1. Case Study from Myanmar Professor Zaw Wai Soe Rector University of Medicine #1, Yangon Strengthening Health Care Systems

2. 1927... Burma – Myanmar change, Emergency Medicine Our Case

3. Myanmar is the largest country in mainland South-East Asia 15 States & Regions 74 Districts 330 Townships 64 Sub-townships 2891 Wards 13698 Village tracts 64817 Villages

4. Surgery & Anaesthes ia in Myanmar today Surgery & Anaesthes ia in Myanmar today

5. Shwedagon PagodaPopulation 51.49 m Growth Rate 0.8 in Rural Areas 70% National Groups 135 Languages100 Buddhists90% Age Groups 0 – 14 32% 15 – 59 15 – 5959% > 60 9% 93 M : 100 F

6. Mandalay Inlay Lake Adult Literacy Rate89.5% IMR62 U5MR72 MMR1.44 Life expectancy Urban72.1 Rural65.5

7. Medical Universities Total # studentsIntake University of Medicine(1) Yangon3454400 University of Medicine, Mandalay 2881300 University of Medicine(2)Yangon2945300 University of Medicine, Magway1984200 University of Medicine, Taunggyi 100 Total 1,30 0

8. 2013~2014 Total No. of doctors 31542 Total No. of Nurses 29532 Total No. of MW+LHV 24902

9. Changes in Myanmar The Lady was out, She was elected... The doors of Myanmar begin to open... 2011-12

10. Prof. David AK Watters Dr. Tai Wai Wong Prof. Peter Cameron Mr. James HB Kong

11. DEVELOPMENT OF EMERGENCY MEDICINE IN MYANMAR Dr Zaw Wai Soe MBBS, MMedSc(Ortho), FRCS(Glasgow), DrMedSc(Ortho) Dip in Med Education Professor of Orthopaedics & Traumatology University of Medicine 1, Yangon Yangon General & Yangon Orthopaedic Hospital(s)

12. Emergency Medicine Development in Myanmar Phase I Diploma Course & EM Departments in Major Cities Phase II Masters in EM EM Department in State & Division Phase III EM Department in Universities Local MMedSc (EM) Dip of EM Nursing EMT & Paramedics Training

13. Total injury morbidity – 11.5 % is HIGHEST in 2012 !

14. Total injury mortality– 8.1 % is HIGHEST in 2012 !

15. Burden of Injury in Myanmar 1 st leading cause of Hospitalization11.5% 1 st leading cause of DEATH8.1% only 1 ’National’ Blood Bank !?

16. Health Expenditure (1998– 2015) 1000 Kyats = $1 USD

17. National Seminar on development of EMS in Myanmar

18. EMS Plan Advocacy meetings – regional & departmental National Seminar on development of EMS in Myanmar Submission to National Health Committee Pilot projects Implementation by Phases...

19. Resource collection

20. Central31 97 Emergency Physician 10 State & Divisional 37Neurosurgeon11 District29Ortho & Trauma208 Township352General Surgeon323 Station552Ob-Gyn358 Total1001Anaesthetists201 Population 51 million 1,11 1 Doctors per 100,000 population 2.2 Hospitals & Manpower (2013- 14)

21. MMed Sc at Central level 2 months courses to Gen Surgeons from State & Divisional H’s 2 months courses to Gen Surgeons from State & Divisional H’s 4 X 3 X 6 = 72 will start in March 2015-6 4 X 3 X 6 = 72 will start in March 2015-6 20 sets of neuro instruments & CTs in State & Divisional H’s 20 sets of neuro instruments & CTs in State & Divisional H’s Emergency Medicine0252015 Neurosurgery052016 Orthopaedics20602015 General Surgery30682015 Obstetrics & Gynaecology 30652015 Anesthesiology30602015 URGENT Need of Neurosurgeo ns

22. planned at Primary Level Primary Emergency Care Adult & (Paediatrics) Emergency Anaesthesiology Emergency Obstretics & Gynaecology 1 year Curriculum In State & Divisional Hospitals Focus Emergency Care Select from & serve in State & Divisional... 5 X 20 = 100 per year Diploma in...

23. Limited Facilities

25. How do to do this ?? Phase I Phase II Phase III Phase IV

26. Yangon General Hospital (c 1906) Thank you for your support & kindness to Myanmar