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March 24, 2015

Myanmar EMS Brief 2015 by Marko Cunningham

March 24, 2015 | By |

This month I traveled to Myanmar for 1 week on a fact-finding mission into the state of the Myanmar Emergency Medical Services System, in particular, the Pre-Hospital volunteer rescue organizations and their role in the system.

After 15 years of working in the Thai EMS System I had surmised that the Myanmar EMS system would grow in a similar way to the Thai EMS system, and that the core of the Pre-hospital EMS System would be undertaken by volunteer rescue workers. In Thailand this system has been running for over 100 years now and several years ago when Myanmar opened its borders to foreigners once again I immediately noticed a similar pattern developing there. I immediately contacted a rescue group in Myawaddy on the Thai border and began working with them since 2012 and developed a good working relationship there. Immediately following my team from Bangkok went there on several occasions to train and donate basic ambulance equipment to fit out their ambulances.

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Since that time they have taken upon themselves to be the EMS leaders in Myanmar and have traveled all across Myanmar teachers others what they have learnt. They have made quite a name for themselves and even appeared on TV in many states across Myanmar. They also added their own training in Fire-Rescue, rope-work, and Mass-Casualty.

The volunteer spirit is strong in Myanmar and it can easily support a vast network of volunteers to cover all of Myanmar as Thailand does.

Today

On this trip to several rescue groups from South of Yangon to the North of Mandalay I have seen the results of this training and mostly it is good but I can see that there is a desperate need for more formal and uniform training across Myanmar and still so many groups have no access to this training.

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After meetings with the Myanmar Red Cross, ER Heads of both Yangon and Mandalay hospitals and NGO workers involved in the Myanmar EMS’s, I realized that a more formal training model is needed for all of Myanmar, a model that takes into account the limited resources of these volunteers, the transportation networks which include boats as a primary form of transport in some areas and also areas that have no road access at all or limited access in the rainy season, and also such things as the types of poisonous snakes there.

Future

Myanmar EMS has only recently had Emergency Medicine graduating doctors and staff, many of who were already doctors but have changed their specialty to EM. Much of this work has been done with the help of Australian government programs. The future of EMS is the introduction of Emergency Medical Technicians (EMT’s) down to EMT-B level and also the upgrading of nurses to ER nurses. The future therefore looks good for the higher end EMS System.

Unfortunately there at present there is no plans for the development of the First Responder (FR) who at present take care of over 90% of Pre-Hospital cases. In an emerging economy such as Myanmar the resources to make these rescue workers obsolete seems unlikely and as in Thailand today those rescue workers still deliver over 90% of all pre-hospital care patients.

Conclusion

Right now, Myanmar is in desperate need of FR training and resources. This will have to come from private sources as at present the government has no plan to assist these workers in any way.

Within the next few months I plan to write a FR manual to translate into Burmese and make it available for all rescue workers in Myanmar (as a free download). Hopefully this will prompt others NGO’s or government to acknowledge the importance of First Responders in their EMS system and take advantage of this massive and free resource.

Equipment is hard to source for these groups but ease of access and price from Chinese companies has led to the availability of most basic equipment but of big concern are more expensive pieces of hardware. Some government fire agencies have extrication equipment but in Thailand Rescue groups use their own which many people think is better (from a medics view). The pricing of these sets keeps it out of reach of most rescue groups. We plan to assist in sourcing initially 3 sets to cover Yangon-Napyitaw-Mandalay highway and regions for rescue groups and training for their use.

Finally, I have seen literally hundreds of ambulances and equipment donated to the government sitting collecting dust. The lengthy process of dealing with government officials and also misappropriation government practices that plague much of South East Asia are a warning to those who get involved. Much thought and planning is needed to get the most from your investment here.