BURMA MILITARY MEDICAL SERVICE
A. General introduction about Military Medical Service
• Generally, there is various military base services work under the administration of the Ministry of Defense. They are Medical Service, Military Engineering Service, Artillery Service, Armor Service, Signal Service, Defense Service Computers, Ordinance Service, etc in Burmese Army. In the above mentioned services, Medical Service is one of the most important services which based on the Infantry Services in order to give health care for the whole army.
• In Directorate of Medical Service, the executive position is filled by a Major General from medical field. There are many sub offices under Directorate of Medical Service; they are medical covering Department, Disease Control Department, Medical Categorized and Pension Department, Hospital Management Department, Personnel Department and so on.
• In administration Sector of DMS, the majority of the staffs are graduated as PhD level in Medical Science in Public Health from Public Medical Institute and Defense Service Medical Academy (DSMA). Nowadays, many job positions are substituted with Medical Officer who graduated from DSMA.
• There are Defense Service Hospital, Medical Battalion, Disease Control Unit and Non-mobile Drug Store Unit under the direct control of Director of Medical Service.
• It is reported that there are 2x1000 bedded general hospitals, 2 x700 bedded general hospitals, 2x500 bedded general hospitals, 1 Orthopedics Hospital, 1 Obstetric & Gynecology & Pediatric hospital, 4 x 300 bedded general hospitals, 20x 100 bedded district hospitals and 40 bedded clinics each in the Regional Military Force in Burmese Army. In addition there are 14 Medical Battalion to cover the battles field. As in General, all the army medic’s major responsibilities are for the care of the sick and wounded, with the following evacuation of the wounded to hospitals in the rear areas.
B.Burmese ruling government and health care
• Military Medical Service has to full fill the desire of Senior General Than Shwe, Vice Senior General Mg Aye and other Generals & Lieutenant Generals by the command of Director of Service in term of handling health issues for their families and themselves. Beside this, the Services closely cooperated with Medical Battalion in the front line for emergency treatment, prevention of contagious diseases, etc. In addition, the service communicates as a media between Public and Military medical personal‘s relationship.
• Army Medical Specialist and public doctors have to take health care of the dictators in daily schedule. In addition, they have addition responsibilities like interpreting between the generals and Foreign Doctor whenever the generals go for medical checkup or treatment in Singapore, Bangkok or any hospital in foreign country.
• The 2x1000 Bedded Hospitals in Mingalardon and Naypyidaw are the most facilitated army hospitals in Burma, those hospitals handle the transferred cases from 100,300,500 and 700 Bedded Hospitals and civilian patient cases in Rangoon & Naypyidaw division. In that two biggest Army hospitals, Naypyidaw hospital is more facilitated than Mingalardon therefore Naypyidaw hospital is called as a VIP hospital. There are many modernized machines for instance, CT scan, Ultrasound, Endoscopic Machines, etc. Those items were purchased from foreign nation and functioning well at the beginning. Therefore the Generals and their families make the medical checkup monthly whether it is necessary or not. Specialist officers are willing to explain the side effects of unnecessary taking radiological examination for example Leukemia. There are some evident of the danger for following the rules especially to educate the General’s family. Therefore, medical experts do not dare to explain or warn them in order to avoid consequences.
C. Health Care Nightmare
• the Medical Specialist are being worried about the maintenance of those important machinery. As I mentioned in the previous paragraphs, there has been a lots of miss use from the official. It is difficult get permission from Ministry of Defense, in terms of spending money for buying spare parts, maintenance cost. If the machine were broken or not functioning, the experts will get more chance of dismiss or force to resign. There are lots of disagreement and conflicts between the medical experts and military juntas. The juntas never understand the medical field and always trying to influence with their tiny brain. The valuable machines are only for the people who have arbitrary power not for suffering soldier nor their family.
• The lower rank officers and other ranks are depending for their health issues on Mingalardon Hospital whereas there are no enough drugs, no advance instruments & machines. Medical Officers treat as much as they can with fragmentary condition. There is only one special & useful CT scan machine at 2MH for DSGH, DSOH, DSOGCH which are relied by people of lower country. There are many disturbances in investigation due to worn-out machine and artifact in imaging. Even in emergency condition for e.g.; head injury, haemorrhage in cranium; special investigation can’t be done until this old machine become re-functioning. Therefore patients who have severe illness are expired without getting effected treatment. Although officers can do necessary investigation at outside clinic, poor other ranks wait for God. And although doctors inform the drawback of old machines, the officials never taken action to renewal or regular servicing for old instrument and in some case, the informer will be punished for being efficient.
• Diagnostic lab machines are too old to give efficient answer. There is no enough film for X-ray, therefore in order to look result on film, the doctors can only provide on a small film for minor cases in order to save the budget; however to give the treatment to government official, the doctors need to be extra cautious and use good medicine. Therefore most doctors are so sorry and disappointed when they cannot help to fellow soldiers and their families.
• Lack of funding and lack of instrument problems are the biggest issue in Army hospital. Military doctors solve the financial problem of emergency treatment by their selves by collection of donation from fellow officers, DSMA’s cadets, housing officers and some friendly generals.
D. Life threatening diseases
• Regarding cancer cases in Burma, it is found that the early diagnosis, treatment, health care are below standard rather than other south East Asian countries. There are only two places to take radio therapy in the whole country. The radio-therapeutic machine in 2MH was no longer function just after buying, therefore the cancer patients from both civilian and military rely on the machine in oncology unit of Yangon Hospital.
• In that department, a lot of cancer patient are waiting for their turn to get radiation therapy in daily basis. In that department, a lot of cancer patient are waiting for their turn to get radiation therapy in daily basis. The radiation machine is not a digital one; it is old model and very poor stages due to long time usage without regular maintenance. There are not at all modern high medical technology machines, equipments, in Burma. Radiation for cancer patients is very problematical. The doctors need to examine the patient with extra care and decide which amount of radiation need to give in effected area. Radiation Dose therapy needs to be very accurate otherwise it can deteriorate the surrounding tissue near cancer effected area. Patients who cannot afford to arrange medical treatment in abroad are suffering and taking risky treatment from unreliable radiation machine. It is too risky for the patient and the physician by using un-reliable instrument. The Government should be taken action about this matter.
• Nowadays, all people (including senior staff members from health care) hate the military due to the most barbaric treatment to the protester in 1988 student revolution and 2007 Saffron revolution. Moreover, the government failed to help vulnerable victim from cyclone Nargis. As the result of this hate crime, the lower ranks soldiers have been experiencing all ill treatment from civilians. It is understandable from both side, everyone are suffering due to this stupid administration. Everybody fed up this unfair, miss leading, uneducated government.
• As I indicated earlier in the above paragraphs, a lots of cancer patient ‘lives were expired due to insufficient/inadequate resources, technology and irresponsibility from ruling government.
• In the military, even (500 bedded, 700 bedded) hospital also facing the problems due to insufficient drugs and equipments to treat life threatening diseases like cancer, HIV, etc. In addition, the unnecessary interference from the military dictatorships can affect the disturbance for the military doctors. As far as I seen in Burma, most 100 bedded hospitals have no doctor, no operation theater and no laboratory. Therefore as in case the soldier gets injury in front line, military doctors have to send him to civilian hospital to take emergency treatment. Even though civilian doctors hate the military, they do treat the patient as a patient and treat them as equal as other civilian patient. Civilian doctor understand military doctor’s difficulty and willing to give humanitarian aid to the soldiers. All doctors whether from military or civilian treat with ethic and sympathy, because caring other health is human holy responsibilities.
• There is one policy for soldier that is; one suffers HIV, he is urgently expelled from army by urgent board. Because of very poor health care in our nation, HIV patients die just after they know the result of HIV on investigation. Because of government’s neglect, doctors wait and see for HIV suffering patients even there are many drugs for long survival of those patients nowadays.
• I mentioned a lot about military hospital before, the current situation in public general hospital condition is worse than in the old days. There are full of blame and criticism towards doctors and all health care staff for poor, limited health care service. Patients have to buy their own medicine from black market. The government completely ignores public health service whereas you can see enormous amount of spending in military expenses.
• DSH & MB get medicine from Non mobile Drug Store Unit, the medicine are generally approached to expire date or already expired which can buy from China with good deal but less effective and dangerous medicine. Most Medical Assistant Devices are supply from Chinese company for example RESHIN COMPANY, which has a good friendship and economically links from the generals. However, they are not willing to repair as in case of damage or un-functioning.
• Generally, the procedure to get the necessary drugs and equipment is so wasting in time. The Medical Service Team need to get approval from different channels until it reaches to the Ministry of Defense just only to get permission to buy it. Therefore most medicines are spoiled due to unnecessary delay.
• Hospital can’t give adequate supply to patients, therefore medical doctor prescribes the medicine to purchase from black market, if senior official finds out about prescribing drugs to buy from black market is too serious crime for medical experts. The government takes action against the doctors and experts just for prescribing necessary drug for the patient from outside market. Drugs distribution for Light Infantry Regiment and other units are controlled from Medical Battalion. Drugs for unit clinic, labor room and drugs for frontline are take out in timely interval. But there are many ridiculous things; no drugs for control infections just like diarrhea in the rainy season, no drug for malaria at malaria endemic area, no anesthetic drugs & instruments for war injury.
E. Medical Battalions
• There is one in each of Regional Military Force, drugs are distributed from MB to other related units. There are always complained and disputed between MB & Units because of inadequacy of important drugs just like anti-malaria, anti-diarrhoeal, antibiotic and etc.
• MB gives medical cover to Tactical Operation Command & Division. When the area commanders wander, one of MO in MB follows them to give medical cover with non-issue drugs. MB planning resources just like; MO & nurses in order to give medical care to Based Tactical Operation Command, Tactical Command & Division Command.
• As I mentioned above MB gives medical care for commander, also gives care for their families. Although the commander & their family members are so haughty, MO fulfills their needs. Under the circumstance of inadequacy, unnecessary interference from the military dictatorships and oppressiveness MB materialize the desire of Ministry of Defense.
F. Defense Services Medical Academy (DSMA)
• Defense Services Medical Academy (DSMA) was established in 1992 and located in Mingaladon, Rangoon, is the University of Medicine of the Myanmar Armed Forces. DSMA was founded in 1992 as the Defense Services Institute of Medicine (DSIM) to develop doctors to serve in the Myanmar Armed Forces. Prior to the founding of the academy, the Burma Army had recruited its medical and dental officers from civilian medical school graduates, who had to undergo a month-long basic military training program at the Medical Corps Center. While the medical corps of the Burma Army had always been short of physicians, by the early 1990s, the shortage became more pronounced as the military government, fearing student unrest had shut down most civilian universities, following the 8888 Uprising in 1988. Most civilian universities were closed off and on for much of the 1990s. The military run universities essentially became the only venue for those who wished to continue university education inside the country. Because of inadequacy in lectures, teaching aids and shortening of learning period in each year, there are given birth quantitative more than qualitative doctors.
• To the end of 2001, the rector in DSMA is filled by Brigadier General from medical field. They understand the nature of medical students, how to teach & how to rise up them. Later this post is filled with Brigadier General from Infantry. Anywhere can you hear and see the rector of Engineering University is not engineer and rector of Medical University is not doctor. In these DSTA and DSMA, rector are just Brigadier General who has degree of B.Sc ordinary and they can’t understand engineering and medical students how need to study and their feeling so they rule what they want wrongly for example, these students didn’t study after 9 pm even at private study period shortly before exam. So those students study stealthily for their knowledge. And the huge baggie is qualification of DSTA and DSMA students, if one of the 1st year student is not qualify to attend 2nd year, their teacher can’t him let stay at his old year because military junta need to just quantity not quality so the choice of the university by marks, which passed BEHS exams, is really proper in these military university.
• After graduation, DSMA cadets are commissioned with the rank of Lieutenant in the Myanmar Army Medical Corps. They have been sent Medical Battalions to provide the healthcare in rural area. They suffer unnecessary interference from the military dictatorships. Many patients in frontline are expired because of neglect of administer for timely referral to hospital. More over MDs are forced to give false statement upon the cause of death . It is clearly seen that, most area commander avoid to get blame and let MDs to cover their crime. In fact, the cause of death is lack of responsibility from the high – ranks officials.
G. Relationship between military doctors and civilians
• In 2007 Saffron revolution, many military doctors suffered abhorrence from injured protesters even they gave treatment to them because of Uniform Phobia. Two to three days later, the protesters realized people who gave medical treatment were soldier but they couldn’t harm & gave help. After that they made a vow about tortures to military doctors. But the doctors nothing can do for them apart from medical treatment because they were watched behind. So Military doctors suffered shame themselves as they couldn’t give any humanitarian aids to unarmed people.
• After cyclone Nargis in 2008, many military doctors also suffered abhorrence from injured cyclone victim because of victim’s Uniform Phobia even they gave treatment & some help to them. Military doctors shared drugs from NGO because stupid government didn’t give adequate drugs & equipments. Even though they implicated with good-will just like as public doctor, they got only abhorrence & hate. The villager warmly welcome to public doctor but not to them. Even though they are doctor, they are treated as soldier/killer. Therefore, Military doctors are downhearted as they are being a part of SPDC.
• Military doctors always lower & humiliate in communicating with public medical association.
• At 2009 December, MO of DSMA transferred in order to serve as Infantry MO in each LIR. They experienced distasteful interference of second in command & commanding officer of units. CO controlled drugs in their hand. If MO wants to use for patients, he have to make summiting to them. It is not suitable for emergency. CO orders to treat their ill soldier & pregnant mother but they don’t want to refer hospital. Because they don’t want to diminish their resources & give support if they are admitted to hospital. They order to do child birth to the pregnant mother without providing any necessary support like Instruments & Drugs. For that reason, there are many conflicts between MO & their CO.
• As I mentioned above, many military medical persons suffered distasteful, disgusting, downhearted feeling in their mind and wanted to make rebelling & refuting their own government nowadays.
