AM In order to compare and contrast MCH services in a developed country (Australia) with those of our motherland (Myanmar), a snap shot of such services in New South Wales, Australia, is presented. Apart from highlighting some shortcomings in the N.S.W. and Australian health care system, the deficiencies in Myanmar health care are highlighted. All Myanmar graduates can help our Myanmar health services in catching up. Myanmar graduates have a lot to do to mobilise Australian resources (governmental, service clubs [e.g., Rotary and Lions clubs] and non- governmental organisations) to be successful in improving preventative MCH services in Myanmar.

Formerly Medical Officer of Health & Assistant Regional Director (Medical), Western Metropolitan Health Region, NSW Dept. of Health. Had statutory responsibility for public health of 1.2 million people living in the Western Metropolitan Health Region.

Joseph graduated in Medicine from the Institute of Medicine 1, Yangon and worked as Township Health Officer in various roles. He later migrated to Australia where he joined NSW Health Services and a group of GPs in Wollongong.

His qualifications are MBBS, DTM&H, DPH, MHP, FRACMA, FACPHM.

He was awarded Membership in the Order of Australia for GP services to Burmese migrants, refugees and humanitarian work overseas.

[email protected]



& 11th

April 2012

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Delivery of Paediatric Cardiology Services in

Resource Poor Countries Dr. Philip Roberts In the last 30 years there have been significant advances in the delivery of congenital cardiac services in well-resourced countries. In particular surgical and catheter-based interventions have altered management strategies with an increased number of patients surviving to adult years.

All these types of interventions – surgical and catheter – happen in expensive facilities with expensive teams. Apart from personnel, cardiac theatres with bypass machines and ECMO machines as well as dedicated cardiac catheter laboratories are required.

The allocation of resources for such facilities may not be appropriate for developing countries and individual decisions need to be made about where resources should best be allocated within any community.

However, it should be remembered that a significant number of cardiac conditions in developing countries are acquired and that in many instances a focus on prevention rather than cure is appropriate.

During the course of my talk I will examine and discuss several possible strategies that could be considered for less well-resourced countries.

Dr. Philip Roberts Interventional Cardiologist

Children’s Hospital at Westmead Sydney, Australia

[email protected]



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Mental Health Interventions: A Pathway to Maternal and

Child Well-being Dr. Raymond Tint Way The risks in childbirth have been noted since antiquity, depicted by a Burmese saying: “A woman in labour faces danger no less than a man on a raft in a raging river”.

The impact of traumatic perinatal experience on the physical and psychological health of mothers and children can be substantial and lasting. The need for early mental health intervention as a form of primary prevention is discussed.

The concept of the “mother-infant bond” and Bowlby’s “attachment” theory is presented. The ramifications of the “breaking of the bond” and the importance of psychological treatment in restoring maternal and child well-being are highlighted.

Research suggests that “mainstreaming” of mental health services and the development of culturally sensitive Community mental health facilities contribute to increased utilisation and access. The speaker will share his experience of working in Australia, where mental health care has been an integral part of MCH services, as well as general practice.

He reports on how to deal with psychological trauma of grief and loss in

the perinatal period when resources are inadequate; or overwhelmed, as in a natural disaster. Emphasis is placed on the model of “Train the Trainer”, used by BMAA after Cyclone Nargis.

Collaboration is proposed between health care delivery services in Australia and Myanmar, e.g., scholarships for clinical psychologists, joint research, funding for development of community services; and “Train the Trainer” programs involving general practitioners, midwives and nurses to equip them with the skills necessary to promote and restore maternal and child well-being.

Dr. Raymond Tint Way is a consultant psychiatrist and psychotherapist in private practice in Sydney. He is a VMO psychiatrist in the Mood Disorders Unit at Northside Clinic, Greenwich, New South Wales. In the aftermath of Cyclone Nargis in 2008, Dr. Tint Way trained a core group of Burmese-speaking general practitioners in Sydney, who conducted “psychological first aid” [TOT model] and implemented a pilot psychosocial project in Burma.

[email protected]



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April 2012

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My Personal Experience of Maternal and

Child Health in Myanmar Dr. Joyce Conolly

During my visits to Burma in the past 10 years I have become aware of the horrendous difficulties many Burmese people live with.

These experiences have empowered me to:

1. Become involved with the local GP in the Shan state in the translation into the Shan language of the health books “Where There Is No Doctor” and “Where Women Have No Doctor”.

2. To visit villages and orphanages to give donations to them or to give medical care to the village people.

3. More recently, to become involved in the education of health care workers in basic medicine, psychotherapy and obstetrics in Yangon and the villages.

MB B.CH BAO BA Trinity – Dublin University 1963

1964 - 1966 Hospital Medical Officer in UK and in Australia 1974 - 2004 General Practice Australia

For the past ten years I have visited hospitals, worked in orphanages and villages, lectured health care workers in Burma

Park House, Level 7, 187 Macquarie Street, Sydney 2000 Email: [email protected]



7

Asia Pacific Community Mental Health Development Project A/ Prof. Chee Ng

To reflect on the direct and indirect link between physical and mental health, the slogan “No health without mental health” has been widely advocated by WHO and other global health bodies. Improved mental health can have positive impacts on the key MDGs, including maternal health and child mortality such as through increased adherence to critical prevention and treatment programs for antenatal and postnatal care. The challenges to meet the mental health needs for diverse populations in this global context are enormous. Faced with the relative lack of resources in terms of workforce, facilities, treatment and service provisions, the Asia-Pacific region is making greater efforts to extend the reach of mental health service to the community level through innovations involving partnerships with existing community resources. The Asia-Pacific Community Mental Health Development (APCMHD) Project was initiated by Asia-Australia Mental Health in collaboration with the WHO Western Pacific Regional Office in 2005. It aims to promote and inspire best practice in community mental health care in the region by bringing together a high-level mental health network of government, clinical and academic leaders from 17 Asia-Pacific nations to work collaboratively.

The first and second APCMHD Summary Reports respectively outlined best practice models of community mental health care and effective partnerships in each of the participating countries. It highlights diverse working partnerships with key community stakeholders including primary health workers. Learning from these principles and challenges in building the coalition and system of services for community mental health can inform future policies in mental health care.

Asia Pacific Community Mental Health Development Project

Associate Professor Chee Ng1 and Ms

Julia Fraser2

1Director of International Psychiatry

Unit, University of Melbourne, Co-Director of Asia-Australia Mental Health, Site Director of WHO Collaborating Centre in Mental Health St Vincent’s Mental Health, and Executive Board Member of Pacific Rim College of Psychiatrists. 2Associate Director, Asialink Centre,

University of Melbourne, and Co-Director of Asia-Australia Mental Health.

[email protected]



& 11th

April 2012

8

General Practitioners’ Liaison Project between

Malaysia and Myanmar Prof. Kyaw Tin Hla In order to achieve the necessary changes in capacity building to reduce the infant and maternal mortality rate in Burma, a comparison is made with what is happening in the part of the world close to home.

A successful strategy has to start well. Using available resources, it should be practical, affordable and locally relevant.

The paradigm shift in capacity building towards improving health standards has to begin at the grass root level, i.e., rural and urban general practice training. The standard of GP training can be improved by a properly structured program in which emphasis is placed upon trainer-trainee interactions with involvement of academia.

Liaison between the Academy of Family Physicians of Malaysia and the General Practitioners’ Society under Myanmar Medical Association has already commenced.

Colleagues from Malaysia have recommended an establishment of a dedicated server offering modular learning. A diploma in Family Medicine from Myanmar is an essential requirement for this training program.

Proper accreditation and international recognition may help towards achieving FRACGP [Fellowship of the Royal Australian College of General Practitioners]. Professionals trained overseas from the Academy of Family Physician Malaysia could also offer assistance with certain training sessions.

“SOE Grant” has pledged to eligible Burmese candidates to achieve this aim.

Consultant General Surgeon, Breast and Endocrine

M.Sc. (Surgery) FRCS (Edin)

Lecturer in University Malaya, Kuala Lumpur, UNIMAS, Kuching, IIUM, Kuantan and MAHSA KL Malaysia

Lecturer, Researcher and Educator for the last 42 years in Burma and overseas. Worked for 21 years as surgeon, Lecturer in Burma, Singapore and Scotland.

[email protected]



9

NGOs and their role in Health Care in Myanmar A/Prof. Bruce Conolly, AM From 1970 – 1998, I have been involved in Voluntary Medical Missions in more than 20 developing countries focusing on teaching and the surgical and non-surgical treatment of patients of all ages with all manner of conditions of their hands and upper extremities. Since 1998 my work has been concentrated on Vietnam, Laos and Burma under the umbrella of two NGOs: the Rotary Club of Mosman and Grace Works, which have provided a structure to increase the effectiveness and enjoyment of my missions. This structure will be discussed in some detail.

Associate Professor of Hand Surgery, Conjoint Appointee, University of New South Wales 1992-present.

Clinical Associate Professor of Hand Surgery, University of Sydney 1993-present. Adjunct Professor, Notre Dame University.

President, Asia Pacific Federation for Societies of Surgery of the Hand, 2009 – 2012.

[email protected]



& 11th

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A Perspective of Graceworks in the Promotion of General Wellbeing of Mothers and Children in Myanmar Mr. Peter Simmons

Mothers and babies are the most vulnerable members of any society. The manner in which they are treated and cared for is directly related to the well-being of society.

Medical competence and cultural awareness are diverse issues that are crucial elements to the quality of maternal health care. Provision of such care, particularly in rural areas, can be a formidable challenge when fear and suspicion of health workers and hospitals often provide a very real threat to medical services.

To maintain good health there must be a nutritional balance in the food intake of the poor.

The chronically poor cannot afford meat and vegetables but providing opportunity for wealth through sustainable income generation connects two important keys to wholeness – health and economic stability.

I conclude that the issue of maternal health care in Myanmar is as much about the cultural, traditional, and generational considerations as it is about medical services.

The answers must not be found in focusing on health care in isolation but embracing a broader perspective that includes the educational and economic well-being of every community member.

Peter Simmons is the CEO of Graceworks, which he founded in March 2004. He is an associate of the Australian Institute of Management and has served on the board of Teen Challenge Victoria and as Chairman of Youth for Christ Victoria.

He has an extensive business background and is former winner of the Collie Trust Foundation scholarship. He is currently studying for a Masters of International and Community Development at Deakin University, Melbourne.

[email protected]



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‘Can Research in Developing Countries be both Ethical and Responsive to those Countries’ Health Needs? A UNESCO Bioethics Approach

A/ Prof. Russell D’Souza

To avoid exploitation of host communities in the developing countries, many professionals and organisations suggest that research subjects must receive the best methods available worldwide.

On the other hand there are increasing concerns that this requirement can potentially block important research intended to improve health care in developing countries. After studying the consequences and in attempting to resolve the dilemma, the UNESCO Asia-Pacific Bioethics network developed a framework for the conditions under which it might be acceptable to provide subjects in developing countries with less than best methods.

While institutional review boards should assume a default of requiring the best methods – meaning the best methods available anywhere in the world –exceptions might be granted to this default in developing regions.

This presentation will discuss that research studies that satisfy identified conditions as scientific necessity, relevance for the host community, sufficient host community benefits, subject and host community non-maleficence could be granted exceptions

so that research is not blocked and research that can improve health care in developing countries will not be lost.

The case of the controversial trials for HIV vertical transmission of HIV infection from mother to child is discussed as an example to demonstrate that allowing research using suboptimal methods only when scientifically necessary (as was the case in nevirapine single agent trials) has now revolutionized perinatal HIV treatment in developing countries, potentially saving millions of lives.

Chair Asia Pacific Bioethics Network for

Science Education and Technology

UNESCO Chair in Bioethics

[email protected]



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What would a reliable Pathology system mean for Maternal and Child Health in Myanmar? A/ Prof. John Aaskov Effective health care, both preventive and curative, depends on accurate diagnoses. In resource-poor settings, this frequently is not possible. As a result, the poor often pay, with funds they can’t afford, for tests that are unreliable, for treatment that is inappropriate and with medication of dubious quality.

In addition, governments may mount health campaigns against problems that don’t exist, or fail to evaluate programs that have been inappropriately targeted. In the absence of a reliable diagnostic system, there can be no evaluation of the effectiveness of most health interventions. In order to get value for scarce health funds, Myanmar must develop a reliable, safe pathology service that focuses on diagnostic services that will deliver the greatest benefit to most people and support the Ministry of Health to include evidence-based evaluation of outcomes in health planning.

Australia could play a significant and long-term role in establishing and staffing such a service along with the in-built quality checks to ensure it provides timely and cost-effective support to the Myanmar health system.

Assoc. Professor John Aaskov PhD (Leeds) FRCPath (U.K.). Director W.H.O. Arbovirus Reference Centre, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane. Tel: 61 7 3138 6193. E-mail: [email protected]. Research interests – diagnostics and vaccines for mosquito-borne viral diseases of Asia and the Pacific. Professional interest – enhanced Pathology services in resource poor settings.



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Significance of LBW in Myanmar Prof. Aye Aye Thein

More than 20 million infants worldwide, representing 15.5% of all births are born with low birth weight. About half of these are in South Asia. In Myanmar, the incidence of LBW is difficult to estimate as a large proportion of infants are delivered at home and most are not weighed at birth. UN agencies estimate the incidence of LBW in Myanmar is about 15% (Source: UNICEF State of World’s Children Report, 2009). It is noted that LBW is one of the major determinants of neonatal survival as well as postnatal morbidity countrywide since about 30% of neonatal death is attributed to LBW babies, according to the “ Nationwide Cause-Specific Under-5 Mortality Survey 2002-2003”.

A real breakthrough in neonatal care and a reduction of LBW mortality and morbidity will occur only when the quality of prenatal and medical care can be improved both in rural and urban communities simultaneously. In Myanmar, Maternal and Child Health including newborn care has been accorded as a priority issue in the National Health Plan, aiming to reduce the maternal, newborn and childhood mortality and morbidity. Although there is no specifically instituted program for control of LBW, the majority of public health interventions are being addressed

and implemented through ongoing programs for MCH, nutrition and literacy, within the context of existing policies and guidelines in collaboration with related departments, UN agencies, national and international NGOs.

However effort should be intensified to implement effective strategies for the reduction of LBW births and improving the care of these vulnerable neonates.

DR. AYE AYE THEIN MBBS, DCH, MMedSc (Paed),

MRCPCH, FRCP. Consultant Neonatologist

Professor & Head, Special Care Baby Unit, Central Women’s Hospital,

Yangon, Myanmar.

[email protected]



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The overview on Maternal Mortality in Myanmar Prof. Aye Aung Maternal mortality in Myanmar was 420/100,000 in 1990 and 240/ 100,000 in 2008, showing an improving trend and aiming to achieve a better result in coming years. The Millennium Development Goal (MDG-5) is also targeted. Reproductive health policy and reproductive health services set strategies to: (1) improve antenatal, intrapartum, postpartum and newborn care; (2) provide quality services for birth spacing, prevention and management of unsafe abortions; (3) prevent and reduce reproductive health infections and sexually transmitted infections including HIV, cervical cancer and gynaecological morbidities. They also include promotion of sexual health, including adolescent reproductive health and partners’ involvement. Unmet needs will be also discussed.

Professor of Obstetrics and Gynaecology

North Okkalapa Teaching and General Hospital, Yangon. M.B.,B.S. M.Med.Sc.(OG)

MRCOG (UK)

Member, Central Executive Committee, Myanmar Medical Association (MMA) Academic Chairman, MMA Chairman, International Relation OG Society MMA Central Executive Committee, MSEM Member, Endoscopic society MMA

[email protected]



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High Risk Pregnancy and its management

Dr Miguel Marquez Most maternal deaths are avoidable, as the healthcare solutions to prevent or manage complications are well known. The WHO documented that in 2008, 358,000 women died due to pregnancy- or childbirth-related complications, of which the majority developed during pregnancy. An estimated 80% of these maternal deaths are due to:

o severe bleeding (mostly bleeding after childbirth)

o Infections (usually after childbirth) o high blood pressure during pregnancy

(pre-eclampsia and eclampsia) o obstructed labour o unsafe abortion

Antenatal care should ideally be readily and easily accessible to all women as good prenatal care has the purpose of early detection and medical treatment to help prevent complications. A healthcare provider in these pre-pregnancy visits is especially important to identify any conditions that put the mother, the developing fetus, or both at higher-than-normal risk for complications during or after the pregnancy and birth. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has published in March 2011 standards of maternity care for Australia and New Zealand. It considers that all communities should have access to maternity services which meet the needs of the population, they should be appropriate, acceptable and accessible to all women and their families. It should ideally provide choice and the women should be involved in the planning and monitoring of such services.

These services should involve a multidisciplinary team with good inter-professional communication in which early identification, referral if necessary, and appropriate management of any women with obstetric or other complications.

A number of women will have pre-existing conditions that may become important during pregnancy and they need to be aware of the effect of their condition(s) on pregnancy, and of pregnancy on their condition. Ideally all women should have pre-pregnancy counselling in view to detect any clinical conditions that may be of relevance to the forthcoming pregnancy but are ideally managed prior to pregnancy.

We will briefly review what screening is performed to detect pregnancies at higher-than-normal risk of complications and what recommendations exist for their treatment.

Dr. Marquez was born in Uruguay, did the primary medical degree in Uruguay (MMBB), and then migrated to Australia in 2002. Obtained full medical registration in 2006. Currently in 4th year ITP trainee in O&G. Working at Westmead and Blacktown Hospital.


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Antenatal Shared Care Dr. Aye Aye Bartlett

Antenatal shared care (ANSC) is a program that gives women with low risk pregnancies the choice of having most of their antenatal care shared between the hospital and doctor or local midwife who is affiliated with the hospital. It is aimed to develop and encourage standardised antenatal and postnatal protocols and provide high standards of obstetric care.

It was introduced in the early 1990’s in Australia and this program is based on the fact that antenatal care is an appropriate component of the activities of a family physician which provides comprehensive and co-ordinated whole person health care of both physical and psychological well-being of mother and child.

Regular monitoring of the mother and intrauterine foetal growth and development is important throughout pregnancy.

At the same time, the assessment and management of the psychosocial aspects of the antenatal period should not be overlooked. Psychological assessment of all pregnant women is an integral part of good antenatal care.

Modification of the challenges in both antenatal care of rural and urban parts of Australia highlights the importance of

good antenatal care. This can help improve perinatal mortality and enhance maternal wellbeing.

This paper will focus particularly on the strategies that modify the antenatal care in indigenous people and overcrowded urban antenatal clinics. It is hoped that these examples will be useful in implementing a maternal and child care approach to improve perinatal mortality rates in any community.

Dr. Aye Aye N.M.Bartlett MBBS, MSc, FRACGP,

General Practitioner, Sydney, Australia.

[email protected]



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Seeking Practical Benefits in Medicine from National Reconciliation in Myanmar Mr. Trevor Wilson

Myanmar’s current transition depends critically on the human talents available to devise and implement the change programs the Myanmar Government has adopted. It is not hard to see why this should be so when account is taken of the fifty years of enforced isolation and conformity under Ne Win and the SPDC which essentially left Myanmar behind even its small ASEAN neighbours, Laos and Cambodia, in socio-economic development. One way to overcome the large gap in human resource capacity is for overseas Burmese to return to help achieve changes, as happened in Cambodia, Laos and Vietnam. There is no reason for Burmese living overseas to fear going “home”, and some high-profile Burmese have already done so.

Trevor Wilson retired in August 2003 after more than thirty-six years as a member of the Australian foreign service, the last fifteen as a member of the Senior Executive Service, after serving as Australian Ambassador to Myanmar (2000-03). Since October 2003 he has been a Visiting Fellow on Myanmar/Burma at the Department of Political and Social Change, School of International, Political and Strategic Studies, Australian National University.

Since 2004, Trevor Wilson has been co-convener of the Myanmar/Burma Update conference series at the Australian National University. He has (co)-edited four volumes of the conference papers, Myanmar’s Long Road to National Reconciliation (ISEAS 2006); and, with Monique Skidmore, Myanmar: the state, community and the environment (Asia Pacific Press, 2007); and Dictatorship, disorder and decline in Myanmar (ANU E-Press, 2008); and with Monique Skidmore and Nick Cheesman, Ruling Myanmar From Cyclone Nargis to National Elections (ISEAS 2010) based on the 2009 Myanmar/Burma Update. With David Kinley, he co-authored a case study of Australia’s human rights training in Myanmar ‘Engaging a pariah: Human rights training in Burma/Myanmar’ (Human Rights Quarterly, Vol. 29 No. 2, May 2007). He has written numerous opinion pieces and given many interviews about the situation in Myanmar/Burma. [email protected]



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The Importance of having an Integrated Emergency System to improve Healthcare Outcomes for Burma

Prof. Peter Cameron Healthcare in Myanmar is grossly under-funded and lacking in system design. To enable access to even basic care, an emergency health system must be developed across the country. A dedicated team of local specialists and the Myanmar Medical Association have come together with the International Federation for Emergency Medicine and doctors in Hong Kong and Australia to design a training course in basic emergency procedures for doctors working in emergency departments. This will be extended over time to a specialist Master’s course. The program has been endorsed by the ministry and will help ensure that women and children (and men) will have access to life-saving medical care.

Professor Peter Cameron is the President of the International Federation for Emergency Medicine and Academic Director of The Alfred Emergency and

Trauma Centre, Monash University, Melbourne, Australia. He has extensive

experience in developing emergency systems at a national and international

level. [email protected]



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“Upcoming Challenges on MCH in Mon, Karen and Tanintharyi States/Division after Repatriation/Resettlement of Refugees from camps in Thailand” Dr. Tun Aung Shwe Since the end of 2011, Myanmar government has held peace talks with all major ethnic resistance groups in the country including Karen National Union (KNU) - Burma’s longest running resistance group, which has fought for greater autonomy over six decades. On the 12

th of January 2012, the

government has signed a ceasefire deal with the KNU. It is the first written ceasefire agreement between both parties in 63 years. Although it is still early days, there are hopes of reconciliation and of refugees returning home.

The refugees’ previous residences in Myanmar are located mostly in Karen State, Mon State and Tanintharyi Division. Extra and new health demands on current health services in the states and divisions will be seen when resettlement program commences for over 135,000 refugees.

Several studies conducted in the refugee community revealed that reproductive health, maternal and child health are the key health issues. For Myanmar as a whole, and for Mon, Karen and Tanintharyi states and divisions in particular, childbirth remains potentially hazardous.

Thus, maternal and child health remains an issue of concern for the government, policymakers and health planners as well as women, their families and communities.

Collection, review and analysis of already available information about health issues provide greater understanding on the upcoming challenges in MCH from resettlement of refugees from the camps in Thailand. The findings and recommendations from the study will contribute to informed decision-making for all stakeholders.

Dr. Tun Aung Shwe MBBS, MDevS, MPH, MHM

Associate Lecturer (Part-time), Co-convenor: Program Design and

Evaluation course, Program Officer: Football United Action Research

Program, School of Public Health and Community Medicine, University of

New South Wales, AUSTRALIA [email protected]



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Maternal & Child Health in Humanitarian Emergency Affairs Dr. Kyi Minn Women and children are the most affected during humanitarian emergencies, whether by natural or man-made disasters, especially in developing countries. More disasters are expected in the future because of global warming and climate change. As all countries are striving to achieve the Millennium Development Goals by 2014, the humanitarian emergencies could be a hindering factor in achieving goals 4, 5 and 6. Women and children represent the majority of vulnerable population in any emergency. A well-planned and timed disaster risk reduction including maternal and child health issues (reproductive health services, antenatal care, obstetric emergencies, post natal care, infant and young child feeding) along with other comprehensive interventions will reduce vulnerability and improve the survival of mothers and children during emergencies.

Dr Kyi Minn graduated as a medical doctor from Rangoon Institute of Medicine (1) and received his Master of Public Health from the National University of Singapore. He is working for World Vision as the Regional Manager for Health Nutrition and HIV program for the Asia Pacific Region based in Myanmar. He initiated and managed the World Vision’s Cyclone Nargis Emergency Program in Myanmar in 2008 with a team of expatriate and local staff. He is currently a member of Public Health Association of Australia, American Public Health Association, International AIDS Society, RACGP (Victoria branch), and Myanmar Medical Association. He is also a Fellow of Nossal Institute for Global Health, the University of Melbourne. Contact email: [email protected]



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Establishing Paediatric Developmental Service in Myanmar Dr. Ohn Nyunt and Dr. Kyaw Myint Malia Children with special needs such as cerebral palsy, autism, genetic syndrome and neurological problems benefit significantly from early intervention. To allow early intervention, it is crucial that those children are seen and treated in a specialized paediatric developmental service. Such service demands a multi-disciplinary care model that includes medical, nursing, and allied health care. It is generally challenging to staff the multidisciplinary team with appropriately qualified and experienced professionals.

We aim to form an effective collaboration with our Myanmar and international counterparts to work together to establish a Paediatric Developmental Service in Myanmar. We can collectively seek funding to train an appropriately qualified individual from Myanmar in Australian Universities. Furthermore, we will seek suitably qualified persons who are willing to render their services on a voluntary basis, to visit Myanmar to assist and oversee further development of clinics.

We intend to support Myanmar paediatricians on a long-term basis, with evidence-based resources and protocols.

We also aim to organize conferences in Myanmar and invite international experts in the field. Success of the

project lies dependent on effective collaboration and working as a team toward the goal. Contact person: Dr. Ohn Nyunt (Paediatric Endocrinologist) [email protected]

Dr Ohn Nyunt

Dr Malia Kyaw Myint

The author, Dr. Ohn Nyunt, and the presenter, Dr. Malia Kyaw Myint, are both proud graduates from The Institute of Medicine (1). They both have further qualifications in Australia and are working in Sydney. Dr. Ohn Nyunt is a Paediatric Endocrinologist and Dr. Kyaw Myint is a General Practitioner. [email protected]




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Emergency Obstetric Care (EmOC) and RH training provided to CHW along the Thai-Burma border Dr. Alice Khin Saw Win (Co-authors: Dr. Cynthia Maung, Dr. Terrance Smith, Dr. Thein Win, Sophia Hla)

Background On both sides of the Thai-Burma border area, most women deliver at home with TBA (Traditional Birth Attendants). They have no access to emergency obstetric care and very limited access to health care services because of travel difficulties and security issues. Thus health services to these populations are provided only by local community health workers. EmOC and RH training is funded by the Columbia University's Mailman School of Public Health and Marie Stopes International (MSI), as part of the RAISE initiative.

Objectives 1. To promote maternal and child health and reduce death rates 2. To build capacity of community health workers in order to provide comprehensive RH services for the target population

Methodology Community health workers were trained for comprehensive RH services. They returned to their local community after an eight-month training. They were provided with RH equipment, supplies and medicine.

Results Clinical skills improved, thus enabling them to provide critical RH services upon return to the regions in which they work. Challenges are difficulty with communication with and transportation to project sites, and poor access to referrals for caesareans.

Conclusion The UN Millennium Development Goals (MDGs) address RH as a vital building block towards improving maternal health, reducing child mortality and eradicating poverty. "Complications related to pregnancy and child births are among the leading causes of mortality and morbidity of women of reproductive age in the developing world. Many of these problems are preventable through improved access to adequate health care services and emergency obstetric care"- United Nations (UN) Fourth World Conference on Women.

Since year 2000, I have started working with Dr. Cynthia Maung, the director of Mae Tao Clinic in Mae Sot, Thailand. I started promoting the concept of the relationship between health and human rights, the negative health consequences of human rights violations and the


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importance of knowledge on respecting, promoting human rights among health workers in Mae Sot area. With my initiative, human rights law, the right to health law and medical ethics were developed and integrated in the curriculum for training of health workers. I received “The Alberta Centennial Medal” from the Government of Alberta in 2005 for my work on human rights.

Dr. Alice Khin Saw Win MBBS, MMedSc (Int.Med), PhD (c)

Faculty Lecturer Faculty of Nursing, Medicine and

Dentistry University of Alberta

E mail: [email protected] Graduated from IM 1 (1972 batch)


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“Saving the lives of Myanmar Women: The Way Forward” Dr. Si Lay Khaing Maternal mortality ratio in Myanmar was reported at 240 per 100,000 live births in 2008. In Myanmar, most births take place at home. 87% of maternal deaths occurred in rural areas, of which 88% died at home, 2% died on the way to a healthcare facility, and 10% died at the facility. An estimated 3,800 women die in pregnancy and childbirth each year, from hemorrhage (24%), sepsis (15%), unsafe abortions (13%), eclampsia or hypertension (12%) and obstructed labour (8%). Lack of skilled birth attendants, proper equipment and adequate drugs are the factors contributing to the high mortality ratio. Building the capacity of medical staff and auxillary midwives through education and upskilling would be helpful. Active management of third stage of labour with oxytocics and optimization of haemoglobin level during antenatal period are essential to reduce mortality from haemorrhage. Appropriate use of antibiotics, availability of clean water, disposable clean delivery kits and rapid microbiological diagnostic tests are all necessary to prevent sepsis. Early detection and management of pregnancy induced hypertension and wider usage of im Magnesium

Sulphate in rural settings should be promoted. Abortions in Myanmar are illegal and religiously unacceptable. The issues on unsafe abortions could be tackled by promoting effective use of contraception and education. The rate of cervical cancer screening in Myanmar between 18-69 year old was 0.9 %, 1.9 % in urban areas and 0.4 in rural areas over the last 3 years. It is therefore an area that would require further improvement.

Allowing further research programs for Reproductive health and increasing allocation of Myanmar budget for the healthcare sector will strengthen the Health system and in turn reduce maternal mortality.

“In an ideal world, no mother should die while giving life.”

MB BS (Yangon), 1982 Master in Obstetrics & Gynaecology (University of Malaya) Specialist Obstetrician & Gynaecologist & Senior Lecturer, University of Malaya Researcher in the field of developing new drugs for gynaecological cancers (working

towards a PhD). Email: [email protected], [email protected]




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Part-2 List of Participants


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List of Participants

1 Aaskov, A/ Prof John – QLD University of Technology, Brisbane

2 Aung, Dr Mon Mon – MMCWA,Nay Pyi Taw, Myanmar

3 Aung, Dr Saw – Physician, NSW

4 Aung, Prof Aye – OG, IM(2), Myanmar

5 Aye, Dr Khin Myint – ACT

6 Baguley, Justin – AusAID

7 Bartlett, Dr Aye Aye – GP, Sydney

8 Brancatisano, Stephen – University of Sydney

9 Cameron, Prof Peter – Alfred Emergency & Trauma Centre, Monash University

10 Carpenter, Anne – Graceworks Myanmar

11 Chaung, Tang Sw – Malaysia

12 Chaw, Dr Hla Yin – GP, NSW

13 Chen, Dr Tony – Ophthalmic Surgeon, Florida, USA

14 Conolly, A/ Prof Bruce, AM – Clinical Associate Professor of Hand Surgery, University of Sydney

15 Conolly, Dr Joyce – GP, Health Educator, Graceworks, Myanmar

16 DeSouza, A/Prof Russell – Psychiatrist, University of Melbourne

17 Fraser, Julie – Asia Link Centre, University of Melbourne

18 Gorbac, Elizabeth – Sydney

19 Halladay, Helen – Sydney

20 Halladay, Richard – Sydney

21 Han-Tin, Sonny – Sydney

22 Hearn, Prof John – Deputy Vice Chancellor - International, University of Sydney

23 Hla, Prof Kyaw Tin – Surgeon, KL, Malaysia

24 Hlaing, Dr Swe Swe – Myanmar

25 Htut, A/ Prof Thein – Gastroenterologist, Brisbane, QLD

26 Htut, Dr Sao Nyunt Wadi – Brisbane, QLD

27 Htwe, Dr Thandar – GP, Sydney


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28 Jeffrey, Prof Heather – Chair of Maternal & Child Health, University of Sydney

29 Khaing, Dr Si Lay – OG, KL, Malaysia

30 Khin, Dr Mu Mu – Sydney

31 Khin, Dr Nan Thu Thu – Sydney

32 Khin, Dr Alice – Lecturer, University of Alberta, Canada

33 Kranz, Dr Brenda – University of Sydney

34 Kyaw Hla, Prof Samuel – Paediatrician, MMA, Myanmar

35 Kyaw Win, Dr Raymond – Myanmar

36 Kyaw, Dr Amarcho – Dental Practitioner, Sydney

37 Kyaw-Myint, Dr Thane Oke – Paediatrician, ACT

38 Kywe, Prof Khin Lay – OG, Myanmar

39 Lin, Dr Bernadette – GP, Perth, WA

40 Lin, William – Nursing, Sydney

41 Malia, Dr Kyaw-Myint – GP, Sydney

42 Mangrai, Cheri – Radio Australia, Melbourne

43 Marlar, Win – QLD

44 Marquez, Dr Miguel – Senior Registrar in O&G, Westmead Hospital, Sydney

45 Maung, Dr Maung – Sydney

46 Maung, Dr Win – London, UK

47 Maung, Mrs Khin San Win – London, UK

48 Minn, Dr Kyi – World Vision Myanmar

49 Moe, Dr Moe – Sydney

50 Moe, Dr Soe – Ophthalmologist, Sydney

51 Myint, Thida – Dental, Sydney

52 Ng, A/ Prof Chee – Psychiatrist, University of Melbourne

53 Nyunt, Dr Khyne – GP, Sydney

54 Nyunt, Mr Ba – Orthopaedic Surgeon, Darwin, NT

55 Nyunt, Mrs Than Than – Darwin, NT

56 Oo, Tun Tun – Nursing, Coffs Harbour, NSW


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57 Pe, Dr Hla – Myanmar Red Cross, Myanmar

58 Pereira, Dr Joseph, AM – Sydney

59 Phyu, Sabai – Nursing, NSW

60 Raman, Dr Shanti – UNSW, Sydney

61 Roberts, Dr Philip – Interventional Cardiologist, Westmead Children’s Hospital

62 Saffin, The Hon. Janelle, MP

63 Sann, Dr Sann , Paediatric Psychiatrist – UK

64 Shrekker, Tom – Sydney

65 Shwe, Dr Ba – MMA, Myanmar

66 Shwe, Dr Tun Aung – UNSW , Sydney

67 Simmons, Margaret – Graceworks Myanmar

68 Simmons, Peter – CEO, Graceworks Myanmar

69 Sitharthan, Dr Gomathi – University of Sydney

70 Skidmore, Prof Monique – Pro Vice- Chancellor, University of Canberra, ACT

71 Soe, Prof Yin Yin – OG, Myanmar

72 Soem, Thomas – University of Sydney

73 Swe, Dr Nu Nu, Author – Myanmar

74 Swe, Thet – Malaysia

75 Tan, Dr Christine – GP, Sydney

76 Taw, Dr Harry – Anaesthetist, USA

77 Taylor, Prof Richard – UNSW, Sydney

78 Thein, Dr Rosie – Canada

79 Thein, Dr Win Myint – GP, Coffs Harbour, NSW

80 Thein, Prof Aye Aye – Neonatologist, IM(1), Myanmar

81 Thiagarajan, Prof Sitharthan – School of Medicine, University of Sydney

82 Tin, Prof Khin Than – OG , Myanmar

83 Ting, Dr Beatrice – Texas, USA

84 Ting, Prof Stan – Immunologist, Texas, USA

85 Tint, Dr Daw Khin – Sydney


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86 Tsen, Jade – Flinders University, South Australia

87 Tun, Dr Myint – GP, Sydney

88 Tut, Dr Aung Myat – GP , QLD

89 Way, Dr Raymond Tint – Psychiatrist, Sydney

90 Way, Mrs Mary – Sydney

91 Wilson, Trevor – Visiting Fellow, ANU

92 Win, Daniel – CEO, Global Aid Network, Australia (GAiN), Sydney

93 Win, Dr Esther – GP, Sydney

94 Win, Dr Khin Than – GP, Wollongong

95 Win, Dr Kyaw – MMA, Myanmar

96 Win, Dr Than Than – Myanmar

97 Win, Dr Ko Ko – Penang, Malaysia

98 Wong, Dr Rose – GP, Sydney

99 Wong, Dr Theresa – GP, Sydney

100 Wong, Dr Thomas – GP, Sydney

101 Zaw, Dr Kyaw – Sydney

102 Zwi, Prof Anthony – UNSW, Sydney


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University of Sydney’s Media Release


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Part-3 Photographic Section

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The Hon Janelle Saffin MP delivering an opening speech.

Professor John Hearn welcoming the audience.

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Prof Samuel Kyaw Hla - Myanmar

Dr Mon Mon Aung - Myanmar

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Day 1 audience

A/Prof Bruce Conolly

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Professors Stan Ting & Heather Jeffrey in the front row

From L to R - Dr Kyaw Win, Prof Samuel Kyaw Hla, Dr Tint Way, Dr Brenda Kranz, Dr Gomathi Sitharthan and Prof Sitharthan Thiagarajan

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Lunch break – Prof John Aaskov, Prof Aye Aung, Dr Thane Oke Kyaw-Myint, Prof Yin Yin Soe

Daw Aung San Suu Kyi addressing delegates at the seminar on Day 1 (video message)

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Prof Aye Aung - Myanmar

Prof Aye Aye Thein - Myanmar

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A/Prof Thein Htut, Prof Sitharthan & Mr Justin Baguley

Dr Aye Aye Bartlett - BMAA

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Dr Tint Way (BMAA) & Dr Gomathi (Sydney University)

Dr Tun Aung Shwe - BMAA

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Networking

With the Building Bridges banner

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Burmese Medical Association Australia Organising Committee for Global Reunion and Seminar for Maternal and Child Health in Myanmar

L to R: (Front row) Dr Amarcho Kyaw, Dr Thane Oke Kyaw-Myint, Dr Joseph Pereira, Dr Raymond Tint Way, Dr Theresa Wong, Dr Kyaw Myint Malia, Dr

Khyne Nyunt. (Second row) Thida Myint, Dr Christine Tan, Su Su Hlaing, Dr Aye Aye Bartlett, Dr Yamin Oo, Dr Ohn Nyunt, Dr Rose Wong, Dr Hla Yin Chaw, Dr Lavenda Tun. (Third row) Dr Myo Thu Han, Dr Tun Aung Shwe, Dr Myo Thant, Dr Thandar Htwe, Dr Esther Win, Dr Zaw Win Oo, Dr Thomas Wong

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Annex

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Documents

building bridges - University of Sydneysydney.edu.au/health-sciences/building-bridges.pdf · Building Bridges, the title of this seminar, is most apt , given what is taking place