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Published on Monday, 25 February 2013 17:54 Written by Dr. Thein Myint
Intensive Care Unit of the Yangon General Hospital (Photo – EMG)
As the respect paying ceremony of faculty members was on the mark, I have been to the University of Medicine (1) (formerly the Institute of Medicine 1) in Lanmadaw in the first week of January 2013.
The façade and the environment are splendid with cooling water fountain. The front lawn is much greener and neat compared to our days at the IM (1). As it was a bit early, I casually strolled to the classrooms and glanced from the outside and peeked inside. I felt that the existing teaching aids inside seemed to be poor in quality if they are equate to our days.
A few days back, I was at the Intensive Care Unit of the Yangon General Hospital to cheer up a friend who was taking treatment. Before the arrival at the ICU, I imagined and visualized it as a modern facility of the largest hospital in Myanmar. I was displeased to see the ICU. The apparatuses and equipment used at the unit are worn out and obsolete. I am enveloped with sadness to witness that the physicians have no alternative but to handle the available things in treating the patients.
High rise towers, super markets and mini markets are mushrooming in Yangon; however, the Alma Mater and the hospital that we had studied in good old days over thirty years ago have no visible improvement. Cleanliness is poor. On my way back from the ICU, the homeless dogs were enjoying the luxury of sleep near the rooms of the doctors, making the environment ugly. Relatives providing care and help to the in-patients at the hospital were seen in poor conditions to whom I have sympathy.
During our school days, the people had the opportunity to take medical treatment at the hospitals across the country free of charge. Gradually, the free system of treatment changed and the “cost sharing” for the affordable class for medical expenses is deliberately pushed ahead by the “wise guys”, putting burden to the people. The hospital only offers the equipment and the medical service.
Over the years, the situation deteriorated as the “cost sharing” intended only for the rich class expanded to all walk of life and the poor patients shared the cost of medicine and related items. The conditions of hospitals and dispensaries dived down.
In some hospitals, the expenditures and spending of the medical facilities are being appropriated from the patients through the special medical examinations and the doctors keep and maintain the situation to continue the health care system.
Ironically, the patients usually lamented when they were told to take treatment at Taunggyi in Shan State if the patient does not want to wait for long in Yangon when the Radiation Therapy machine is not functioning at the Yangon General Hospital. Taking treatment for cancer malady could not wait for long duration. Early diagnosis and prompt treatment is the most appropriate method. Travelling to Taunggyi for radiation treatment is a burdensome for the underprivileged patient as it involved acquaintances as well as cost, triggering difficulty. Things to be fulfilled are uncountable. Requirements on the part of the people are myriad.
There are five medical institutions such as the University of Medicine (1) in Yangon, the UM (2) in Yangon, the UM in Mandalay, the UM in Magwe and the Defense Services Medical Academy, all nurturing medical professionals.
Medical institutions for the civilian sphere are producing 2400 doctors annually. By citing and giving reasons to produce qualified doctors, the Ministry of Health pulled in only 1200 interns beginning 2012, slashing half in numbers of medical students. Educational stipends for the national races of the border regions should be elevated and prioritized.
In recent years, there are many unemployed doctors in the country. Some migrated to other countries and took up available jobs and some affordable people send the doctors for further studies abroad. Some joined whatever available jobs. As the journal publication is booming, some joined the bandwagon of journalism and became journalists, making distance from what one has learned at the institute. The old timer professors and veteran faculty members are sure to feel bad with much sadness to witness the situation on ground reality.
Some of the responsible persons in the Ministry of Health are of the view, and expressed from time to time, that the difficulty and dilemma encircling the ministry is the disproportionate or lop-sided ratio between the number of doctors and the patients. To be more exact, the ratio between the specialist doctors and the patients is more unbalanced. Under the circumstances, the specialists have to shoulder the main responsibility at the respective hospitals and to offer medical services to the patients at the private clinics and hospitals. Therefore, the Ministry of Health should focus and pay attention in the drive to cultivate and cherish more specialists.
We are very happy to learn that the parliament has recently allocated the health budget 14 times more than the previous budget. Moreover, the parliament also decided to divert funds amounting 12 billion kyats to other needy projects instead of the construction of four hospitals in Nay Pyi Taw, capital of the nation, which was proposed by the Ministry of Health.
We would be more than happy if the near dilapidated health ministry could work on the tasks such as restocking drugs and health related equipment, renovating and upgrading the existing hospitals, recruiting young doctors and beefing up professionals at the dispensaries and hospitals. Thinking optimistically, we are satisfied in advance that the problems and issues enveloping the Ministry of Health would be resolved gradually. However, as the looming issue involves financial matters and commercial use of the building, a strict mechanism and procedure should be applied to avoid unnecessary and risky loss popping up as collateral damage.
The budget proposal submitted to the parliament from the Ministry of Health covers a spate of expenditures on the health reforms to be undertaken in motley assortment of areas, for that we are delighted. However, we regret to say that the project to construct the University of Medicine in Taunggyi, being submitted from the Ministry of health to the parliament, at the cost of kyats five billion, is untimely, premature and inconsistent with the existing circumstances of the country. Furthermore, the proposal went on to express that more Universities of Medicine are in the pipeline after Taunggyi. The construction of a university involves mega expenses and that the responsible persons are not in a state to deny that they never ever mingle with the construction companies. The construction of new buildings means to add news ones as the old facilities are not enough. When someone examines the façade and outer face value of the existing universities of medicine, they are not so bad in the eyes of the viewers. However, all the medical students understand well that the number of teaching aids and materials are not sufficient and the instruments tend to be obsolete.
The nightmare that the medical students are facing is the tuition system. When I was attending the Institute of Medicine, there was no tuition at all. Therefore, the universities of medicine should be reorganized into compact institutions. The problem of tuition crops up as the ratio of faculty members and the students is not compatible. One more predicament is the lack of interest of the professors and associate professors to visit the hospitals elsewhere in the countryside for pragmatic teaching.
In shaping a perfect university, the creation of “university campus life” plays a vital role. University of Medicine in Magwe is less likely to switch into a good campus life compared to Yangon and Mandalay. Even before the construction of a university of medicine, the hospitals equipped with teaching facilities must be upgraded as the first step. At the time when the Magwe University of Medicine was constructed, the Magwe General Hospital was not top up with required items and expertise, resulting with chaotic conditions for the UM. A university of medicine could be complete with the backups such as teaching facility hospital, the venue for practical round under the teaching professor, and the hostels for the students. The medical students attending the Magwe University of Medicine are staying at private hostels and struggling against all odds in life, which are heard profusely. We have full sympathy as well as empathy towards the parents who suffered untold misery resulted out of the misfortune of the children.
All in all, the budget allocation in billions of kyats being diverted from the original plan to build four hospitals into other expenditure in upgrading and renovation of medical institutions across the country including Yangon General Hospital is indeed a very noble idea.
Earmarked budget for the news construction of Taunggyi University of Medicine should be shared with other universities through collaboration and cooperation as necessary. It seems that the number of doctors is in surplus for the time being. At a time when more doctors are in need, then the national races in the border areas should be inducted at the Defense Services Medical Academy in batches, in a way to foster unity among the national races for the benefit of the country. Other universities of medicine should open up their doors in taking medical students.
Only at a time when things are filled up in good conditions in the health care sector with the government capable of allocating enough budgets for medical services, the construction of Taunggyi University of Medicine should be considered. We are of the view that the existing medical universities should be upgraded first in their distinction and quality. The current plan to construct Taunggyi University of Medicine is not agreeable.