ျမန္မာႏိုိင္ငံမွလူနာမ်ား အထူးကုဆရာ၀န္မ်ား၏ စမ္းသပ္ခံျဖစ္ေန

dear all

I first read the above article at:

http://saffrontoward.blogspot.com/2009/12/blog-post_8961.html

in my google reader and decided to distribute to my friends because it concerns problems in the private medical practice highlighted by the death of a girl following surgery for appendicitis (whether there was actual acute appendicitis or not, I do not know, as it was not officially released) and later diagnosed as Dengue Haemorrhagic Fever (whether premortem or postmortem, I do not know, for the same above reason).

There was a lot of debate regarding the case and I wrote a reply to my son Linn Zaw Win, when he asked my opinion about it and sent bcc: to some friends (about 15). I will post it after I have posted this one.

I had written a comment for this article and distributed to my friends, colleagues and co-workers (over 80 persons). I thought it would be the end to it as was the mail concerning the earlier case.

However, my friend and classmate Dr. Kyaw Lwin replied to me with his comment and distributed it to around 40 persons. I was moved that he found my commentaries worth forwarding.

This led to the next (this) step. To post it on my blog, edited of course, and maybe modified later with updates.

please read my acknowledgements at the end

all
please read the article first (in burmese) at

http://saffrontoward.blogspot.com/2009/12/blog-post_8961.html

I cannot reproduce it correctly here because of font error. But when I look at the preview, I find the words in Burmese correct.

and then my remarks (in english)

below the original article

I feel that although many points about hospitals are correct
the blame put on the treating doctor and all doctors is not
if all doctors in Myanmar are not competent, where should patients go for treatment?
it is easy to put the blame on others

HERE is the original article:

via အတၱကင္းစင္ဒီမိုကေရစီလြင္ျပင္ by wanna23 on 12/23/09

24/12/2009
အမ်ိဳးသမီး တဦးအား ေဆးထည့္ေပးေနပံု
Photobucket
လူနာတဦးအား CT Scan ရိုက္ရန္ျပင္ဆင္ေနပံု
Photobucket
Photobucket
ျမန္မာျပည္၏ အႀကီးဆံုး ရန္ကုန္ေဆးရံုႀကီးပံု(အဂၤလိပ္ေ

ခတ္ ကတည္းက တည္ေဆာက္ခဲ့ေသာ အေဆာက္အဦးမ်ား ျဖစ္ပါသည္။)
ျမန္မာနိုင္ငံ ျပည္သူလူထုမ်ားမွာ အထူးကု ဆရာ၀န္ၾကီးမ်ားႏွင့္ အျခားက်မၼာေရး ၀န္ထမ္းမ်ား၏ အစမ္းသပ္ခံ ဘ၀တြင္ က်ေရာက္ေနေၾကာင္း မိခင္အား ေဆး၀ါးကုသေပးရန္ သြားေရာက္ခဲ့သူ ဘန္ေကာက္တြင္ ေနထိုင္ အလုပ္လုပ္ကုိင္သူ ျမန္မာအင္ဂ်င္နီယာ တစ္ေယာက္က ေျပာသည္။ 

ျပီးခဲ့သည့္ ရက္ပိုင္းက ရန္ကုန္ျမိဳ ့တြင္ နာမက်န္းျဖစ္ေနေသာ အသက္ ေျခာက္ဆယ္ေက်ာ္ အရြယ္မိခင္ၾကီးအား သြားေရာက္ ေတြ ့ဆံုခဲ့သူ ျမန္မာအင္ဂ်င္နီယာက “ က်ေနာ့္ အေမ တစ္ေန႔ကို ေဆးခန္းသြားျပတာ က်ပ္ေငြ ေလးေသာင္းေက်ာ္ ကုန္ပါတယ္။ ပထမေတာ့ ဒူးေဂါင္း နာတယ္ဆိုျပီး ေဆးထိုးတာေပါ့ေနာ္၊ အထူးကုေတြက ဒီေဆးလူၾကီးနဲ႔ တည့္လား မတည့္လား မသိဘူး၊

၃လေလာက္ ဆက္တိုက္ထိုးလိုက္တာ။ ေဆးကို အသက္ၾကီးတဲ့ လူဆိုေတာ့ မေခ်နိုင္ဘူး။ အထဲမွာ သြားခဲေနတယ္။ တင္ပါးမွာ ျပည္တည္လာတဲ့ အတြက္ ခြဲလိုက္ရတယ္” “အိႏၵိယတို႔၊ တရုတ္တုိ႔က အေပါစား ေဆးကုမၸဏီေတြက ထိုးေဆးေတြ စားေဆးေတြကို ေၾကညာေပးတာ ျဖစ္ တယ္။ ဆရာ၀န္တုိ႔ ေဆးခန္းပိုင္ရွင္တုိ႔က အဲဒီေဆးေတြကို ကုမၸဏီေတြက အခမဲ့ရတာ ျဖစ္တယ္။ ေရာဂါေကာင္း မေကာင္း လူနာေတြနဲ ့ စမ္းသပ္တယ္။ ေရာဂါေပ်ာက္ရင္ အျခားလူေတြကို ညႊန္ျပတယ္၊ အဲဒီေဆး နာမည္ရ သြားရင္ ဆရာ၀န္ေတြနဲ ့ေဆးခန္းပိုင္ရွင္ေတြကို ကုမၸဏီေတြက

ပိုက္ဆံေပးတယ္၊ ေရာဂါတျခား ေဆးတျခားျဖစ္တဲ့ လူကေတာ့ ေသတာေပါ့ဗ်ာ။ သူတုိ႔ အက်ိဳးအျမတ္ ကိုပဲ ၾကည့္ၾကတယ္။ လူ႔အသက္ တစ္ေခ်ာင္း တန္ဘိုးထားရေကာင္းမွန္း မသိၾကေတာ့ဘူး”ဟု ေျပာသည္။

ရန္ကုန္ မႏၱေလးႏွင့္ အျခားျမိဳ႕ၾကီး တိုင္းတြင္ အထူးကုေဆးခန္း၊ ေဆးရံုးမ်ား ျမန္မာ တစ္ႏိုင္ငံလံုးတြင္ ဖြင့္လွစ္ ထားေသာ္လည္း ကၽြမ္းက်င္ေသာ ဆရာ၀န္ႏွင့္ အစြမ္းထက္သည့္ ေဆး၀ါးမ်ား အထူးနည္းပါးေၾကာင္း လူနာရွင္မ်ားက ေျပာျပၾကသည္။

က်မၼာေရး၊ ပညာေရး ဗဟုသုတ နည္းပါးလြန္းေသာ ျမန္မာလူမ်ိဳးတို႔မွာ ဆရာ၀န္ေျပာသမွ်ယံု၊ ဆရာ၀န္ ေပးတာစား၊ အေနအထားျဖင့္သာ ရွိေနသျဖင့္ လူနာအခ်ိဳ႕မွာ ေရာဂါမ်ား ကၽြမ္းခဲ့ၾကရသည္။

အထူးကု ဆရာ၀န္ၾကီးတစ္ဦး၏ ဆံုးျဖတ္ခ်က္ခ် မွားျခင္းေၾကာင့္ ၂၀၀၄ ခုႏွစ္၀န္းက်င္က ရခိုင္ျပည္နယ္၊ ေက်ာက္ျဖဴ ခရိုင္ စီမံကိန္း ဦးစီးမွဴးတစ္ဦး ေသဆံုးခဲ့ရျခင္းကို ဘန္ေကာက္တြင္ အလုပ္လုပ္္ေနေသာ ကုိ၀ဏၰက ေျပာျပသည္။

“ခရိုင္စီမံကိန္း ဦးစီးမွဴး နာမည္က ဦးစံေရႊဦး ပါ၊ အရက္လည္း မေသာက္ ေဆးလိပ္လည္း မေသာက္တတ္ဘူး၊ ပညာေတာ္လည္းေတာ္၊ တတ္လည္းတတ္တယ္၊ အသက္ သံုးဆယ္ေက်ာ္ ကတည္းက ခရိုင္အဆင့္ အရာရွိျဖစ္တာ။ အဲဒါဗ်ာ ေနမေကာင္းလို ့ ရန္ကုန္မွာ ပုဂၢလိက အထူးကု ေဆးရံုက အထူးကု ပါရဂူဆီမွာျပတာ။ အသဲေျခာက္တဲ့ ေရာဂါ ဆိုျပီး ေစ်းၾကီးတဲ့ အဆင့္ျမင့္ေဆးေတြကို ၀ယ္ေသာက္ရတာ၊ ဓါတ္မွန္ရိုက္၊ အယ္ထရာေဆာင္းရိုက္၊ အစံုပဲ တစ္လတစ္ၾကိမ္ ရန္ကုန္သြားျပရတယ္။ ၁ႏွစ္ေက်ာ္ေလာက္ ကုလာျပီးေတာ့ ေရာဂါကၽြမ္း လာျပီ။အဲဒီေတာ့မွ အဲဒီအထူးကုဆရာ၀န္ၾကီးက ေက်ာက္ကပ္ ဆရာ၀န္ၾကီးဆီကို ေျပာင္းေပးတယ္။ ေက်ာက္ကပ္အထူးကု လက္ထဲေရာက္ေတာ့ ေက်ာက္ကပ္တစ္ဖက္က လံုး၀မေကာင္းေတာ့ပဲ ေသခဲ့ရ တယ္ဗ်ာ”ဟု နီးနီးကပ္ကပ္ ေနထိုင္ဖူးသူ ကို၀ဏၰကေျပာျပသည္။

ျပီးခဲ့ေသာ ေအာက္တိုဘာ ၂၇ ရက္ေန႔က အသက္ (၁၅) ႏွစ္အရြယ္ (၉) တန္းေက်ာင္းသူ မခိုင္ရႊန္းလဲ့ရည္၊ ရန္ကုန္ျမိဳ ႔ ေရႊဂံုတိုင္ SSC အထူးကုေဆးခန္းတြင္ ေဆးကုသရင္း ေသဆံုးခဲ့ရျပီး

ေနာက္ပိုင္း ျမန္မာျပည္ ျမိဳ႕ၾကီးမ်ားတြင္ ေဆးရံု ေဆးခန္းတို ့က လူနာမ်ားကို ေတာ္ရံုႏွင့္ လက္မခံသကဲ့သို ့

လူနာရွင္မ်ားကလည္း ေတာ္ရံု ဆရာ၀န္တုိ ့အား မယံုၾကည္၀ံ့ ျဖစ္ေနၾကေၾကာင္း လူနာရွင္ မိသားစု၀င္မ်ားက ေျပာၾကသည္။ ေရာဂါ ကၽြမ္းလုကၽြမ္းခင္ အဆင့္ရွိေသာ လူနာမ်ားကုိ လက္ခံကုသရန္ျငင္းဆန္ေနၾကသည္။ အထူးကု ေဆးရံုႏွင့္ ေဆးခန္းတုိ ့တြင္ လူနာတစ္ဦးလာေရာက္ ကုသမည္ဆိုပါက သတ္မွတ္ထားေသာ စရံေငြကို ၾကိဳတင္ေပးသြင္းထားမွ လက္ခံကုသ ၾကေၾကာင္း ျမန္မာအင္ဂ်ီနိီယာက ေျပာျပသည္။

အနီးစပ္ဆံုး ထိုင္းနိုင္ငံႏွင့္ ယွဥ္ျပေျပာဆိုရာတြင္ “ဗမာျပည္မွာ ေငြကိုျပမွ ကုေပးတာ ေငြကိုမျပနိုင္ရင္ ေသသြားပေစ ေဆးကုမေပးဘူး၊ ထိုင္းမွာေတာ့ လူ႔အသက္တစ္ေခ်ာင္းက လူမ်ိဳးဘာသာမ ေရြး မရ အရလုျပီး ကုေပးတာ။ သန္႔ရွင္းမႈအပိုင္းမွာလည္း မိုးနဲ ့ေျမေလာက္ကို ကြာတယ္။ ထိုင္းက ေဆးရံုေတြမွာ ေဆးနံ႔မနံဘူး၊ အိမ္သာအနံ ့အသက္လည္း မနံဘူး၊ ဗမာျပည္မွာရွိတဲ့ ေဆးရံုေတြကို သြားၾကည့္ ေဆး\��.c�ذ�z M��M�WG��˞J��fCތ�=b�P���+��t��0�z�Q����G�CR�S�*mZ�z���e��z ��阡[��K���,Jԫ/J�i��}��o��?q�J\�!f{y��zl�@7�l��.�,��,�� ��c�tz�U�\�\��ب�Mgd �����W�l8vd��c,��W���!��q2n7f���4���W/e���”�qt��y�qv���8�.lw���ELK�VG��|\���l��n����zန႔ံေပါင္းစံု နံေနတာပဲ၊ အိမ္သာလည္း စနစ္တက်မရွိ၊ အိမ္သာထဲမွာ အမွိဳက္ပံုးလည္း မရွိေတာ့ မိန္းမေတြအသံုးျပဳတဲ့ ပစၥည္းေတြ အိမ္သာထဲမွာ ဒီအတိုင္းပစ္ခဲ့တာေပါ့၊ လက္ေဆးခန္းဆိုတာလည္း မရွိဘူး။ ျမန္မာနိုင္ငံက ေဆးရံုေတြ ေဆးခန္းေတြ ထိုင္းျမန္မာ နယ္စပ္က မယ္ေတာ္ေဆးခန္းကို မွီဖို႔ ႏွစ္ဆယ္ခ်ီျပီး လိုက္ရပါလိမ့္ဦးမယ္” ဟု ျမန္မာ အင္ဂ်င္နီယာက ေျပာသည္။

http://saffrontoward.blogspot.com/မွကူးယူေဖၚျပသည္

at url:

http://saffrontoward.blogspot.com/2009/12/blog-post_8961.html

HERE is my remarks between the original article:

24/12/2009
အမ်ိဳးသမီး တဦးအား ေဆးထည့္ေပးေနပံု
Photobucket
လူနာတဦးအား CT Scan ရိုက္ရန္ျပင္ဆင္ေနပံု
Photobucket
Photobucket
ျမန္မာျပည္၏ အႀကီးဆံုး ရန္ကုန္ေဆးရံုႀကီးပံု(အဂၤလိပ္ေခတ္ ကတည္းက တည္ေဆာက္ခဲ့ေသာ အေဆာက္အဦးမ်ား ျဖစ္ပါသည္။)
ျမန္မာနိုင္ငံ ျပည္သူလူထုမ်ားမွာ အထူးကု ဆရာ၀န္ၾကီးမ်ားႏွင့္ အျခားက်မၼာေရး ၀န္ထမ္းမ်ား၏ အစမ္းသပ္ခံ ဘ၀တြင္ က်ေရာက္ေနေၾကာင္း မိခင္အား ေဆး၀ါးကုသေပးရန္ သြားေရာက္ခဲ့သူ ဘန္ေကာက္တြင္ ေနထိုင္ အလုပ္လုပ္ကုိင္သူ ျမန္မာအင္ဂ်င္နီယာ
တစ္ေယာက္က ေျပာသည္။

ျပီးခဲ့သည့္ ရက္ပိုင္းက ရန္ကုန္ျမိဳ ့တြင္ နာမက်န္းျဖစ္ေနေသာ အသက္ ေျခာက္ဆယ္ေက်ာ္ အရြယ္မိခင္ၾကီးအား သြားေရာက္ ေတြ ့ဆံုခဲ့သူ ျမန္မာအင္ဂ်င္နီယာက “ က်ေနာ့္ အေမ တစ္ေန႔ကို ေဆးခန္းသြားျပတာ က်ပ္ေငြ ေလးေသာင္းေက်ာ္ ကုန္ပါတယ္။ ပထမေတာ့ ဒူးေဂါင္း နာတယ္ဆိုျပီး ေဆးထိုးတာေပါ့ေနာ္၊ အထူးကုေတြက ဒီေဆးလူၾကီးနဲ႔ တည့္လား မတည့္လား မသိဘူး

၃လေလာက္ ဆက္တိုက္ထိုးလိုက္တာ။ ေဆးကို အသက္ၾကီးတဲ့ လူဆိုေတာ့ မေခ်နိုင္ဘူး။ အထဲမွာ သြားခဲေနတယ္။ တင္ပါးမွာ ျပည္တည္လာတဲ့ အတြက္ ခြဲလိုက္ရတယ္” “အိႏၵိယတို႔၊ တရုတ္တုိ႔က အေပါစား ေဆးကုမၸဏီေတြက ထိုးေဆးေတြ စားေဆးေတြကို ေၾကညာေပးတာ ျဖစ္ တယ္။ ဆရာ၀န္တုိ႔ ေဆးခန္းပိုင္ရွင္တုိ႔က အဲဒီေဆးေတြကို ကုမၸဏီေတြက အခမဲ့ရတာ ျဖစ္တယ္။ ေရာဂါေကာင္း မေကာင္း လူနာေတြနဲ ့ စမ္းသပ္တယ္။ ေရာဂါေပ်ာက္ရင္ အျခားလူေတြကို ညႊန္ျပတယ္၊ အဲဒီေဆး နာမည္ရ သြားရင္ ဆရာ၀န္ေတြနဲ ့ေဆးခန္းပိုင္ရွင္ေတြကို ကုမၸဏီေတြက 

ပိုက္ဆံေပးတယ္၊ ေရာဂါတျခား ေဆးတျခားျဖစ္တဲ့ လူကေတာ့ ေသတာေပါ့ဗ်ာ။ သူတုိ႔ အက်ိဳးအျမတ္ ကိုပဲ ၾကည့္ၾကတယ္။ လူ႔အသက္ တစ္ေခ်ာင္း တန္ဘိုးထားရေကာင္းမွန္း မသိၾကေတာ့ဘူး”ဟု ေျပာသည္။

did the patient die because of error of treatment? that the wrong medicine was given?
was the medicine used really a new drug on clinical trial?
or did the patient died because of the negligence of the treating doctor?
how long after the abscess in the buttocks have been incised that the patient died?
was the abscess the result of the injection (that is type of medicine injected)?
or the method of injection?
or because the injection site was not massaged as written?
if the patient could not massage because of old age, why did not the family and attendants do it for the patient during their care?

did the patient die because of the terminal nature of the disease?and no other doctor could prevent death?
why did the patient and the family not change doctor when they are unsatisfied with the treating doctor?
these questions need to be investigated properly to get to the correct conclusion
most family are dissatisfied when their close ones die
but they should think clearly whether there is negligence in the treating doctor/s
they always have the option of changing doctor and hospital in Yangon
unlike in small towns, where one has to go to another town to change doctor or hospital

ရန္ကုန္ မႏၱေလးႏွင့္ အျခားျမိဳ႕ၾကီး တိုင္းတြင္ အထူးကုေဆးခန္း၊ ေဆးရံုးမ်ား ျမန္မာ တစ္ႏိုင္ငံလံုးတြင္ ဖြင့္လွစ္ ထားေသာ္လည္း ကၽြမ္းက်င္ေသာ ဆရာ၀န္ႏွင့္ အစြမ္းထက္သည့္ ေဆး၀ါးမ်ား အထူးနည္းပါးေၾကာင္း လူနာရွင္မ်ားက ေျပာျပၾကသည္။

is it real? I do not think so
is the death of the patient being blamed on the incompetence of doctors?
that other doctors are also not good? is it why they did not change doctors?
why is it that there are few good doctors in Myanmar / Yangon? (I do not agree)

if all the specialists are not good, how shall we solve the problem? (I think the accusation is false)

က်မၼာေရး၊ ပညာေရး ဗဟုသုတ နည္းပါးလြန္းေသာ ျမန္မာလူမ်ိဳးတို႔မွာ ဆရာ၀န္ေျပာသမွ်ယံု၊ ဆရာ၀န္ ေပးတာစား၊ အေနအထားျဖင့္သာ ရွိေနသျဖင့္ လူနာအခ်ိဳ႕မွာ ေရာဂါမ်ား ကၽြမ္းခဲ့ၾကရသည္။

many diseases like hypertension, diabetes mellitus and many chronic diseases like cirrhosis of liver and cancer cannot be cured and although treated, progress and complications set in till terminal stage is reached

အထူးကု ဆရာ၀န္ၾကီးတစ္ဦး၏ ဆံုးျဖတ္ခ်က္ခ် မွားျခင္းေၾကာင့္ ၂၀၀၄ ခုႏွစ္၀န္းက်င္က ရခိုင္ျပည္နယ္၊ ေက်ာက္ျဖဴ ခရိုင္ စီမံကိန္း ဦးစီးမွဴးတစ္ဦး ေသဆံုးခဲ့ရျခင္းကို ဘန္ေကာက္တြင္ အလုပ္လုပ္္ေနေသာ ကုိ၀ဏၰက ေျပာျပသည္။ 

ခရိုင္စီမံကိန္း ဦးစီးမွဴး နာမည္က ဦးစံေရႊဦး ပါ၊ အရက္လည္း မေသာက္ ေဆးလိပ္လည္း မေသာက္တတ္ဘူး၊ ပညာေတာ္လည္းေတာ္၊ တတ္လည္းတတ္တယ္၊ အသက္ သံုးဆယ္ေက်ာ္ ကတည္းက ခရိုင္အဆင့္ အရာရွိျဖစ္တာ။ အဲဒါဗ်ာ ေနမေကာင္းလို ့ ရန္ကုန္မွာ ပုဂၢလိက အထူးကု ေဆးရံုက အထူးကု ပါရဂူဆီမွာျပတာ။ အသဲေျခာက္တဲ့ ေရာဂါ ဆိုျပီး ေစ်းၾကီးတဲ့ အဆင့္ျမင့္ေဆးေတြကို ၀ယ္ေသာက္ရတာ၊ ဓါတ္မွန္ရိုက္၊ အယ္ထရာေဆာင္းရိုက္၊ အစံုပဲ တစ္လတစ္ၾကိမ္ ရန္ကုန္သြားျပရတယ္။ ၁ႏွစ္ေက်ာ္ေလာက္ ကုလာျပီးေတာ့ ေရာဂါကၽြမ္း လာျပီ။အဲဒီေတာ့မွ အဲဒီအထူးကုဆရာ၀န္ၾကီးက ေက်ာက္ကပ္ ဆရာ၀န္ၾကီးဆီကို ေျပာင္းေပးတယ္။ ေက်ာက္ကပ္အထူးကု လက္ထဲေရာက္ေတာ့ ေက်ာက္ကပ္တစ္ဖက္က လံုး၀မေကာင္းေတာ့ပဲ ေသခဲ့ရ တယ္ဗ်ာ”ဟု နီးနီးကပ္ကပ္ ေနထိုင္ဖူးသူ ကို၀ဏၰကေျပာျပသည္။

was the diagnosis of cirrhosis wrong? that there was no liver cirrhosis?
was the diagnosis of kidney failure missed?
was the kidney failure present from the onset? how did they know? did the kidney specialist said that the kidney failure was present over 1 years before the patient was referred to him/her?
or did the kidney failure developed later during the treatment for cirrhosis?

regarding death of a terminally ill patient, no doctor can prevent death
it is only whether there is criminal negligence on part of the treating doctor that is the important factor
whether the diagnosis was wrong
treatment was wrong
there was negligence
or whether the patient died in spite of having the best treatment available as the condition was terminal?

ျပီးခဲ့ေသာ ေအာက္တိုဘာ ၂၇ ရက္ေန႔က အသက္ (၁၅) ႏွစ္အရြယ္ (၉) တန္းေက်ာင္းသူ မခိုင္ရႊန္းလဲ့ရည္၊ ရန္ကုန္ျမိဳ ႔ ေရႊဂံုတိုင္ SSC အထူးကုေဆးခန္းတြင္ ေဆးကုသရင္း ေသဆံုးခဲ့ရျပီး

ေနာက္ပိုင္း ျမန္မာျပည္ ျမိဳ႕ၾကီးမ်ားတြင္ ေဆးရံု ေဆးခန္းတို ့က လူနာမ်ားကို ေတာ္ရံုႏွင့္ လက္မခံသကဲ့သို ့

လူနာရွင္မ်ားကလည္း ေတာ္ရံု ဆရာ၀န္တုိ ့အား မယံုၾကည္၀ံ့ ျဖစ္ေနၾကေၾကာင္း လူနာရွင္ မိသားစု၀င္မ်ားက ေျပာၾကသည္။ ေရာဂါ ကၽြမ္းလုကၽြမ္းခင္ အဆင့္ရွိေသာ လူနာမ်ားကုိ လက္ခံကုသရန္ျငင္းဆန္ေနၾကသည္။ အထူးကု ေဆးရံုႏွင့္ ေဆးခန္းတုိ ့တြင္ လူနာတစ္ဦးလာေရာက္ ကုသမည္ဆိုပါက သတ္မွတ္ထားေသာ စရံေငြကို ၾကိဳတင္ေပးသြင္းထားမွ လက္ခံကုသ ၾကေၾကာင္း ျမန္မာအင္ဂ်ီနိီယာက ေျပာျပသည္။

အနီးစပ္ဆံုး ထိုင္းနိုင္ငံႏွင့္ ယွဥ္ျပေျပာဆိုရာတြင္ “ဗမာျပည္မွာ ေငြကိုျပမွ ကုေပးတာ ေငြကိုမျပနိုင္ရင္ ေသသြားပေစ ေဆးကုမေပးဘူး၊ ထိုင္းမွာေတာ့ လူ႔အသက္တစ္ေခ်ာင္းက လူမ်ိဳးဘာသာမ ေရြး မရ အရလုျပီး ကုေပးတာ။ သန္႔ရွင္းမႈအပိုင္းမွာလည္း မိုးနဲ ့ေျမေလာက္ကို ကြာတယ္။ ထိုင္းက ေဆးရံုေတြမွာ ေဆးနံ႔မနံဘူး၊ အိမ္သာအနံ ့အသက္လည္း မနံဘူး၊ ဗမာျပည္မွာရွိတဲ့ ေဆးရံုေတြကို သြားၾကည့္ ေဆးနံ ့၊ေသးနံ ့ ကြမ္းတံေတြး အပုပ္နံ စံုေနတာပဲ၊ ေဆးရံုဘယ္နားမွာလည္း ေမးစရာ မလိုဘူး ခပ္ေ၀းေ၀းကတည္းက အန႔ံေပါင္းစံု နံေနတာပဲ၊ အိမ္သာလည္း စနစ္တက်မရွိ၊ အိမ္သာထဲမွာ အမွိဳက္ပံုးလည္း မရွိေတာ့ မိန္းမေတြအသံုးျပဳတဲ့ ပစၥည္းေတြ အိမ္သာထဲမွာ ဒီအတိုင္းပစ္ခဲ့တာေပါ့၊ လက္ေဆးခန္းဆိုတာလည္း မရွိဘူး။ ျမန္မာနိုင္ငံက ေဆးရံုေတြ ေဆးခန္းေတြ ထိုင္းျမန္မာ နယ္စပ္က မယ္ေတာ္ေဆးခန္းကို မွီဖို႔ ႏွစ္ဆယ္ခ်ီျပီး လိုက္ရပါလိမ့္ဦးမယ္” ဟု ျမန္မာ အင္ဂ်င္နီယာက ေျပာသည္။

the condition of the private hospitals has much to be improved upon
as with all conditions of life in Myanmar
I once met a rich man from Loikaw, who had been to the Thai border town hospital
while he was staying in Yangon, he had to attend a Yangon private hospital
after staying overnight, he got out saying he cannot stay there
he left without completing his treatment
it is his right to choose the hospital and doctor he wants to be treated
he can go abroad to be treated if he can afford and is in condition to be able to travel there
but if he cannot, he will have to be treated in one of the hospitals in Myanmar
private or government
and I think there is not much to choose
except the treating specialist
and the location of one’s home regarding the choice from a few private hospitals available
the selection of the specialist is the most important factor
that is why super specialists have all the patients wanting to be treated by them
and their work load is too much
and cannot pay time to each of the patients adequately
the private hospitals which can attract the super specialists are the top ones
getting the richest patients
and can therefore offer the best facilities
2nd class hospitals have only 2nd class specialists
and get only poor patients
the vicious cycle is evident
improvement of the services of private hospitals will come in time
as with the slow rate of improvement of our economy

regarding the remarks about the latrines of the private hospitals:
I have been to the ThaHtayKyun hotel and the KL Crown Plaza
also the Sedona, Traders, Inya Lake, the best hotels in Yangon
the cleaniness of the above hotels are much better than the Yangon 5 star, 4 star hotels
why?
if the latrines in the 5 star hotels in Yangon has much to be desired
it is not surprising about the conditions of the private hospitals in Yangon

when I was young and there were coal steam locomotive engines in the railways
there were Indian locomotive engineers
they had the assistants clean the interior of the locomotive
to such a degree that their white uniforms are never dirtied by the coal dust
nowadays, with the diesel locomotives, and the all Bamar crew
the interior of the diesel locomotives can dirty your clothes if you touch the walls
in the early 1960s
the latrines in the Rangoon General Hospital were clean
and also that of the Railways Head Office
with Indian workers to clean the latrines
around the 1970s
the condition of the RGH latrines were terrible
no water, no sanitation
with Bamar cleaners
even the few Indian cleaners at the time were not working as their forefathers did
from this state of condition
comes the private hospitals
staffed by people who are used to living in squalor
cleaners who do not want to work
supervisors who do not know the standard that is required
the system and mentality of “Ya. Bar Dae……”
which is the source of our degradation
and a Medial Superintendent of a private hospital (retired government MS) who remarked to me: latrines will be smelly (Ein Thar Hso dar Nan Hmar Pawt.)
when I complained to him that the latrines of his hospital were smelly

we are living in a world
cut off from the world
eyes closed
ears closed
only the satellite tv hints to us what life on the other side is
if the private hospitals are not good, who do we blame?
what is the alternative?

there are very little private specialists in Myanmar
what little there is are those who do not want to leave the country
and yet does not want to continue working in government hospitals
but had to be in-service for their post grad studies to specialize

private hospitals need private specialists
not only as consultants
but also as residents to take care of the in-patients in the absence of the consultants
and also the patients who come directly to the hospital for treatment
not admitted by the consultants from their private practice

why does our government not allow non-government doctors specialization?
it has been over 20 years since the country opened up
yet
it is not enough
in terms of education, health, roads
we cannot blame our backwardness to the British anymore
the British ruled the whole country only from 1885 to 1948
less the Japanese period
around 60 years

we have been independent for 61 years
and from the best South East Asian country in 1962

with the best airport in SE Asia: Mingalardon airport

the best cinema hall in SE Asia: Thamada cinema ( formerly known as The President)
from having the Medical School where Malaysians came to attend

everyone here knows what we are now

Cont’d:

look at our neighbours

Laos recently held the SEA Games

Bangaladesh is exporting medicines to Myanmar

in Malaysia, there is now a School of Medicine in Sabah (a friend and classmate of mine, Dr. Zaw Lin, Ph. D. (microbiology), M. B. ,B.S.,  former Associate Prof. of Department of Biotechonology and Staff of Department of Microbiology, Institute of Medicine I, Yangon, is now working there [and there are several Schools of Medicine in KL, where many former staff of the Institutes of Medicine are working]

I hear that Medical Schools from Malaysia are recruiting students from Myanmar

why do specialists resign from their prestige jobs and go abroad?

why do they not live and practice in Myanmar?

Kyaw Lwin

to

show detais 10:12

Dear All,

Good to read especially the analysis in English by Dr. NW.

Comment by the forwarder.

Good analysis. Though the BKK hospitals like Bunrumgrad and Sing Hospitals like Mount E are very very good, one as to pay a lot. Can everyone in this country afford to go to these Hospitals? No way.

But money doesn’t matter in all these things. We need to change the attitude. We must change the attitude like  “Ya Bar Dae” ” (Ein Thar Hso dar Nan Hmar Pawt.)   Thans Ko NW for the good and fair analysis .

NW‘s reply

thanks ko kyaw lwin
for your encouragement
and fowarding my mail to others
with your comments
nw

Acknowledgements

there is a saying in the 38 Mingalar concepts

acknowledging those who made contribution to you is a good deed (my translation of: KyayZuu TinHtaike Thu Ko, KyayZuu Ti. Tat. Chinn Thi Mingalar TaParrr Phyit Thi

[not the original, but what I remember; please correct me if I got it wrong and I will be indebted to you]

First of all, I would like to thank Ko Ko, who introduced me to this blogsite and advised me to post my recent travel photos and experiences here.

Ko Joseph, who encouraged me in my planning of the recent trip to the North and to share my experiences on the web

Ko Kyaw Lwin, who by his forwarding of my commentary on the above topic, gave me an idea of posting it on my blogsite.

ps

maybe I am getting old and dotty

doing things which I would have never thought of doing just a few months back

I will get older and more dotty

but the blogsite I have created here would live on even if not updated so long as wordpress continues to support it

so friends, last, but the least, I would like to thank the wordpress organization, whoever you are of permitting me to post this blogsite

 

21 Oct 2010

here are new comments to this blog:

Nyi Win the post was written some time ago in 2009
we have been independent for 62 years now
with no end of the tunnel we are in, in sight

Alvin Sumedha Lee

That case was debated in many blogs and even on FB… unfortunately, the discussions were in burmese and I couldn’t really make much out of them due to language restrictions. At that time, I can only feel that those who are not directly inv…olved but merely read from reports may not be able to give a fair overall comment. But at the same time, I can understand the many reasons for deterioration of medical standards. Sad to know, and I guess there is just too many people to be ‘blamed’ for the unfortunate death of the young girl.
What we can do, at our age now, is not to just feel sorry for the situation. We can try to actively pass on any knowledge and skills we have so that the next generation can rebuild what was lost through political upheavals and effect of sanctions.

Nyi Win

thanks Alvin
yes, there are too many people to be blamed
but as my cousin Oliver wrote earlier on my note “Who is responsible?”:
the problem is not the people….It is the mangement system and policy is not working …..The truth is simply IT… IS NOT WORKING If this the situation it is obvious the CEO / THE Chief is responsible ……… No doubt of it………..

Myo Zaw Nyunt

Hello Sayar,
Let me share my experience in hospitalization and clinical treatment in MM, Bangkok and Singapore. To be honest, I like treatment in Bangkok and SG. Once in BKK for my palpitation and another two treatment at Singapore.

Aside fro…m a bit language problem in Bangkok, the rest are satisfied. Singapore is the best.

In Singapore, one GP handled for my long gastric problem for two times, after that, he changed his mind and suggest to go to Singapore General Hospital as he can’t handle anymore…Very impressive. If you can’t handle, better recommend to the one who know more. This is professional way.

Now, I feel better with two times treatment and long term medication.

Conclusion is, it is clear that , in Myanmar, even though you spend time and money to get treatment and know the root cause, most are not satisfied. It’s because of some specialist.

Nyi Win thanks ko Myo for sharing your experience and thoughts

Kyaw Minn Thu21 October 2010 at 12:44

Subject: Health care in Myanmar, private hospital

U lay nyi,

I read your blog regarding health care in myanmar especially private hospitals. I don’t know what to say as I have seen the difference between health care in developed part of the world and underdeveloped world. I still feel that government hospital especially YGH, NYGH are safer and better for acute emergencies than private hospital.

What I notice is, lack of system in place in haealth care. Still has a lot of bureaucracy with central control. I agree with you that people’s attitude must be change “Ya Bar Dae”. Health care costs is not cheap. new medicines, technologies available only after investing millions of dollars over many years.

There are many more factors involed. Our country failed to retain educated professionals, that is the said thing. There are so many successful burmese professionals all over the world. I am sure they all have some degree of willing to go back home and rebuild the country.

I hope I would be able to see you when I visit Yangon next time as we can chat about various things. I am sorry for not being able to meet you last time.

Best wishes,
Kyaw M Thu

Nyi Win October 21 at 2:59pm

KMT, successful burmese professionals all over the world going back home to rebuild the country is not feasible at the moment
CHANGE is what we need and it will not occur in the foreseeable future
Myanmar will change when it will
not before
in the meantime, Myanmars must think of themselves first

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3 Responses to “ျမန္မာႏိုိင္ငံမွလူနာမ်ား အထူးကုဆရာ၀န္မ်ား၏ စမ္းသပ္ခံျဖစ္ေန”

  1. Nyunt Says:

    Can you help me what to do if I cannot read the posting written in Burmese?

  2. nyiwin Says:

    21 Oct 2010

    here are new comments to this blog:

    Nyi Win the post was written some time ago in 2009
    we have been independent for 62 years now
    with no end of the tunnel we are in, in sight

    Alvin Sumedha Lee

    That case was debated in many blogs and even on FB… unfortunately, the discussions were in burmese and I couldn’t really make much out of them due to language restrictions. At that time, I can only feel that those who are not directly inv…olved but merely read from reports may not be able to give a fair overall comment. But at the same time, I can understand the many reasons for deterioration of medical standards. Sad to know, and I guess there is just too many people to be ‘blamed’ for the unfortunate death of the young girl.
    What we can do, at our age now, is not to just feel sorry for the situation. We can try to actively pass on any knowledge and skills we have so that the next generation can rebuild what was lost through political upheavals and effect of sanctions.

    Nyi Win

    thanks Alvin
    yes, there are too many people to be blamed
    but as my cousin Oliver wrote earlier on my note “Who is responsible?”:
    the problem is not the people….It is the mangement system and policy is not working …..The truth is simply IT… IS NOT WORKING If this the situation it is obvious the CEO / THE Chief is responsible ……… No doubt of it………..

    Myo Zaw Nyunt

    Hello Sayar,
    Let me share my experience in hospitalization and clinical treatment in MM, Bangkok and Singapore. To be honest, I like treatment in Bangkok and SG. Once in BKK for my palpitation and another two treatment at Singapore.

    Aside fro…m a bit language problem in Bangkok, the rest are satisfied. Singapore is the best.

    In Singapore, one GP handled for my long gastric problem for two times, after that, he changed his mind and suggest to go to Singapore General Hospital as he can’t handle anymore…Very impressive. If you can’t handle, better recommend to the one who know more. This is professional way.

    Now, I feel better with two times treatment and long term medication.

    Conclusion is, it is clear that , in Myanmar, even though you spend time and money to get treatment and know the root cause, most are not satisfied. It’s because of some specialist.

    Nyi Win thanks ko Myo for sharing your experience and thoughts

    Kyaw Minn Thu21 October 2010 at 12:44

    Subject: Health care in Myanmar, private hospital

    U lay nyi,

    I read your blog regarding health care in myanmar especially private hospitals. I don’t know what to say as I have seen the difference between health care in developed part of the world and underdeveloped world. I still feel that government hospital especially YGH, NYGH are safer and better for acute emergencies than private hospital.

    What I notice is, lack of system in place in haealth care. Still has a lot of bureaucracy with central control. I agree with you that people’s attitude must be change “Ya Bar Dae”. Health care costs is not cheap. new medicines, technologies available only after investing millions of dollars over many years.

    There are many more factors involed. Our country failed to retain educated professionals, that is the said thing. There are so many successful burmese professionals all over the world. I am sure they all have some degree of willing to go back home and rebuild the country.

    I hope I would be able to see you when I visit Yangon next time as we can chat about various things. I am sorry for not being able to meet you last time.

    Best wishes,
    Kyaw M Thu

    Nyi Win October 21 at 2:59pm

    KMT, successful burmese professionals all over the world going back home to rebuild the country is not feasible at the moment
    CHANGE is what we need and it will not occur in the foreseeable future
    Myanmar will change when it will
    not before
    in the meantime, Myanmars must think of themselves first

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