Here is a feature article on Frank!
Experts are divided on whether ACT use in Myanmar will "halt the spread to Africa and India".
Jamie
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Medical Action Myanmar; Yangon
Prosperoworld
Wednesday, November 21st, 2012
Dr Frank Smithuis, a tall Dutchman who has lived in Burma for 18 years, rolls up in his new second-hand car to take us to one of Medical Action Myanmar’s clinics in the township of Hlaingthayar. Serving a population of 340,000, it is one of the poorest in Yangon. Dr Frank, previously director of Médécins Sans Frontières, founded MAM recently and his work has been recommended to us by several different people. His name seems to be recognised all over the world, from the FT Asia correspondent in Bangkok to Intelligence Squared, with whom we share office space in London. He is energetic, outspoken, uncompromising, and passionate about what he does.
Due to the shortage of basic healthcare here, hundreds of children die each year in Yangon of treatable diseases: TB, HIV/AIDS, respiratory tract infections, and diarrhea. The clinic we visit bears the well-worn marks of an organised and busy establishment. Serving up to 250 patients a day, for free, 38 staff here work 7 days a week and their services include HIV/AIDS treatment and counselling; a feeding centre for babies; laboratory testing; family ‘spacing’ counselling and medication as well as advice and treatment for the growing number of sex-workers. There are at least 10 brothels in this township alone. With the large number of HIV/AIDS cases and not enough prevention and treatment activities, education is a key area of growth for all NGOs dealing with the disease.
Laboratory testing at MAM
Dr Frank’s speciality is in malaria treatment and he has published much on the subject. Myanmar is badly afflicted by malaria, with an estimated 4.2 million cases a year, affecting 69% of the population who live in areas where it is endemic. 75% of malaria deaths in the whole Mekong region occur in Myanmar, where the growth of drug resistant strains has been identified.
We learn that the parasite responsible for malaria is only transmitted by female, pregnant mosquitoes. The treatment of malaria requires precise dosage and intervals between these, therefore requires ‘proper’ consultations and treatment. In matters of prevention, factors like ‘biting’ hours can outwit the statisticians. In some parts of the world, mosquitoes bite after dark, in others, key biting times are between 6 and 7 pm – long before bed nets are put up. We realise that even the most reputable organisations blunder with ‘treatment’ for this pervasive disease.
On a tight budget, MAM works with 220 staff both in Yangon and more recently, on malaria- treatment and prevention work in Mon and Kayin State. As recently published by Dr Frank in the Herald Tribune (March 30th 2012), the alarming development of artemisinin-resistent malaria parasites is going to become a serious global health threat. The previous breed of malaria parasite that developed resistence to Chloroquine claimed millions of lives in Asia and Africa over the past 50 years. Artemisinin significantly decreased the death rate of malaria but with resistance now looming the same situation threatens to recur again if nothing is done to stop it.
An informal medical consultation
If this strain of parasite can effectively be treated in Myanmar, it could halt the spread to Africa and India, where it would wipe out more than 200,000 children annually.
With only two more days before our visit to the River Doctor’s clinic in the Irawaddy Delta, we too have to start taking malarone – the tourist malaria prevention pill which will tackle any invading parasite if one were unluckily enough to get bitten. Its side effects however, including ‘strange dreams’ are uncomfortable to say the least. Despite much Deet spraying, the mosquito still preys on me, notably on my ankles (Dr Frank confirms that it is true: mosquitoes have a strong sense of smell and prefer some humans to others).
Dr Frank’s battle might be on a smaller-scale than an operation like the Bill and Melinda Gates Foundation, but more attention to the kind of detail he shares with us, and a concerted effort to stop the spread of the new artemisinin-resistent parasite, would save thousands of lives. Medical Action Myanmar is clearly doing excellent work.
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