Myanmar

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Key medical figures:
• 519,100 outpatient consultations
• 33,200 patients on first-line ARV treatment
• 13,600 patients treated for malaria
• 3,300 patients under treatment for TB

Myanmar

There is an ongoing medical humanitarian crisis in Rakhine state, and there are concerns about the increasing challenges faced by those assisting people  in need of healthcare.

While violence and segregation continue in Rakhine state, more than 100,000 people remain displaced, living in appalling conditions in camps, and  almost entirely cut off from healthcare and other basic services including clean water. Communities living in isolated villages and townships, most in  Northern Rakhine state, also face great difficulty in accessing medical services. As the minority Rohingya remain extremely vulnerable, Médecins Sans  Frontières (MSF) is striving to overcome significant challenges and obstacles and provide free, high-quality medical assistance to those most in need.

Working closely with local communities, the team has offered basic healthcare, obstetric services, mental healthcare, treatment for HIV/AIDS and tuberculosis (TB), and supported emergency referrals. MSF also treated 10,816 malaria patients, 84 per cent of the nationwide total. Staff worked in 10 townships across the state, in fixed and mobile clinics in 24 camps for displaced people and in a number of isolated villages.

Throughout 2013, MSF continued to urge the government and the communities of Rakhine to work together with international Ko Min Naing Oo 37  years old, Yangon. TB first came into my life in June 2000 and kept coming back over the next 13 years, getting harder and harder for the doctors to  treat it. I took many different kinds of pills and injections over the years but nothing seemed to get the disease out of my body for good. Before I  started, I was able to carry out normal physical activities, but after I felt tired and exhausted. The side effects from the treatment were strong and it  was really difficult to manage. I felt dizziness, pain in my buttocks from all the injections and had problems with my hearing. I felt nauseous when I  smelled cooking, found myself easily getting angry, constantly weak and tired, always having diarrhoea, and experiencing hallucinations. I tried to  forget my emotional pain by realising that there are other people who were more socially, economically disadvantaged and with worse health than I  was. I often reminded myself that I needed to get back my good health in order to save my family from a miserable situation. From the MSF blog, ‘TB & Me’ organisations to ensure that all patients in need of emergency medical services could access the necessary care, regardless of their background or ethnicity.

HIV and TB programmes
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. People with HIV are more likely to have active TB, and multidrug-resistant TB (MDR-TB), which is harder to diagnose  and requires two years of arduous treatment, is also an emerging health problem.

MSF runs projects treating HIV and TB patients in Kachin, Shan and Rakhine states, as well as in Yangon and in Dawei in Tanintharyi region. After three years of collaboration with the prison department in Yangon, MSF officially closed its HIV project in Insein prison in December. MSF had  provided counselling and testing to 1,400 prisoners and conducted more than 15,000 outpatient consultations since the programme began in 2010.

In 2012, MSF started a programme in Yangon in conjunction with the Ministry of Health, which continued this year, treating 58 patients with  MDR-TB.

No. staff end 2013: 1,299 | Year MSF first worked in the country: 1992

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