Better quality life for patients

YANGON - Mr Ko Ko Maung sat crossed-legged on his hospital bed as he listened intently to the Buddhist scriptures emanating from a portable radio.

Months ago, he was in such agony that he could sleep for only five-minute intervals before the next jolt of pain would shoot up his jaw and cheek and wake him.

On finding out he had cheek cancer in February, he turned to a traditional medicine doctor and paid 300,000 kyat (S$400) for herbal injections and powder. But the tumour in his left cheek swelled and became infected.

It drove him to seek treatment at Yangon General Hospital where he is awaiting chemotherapy. He takes five tablets a day now to manage the pain.

"I can now do simple daily tasks like praying because my pain has gone down by 50 per cent," said the 35-year-old.

Palliative care can offer a better quality of life for terminally ill patients during their remaining years, said his radiation oncologist, Dr Wah Wah Myint Zu.

She is a trainee on Myanmar's first palliative care training programme run by the Lien Foundation. She knows many hurdles exist before patients there can get the palliative care they need.

"Many turn to traditional medicine and end up scarred, infected or having their cancer spread to an advanced stage," she said.

A lot of people do this as they have no access to proper treatment, said Professor Myint Thaung, secretary-general of the Myanmar Medical Association.

"Seventy per cent of our population are villagers who cannot afford government hospitals. Even for those with money, our doctors are not trained in palliative care," he said.

He plans to work with Myanmar's Traditional Medicine Council to see how traditional medicine outfits could be better regulated.

Another solution, he said, is to increase the availability of strong painkillers like morphine. Myanmar keeps a tight rein on the prescription of morphine due to fears over its illicit use.

"It is a cheap drug and can help patients with severe pain. But we do not have any," said Dr Thaw Dar Pa Pa Tun, medical oncologist at Magwe General Hospital.

Dr Cynthia Goh, a Singaporean palliative care veteran, is trying to work with Myanmar health officials to get the government to set up factories to produce the drug locally and change legislation.

Prof Myint Thaung said the medical association has plans to set up palliative care units in all government hospitals by 2015.

Myanmar quadrupled its health budget last year and ramped up doctor training. It is also tweaking its health financing system to make it similar to Britain's universal coverage system.

And it is planning to introduce palliative care into its undergraduate curriculum and improve pain medication guidelines. Dr Goh said: "They are catching up fast."

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