”Until morphine is more widely available in Myanmar, patients will not be getting the most effective pain relief possible in hospitals.”
“They can’t get any such medications once they go home, hence the needless pain and stress.”
– Dr Ramaswamy Akhileswaran, co-leader of the Lien Collaborative’s Myanmar program and palliative care specialist from Khoo Teck Puat Hospital, Singapore.
Myanmar, a country with a population of 54 million people, has made strides in the development of palliative care despite the difficulties it faces. Oral morphine is being made available by the government of Myanmar. Several doctors have enhanced their palliative care skills and knowledge through attending overseas training programs. Major government institutions like Yangon General Hospital, Mandalay General Hospital and the No.2 Military Hospital, which are in the process of building up their palliative care services, will become the teaching centres in palliative care in the future.
According to the Global Atlas of Palliative Care, published jointly by the WHO and the Worldwide Hospice Palliative Care Alliance (WHPCA), Myanmar suffers from inadequate access and availability of hospice and palliative care. Its palliative care activities are heavily donor dependent and hence unsustainable.
The usage of morphine is generally low with annual average consumption of less than 5mg/capita, well below world average, contrary to the World Health Organisation’s recommendation of oral morphine as the gold standard and essential medication for pain relief that should be available to suffering patients. The scarcity of palliative care and pain relief medicines in Asian countries like Myanmar are compounded by other socio-economic issues such as poverty, high patient load and overcrowding at public hospitals and healthcare facilities.