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Orthopaedic Outreach Visit to Myanmar (Burma) voluntary project organised through the Royal Australian College of Surgeons
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VISIT TO MYANMAR
I was delighted to visit Yangon (Rangoon), Myanmar (Burma) as part of the team arranged by Dr. James Kong, Plastic Surgeon, a fellow of the Royal Australian College of Surgeons, resident in Hong Kong also. The third member of the team was Dr. T. W. Lee an Anaesthetist from Hong Kong.
The purpose of our visit was to participate in two Primary Care Trauma courses as well as attend and contribute to a trauma symposium as part of the annual general meeting of the Myanmar Medical Association.
We also visited the Yangon General Hospital as guests of Professor Thit Lwin, Professor of Orthopaedic Surgery.
Dr. James P. Kong should be congratulated for his enthusiastic, precise, and disciplined organisation of this trip. His original suggestion that the College run primary trauma care courses to help with reconstruction of Myanmar following the Cyclone Nargis in May 2008 was inspired, timely and appropriate. This is a real contribution that he and the College are making from the day to day trauma management of patients in Myanmar. Dr Kong’s ability to converse in the local language (he was born in Burma) his understanding of the local customs, and politics, has greatly contributed to the success previous courses and to this particular meeting.
Dr. T. W. Lee is a remarkable man who has contributed to at least ten Primary Trauma Care courses in past locations such as Mongolia, Beijing and Hanoi. He is an examiner at the Royal Australian College of Anaesthesia and is currently the CEO of Pok Oi Hospital, Hong Kong. He frequently uses his holiday time to supervise Primary Care Courses.
Primary Trauma Care courses are adapted from the EMST courses by the WHO for the developing world. The two courses recent that we attended, were instructed by Myanmar surgeons and Primary Care physicians, all had previously attended a basic and an advanced course.
On the evening of the day that I arrived, on the 23rd January, 2010 I met Dr. Kong and Dr. Lee and went over the program for the next few days. We rehersed the symposium and the next day, 24th January, 2010 we met the Myanmar Medical Association President, Professor Kyaw Myint Naing and the secretary general, Professor Myint Thaung. I discovered the current president, Professor Kyaw Myint Naing, had attended the same institution that I had (The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry, United Kingdom) a few years earlier than I.
On Monday 25.01.2010 we presented a Trauma Symposium based on a real life bus accident in which 21 people died in Hong Kong. During the course of the day I discovered it was extremely rare for any visiting doctors to attend Myanmar Medical Association, in recent years and we were flattered to have been given this opportunity.
That evening we were invited the Australian Embassy by the Ambassador Ms Michelle Chan for the Australia Day even function. I briefly discussed with her the possibility of continuing an avenue of donation of both surgical equipment, text books and journals. I understand Associate Professor Bruce Connolly, Hand Surgeon from Sydney has been visiting Burma and has provided this sort of help in the past.
The Primary Trauma Care courses started on Wednesday. Approximately one third of the attendees were practicing orthopaedic surgeons, the third were practicing general surgeons and the rest were primary trauma care physicians. All the participants were involved in management of trauma both at the either major hospitals, such as the Rangoon General Hospital, or in smaller towns and village hospitals.
I met Dr. Christoferson Aung who had attended the Alfred Hospital on a brief fellowship under the care of Mr. Michael Fogarty in 1976. He spoke highly of the experience then as well as the help of collection of orthopaedic devices which he brought back with him to Myanmar from the Alfred Hospital at that time.
James Kong and I were invited to attend a symposium on injury prevention at the Department of Medical Research, (lower Myanmar) Yangon. I attended as James was commencing the first course on the 27th January, 2010
The chairperson was Professor Pe Thet Khin, Rector of University Medicine (1), Yangon and the other chairperson was Dr Tim Minh, Rector of University Public Health I discussed the Victorian Legislation in relationship to motor car accident prevention with respect to seat belt constraints, breathalysers, speed cameras and provisional licensing arrangements for drivers. I mentioned the dramatic effect this has had on the level of road traffic deaths.
I understand Dr. James Kong is planning two further Trauma Courses in March and May 2010. Up until now there have been six Primary Care courses and there are local instructors doing an excellent job in maintaining and developing these courses.
The participants certainly enjoyed the unusual learning experience, the Primary Trauma Care course where they were encouraged to participate in acting as patients and in the hands on exercises. Unfortunately no participant in either of the two courses actually regularly used a seat belt ! James Kong asked each group this question at the first introduction of the day !
I think the College should undoubtedly continue to support colleagues in Myanmar in the future. This can be achieved with donations of journals, text books and appropriate equipment such as internal and external fixation and fracture management and help in running courses to train the trainers (as per the PTC courses) I think would be helpful. I think encouraging visiting senior clinicians to our meetings and courses would also be helpful.
My own impression of Myanmar is the country that is cautiously with an unforeseeable future, especially after the planned forthcoming election.
My colleagues are very aware of their isolation and desperately want to participate in the body of surgical knowledge.
I had two long discussions with the current Myanmar Medical Association Secretary, Professor Myint Thuang who was keen to start a library at the Medical Association in Yangon and as well as develop a library in the Orthopaedic Hospital in a separate location in the Yangon Medical Hospital.
Mynamar has the largest land mass of any country in South East Asia and has a population of 57 million, slightly more sparsely dispersed compared to other South East Asian countries. Transport implications may be more similar to Australia than other countries in South East Asia.
Hopefully we could continue to help our colleagues in Myanmar.
MAX P. ESSER
cc. Ms Dahlia Moss
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