Weak public health care, invitation to disaster: Medical expert

by Mungpi
Monday, 04 May 2009 22:41

New Delhi (Mizzima) - Military-ruled Burma has set up medical checkpoints at its International airports in a step to prevent travellers carrying the deadly Swine influenza virus into the country.

Burma’s state-run newspaper, New Light of Myanmar, on Sunday and Monday carried pictures of medical staffs carrying out medical checks on travellers at Rangoon and Mandalay International Airports.

Following an outbreak of the Swine Flu in Mexico and parts of the United States, Burma’s health ministry told Mizzima that it is releasing a warning and are getting ready to check at international airports.

Despite the government’s response, Dr. Voravit Suwanvanichkij, a research associate at the Center for Public Health & Human Rights at the Johns Hopkins Bloomberg School of Public Health, said preventive measures at the airports alone are insufficient as the disease could still find its way into the country through other entry points.

Most travel from and into Burma, which has at least 2 million of its citizens in neighbouring Thailand as migrant workers, is not via the country’s airports, and the country also shares porous boundaries with China, India, Bangladesh, Laos and Thailand.

Dr. Voravit, who is based in Thailand, said placing checkpoints at international airports alone cannot effectively ensure that no travellers would come in with influenza disease. It also requires a proper public health system which can immediately detect an outbreak of disease and institute timely preventive measures to prevent further spread.

“A proper public health system is almost non-existent in Burma,” said Dr. Voravit, who has visited the country a number of times and has been closely following the health care system of Burma, adding that it could be disastrous if the flu finds its way into Burma.

He added that the likelihood of this outbreak of Swine flu reaching Burma is relatively small, compared to others in the region, given its isolation.

“But the flip side is that Burma does not have a health care system, so if there is an outbreak in Burma, it would likely be quite extensive and quite late before it is recognized and control measures are implemented,” Dr. Voravit said.

The Swine Flu, technically known as A/H1N1, has symptoms similar to many other diseases endemic to Burma, symptoms that are non-specific. Adequate laboratory and personnel are needed in order for early detection and diagnosis, which remains lacking in Burma.

Added Dr. Voravit, although a potential outbreak of Swine flu is a big concern in Burma, it should not detract from preventable diseases such as malaria and tuberculosis, which continues to be major causes of death and disability in Burma.

“we can focus on Swine flu or influenza but at the end of the day, Burma’s health care system can’t even cope with preventable diseases that has been plaguing Burma for decades, especially in rural areas of the country,” he said.

Though there are low direct contacts with Burma and the countries that have an outbreak of Swine Flu, it is not impossible that the disease would not reach Burma as it has been reported of detecting the disease in Asia.

He said, the likelihood of swine flu spreading to other countries in the Southeast Asia is much bigger than Burma, because many countries, including Thailand and Singapore, in the region are much more connected to the international community.

“In this regard Burma is a little shielded from that [Swine flu]. But on the other hand, once it [Swine flu] gets established in this region and if we are to find this disease enter into Asean, then Burma can be vulnerable,” said Dr. Voravit, referring to the 10-nation Association of Southeast Asian Nations (Asean), of which Burma is a member.

“Of course once it [Swine flu] gets Burma, the disease spreading out of control is very big, given that public health system is marginal,” he added.

According to the United Nations World Health Organization, on Monday there is an estimate of 1,003 cases of H1N1 virus found in twenty countries across the globe.

The Burmese military government’s annual expenditure on health is estimated to be only at USD 0.70 per person, which is one of the lowest in the world. WHO in 2000, rank Burma’s health system at 190 out the total of 191 countries, only outperforming Sierra Leone.