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Burma (Myanmar) boots medics, citing no need

Authorities have ordered Asian doctors in the cyclone-hit south home. The urgent need is for volunteers who bring basic care to far-flung villages, some aid workers say.

By Correspondent of The Christian Science Monitor / June 19, 2008

Dispersed: Cyclone victims in the Irrawaddy Delta. Some refugees have been sent home from camps, putting them out of reach for aid.



Bangkok, Thailand

Having led Thailand's first medical mission last month to cyclone-ravaged Burma (Myanmar), Pichit Siriwan, a doctor, was on standby for another two-week tour. But last week he got word that Burmese authorities no longer needed the services of his 30-person team.

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The notice came as part of a broad drawdown of Asian medics in the disaster zone – another entry, perhaps, in the ledger of international outrage against a junta whose deep suspicion of foreign influence has slowed aid efforts since a May 2-3 cyclone killed tens of thousands of people.

For weeks, aid agencies have warned of the threat of disease to survivors and called for greater international assistance in affected areas, which are under tight military control.

But another explanation for the exodus of Asian doctors, whose primary role was in temporary camps, may be the shifting nature of the disaster.

As more people return to their shattered communities, aid workers are trying to put in place village-level systems that can offer preventive primary care and screen the population for any epidemic outbreaks.

These rely more on local volunteers and mobile clinics than on hospitals and foreign doctors, who are usually primed to treat trauma patients.

"We were told that we're no longer needed.... I think that they need help, but in the right way," says Dr. Pichit, a physician at Chulalongkorn Hospital in Bangkok and a member of the Thai Red Cross.

Healthcare shortages

Aid agencies say that cyclone-affected areas are reporting cases of various diseases, as well as mental trauma from the tragedy.

But aside from the emotional trauma, all these conditions were long prevalent in the Irrawaddy Delta and elsewhere in Burma, a grindingly poor and insurgent-racked country that spends a minuscule proportion of its income on healthcare.

In Laputta, a delta township of roughly 350,000 people, the main hospital is said to have only one fully qualified doctor.

Last week, the UN warned of a shortage of trained midwives and clean facilities for tens of thousands of pregnant women in the delta. William Ryan, a spokesperson for the UN Population Fund, told reporters that health kits designed for safe deliveries were being sent via Burma's Ministry of Health to affected areas.

Burma's maternal mortality rate of 380 per 100,000 live births is four times higher than that of neighboring Thailand.

Dispersed survivors hard to reach

Aid workers say the closure of displacement camps in the delta, which international human rights groups have criticized as forced relocation, has added to the urgency of rebuilding local health networks. The dispersal of survivors to remote areas where water and food supplies are uncertain is stretching local medical personnel, whose numbers were already depleted by the tragedy.

But aid workers haven't received reports of any major disease outbreaks, such as cholera and measles, as many had originally warned.