Here is an op ed. A direct challenge to the new #NLD government.
Jamie
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Community health: We care for our own
Health Convergence Core Group
Tuesday, 29 March 2016
With the convening of the National League for Democracy-dominated parliament and the formation of the U Htin Kyaw cabinet – including the appointment of Dr Myint Htwe as the new minister for health – we, along with our conflict-affected communities, are hopeful that there is finally light at the end of a long, dark tunnel.
Like millions of our countrymen and -women, we hope the NLD’s campaign promise of change means a strong repudiation of the centralised policies of successive military and quasi-military governments. These policies have fuelled conflict and human rights abuses, and have decimated the health of our communities.
Despite these impacts on our communities, we have refused to sit by idly in the midst of this man-made disaster. Over the past three decades, we built our own community-centred health systems according to a devolved, locally managed model. This has enabled us to deliver the services most needed and demanded by our communities, focusing on primary healthcare, especially maternal and child health. Local health professionals have led the way, using our own languages and cultures.
In Myanmar today, our ethnic-managed health networks have grown to include more than 2600 staff members who operate 125 mobile teams, 114 clinics and over 50 specialised service centres. They provide care to over 185,000 patients a year, out of a target population of more than 500,000 internally displaced persons.
We have developed our own standardised curricula to train different categories of health professionals needed to operate our programs and deliver vital health-related services, along with a standardised health information system to address the dearth of reliable health data in our communities. This data is crucial for cost-effective health programming.
Ours is a model that can respond quickly to acute health and humanitarian challenges, such as new displacement, outbreaks of infectious diseases and natural disasters. We have always been and continue to be ultimately accountable to the communities we serve.
The current national health system enshrined by the 2008 constitution grants Nay Pyi Taw exclusive legislative and fiscal control over health, with local administrations only accorded coordination and supportive roles. It is this extreme centralisation which must be tackled first to bring about a progressive governance structure which will allow Myanmar’s national health system to become one that we can all be proud of.
We share the same goals as our health colleagues in the NLD administration: working together to bring the disparate health programs in the country into an integrated, coherent primary health system - one which is accessible, comprehensive, equitable, and responsive to all of the peoples of Myanmar according to their differing contexts, languages and needs.
There are many challenges to realising this dream, but among the most daunting is that there must be a genuine devolution in the health governance of Myanmar. Devolution must occur in tandem with reforms toward a federal system, one in which state and region administrations have greater decision-making powers over their own affairs and the decisions that impact the health of our communities.
In addition, but no less daunting, key social and political realities that continue on the ground must be urgently addressed, realities that have severe and wide-ranging impacts on the health of our community members. There must be an inclusive and sustainable peace and an end to the culture of abuses against our peoples, including the epidemic of land confiscation and evictions.
It is only through an inclusive and comprehensive process that health inequities may be finally addressed and all of our peoples finally attain their long-denied right to health. We deserve nothing less.
The Health Convergence Core Group (HCCG) is a coalition of eight ethnic and community health organisations headed by the Mae Tao Clinic, Back Pack Health Worker Team and Burma Medical Association, and was formed in 2012. It is a multi-ethnic health governance body working toward devolved healthcare under a future federal system in Myanmar.
http://www.mmtimes.com/index.php/opinion/19702-community-health-we-care-for-our-own.html
