As Myanmar (also known as Burma) makes tentative steps towards democracy, sanctions have been dropped and the world is rushing to do business here.
MSF in Myanmar 2014
In recent years, conveniences such as mobile phone coverage, internet access and internationally linked ATMs have all improved or made their debut.
With over 100 ethnic groups, the southeast Asian country of over 56 million people is as diverse as they come.
But, this diversity has recently been the source of considerable ethnic tension and has fuelled intermittent protests and separatist rebellions.
Myanmar also has high HIV and tuberculosis rates, and MSF is the largest provider of HIV/AIDS care in Myanmar; treating over 33,000 patients in a country where fewer than one in three people who need antiretrovirals receive them.
Médecins Sans Frontières/Doctors Without Borders (MSF) first worked in Myanmar in 1992
Ma*, diagnosed with advanced HIV and cytomegalovirus retinitis (CMV; an HIV-related infection that causes blindness). Ma was the first MSF patient to take valganciclovir, a landmark treatment for CMV.
“If I had not [attended] the clinic in Dawei, I would probably be dead. For the CMV, the doctor said that when he looked into my eyes, he could see a lot of lesions in my retina through the lens.
“But after four months of treatment, that has improved. I have not felt any side effects and I am feeling better now. Before, it was not like that, and I had to lie down all the time.
“Now I can go everywhere by myself. I even got my vision back and can read the text messages on my mobile phone.
“If I hadn’t got the treatment on time, I might have lost my vision within three months. I feel very lucky that I got the chance to take this oral treatment.”
*Name has been changed
“Many of the emergency cases are obstetric related, and most do not end so happily. As in many places, the tradition here is for women to give birth at home thus present to clinic when something’s gone wrong, such as a prolonged or obstructed labour.
“Usually by the time they’ve got to us, the baby has unfortunately died. With limited resources, our best option is usually to stabilise the mother and send her to the local hospital to complete the stillbirth there.
“Explaining the whole situation to the patient and their caretakers is a difficult task, and one I’ve noticed that is often forgotten in the mad rush, especially with the multiple language barriers. It wouldn’t surprise me if most of these women go to the hospital thinking that their baby is still alive.
“A significant majority of our hospital referrals are obstetric complications. Maternal and infant mortality rates are high, and we really need to do something about it.”
MSF’s work in Myanmar: 2014
The MSF project in Myanmar’s Rakhine state, providing basic healthcare to highly vulnerable communities, was suspended for most of 2014.
But by the end of the year it was again providing essential healthcare to thousands of people caught up in a medical humanitarian crisis.
Prior to the suspension, MSF provided medical services in 24 camps for displaced people and in isolated villages across Rakhine.
From June, we were able to provide medical staff to facilities managed by the Ministry of Health in Rakhine, and supplied resources such as vehicles and medical equipment to the Ministry of Health rapid response teams in Sittwe and Pauktaw townships.
HIV patients previously under our care were also supported. After the official resumption of activities, our teams carried out more than 3,400 consultations in less than a month, mainly for people with skin diseases and respiratory tract infections; 550 were for pregnant women.
Not all of MSF’s project activities had restarted by the end of 2014.
A landmark development occurred in 2014 for the treatment of cytomegalovirus retinitis, an HIV-related infection that causes blindness. Approximately one in four severely ill HIV/AIDs patients in Myanmar develops CMV.
Following many years of price negotiations with a pharmaceutical company, MSF began providing its patients in Dawei with valganciclovir, a single daily pill taken orally.
Although it has been available in high-income countries since 2001, this is the first time MSF has been able to use the drug; patients previously had to endure uncomfortable injections directly into the eye.
At the end of 2014, MSF had 1,146 staff in Myanmar. MSF first began working in the country in 1992.
Find out more in our 2014 International Activity Report.