The fight for Universal Health Coverage in Myanmar
3 July 2023
Situated amongst dense foliage, but still vulnerable to air attack, is a general hospital. It is one example of a wider effort that is steadily establishing the reality of Universal Health Coverage in the areas of Myanmar which fall outside the control – but not the reach – of its military.
Established in May 2021, three short months after the military seized power in Yangon, the hospital serves a population of some 40,000 people. In its first month of operation, it treated 131 people. Since December 2022, it has been treating over 1,000 people a month and is slowly, cautiously, adding to the scope of the services it provides.
Those who doubt the usefulness of international aid should visit this hospital – and its two wards ‘of Hope’ (for the men) and ‘of Love’ (for the women). There is not an organisational logo to be seen, just the evidence of how external support is being put to good use: in developing clean water, installing a ramp to support the movement of hospital vehicles during the rainy season, or in the purchase of more sophisticated x-ray machines.
This work, actively encouraged by regional governments, is being led by a partnership between local people and internally displaced health professionals who are refusing to work for the military. It is both deeply impressive and deeply moving to learn about how people’s lives and careers have been upended and how they are now dedicating themselves to mitigating the impact of this horrific and under-reported war which has made Myanmar, alongside Ukraine, the most dangerous place to be a health worker.
One of the displaced, an oncologist without the equipment or the drug supply to practice, is turning her attention to the care of those harmed in conflict and those seeking safe delivery at birth. Another, an assistant surgeon before he arrived here, has not seen his wife or family for two years.
There is pride in what is being achieved but also a palpable sadness.
In another of the hospitals we visited, newly displaced health professionals sat alongside their elders for whom this is the second exile of their lives, the first having happened when the military seized power in 1988. No surprise then, that on the wall of this particular room was a poster entitled ‘The Long March’. What must these younger clinicians be thinking when they listen to the stories of their elders.
The world of these courageous professionals may have narrowed physically but intellectually they remain hugely ambitious, determined to drive up the quality of care using the resources available to them and by investing in their own learning. The support UK institutions are giving, in which diaspora working in the NHS are playing such an important role, is warmly welcomed. This knowledge shared through training, the work on accreditation, the assistance provided through telemedicine, all this is seen as a vital part of the journey to Universal Health Coverage.
Perhaps predictably, I found myself recalling the UK’s own history: a National Health Service founded 75 years ago this week, at a time of unprecedented austerity, but conceived even earlier, in the 1942 Beveridge Report, published while war raged across Europe and the world. People need to know what they are fighting for, not just who they are fighting against.
As the world gathers in New York this September, to consider the promise of Universal Health Coverage, I encourage them to look for inspiration in the hills and valleys of Myanmar. I have rarely learnt so much or been so moved.
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This blog was written by our CEO Ben Simms after a visit to Myanmar in June 2023.
This article has necessarily been anonymised in order to avoid reference to any individuals or specific locations.
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