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Myanmar UK Health Alliance Newsletter

July 2019
Welcome to the Myanmar UK Health Alliance Newsletter!
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Recent Updates and Highlights

Public Health England’s collaborative work on International Health Regulation Compliance 

Public Health England’s (PHE) work program to strengthen Myanmar’s compliance with the International Health Regulations continues to gather momentum with two important events taking place in April 2019.

Poison control and treatment round table 

Representatives from across the health system in Myanmar came together for the first time alongside experts from the WHO and PHE. Meeting in Yangon, they discussed multi-stakeholder collaborations with the view to strengthen the capacity and capability of the National Poisons Control Centre and Poison Treatment Units. The round table, as pictured below, was a resounding success and marked a significant step in the implementation of PHE’s work in Myanmar.

After-action review (AAR) workshop

The AAR is one of four instruments in the monitoring and evaluation framework of the International Health Regulations (2005) and is an important learning tool for informing stakeholders on:
  • Best practices
  • Challenges
  • The causes of gaps in preparedness
Together with the Department of Public Health Myanmar, PHE successfully delivered the AAR workshop on health response to the Yangon waste fire April-May 2018 in Nay Pyi Taw, Myanmar on 30th April 2019. The workshop used a hybrid model combining methods from the WHO and PHE’s structured debrief process. The Deputy Director General (Disaster) from the Department of Public Health, Dr Aung Kyaw Htwe, provided the opening speech.


BFIRST/BSSH trip to Yangon, Myanmar April/May 2019

Members of the British Society for Surgery of the Hand (BSSH) & British Foundation for International Reconstructive Surgery (BFIRST) visited Myanmar in April 2019. The team include:
  • Mr Tony Barabas (Consultant Plastic and Hand Surgeon, Hinchingbrooke Hospital, Cambridgeshire) - Trip Leader
  • Mr Wee Lam (Consultant Plastic and Hand Surgeon, Royal Hospital for Sick Children, Edinburgh, St John’s Hospital, Livingston)
  • Mr David Bell (Consultant Plastic and Hand Surgeon, St Helens and Knowsley Hospitals NHS Trust, Liverpool)
  • Mr Haz Alfeky  (Consultant Plastic Surgeon, University Hospital Coventry and Warwickshire, Coventry)
  • Miss Jill Baker (ST6 registrar in Plastic Surgery, Royal Hospital for Sick Children, Livingston, St John’s Hospital, Edinburgh)

Trip objectives and outcomes:

1. Develop closer ties between the plastic surgery and orthopaedic departments, particularly in the area of lower limb trauma

On Monday 29th April the first orthoplastic morning trauma meeting and ward round was undertaken identifying four lower limb trauma cases. During the week, orthopaedic and plastic surgery consultants and juniors from Yangon general hospital operated together with Mr Bell and Mr Alfeky to perform debridement, skeletal fixation and soft tissue coverage on the identified cases. 

2. Meet with and develop a better understanding of Yangon General Hospital (YGH) Plastic Surgery Department requirements

Professor Moe Thuzar, Dr Win and their team described the provision of burn surgery across Myanmar and the results of their burns unit. The department has identified burns as the major area that requires investment and improvement. Ideally there should be a new burns facility built which would include a larger operating theatre, more capacity for beds, an intensive care or higher dependency unit, and an improvement in cleanliness and sterility. This is beyond the scope and financial assistance that the BFIRST charity can provide, but we will aim to highlight the need to the Department of Health in Myanmar. The BFIRST charity have agreed to help with running a burns course and facilitate discussions over the future of burns surgery in Myanmar. 

3. Run micro-surgical course for junior doctors in the orthopaedic and plastic surgery departments 

Mr Wee Lam (Edinburgh), Miss Jill Baker (Edinburgh) and Mr Tony Barabas (Cambridge) ran a 2 day simulation course, with help from nurse Hannah Spires (Bristol). There were 29 participants on the course: 24 orthopaedic doctors in their second year of training and 5 plastic surgery doctors who were junior registrars.

The first practical session started with the participants using the Microtrainer® to place 9 equidistant sutures in a 8mm latex strip.  This allowed the participants to become familiar with handling the micro-instruments and operating whilst looking through surgical loupes.  

Throughout the two days participants progressed through large artery repair, small artery repair, end-to-side arterial repair and nerve repair.  At the end of the second day the participants used the Microtrainer® again, and were tasked to place 9 equidistant sutures in a 4mm microstrip. This allowed us to evaluate their improvement with each individual student receiving a score and feedback.


World Child Cancer workshop in Mandalay 

Experts from World Child Cancer group Professor Robert Carr (Guys & St. Thomas’ Hospital, London) and Dr. Denise William (Addenbrooke’s hospital, Cambridge) conducted a two day workshop during the first week of May at Mandalay Children’s Hospital. Following this, the team joined the 2nd Myanmar National Workshop on the Childhood Cancer Control Program on the 8th and 9th May alongside other key stakeholders including WHO and Ministry of Health & Sports.

Soapbox Collaborative Visit

Soapbox representatives, Professor Wendy Graham (Professor of Obstetric Epidemiology at LSHTM and Chief Scientific Adviser, Soapbox Collaborative) and Dr Elizabeth Goodburn (Senior Technical Advisor, Soapbox Collaborative), visited Myanmar in January 2019 and participated in the week long WASH Symposium of the 47th Myanmar Health Research Congress. 

Presentations were made on (1) the rising proportion of institutional deliveries and the pressing need for effective Infection Prevention & Control  (IPC)  to prevent avoidable deaths of mothers and newborns from hospital acquired infections (HAIs) (2) the elements of the TEACH-CLEAN Package, a participatory training program for hospital cleaners, which has been developed by Soapbox and (3) the findings of a WASH in health care facilities (HCFs) Needs Assessment which had taken place in 2017 led by MoHS DMR in partnership with Soapbox, LSHTM, WaterAid and UNICEF. 

The joint project between Jhpiego and WaterAid aims to improve WASH and IPC in HCFs with a focus on maternity units and prevention of hospital acquired infections in mothers and newborns. The Supporting Safer Births in Myanmar project is funded by the Australian Government’s Department of Foreign Affairs and Trade through their Water for Women Fund and will initially focus on 5 township hospitals. They also had the opportunity to support a practical demonstration of the techniques and participatory nature of the TEACH-CLEAN package for training hospital cleaners, as pictured below. 

The UK-based Soapbox Collaborative ( is a relatively small partner in this significant project but very much welcomes the opportunity to further develop UK-Myanmar partnerships in the health field.  

Upcoming Diaspora Event
Saturday 28th September, London

An event to connect interested UK experts, diaspora or interested partners to the work of MUKHA thematic working groups in order to gauge interest in involvement with the work on a practical or advisory level. For this event we will be specifically focusing on Medical Education, Laboratory Services, and General Practice.
We will be sending out invitations to the event, but are happy to receive expressions of interest from individuals. Please contact (Country Programmes Officer). 

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