Myanmar News Links: Burma Removes 1,000 Doctors From Blacklist

Burma, Myanmar, health care, medical, doctors, reform, blacklist

A patient rests in bed at a hospital in downtown Rangoon. (Photo: JPaing / The Irrawaddy)

RANGOON — Burma's government has removed more than 1,000 Burmese doctors from a blacklist that stripped them of their medical licenses and prevented many who lived abroad from returning home.

As Burma attempts to overhaul its long-neglected health care system and address a major shortage of doctors, the government on Thursday removed 1,010 doctors from its blacklist at the recommendation of the Ministry of Health, according to Myo Win Aung, a ministry director at the President's Office.

He said in a statement that many more doctors remained on the blacklist but would be removed in the future.

The blacklist, which is not accessible to the public, prohibits Burmese doctors who live overseas from returning home, while also preventing trained doctors in the country from practicing locally or moving abroad.

Of those removed from the list, about a tenth of the doctors were sanctioned early in their careers, after graduating with bachelor's degrees in medicine and surgery, because they refused to move out to rural areas where they had been posted to work, or because they decided to take leave without permission. Some doctors never returned after traveling to the United Kingdom, Singapore and other countries for training or medical workshops, while others were allegedly involved in cases of hospital mismanagement or corruption. Some were dismissed and blacklisted for making a mistake on duty.

Dr. Soe Khine, an expert in consumer health and security, welcomed the government's move to remove the doctors from the blacklist, but said it was wrong to put many of them on the list in the first place.

"If a doctor breaks the law or is not working according to proper ethics, or is corrupt or asks for an inappropriate amount of money from a patient, he should be blacklisted. But if they do not break the law, they shouldn't be on the blacklist," he told The Irrawaddy.

Burmese doctors say that those who were removed from the blacklist will be able to reapply for their licenses through the Myanmar Medical Council, which is under the Ministry of Health.

Win Zaw, secretary of the Myanmar Medical Association, said doctors would likely receive licenses so long as they had not been blacklisted for malpractice, corruption or hospital mismanagement.

"Since the country needs manpower, they will be able to work for the country," he said. "They can also travel or work freely in the country as well as abroad."

Doctors are in extremely short supply in Burma, where the former military regime neglected the health care system for decades. Availability varies from about six doctors per 100,000 people in Mon State to about 59 doctors for the same population in Chin State, where more health personnel have been posted due to the nature of terrain and difficulty of travel, according to Ministry of Health statistics from 2009, the latest publicly available.

Rangoon Division and Mandalay Division, where major teaching hospitals are located, have a relatively high concentration of medical doctors, with 46 doctors and 23 doctors per 100,000 people, respectively.

The lack of doctors has led to an overreliance on midwives, who are responsible for about 3,000 patients each in some rural states, according to the Ministry of Health. In addition to overseeing labor, midwives are often tasked with primary health care, ante and postnatal care, and collecting health data.

Burma's former junta spent less than US$1 per person on health care five years ago. The current government, which came to power in 2011, has allocated a bigger share of funds for health, but health care spending still accounts for only about 3 percent of the national budget.

Among leaders of the health care reform effort is Dr. Tin Myo Win, the personal physician of opposition leader Aung San Suu Kyi. The doctor, who is developing the national health policy for Suu Kyi's National League for Democracy (NLD) party, says many doctors moved abroad during military rule, and he is urging them to return now and offer their services—even briefly.

"When I was in the [United] States for about a month, arranging everything for the visit of Daw Aung San Suu Kyi, I met so many Americans and Burmese nationals living there. I asked them to come back, and they're very willing to, provided it's not permanent," he said. "That's fine. Come work with us, train the doctors here."

If doctors return, this might alleviate the shortage of health personnel in rural areas. "No doctors want to go there—that's understandable," he said. "If you can send someone from the United States to work there in the border area, they can spend about a month there. Then we are happy, they have lots of job training."

Burma's border areas are largely undeveloped and impoverished, and many experienced decades-long insurgencies during military rule. Today clashes continue in some border states, including Kachin State and Shan State, while communal violence between Muslims and Buddhists has torn apart communities in Arakan State. Medical aid workers say that this unrest has made it difficult to recruit staff.