Body weight control and exercise for your health

For health, everyone should check their body weight and calculate their BMI body mass index to find out whether their body weight is within the desired range, overweight or obese.

Obesity is the problem with developed countries and the well to do in the developing countries!

Body Mass Index / BMI should be between 20–25 with the ideal figure being 23. If it is over 25, one is overweight and if over 30, obese.

Body weight is the result of the balance between food intake and energy consumption. There is calorie intake on one side and energy expenditure on the other. If one eats in excess of his energy requirement, the extra food is stored in the body as fat and body weight increases.

To reduce body weight, one has to reduce food intake and increase muscular work to burn out excess fat. To eat more while doing exercise is self defeating.

To begin, reduction of food intake has to be done gradually with the aim to get only about 5 lb weight loss a month. Do not aim to get quicker results as it might not be good for your health, especially if you have medical conditions like diabetes melliltus, hypertension and heart failure which are associated with obesity.

First, reduce your meal intake by a quarter of what you usually eat and cut back on snacks. Snacks are the hidden main problem in body weight problem cases. Do not eat anything if you are not hungry, and then, only eat the minimum that will appease your hunger. Do not have snacks unnecessarily, especially when watching television and having a conversation. Having beer is also a problem as beer and the snacks which are taken both aggravate the problem.

Take plain tea or water if you are thirsty and avoid milk and sugar in beverages including juices. Juices stimulate the appetite and one is left with desire to drink more rather than being satisfied.

Some weight reduction programs that restrict water is also not good for health as one becomes dehydrated and the weight loss is not the real fat reduction, and will revert when one takes fluid to correct the dehydration.

Any food that contains carbohydrate (rice, wheat, cereals, etc.), protein (meat, fish, eggs, etc.) and fat (animal fat, fish fat, oil, butter, margarine, lard, etc.) taken in excess of body requirements is stored in the body as fat. Of these, fat has double the calorific value than the other 2, so intake of 1 G of extra fat is equivalent to taking 2 G of extra carbohydrate and protein.

To burn out the excess fat, one has to do vigorous exercise till the body secretes adrenalin. Adrenalin produces glycogenolysis, breaking the glycogen stored in muscle and liver and increase the blood glucose level, thereby suppressing hunger. More important for weight reduction, it also causes lipolysis, breaking down the fats stored in fat cells of adipose tissues, reducing the body fat. Mild exercise, without the secretion of adrenalin is not enough to reduce the body fat and will not reduce body weight.

How does one know whether exercise is sufficient to produce outpouring of adrenalin? If adrenalin is secreted, one has heightened senses and increased heart rate. There will be a sense of breathlessness from the amount of physical exercise required and there will also be sweating for body temperature regulation. One has to exercise up to that stage: breathlessness, pounding heart and sweating to be sure to get weight loss.

Safe Water Supply

I have a notion about the current trend of drinking bottled water in Yangon and all the cost and difficulties it entailed. I am not part of that trend and still drinks water from our tubewell, either from the tap or from a sand filter which have been in use for over 40 years at home.

Recently, I read a blog by Sourav Roy which I have produced below:

Water water everywhere and not a drop to drink!

June 6, 2010 · 4 Comments

Why are we scared of drinking water? Everytime, when we travel, why are we afraid to drink water from railway station filters? Why do we so often come across shouts of “Don’t drink that water!” ringing in our ears? And we take the advice seriously- we pledge our loyalty to bottled water, we distrust the ability of water filters to tame the toughest bacteria, and the money we spend on water during an average day of travel, is more than the daily wages of half of our countrymen!

70% of earth is covered with water. 57% of human body weight is water. And still, a middle class working class hero is afraid of it! He purchases bottles, which are never recycled, and manufactured under conditions one will puke upon! The piping, the bottling, the transportation, the greenhouse gases are all unnecessary! So, not only we are ridiculing ourselves by becoming slaves to packaged water, but also adding enormous amount of wastes to our mother earth! Bottled water is not safer and certainly not cheaper than running water! And I don’t think it tastes any better either!

Why don’t we start using reusable bottles? Have we totally forgotten bottles made of stainless steel or lined aluminum? Start reusing any convenient bottle you have at hand! More than 80% of the country drinks regular municipality supplied water- are they dead? Why only the privileged few has stomach-ache, head-ache, tooth-ache if they drink running water? The point is simple! Humans are getting conditioned by their own luxuries. We are being pampered to an extent that only disasters teach us to appreciate the nature and all its offerings, or are we waiting for a day when water will be costlier than petroleum?

P.S.- I have submitted this article for the recent blogadda contest organized on World Environment day. This article is sponsored by Pringoo.

 

Reading this blog led me on a train of thought influenced by my experiences.

I still drink water at home the way I did for over 20 years. Water from tube well filtered through a sand filter that was bought in a pottery shop and filled with home cleaned sand. My father made it and although the trend now in Yangon is to drink bottled water, I still drink water the usual way.

When I was young, we have not heard of any bottled water. Back then, we drank water from the Railways Department tube well that is supplied to the quarters where we lived and passed through a cloth filter, the traditional way. Later, when my parents moved to downtown Rangoon, we drank municipal supplied water. It was then that my father prepared a sand filter, and we have used it for over 40 years even after we moved again about 20 years ago to the current house where I now live and we use tube well water again as municipal water is unavailable.

When I rowed in the Kandawgyi and Inya lakes, I drank a lot of the lake water, although they contained visible particles. When we travelled, we drank any water available locally, including the water sold at railway stations which are essentially water from the Railways sources. They were sold in pots and everyone bought them. Some bought boiled water.

When I was attending microbiology classes, a teacher taught us methods of water filtration and when he came to the topic of the cloth filter that most used at home, he remarked that its real function is to remove leaves and earthworms. In actual, it removes much smaller particles and most that are visible of course. Sand filters and candle filters were the best available at the time.

When drinking water debuted some time ago, I wondered whether they will make a business in Myanmar as we are a poor underdeveloped country. But I was surprised at the way our people embraced the notion of drinking the bottled water and today, it has become a way of life to drink bottled water in Yangon and while travelling.

Nowadays people buy potable bottled water and bottled water business is booming and it has become a way of life. But most bottled water sold is not up to the Standards. Apart from some tricksters who refilled the used bottles with any tap water, the quality of many 20 liter water bottles are questionable apart from being free of visible particles.

I read that use of clear plastic bottles is only one of the criteria that the bottled water is up to Standard. The source of the water is also very important and whether it has been tested to screen out “all” possible dangerous substances is also an important factor.

Recently, there are a lot of “arsenic” problems found with tube wells in many countries in Asia, including Myanmar. A news about many areas in the Ayeyarwaddy and Bago divisions being affected had come out and it did not include Yangon. Yet the news did not specifically mention the areas that have been tested and found to be arsenic free so I do not know whether Yangon water supply has been tested and proved to be arsenic free.

The Standard Water Test does not include test for Arsenic so we cannot safely assume that even the approved and big selling brands are arsenic free.

The only consolation I have is that I am drinking water as I had for over the past 30 years and so far I and my family do not have any arsenic poisoning features and I do not have to worry whether the bottled water is safe.

ေၾကကဲြဖြယ္ျဖစ္ရပ္(ဆရ႕ာ၀န္တဦးေၾကာင့္ေၾကြလြင့္ခဲ့ရေသာ ရတနာတပါး

dear all

this is the reproduction of my reply to my younger son Linn Zaw Win who sent me the original article in Myanmar and asked me about my view on the subject

မဂၤလာပါ သူငယ္ခ်င္းတို႔… အခုတင္လိုက္တဲ ့ေမးလ္ဟာ စာေရးဆရာမတစ္ေယာက္လည္းျဖစ္ ဆရာ၀န္တစ္ေယာက္လည္းျဖစ္တဲ ့အျဖဴေရာင္ရဲ ့ေမးလ္ေလးပါ….။ ေဆးပညာအသိုင္းအ၀ိုင္းရဲ ့အျမင္နဲ ့ေရးျပထားတာကို ဖတ္သင္ ့တယ္လို ့ေတာ ့ထင္လို ့ျပန္လည္တင္ျပလိုက္ပါတယ္…။ ဒီေမးလ္ဟာ သူငယ္ခ်င္းတို ့ရဲ ့ေမးလ္ေတြထဲကို ေရာက္ေကာင္းလည္း ေရာက္ေနပါလိမ္ ့မယ္…။ ဒါေၾကာင္ ့ဖတ္ျပီးသူေတြက ေက်ာ္လႊားႏိုင္ျပီး မဖတ္ရေသးတဲ ့သူေတြ ဖတ္ေစခ်င္တဲ ့ရည္ရြယ္ခ်က္နဲ ့တင္ျပလိုက္ပါတယ္…..။

အမွန္တရားကို ျမတ္ႏိုးၾကပါ၊ ျပီးေတာ့ လက္ခံသင္႔မွလက္ခံၾကပါ။

ရန္ကုန္ၿမိဳ ့မွာ လတ္တေလာေလးကမွ အလြန္ေရပန္းစားသြားေသာ သတင္းတခုအေၾကာင္းရွင္းၿပခ်င္လုိ ့ပါ။
SSC မွာမွားယြင္းခြဲစိတ္မိလို ့ေသသြားတယ္ဆိုတဲ ့ေကာင္မေလးၿဖစ္ရပ္ပါ။
ေကာင္မေလးေသဆံုးရမႈအေပၚ တကယ္ကိုပဲစိတ္မေကာင္းၿဖစ္ရပါတယ္ ။
တကယ္ကို ေတာ္တဲ႔ကေလးတေယာက္မို႔လို႔ပါ။
ဒါေပမဲ ့ခြဲစိပ္တဲ ့ဆရာႀကီး အၿပစ္လို ့၀ိုင္းေၿပာေနႀကတဲ ့ဂ်ာနယ္လစ္ေတြကို ေတာ့ တကယ္ကိုစိတ္တိုမိပါတယ္။
အထူးသျဖင္႔ Eleven Media Group ကထုတ္တဲ႔ ဂ်ာနယ္ေတြမွာ ျဖစ္ပါတယ္။

ဆရာႀကီးဦးႀကည္စိုး ဆိုတာၿမန္မာနိုင္ငံမွာ နွစ္ေယာက္မရွိႏိုင္ေတာ႔တဲ ့Surgeon ဆရာ၀န္ႀကီးတစ္ေယာက္ပါ။
ေဆး (၁)၊ ေဆး (၂) ၊ ေဆး မေကြး ၊ေဆးမန္း စတဲ႔ ေဆးေက်ာင္းေလးေက်ာင္းလံုးမွာ Professor & Head ရာထူးနဲ ့ေဆာင္ရြက္ခဲ ့ၿပီး အခု retire ယူထားၿပီး အျပင္ေဆးခန္းႀကီးေတြမွာ ေအာင္ျမင္ေနတဲ႔ ဆရာ၀န္ႀကီးတစ္ေယာက္ပါ။ သူ႔လုိမ်ိဳးလူ ေက်ာင္းေလးေက်ာင္းလံုးရဲ႕ Professor ျဖစ္ခဲ႔တဲ႔ လူမ်ိဳးခုေခတ္မွာ လံုး၀လံုး၀မရွိေတာ႔ပါဘူး။ လူနာေတြေပၚမွာသေဘာထားေကာင္းသလုိ လက္ေအာက္ငယ္သား၊ တပည္႔သားသမီးေတြ အေပၚမွာလည္း ေက်ာသားရင္သားမခြဲျခားပဲ ဆက္ဆံဂရုစိုက္တဲ႔ ဆရာႀကီးတစ္ေယာက္ပါ။

အခုၿဖစ္ရပ္မွာလည္း တကယ္တန္း တာ၀န္ရွိတာ ေကာင္မေလးကို စဖ်ားကတည္းက ကုတယ္ဆိုတဲ ့ GP ဆရာ၀န္ပါ (ေအာင္ရတနာေဆးခန္းလုိ႔သိရပါတယ္)။ သူဟာ ဆရာ၀န္တေယာက္ ျဖစ္ပါရက္နဲ ့ သူ႔ဆီလာၿပတဲ ့လူနာ ေသြးလြန္တုပ္ေကြးျဖစ္ေနတယ္ဆိုတာ diagnose မလုပ္နုိင္တာ သူ ့ညံ့ဖ်င္းမႈပါ။ ေကာင္မေလးက ေလးရက္ေတာင္ဖ်ားၿပီးမွ ဆရာႀကီးဦးႀကည္စိုး ဆီကိုေရာက္တာပါ။ လူနာက ဆရာႀကီးဆီ ေရာက္တဲ ့အခ်ိန္မွာ Dengue Shock စ၀င္ေနပါၿပီ။ ၿပီးေတာ႔ေကာင္မေလးမွာၿပေနတဲ ့လကၡဏာေတြ က appendicitis (အူအတက္ေရာင္ေရာဂါ) နဲ ့ တထပ္တည္းကိုတူေနတာပါ။ ဖ်ားေနတာ၊ အန္တာ၊ ဗိုက္ႀကီးပူတာ၊ ခ်က္ညာပတ္၀န္းက်င္မွာ နာတာ၊ေသြးေႀကာေတြ၀မ္းဗိုက္မွာ ၿမင္ေနရတာ အူအတက္ေပါက္တယ္ဆိုတဲ ့appendicitis ရဲ႕လကၡဏာေတြပါပဲ။ အူအတက္ေပါက္တယ္ဆုိတာ ခ်က္ခ်င္းခြဲမွၿဖစ္တာပါ။ အဲဒါကို လူပိန္းေတာင္သိပါတယ္။ ဆရာႀကီးေနရာမွာ တၿခားနာမည္ႀကီးဆရာ၀န္တေယာက္ ဆိုလည္း မွားမွာပါပဲ။

ဒီေတာ့နည္းနည္းမွစစ္ေဆးမႈမလုပ္ဘူးလား ဆိုၿပီးေမးဖြယ္ရာရွိပါတယ္။ လူနာက စစ္ေဆးလာၿပီးသားျဖစ္ေနလုိ႔ပါ။ ေအာင္ရတနာက ဆရာ၀န္က သူတုိ႔ေဆးခန္းက ခြဲစိပ္ဆရာ၀န္နဲ႔ ခြဲဖုိ႔အတြက္ လုိအပ္တာေတြစစ္ၿပီးသားပါ။ လူနာေကာင္မေလးရဲ႕အဖြားလုပ္တဲ႔သူက သူ႔ဆရာ ဆရာႀကီးဦးၾကည္စိုးနဲ႔ပဲ ခြဲမယ္ဆုိၿပီး SSC ကုိေခၚလာလုိ႔ ဆရာႀကီးကုိ လာျပေတာ႔ ဆရာႀကီးက ECG ရိုက္ခုိင္းၿပီး ေကာင္းရင္ Operation လုပ္မယ္ေျပာၿပီး အေရးေပၚခဲြေပးလုိက္ပါတယ္။ လူနာက ဆရာႀကီးဆီ ေရာက္လာတဲ ့အခ်ိန္မွာ ေသကိုေသေတာ့မယ္ ့အေၿခအေနပါ။ စစ္ေဆးတာ dengue မွန္းသိလို ့မခြဲရင္လည္းမခြဲလို ့ေသတယ္ဆိုၿပီး ၿဖစ္လာဦးမွာပါ။ ဘာလုိ႔လဲဆုိေတာ႔ ေကာင္မေလးရဲ႕ Ultrasound အေျဖကလည္း Appendicitis ျပေနလုိ႔ပါ။ အဲဒီေတာ့ ဘယ္သူ ့အမွားလည္း ဆိုတာသာေတြးႀကည္ ့ပါေတာ့။

ၿပီးေတာ့ေနာက္တစ္ခုက ဆရာႀကီးက လူနာကို တခါပဲ လာႀကည္ ့ၿပီး ၊လက္လြတ္စပါယ္ထားတယ္ဆိုတဲ ့အေႀကာင္းပါ။ ဆရာႀကီးဟာ ဒီလူနာေရာက္မလာခင္ တစ္ပတ္ေလာက္ အလိုကတည္းက တရုတ္ႏိုင္ငံသြားဖို ့ well planned လုပ္ထားၿပီးသားပါ။ လူနာရွင္ေတြက ဆရာဦးႀကည္စိုးမွ ဦးၾကည္စိုးဆုိၿပီး by name နဲ ့ေရာက္လာတာပါ။ ဒီေတာ႔ အဘြားလုပ္သူရဲ႕ မ်က္ႏွာနဲ႔ ဆရာႀကီးက ခရီးမထြက္ခင္ေလး operation လုပ္ေပးခဲ ့တာပါ (အတိအက်ေျပာရင္ ဒီေန႔ Operation လုပ္ရင္ သဘက္ခါ ဆရာႀကီးက သြားေတာ႔မွာပါ)။ ၿပီးေတာ့လူနာ ဆံုးသြားတဲ႔ အခ်ိန္မွာလည္းဆရာႀကီးက တရုတ္မွာပါ။ သူ ့ကနဂိုတည္းက အစီအစဥ္ရွိၿပီးသား ခရီးစဥ္ကိုသြားတာပါ။ ခြဲခန္းကထြက္လာေတာ႔ လူနာကေကာင္းပါတယ္။ ဆရာႀကီးက မသြားခင္ Post-op Accessment လာလုပ္ေပးသြားပါေသးတယ္။

ဆိုလုိခ်င္တာက ဆရာႀကီးကခြဲလိုက္လို ့ေသရတာမဟုတ္ပါဘူး။ ေသမည္ ့လူနာကို ဆရာႀကီးကခြဲမိသြားတာပါ။ မဟာဇီ၀ကႀကီးေတာင္ ကုရင္းေသတဲ႔လူနာရွိခဲ႔မွာပါ။ ဒါေၾကာင္႔လည္း “မမွားေသာေရွ႕ေန မေသေသာေဆးသမား” ဆုိၿပီး စကားပံုရွိခဲ႔မွာပါ။ ေသရမယ္လုိ႔ ရွိၿပီးသားလူတစ္ေယာက္က ေသမင္းလက္က ေျပးမလြတ္ပါဘူး။ ခုေတာ႔ ဆရာႀကီးအျဖစ္က ဓားခုတ္ရာ လက္၀င္လွ်ိဳလုိက္သလုိျဖစ္ရပါတယ္။ ဒီလုိေျပာလုိ႔ လူ႔အသက္ကို တန္ဖိုးမထားတာမဟုတ္ပါဘူး။ စိတ္ရင္းေကာင္းတဲ႔ ဆရာ၀န္ေတြကို ေမးၾကည္႔ပါ။ ကုိယ္ကုေပးေနတဲ႔ လူနာ ကုမရေတာ႔ဘဲ ေရာဂါနဲ႔ေသသြားခဲ႔ရင္ လူနာရွင္ေလာက္မဟုတ္ေပမယ္႔ ၀မ္းနည္းမႈကေတာ႔ ရင္ထဲမွာ အတုိင္းအတာတစ္ခုအထိျဖစ္ပါတယ္။ အဲဒါခံစားခ်က္ကုိ ေဆးရံုမွာ အငယ္ဆံုးေတြပါဆုိတဲ႔ အလုပ္သင္ဆရာ၀န္ေလးေတြေတာင္ ခံစားၾကရပါတယ္။

ၿပီးေတာ့ ေဆးရံုစရိတ္ ၁၁ သိန္းဆိုတာကလည္း ၁၁သိန္းနဲ ့တန္ေအာင္လုပ္ေပးတဲ ေဆးရံုကိုသြားလို ့၁၁သိန္းကုန္တာပါ ။ ၁၁သိန္းကုန္ေအာင္ ၀န္ေဆာင္မႈေပးခ႔ဲ လို ့ တန္သေလာက္ေပးရတာပါ။ မကုန္ခ်င္ရင္ မကုန္တဲ႔ေနရာကိုသြားလုိ႔ရပါတယ္။ အဲဒါကို Weekly Eleven ဂ်ာနယ္မွာ ေရးထားတာေတြက တကယ္ကို ဆိုး၀ါးပါတယ္။ ဘာေႀကာင္႔လဲဆိုတာ အစကမသိပါဘူး။ အဲဒီဂ်ာနယ္တိုက္ပိုင္ရွင္က ေဒါက္တာသန္းထြန္းေအာင္ ၿဖစ္ၿပီး ဆရာ၀န္အခ်င္းခ်င္း Ethic မထားပဲ ေစာ္ကားရသလဲလုိ႔ ေတြးမိပါေသးတယ္။ ေနာက္ေတာ႔မွ သူဟာ အာရွေတာ္၀င္ေဆးခန္းရဲ ့ရွယ္ယာ၀င္တဦးလည္းၿဖစ္တယ္ဆိုတာ သိရပါတယ္။ SSC ဆိုတာ ၿမန္မာနိင္ငံရဲ႕ ၿပင္ပေဆးခန္းၾကီးေတြထဲမွာမွ TOP ပါ။ ၀င္ေငြအေနနဲ႔လည္း အေကာင္းဆံုးေဆးခန္းတစ္ခုျဖစ္သလုိ ဆရာ၀န္ႀကီးေတာ္ေတာ္မ်ားမ်ားလည္း SSC ကိုေရြးၾကပါတယ္။ ဘာလုိ႔လဲဆုိေတာ႔ သူတုိ႔က ေကာင္းမြန္ေျပပစ္တဲ႔ ဆက္ဆံေရးရွိလုိ႔ပါပဲ။ အဲဒါေႀကာင္ ့ အာရွေတာ္၀င္ နဲ ့SSC ဟာအၿပိဳင္သေဘာမ်ိဳးၿဖစ္ေနပါတယ္။ ပိုဆုိးတာက SSC ဆုိတာ ေနာက္မွဖြင္႔တဲ႔ ေဆးခန္းႀကီးျဖစ္ၿပီး အာရွေတာ္၀င္ထက္ေအာင္ျမင္ေနလုိ႔လည္းပါပါတယ္။ အခုၿဖစ္ရပ္မွာလည္း လူနာေသဆံုးၿခင္းထက္ ဆရာႀကီးကို အသံုးခ်ကာ SSC ေဆးခန္းအား တိုက္ခိုက္ၿခင္းၿဖစ္ပါတယ္။

အေသးစိတ္မသိတဲ ့ၿပည္သူလူထုကိုထင္ေယာင္မွားေတြ ၿဖစ္ေအာင္ေသြးထိုးလႈံ ့ေဆာ္ကာ စီးပြားေရး အရသက္သက္တုိက္ခိုက္ၿခင္း ၿဖစ္ပါတယ္။ ဒီဂ်ာနယ္တိုက္ပိုင္ရွင္ ဆရာ၀န္ကိုလည္း အေတာ္ကိုအံ ့ႀသမိပါတယ္။ သူကိုယ္တိုင္ဆရာ၀န္တေယာက္ၿဖစ္ပါလ်က္ႏွင္ ့ဒီလိုသတင္းမွားမ်ိဳးကို ေရးသားထုတ္ေ၀ရဲ တာ ဆရာ၀န္စိတ္ဓာတ္မရွိၿခင္းပင္ ၿဖစ္ပါတယ္။ ဒီလိုဆရာ၀န္မ်ိဳးႏွင္ ့ကုသမည္ ့လူနာမ်ားအတြက္လည္း ရင္ေလးမိပါတယ္။ အင္းေလ ေဆးမကုစားတတ္ရွာလုိ႔ပဲ ဂ်ာနယ္တုိက္ပိုင္ရွင္ ဘ၀နဲ႔ သူမ်ားေတြကုိ ပုတ္ခတ္ၿပီး စားေသာက္ေနရတဲ႔ဘ၀ ျဖစ္ေနရတာေပါ႔ေလ။ ႀကားထဲက ဓားစာခံ ၿဖစ္သြားရတဲ ့ဆရာႀကီးဦးႀကည္စိုးမွာလည္း နာမည္ နဲ႔ ဂုဏ္သိကၡာထိခိုက္ရပါတယ္။ ဆရာႀကီးအတြက္ ဆမ အပိတ္ခံရၿခင္းသည္ ဆရာႀကီး၏ စီးပြားေရးမ်ားကိုထိခိုက္ၿခင္းမရွိေပ။ ဆရာႀကီးက ေအးေအးေဆးေဆးေဂါက္ရိုက္ အနားယူၿပီး ကမာၻပတ္ေနႏိုင္သည္႔အထိ ခ်မ္းသာပါသည္။ လူနာမ်ားက ၾကည္ျဖဴစြာေပးအပ္ေသာ သမာအာဇီ၀ ဥာဏ္ပူေဇာ္ခမ်ားႏွင္႔သာ ခ်မ္းသားေနျခင္းျဖစ္ပါတယ္။ ေဒါက္တာ သန္းထြန္းေအာင္ကဲ႔သို႔ ၀ိသမေလာဘတက္ သူမ်ားကုိပုတ္ခတ္ ၿပိဳင္ဆုိင္မွ စားရေသာက္ရသံုးရသူမဟုတ္ပါ။

Eleven Media Group ႏွင္႔ပင္ အားမရလုိ႔ ဗလာစာအုပ္ေတြထုတ္တာ အဲဒီအတြက္ တျခားတံဆိပ္ေတြအေပၚ ဘယ္လုိေတြအေကာက္ႀကံခဲ႔တာ၊ ေနာက္ 90:00 Minute ဂ်ာနယ္အေပၚေဂ်ာက္ခ်ခဲ႔တာ၊ ခုလည္း SSC ေဆးခန္းကို မေကာင္းႀကံျပန္ပါတယ္။ ဒါေပမယ္႔လည္း ခု SSC ေဆးခန္းက ဘာမွမျဖစ္သလုိ၊ 90:00 Minute ဂ်ာနယ္ကလည္း ေအာင္ျမင္လ်က္ပါပဲ၊ Eleven Sports ဂ်ာနယ္ဆုိတာကလည္း အိမ္သာသံုးစကၠဴသာသာ စကၠဴေတြကို ဂ်ာနယ္ထုတ္ၿပီး သူမ်ားထက္ေစ်းႀကီးေအာင္ေရာင္းေနတဲ႔ ျပည္သူေတြက်န္းမာေရးေတာင္ထိခုိက္ႏိုင္တဲ႔ စကၠဴအမ်ိဳးအစားျဖစ္ပါတယ္။ ဆရာ၀န္ေတြမွာ သမားတို႔ေစာင္႔ထိန္းအပ္ေသာဂုဏ္အရည္အခ်င္းဆုိၿပီး Rule (Oak) of Geneva ဆုိၿပီးကို အခိုင္အမာရွိပါတယ္။ ခုေတာ႔ ေဒါက္တာ သန္းထြန္းေအာင္ဆုိတာ ဆရာ၀န္လုိ႔ေျပာရမွာေတာင္ ရွက္ဖို႔ေကာင္းေနပါၿပီ။ တကယ္ေတာ႔ ဦးသန္းထြန္းေအာင္ အျဖစ္နဲ႔အသိအမွတ္ျပဳသင္႔ၿပီး ေငြရွိၿပီးထင္တုိင္းႀကဲေနတဲ႔ ေအာက္တန္းက်ေသာ စီးပြားေရးသမားတစ္ေယာက္သာျဖစ္ေၾကာင္း လူသိရွင္ၾကား တရား၀င္ေၾကျငာလုိက္ပါၿပီ။ ဒါေတာင္ Royal Eleven FC ေဘာလံုးအသင္းအေနနဲ႔ တတိယတန္းမွာ Winner FC အေပၚ စလင္းကြင္းထဲမွာ ဒိုင္နဲ႔ေပါင္းၿပီး ညစ္ပတ္ခဲ႔တာေတြ၊ ဒုတိယတန္းမွာလည္းေကာင္း၊ ပထမတန္းတြင္လည္းေကာင္း (အဲဒီေဘာလံုးအသင္းမ်ားနာမည္ေတာ႔မေျပာေတာ႔ပါ) ညစ္ပတ္ခဲ႔တာေတြ အမ်ားႀကီး အမ်ားႀကီးပါ။ ေနာက္ထပ္လူသိမခံ၀င္႔၊ ျပည္သူမ်ားမသိသင္႔ေသာ သတင္းမ်ားလည္း Eleven Business Group ႀကီးနဲ႔ ပတ္သက္ၿပီး အမ်ားႀကီးရွိေနပါေသးတယ္။ အထက္ကိစၥေတြမဟုတ္ပါဘူးဆုိၿပီး တရား၀င္ဂ်ာနယ္ေတြကေန ျပန္ျငင္းမယ္ဆုိလည္း ျငင္းႏိုင္ပါတယ္ ဦးသန္းထြန္းေအာင္။

ဆရာႀကီးလို လူေတာ္တစ္ေယာက္အတြက္ နိုင္ငံၿခားဆိုတာ ၀င္ေငြပိုေကာင္းပါတယ္္။ သူ ့ဘ၀အတြက္ပိုေကာင္းတဲ ့နိုင္ငံၿခားမွာမေနပဲ၊ ၿမန္မာနိုင္ငံကို အလုပ္အေကြ်းၿပဳေနတာ ဆရာႀကီးရဲ႕ေစတနာပါ။ တကယ္လို ့သင္ဆိုလွ်င္ေကာ ႏိုင္ငံအတြက္ဆိုၿပီး အနစ္နာခံနိုင္မလား ။ ဒီလိုလူတေယာက္ကို ၀ိုင္း၀န္းပယ္ထုတ္လိုက္ၿခင္းမွာ ဘယ္လို အက်ိဳးေက်းဇုူူးေတြ ၿဖစ္လာနိုင္သလဲ။ စဥ္းစားႀကည္ ့ပါ။ တကယ္တမ္းနစ္နာတာ ကၽြန္မတို ့ၿပည္သူေတြပါ။ အဲဒါကိုေကာင္းမွန္းမသိ ၊ဆိုးမွန္းမသိ သူတပါးကိုပုတ္ခတ္လိုက္ရလွ်င္ပဲ ငါဟဲ ့ဆိုၿပီးၿဖစ္ေနတဲ ့လူ ေအာက္တန္းစား၊လူၿပိန္း၊လူညံ ့မ်ားအား ကၽြန္မတို ့ေဆးေလာကအသိုင္းအ၀ိုင္းက သနားတယ္လို ့ေၿပာၿပီးဟားတိုက္ေတာင္ ရယ္ခ်င္ပါေသးသရွင္ (မီဒီယာသမား မီဒီယာသမားနဲ႔ ရတဲ႔ပိုက္ဆံကိုအရက္ေသာက္၊ အေပ်ာ္ၾကဴး၊ ရပ္ကြက္ေတြမွာ အသံုးမက်တဲ႔သူေတြ Journalist ျဖစ္ေနတာက 98% ပါ)။

တကယ္ေတာ႔ ဆရာႀကီးက ေအာင္ရတနာေဆးခန္းႏွင္႔ ထိုေဆးခန္းမွ ဆရာ၀န္ နစ္နာမည္ကိုစိုးရိမ္ပူပန္ၿပီး SSC ေဆးခန္းႏွင္႔တိုင္ပင္ကာ သူကေခါင္းခံေပးလုိက္ျခင္းျဖစ္ပါတယ္။ သူက အသက္ႀကီးၿပီ ဟုိဆရာ၀န္ေလးက တက္လမ္းရွိေသးတယ္ဆုိၿပီး ဆရာႀကီးဘက္က အနစ္နာခံသြားျခင္းျဖစ္ပါတယ္။ ေလးစားဖုိ႔ေကာင္းေသာ ဆရာႀကီးပင္ျဖစ္ပါတယ္။ SSC ကလည္း အၿပံဳးမပ်က္သလုိ ဆရာႀကီးဦးၾကည္စိုးသည္လည္း ဆရာ၀န္ျဖစ္သည္မွ စၿပီး အနားေကာင္းေကာင္းမယူႏိုင္ပဲ ခြဲရစိပ္ရတဲ႔ဘ၀က ကၽြတ္လြတ္သြားကာ ေကာင္းမြန္လြတ္လပ္ စိတ္ခ်မ္းသားစြာ အနားယူသြားၿပီျဖစ္ပါတယ္။ ဆရာႀကီးေတာ္မေတာ္ဆိုတာကို ျငင္းခံုမေနပဲ ဆရာႀကီးႏွင္႔ပတ္သက္သူမ်ားကို ေမးႏိုင္ပါတယ္။

သူငယ္ခ်င္းတုိ ့လည္း ဒီေမးလ္ကိုဖတ္ၿပီး မသိေသးတဲ ့သူေတြ ကို forward လုပ္ေပးလုိက္ႀကပါေနာ္။

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ေမးေဘာက္ထဲ Forword ေတြ၀င္လာတယ္။ ဒါနဲ့ ဖတ္ၾကည့္ေတာ့ .. တကယ္ကို ေပါက္ကရေတြဖတ္ေနရတယ္ဗ်ာ…။
အျဖဴေရာင္မဟုတ္တဲ့ အမည္းေရာင္(ေဆး-၂) က ေၿပာတာ တရားလက္လြတ္ၿဖစ္လာလို့ ၀င္ပါမိေတာ့တယ္။
သူတို့ေၿပာတာ အရင္ဖတ္ၾကည့္လိုက္….

သူငယ္ခ်င္းတို႕ေရ.. အျဖဴေရာင္ ေဆး၂ ေရးထားတာ တကယ္ကို မွန္ပါတယ္… ဒီေဆးေလာက မွာ ရွိေနတဲ့လူေတြအားလံုးက ဆရာၾကီး ဦး ၾကည္စိုးဆိုတာ ဘယ္လိုလူလဲဆိုတာသိၾကပါတယ္.. ျပီးေတာ့ အစာအိမ္နဲ႕ အူလမ္းေၾကာင္းေရာဂါရွင္ေပါင္းေျမာက္မ်ားစြာကို ကုသခဲ့ဖူးတဲ့ လူေတာ္တစ္ေယာက္ပါ..

တကယ္တမ္း အျပစ္တင္သင့္တာက ေငြရွိရင္ျပီးေရာ ေငြရျပီးေရာဆိုျပီး ဟိုတယ္ခန္းလို ေနရာမွာ ေဆးရံုေဆးခန္းေတြ ေထာင္.. လူနာေတြဆီက ေငြကို လွိမ့္ယူေနတဲ့ PUBLIC CLINIC ေတြပါ။

ဆရာ၀န္ေတြကို ေရာင္းကုန္တစ္ခုလို သေဘာထားျပီး သူတို႕ စိတ္ၾကိဳက္ ျခယ္လွယ္ေနၾကတာပါ…

ေဆးရံုေဆးခန္းလို႕သာ နာမည္ခံထားေပမဲ့ လူနာေတြအတြက္လိုအပ္တဲ့ follow up system ေတြ Investigation ေတြကိုေတာ့ လုပ္ေပးဖို႕ ပ်က္ကြက္ေနတာကို ဘယ္သူမွ သတိမထားမိၾကပါဘူး…

တကယ္တမ္းဆို ရန္ကုန္ေဆးရံုၾကီးလို ေနရာမ်ိဳးမွာျဖစ္ခဲ့ရင္ ဒီလူနာေကာင္မေလးဟာ ေသနိဳင္ဖို႕ chance အခုလက္ရွိထက္ 30-50% ေလာက္ကို က်သြားမွာေသခ်ာပါတယ္.. YGH မွာ၂၄နာရီ

တာ၀န္က် ဆရာ၀န္ေတြအသင့္ရွိေနပါတယ္.. ျပီးေတာ့ EMERGENCY အေျခအေနမွာ ရွိေနတဲ့ ဆရာ၀န္က ဘယ္ဆရာ၀န္ၾကီး ဘယ္ပါရဂူၾကီးရဲ႕ လူနာကို ျဖစ္ျဖစ္… ကာယကံရွင္ဆရာ၀န္ၾကီး မရွိေပမဲ့လည္း လိုအပ္တဲ့ ကုသမွဳေပးခြင့္ရွိပါတယ္.. အဲဒါဟာ လူနာေတြအတြက္ အရမ္းကို safe ျဖစ္ပါတယ္.. အျပင္ေဆးခန္းေတြမွာေတာ့ ပါရဂူၾကီး အထူးကုၾကီးေတြရဲ႕ လူနာဆိုရင္ ဘယ္ASကမွ ကုသခြင့္ မရွိေတာ့ပါဘူး ေသေလာက္ေအာင္ျဖစ္ေနလို႕ ေဆးထိုးခ်င္တယ္ဆိုရင္ေတာင္မွ မရပါဘူး.. အဲဒါဟာ ဘယ္သူထုတ္ထားတဲ့ စည္းကမ္းလဲဆိုေတာ့ clinic ပိုင္ရွင္ ေငြရွင္ေၾကးရွင္ၾကီးေတြ ရဲ႕ အလိုအတိုင္းပါ.. ဘာလို႕လဲဆိုေတာ့ လူနာဆီက ေငြကို မတန္တဆယူထားတဲ့အတြက္ တစ္စံုတစ္ရာ ခၽြတ္ေခ်ာ္သြားခဲ့ရင္ သူတို႕ အျပစ္မျဖစ္ေအာင္လို႕ပါ.. လူနာနဲ႕ဆရာ၀န္ဆိုတာ ဘယ္လိုမွ ခဲြျခားလို႕မရပါဘူး.. အျမဲတမ္း လူနာအတြက္ standby ဆရာ၀န္ေတြရွိေနသင့္ပါတယ္.. ျပီးေတာ့ post-op period မွာလည္း လံုေလာက္တဲ့ care ကိုမေပးနိဳင္တာ ဆရာ၀န္အျပစ္တဲ့လား.. ဒါဆို ဆရာ၀န္ဆိုတဲ့လူက ေဆးကုလည္းသူ… operation လည္းသူ.. investigation လည္းသူ.. အကုန္လံုးကို တစ္ေယာက္တည္းလုပ္ရေတာ့မယ္ဆိုတဲ့ သေဘာျဖစ္မေနဘူးလား.. ကိုယ့္ရဲ႕အမွားကို ဖံုးကြယ္ဖို႕အတြက္ ဆရာ၀န္ကို ဓားစာခံလုပ္လိုက္တာ လံုး၀ မျဖစ္သင့္ပါဘူး .. ဒီလို ထူးခၽြန္တဲ့ ဆရာ၀န္တစ္ေယာက္က ဆမ အသိမ္းခံရလို႕လည္း သူ႕ဘ၀ ပ်က္မသြားပါဘူး.. ျမန္မာျပည္မွာသာ ခုလို လူေတာ္တစ္ေယာက္ကို ဆံုးရွံဳးလိုက္ရတာပါ.. ကိုယ့္စီးပြားေရးတစ္ခုတည္းအတြက္ ဘယ္သူေသေသ ငေတမာရင္ျပီးေရာဆိုျပီး လုပ္ခ်င္ရာလုပ္.. ကေလာင္တစ္ေခ်ာင္းနဲ႕ ေရးခ်င္ရာေရးေနရင္ေတာ့ လံုး၀ကို မတရားပါဘူး။ ဒါေၾကာင့္ တာ၀န္ရွိတဲ့ SSC clinic ကိုေရာ.. မဟုတ္တာေတြေရးျပီး ဆရာ၀န္ေတြကို အပုပ္ခ်ခ်င္တဲ့ အသားထဲကေလာက္ထြက္တဲ့ weekly eleven ပိုင္ရွင္ ေဒါက္တာ အမည္ခံသူၾကီးေရာ ေမးလိုက္ခ်င္ပါတယ္..ဘယ္သူကအျပစ္ရွိသလဲဆိုတာကို..

ေရးသားသူ

ျမတ္မိုရ္.. ေဆး(၁)

ကဲေတြ့တဲ့အတိုင္းပဲဗ်ာ ..

ဒီေတာ့ ကြ်န္ေတာ္ေၿပာခ်င္တာက …အျဖဴေရာင္မဟုတ္တဲ့ အမည္းေရာင္(ေဆး-၂) – ခင္ဗ်ားတို႔ ေျပာတာမ်ားလြန္းေနၿပီ။ အမွန္တရားကုိေတာ့ျမင္ေအာင္ၾကည့္ပါ။ ကုိယ့္ဆရာကုိပဲ အမႊမ္းတင္မေနနဲ႔။ ‘ဒီကိစၥဟာ ျပည္သူေရွ႕မွာ၊ လူအမ်ားေရွ႕မွာ တရား၀င္ရွင္းတာအေကာင္းဆံုးပါ။ အဲဒီလိုရွင္းမယ္ဆိုရင္ ေဒါက္တာၾကည္စုိးရယ္၊ SSC ပုိင္ရွင္ ေဒါက္တာ ေဇာ္ထြန္းရယ္၊ ေဆးေကာင္စီဥကၠ႒ရယ္၊ Eleven က ေဒါက္တာသန္းထြန္းေအာင္နဲ႔ အျခားမီဒီယာသမားေတြ ေတြ႕ၿပီး Debate လုပ္ရင္ေကာင္းမယ္။ ဘယ္သူကမွားလဲ၊ ဘယ္သူက မွန္လဲရွင္းၾကေပါ့။ ဒါဟာ အေျဖမွန္ရဖို႔ပါ။ ဆရာ၀န္ပဲျဖစ္ျဖစ္၊ အင္ဂ်င္နီယာပဲျဖစ္ျဖစ္၊ ဂ်ာနယ္လစ္မီဒီယာသမားျဖစ္လာၿပီဆိုရင္ သတင္းကလည္း မွန္ေနရင္ေတာ့၊ မွန္တဲ့အတိုင္းပဲ ေရးၾကမွာပဲ။ ဒါမ်ဳိးကုိ လံုး၀ေထာက္ခံတယ္။ အဲဒီဆရာ၀န္ကုိ ငါးႏွစ္ပိတ္တာ၊ အေရးယူတာေဆးေကာင္စီကပါ။ ဂ်ာနယ္ေတြက ျပစ္ဒဏ္ေပးတာမွမဟုတ္တာ။ ဘာလို႔ ဂ်ာနယ္ေတြကုိမဲေနတာလဲ။ ပုဂၢလိကေဆးခန္းေတြ ခင္ဗ်ားတို႔ မဟုတ္တာလုပ္သမွ်ေပၚကုန္မွာစုိးလို႔လား။ ခင္ဗ်ားတို႔ေၾကာင့္ မွားယြင္းမႈေၾကာင့္ အသက္ေသဆံုးရတာ ဒီတစ္ေယာက္တည္းမဟုတ္ဘူး။ ျပည္သူေတြကုိလည္း ေမးၾကည့္လုိက္ပါ။ သတၱိရွိရင္ခင္ဗ်ားလည္း ဒီကေလာင္နဲ႔ မီဒီယာေပၚတက္ေရးေလ။ ခင္ဗ်ားတုိ႔နားလည္ဖုိ႔က ဒီကိစၥမွာ ေဆးေကာင္စီက အေရးယူတာေလးနဲ႔ၿပီးေနတာ ကံေကာင္းတယ္မွတ္ပါ။ ႏိုင္ငံျခားမွာဆုိ လူေသမႈနဲ႔ ခင္ဗ်ားတုိ႔အားလုံး ေထာင္က်ေနၿပီ။

ရန္နိုင္

ဘယ္သူေရးတာလဲေတာ့မသိဘူး ရန္ႏိုင္ဆိုတဲသူ … …အၾကံေပးထားတဲ့ Debate ဆိုတာေလးကေတာ့ေကာင္းပါတယ္…လြတ္လပ္စြာေျပာဆိုေရးသားခြင့္မရွိသမွ်ေတာ့ ၊ ညီညြတ္မမွ်တတဲ့ အခြင့္အေရး ၾသဇာ အာဏာေတြ မိုးမႊန္ေနတဲ့ ကြ်န္ေတာ္တို ့ဆီမွ လုပ္ခြင့္ေပးပါ့မလား….

တစ္ခုေျပာခ်င္ေသးတယ္…အျဖဴေရာင္ ေဆး-၂ က တရားလက္လြတ္ေျပာမေျပာ၊ ဆရာသမားဘက္လိုက္မလိုက္ေတာ့ မသိဘူး … ကိုရန္ႏိုင္ email က ဖတ္ေတာင္မဖတ္ရေသးဘူး သူတစ္ပါးကေလာင္နာမည္ကို အသားလြတ္ၾကီး အမည္းေရာင္ ေဆး-၂ ဆိုၿပီး တိုက္ခိုက္လိုက္တာ ဆိုးပါတယ္…

အခုကိစၥက ဆရာ၀န္ နဲ ့ကေလာင္ရွင္ တိုက္ပြဲလား … …

ရန္ျဖစ္မေနၾကနဲ ့ေလ … …ပိုေကာင္းေအာင္ media ကေန တိုက္တြန္းေပါ့ … ဘယ္ေဆးခန္းကေတာ့ ဘာေတြလုိတယ္..လိုအပ္တဲ့ အဆင့္အတန္းကို

၀ိုင္းတိုက္တြန္းၾကေလ …ဒါမွ ျပည္သူေတြအတြက္အက်ိဳးရွိမွာေပါ့ …by name နဲ ့ ဘယ္ေဆးခန္းရဲ ့ ၀န္ေဆာင္မႈ အျပင္အဆင္က ဘာညာေပါ့ သူတို ့အခ်င္းခ်င္း မွ်မ်ွတတနဲ ့ လူနာအက်ိဳးအတြက္ အျပိဳင္အဆိုင္ျဖစ္ေအာင္ လုပ္လိုက္ေပါ့… အဓိကက ပုံမွန္တူေတြအတြက္အက်ိဳးပါ ေဆးခန္းေတြကလာဒ္ေပးတာယူတဲ့ ကေလာင္ရွင္ေတြကို ဒီအတိုင္လြတ္မထားနဲ ့ေပါ့ .. 😉 by name နဲ ့သာေျပာ… ကိုယ္ေျပာတဲ့သတင္းကို ကိုယ္တာ၀န္ယူေအာင္ ကေလာင္နာမည္နဲ ့ ဓါတ္ပံုနဲ ့တြဲမွာ သတင္းေလာကမွာ ေရးခြင့္ေပး … …၀တၳဳ၊ကဗ်ာတို ့ရဲ ့ကေလာင္မွာ ဓါတ္ပံုမပါတာ ကိစၥမရွိဘူး အဲဒါေတြက ရသပိုင္းေလ… သတင္းမွာ ေရးသူနဲ ့ဓါတ္ပံဳမပါေတာ့ သူေရးတဲ့သတင္းက အဆိပ္အေတာက္ဆို ဘယ္သူလက္ခ်က္လဲ၊ ဘယ္သူတာ၀န္ယူမွာလဲ … ေျပာ … အဲဒါေလးလည္း လုပ္ၾကပါဦး….

(X Y)

Reply by Nyi Win

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Nyi Win

Nyi WinLoading…

15 Dec (12 days ago)

lzw
I do not know the exact details regarding the case
either before or after the surgery

but my personal view is that
Prof. U Kyi Soe was in bad luck that the patient died

there has been many cases where Acute Appendicitis was diagnosed and Appendectomy done
only to find during operation that the pre-op diagnosis was wrong
the good appendix has to be removed
to prevent it from developing appendicitis later
many who abroad for good have their appendix removed
to prevent appendicitis (a common disease) and high medical costs abroad
so when the abdomen has been opened and found that the diagnosis of appendicitis is wrong
the appendectomy has to be done
even if it is not appendicitis
it is the usual procedure

diagnosis of appendicitis is a clinical one
investigations like ultrasound and blood tests are not so important
when a surgeon or a non-surgeon government doctor with operation facilities diagnose a case of appendicitis (by clinical methods: history taking, physical examination consisting of inspection, palpation and auscultation) appendectomy has to be done even if the diagnosis is later found to be wrong

the diagnosis of appendicitis might have been made by ultrasound as written
and that it was actually a case of appendicitis
I do not know
also what Prof. U Kyi Soe’s travel plans were
BUT
there was no proper investigation into the case
and the verdict was too quick
a Kangaroo court
looking for a scapegoat and early case closing (to be able to report that the problem has been solved as early as possible)
without giving thought to procedure

I will repeat again
Prof. U Kyi Soe was just unlucky
to be the man in the spot
whatever the details were

the current private hospitals have much to be desired
not being a real hospital in any sense
only being private
paying
better care
in-patient treatment clinics
with no separate wards
and ward incharge (specialist Residents)
who will take care of the patients 24 hours a day for those attending the hospital directly without consulting their specialist of choice
and also patients admitted to hospital by specialists
even in the absence of their treating specialists
because we do not have more than a few non-government specialists
our medical teaching do not permit non-government doctors to attend post-graduate medical studies
being too narrow minded
and unwilling to liberalize
even more than 20 years after Sept 1988 and the open market economy
the doors are not really open
kept nearly closed
by the authorities

Linn Zaw Win to me

show details 16 Dec (11 days ago)

Phewwww……
After reading your reply, I realized that “ေနာက္ဆုံးေတာ့လည္း ဒီဘူတာပဲဆိုက္တာပဲ”
I also understood that Prof. U Kyi Soe was just unlucky since I first read the article from the journal.
Things are so complicated concerning with such things.
You might remember one of my friends whose one leg is supported by iron rods and walking abnormally.
I don’t remember well but as far as I remember, he said that he got shock due to the injection when he was young and you or Mom (I don’t remember) told me that it was just a bad luck of that doctor doing injection to the one who’s getting polio.
May be what I remember are a bit biased.

All (by NW) 28 Dec 2009

what lzw remembered was a classical case of doctors being blamed when someone developed paralytic polio

if a child develops polio, it is difficult to diagnose before the onset of leg weakness

at the time, the treating doctor might give injection to the patient

the injection precipitates the onset of paralysis

on the side injected (sometimes both if both sides are injected on the same day or consecutive days)

the weakness will develop (it might also develop if there had been no injection)

and the doctor is blamed (of course, if there had been no injection, he would not be blamed, but as things are, general practitioners give injections for various reasons which I will not discuss at this time)

the attitude of the public is: Hsay Htoe Hmarr Lo. ChayHtauk Thay Twarr Dae

actually it is not giving a wrong injection (medicine type) or wrong site of injection

but giving injection to a polio case which is difficult to diagnose and was not diagnosed as polio so injection was given

so unless a doctor does not give injection to all patients as a routine procedure and treat with oral drugs only, he will be blamed for the development of paralysis of his patient

if it occurs, although the paralysis was precipitated by the injection, the doctor is just being unlucky to have an early case of preparalytic polio patient come to him/her

ps

sometimes I wonder how the Buddhist teaching of Kan – Kan Ah.Kyoe applies here

does the polio patient becomes lame because of his previous misdeeds?

did the doctor meet a case of polio because of his/her past misdeeds?

or

did the doctor do a wrong thing giving injection to a patient?

I have no answer

ျ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

လူနာတဦးအား CT Scan ရိုက္ရန္ျပင္ဆင္ေနပံု


ျ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:

via အတၱကင္းစင္ဒီမိုကေရစီလြင္ျပင္ by wanna23 on 12/23/09

24/12/2009
အမ်ိဳးသမီး တဦးအား ေဆးထည့္ေပးေနပံု

လူနာတဦးအား CT Scan ရိုက္ရန္ျပင္ဆင္ေနပံု


ျ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