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The MSF continues to treat patients co-infected HIV and TB in Myanmar in collaboration with the Ministry of Health. Photo: MSF

Health officials called Thursday for urgent action to tackle "alarming" rates of drug-resistant tuberculosis in Myanmar where nearly 9,000 people catch the strain of the infectious disease each year.

Treatment programmes in the impoverished nation -- where the healthcare system was left woefully underfunded during decades of military rule -- are expensive and ineffective leaving the deadly illness to spread unchecked, experts warned at a Yangon forum on the issue.

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File picture of Union Minister for Health, Dr. Pe Thet Khin, addressing MRCS & Central Council Members at 70th Central Council Meeting in 2012. (Photo: MRCS)

Union Minister Dr. Phay Thet Khin from the Ministry of Health said that there are only 15 Neurologists in the entire country. The statement was made at the Upper House Parliament held on August 21, in response to an inquiry.

U Kyaw Kyaw, Upper House MP from Rakhine State inquired whether the government had any plans to appoint specialists for general hospitals in Sittwe township.

Dr. Phay Thet Khin responded, “The total number of trainees and Neurologists that are currently employed is only 15. They are already appointed at the University of Medicine, Yangon (1) and (2), Naypyidaw, and Mandalay. We do not have sufficient specialists to be appointed at hospitals in other states and divisions.”
He also added that there are only 12 Neurosurgeons all over the country.

U Kyaw Kyaw had submitted an application to the Parliament requesting appointment of  specialists to the general hospital in his constituency. He has requested for Urologists, Neurologists and Gastroenterologists. The Chairman of the Parliament directed the request to the Union Minister.

Dr. Phay Thet Khin elaborated further that it takes a minimum of 12 years for doctors to become specialists. Therefore, in spite of the government's efforts to produce more specialists, it will not happen easily.

He also added that the policy that was practiced by the former government has changed now and trainings for respective subjects for specialists are being provided separately.

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Win Zaw Oo (C) with Novel Hospital staff inside the Yangon International Airport before his departure to Singapore for treatment. AFP PHOTO

"Big Zaw" has known he was different since a teenage growth spurt sent him soaring above his neighbours in a remote Myanmar village.

Now at seven foot eight inches he is believed to be the country's tallest man, and a recent rise to fame means he can finally seek treatment abroad for the health condition behind his towering height.

"My friends call me Big Zaw," said Win Zaw Oo, who at 233cm is significantly taller than the 168cm (five foot six) average Myanmar man.

"I do not fit in an ordinary car. When the doctor brought me here, he had to hire a truck," said the 36-year-old, who was given access to healthcare after a story about him in state media this year sparked a flurry of interest from reporters and medical experts.

He is now set to undergo surgery in Singapore for a pituitary gland tumour -- which causes the body to produce excessive growth hormones -- because the procedure is too advanced to be carried out in Myanmar, where the health system was left chronically under-funded by the former junta.

Win Zaw Oo, who left Myanmar on Thursday, said he was anxious about the trip.

"I have only seen a toy plane before, so I feel a bit worried about having to fly. But if it is for my health, I must do it," he told AFP ahead of his departure, adding that he was concerned about the future costs of treatment.

His height brings day-to-day challenges.

Win Zaw Oo has gone barefoot for most of his life in his rural village in Magway region, central Myanmar, where his parents and three sisters scratch a living from growing peanuts and sesame seeds on a couple of acres of land.

While his family was able to make extra-large longyis -- the sarong-like skirt worn by both men and women in Myanmar -- for him, custom-made footwear was far beyond the family's modest means.

His condition also means he tires easily and is unable to hold down regular employment, although he says he can help out in village construction because he does not need a ladder.

Shy but friendly, Win Zaw Oo attracts stares when he travels, but at home people are accustomed to him.

"We see him every day in our village... so we do not really think of him as being extraordinarily big," said his cousin Than Htoo.

Myanmar doctors said Win Zaw Oo appeared to have stopped growing, but that his condition carried future health risks.

"He needs to be cured," said Myatthu Mynn, part of the medical team travelling with him to Singapore on a trip funded by private donations from Myanmar and Singapore.

He explained that the procedure -- which usually involves accessing the pituitary gland at the base of the brain through the nose or an incision in the mouth -- is too specialised for Myanmar's hospitals.

Decades of military dictatorship in the Southeast Asian country left the vast majority of citizens without access to even basic healthcare, as the junta state focused on its military spending.

A new quasi-civilian regime took power in 2011, but medical care remains woefully inadequate.

Official figures show the state only allocated around one percent of its expenditure to healthcare in its 2011 to 2012 budget, rising to three percent in 2012 to 2013.

Win Zaw Oo's condition -- acromegaly -- which can lead to gigantism when it develops in puberty, is extremely rare.

Accurate data for Myanmar is unavailable, but Britain's Pituitary Foundation said only around four to six new cases per million of the population are diagnosed each year.

It said health risks include "diabetes, high blood pressure and heart problems with a reduced life expectancy compared to the normal population".

Doctors said only one other extremely tall person has been recorded in recent memory in Myanmar.

Zee Kwet Sein, who is believed to have died in the 1970s, was left blind by her condition and her exceptional height saw her exhibited at fairs in the country's central region.

Win Zaw Oo's recent fame had led him to consider the possibility of a film career to help support his family, although he would rather start a business with his sisters.

But the condition takes its toll.

"I cannot move quickly like the others do. I feel depressed about that sometimes," he told AFP, adding that he does not expect to have a family of his own but hopes medical care will secure his future.

"After the treatment is finished it will be enough to live my life, even if it does not change my appearance," he said.

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Myanmar has started launching mother- related health program this month with the first week of being observed as breastfeeding, official media reported Friday.

During this month, the second week will be nutrition promotion week for under-five children while the third week as the nutrition promotion week for pregnant women and lactating mothers and the fourth as the week for elimination of iodine deficiency disorders, said the New Light of Myanmar.

The launching of the program is coincided with government's call for breastfeeding rather than milk powders and bottle feeding.

The Ministry of Health called on all mothers to pay more attention to breastfeeding which is highly recommended as the most complete form of nutrition for infants and its health, growth, immunity and development.

Breast-fed children are most resistant to disease and infection early in life than formula-fed children.

Although breastfeeding brings a range of benefits for children, milk powder and bottle feeding are sometimes detrimental to child' s health with negative effects.

Meanwhile, New Zealand has recalled up to 1,000 tons of dairy products as bacteria were found in the milk powders and dairy products. A total of 300,000 children in China fell ill after being fed contaminated milk products.

Breast milk has disease-fighting cells called antibodies that help protect infants from germs, illness, and even sudden infant death syndrome.

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World Population Day 2013 - Spotlight on Adolescent Pregnancy. Credit: UNFPA

Vice President Dr. Sai Mauk Kham has called for an end to underage marriages and unsafe abortion practices, claiming that Myanmar’s adolescent birthing rate is too high.

He made the comments at a ceremony commemorating World Population Day, held on Thursday. The event was attended by government officials, diplomats, youth representatives and the UN.

During his opening speech, the Dr. Sai Mauk Kham called on Myanmar’s citizens and decision makers to empower and protect the estimated 2.9 million adolescent girls that live in Myanmar.

The current adolescent birth rate is 16.9 per thousand among those aged 15-19, according to a 2007 Fertility and Reproductive Health Survey. The Vice President claims the figures are high compared to the country’s ASEAN neighbors, and increased support is needed if Myanmar is to reach Millennium Development Goals.

 “This is a matter of human rights to protection as well as access to services through a core package of comprehensive sexuality education and sexual and reproductive health and HIV services” said Janet E. Jackson, UN Populations Fund (UNFPA) representative to Myanmar.

In a proposal outlined during the event, the UNFPA called for in increase in local services including contraception units, STI and HIV clinics, maternal health services and post-abortion care.

“These should be provided to adolescents in a friendly, sensitive, confidential, non-judgmental, and non-discriminatory way, without legal restrictions,” said Jackson, in a press release following the ceremony.

Last year, a report was released that claimed eastern Myanmar was facing a public health crisis, with maternal death rates far surpassing Thailand and urban Myanmar. (http://www.mizzima.com/news/inside-burma/6580-health-crisis-in-eastern-burma-health-survey.html) The report showed a high rate of unplanned pregnancies and unsafe abortion practices.

According to a 2007 World Health Organization report, only 37 percent of Myanmar’s women gave birth with a trained attendant present.

Related articles:

  1. Burma, UN increasing HIV treatment programs
  2. Health crisis in eastern Burma: NGO survey
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Malnutrition is the leading cause of deaths for 40 percent of disease-ridden children in Myanmar, says Union Minister Dr. Pe Thet Khin from the Ministry of Health to the Pyithu Hluttaw (House of Representatives) on 10 July.

“The diseases can be caught easily due to lack of nutrition. They could die without resistance once the disease gets into their bodies,” he says.

Determining whether the child has adequate nutrition levels has to also take the mother's state of health and mortality rates into account. Dr. Pe Thet Khin added that 60 percent of women who die from blood loss is also due to the lack of nutrition.

Dr. Pe Thet Khin admitted that health care is especially weak in border and suburban areas including villages where 70 percent of the country’s population is located. He promised the members of parliament to accelerate tasks in reducing the gap in standard of health care between cities and villages.

In May this year, UNICEF announced that according to a 3-year survey led by the UN, 2.5 million children were undersized due to malnutrition, and 200,000 children have died due to malnutrition.

As a response, Dr. Pe Thet Khin took action to fight against child malnutrition by joining Scaling up Nutrition (SUN) - a global movement by the efforts of nation leaders and organizations dedicated to address the malnutrition problem.

“An individual’s health status, whether malnourished or well-nourished, is not an individual matter.  It also impacts the country’s economy and education,” says Dr Pe Thet Khin at the signing ceremony for SUN held at the Ministry of Health in Naypyitaw.

For the current 2013-2014 fiscal year, the Hluttaw has granted a budget of nearly five hundred billion kyats to the Ministry of Health.

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