The Médecins Sans Frontières (MSF) project in Myanmar’s Rakhine state was suspended for most of 2014, but by the end of the year it was again providing essential healthcare to thousands of people caught up in a medical humanitarian crisis.
A long-established MSF project providing basic healthcare to highly vulnerable communities in northern and eastern Rakhine state was suspended by the authorities in February and resumed only in mid-December. Prior to the suspension, MSF provided medical services in 24 camps for displaced people and in isolated villages across Rakhine.
From June, MSF was able to provide medical staff to facilities managed by the Ministry of Health in Rakhine, and supplied resources such as vehicles and medical equipment to the Ministry of Health Rapid Response Teams in Sittwe and Pauktaw townships. HIV patients previously under MSF care were also supported. After the official resumption of activities, MSF teams carried out more than 3,400 consultations in less than a month, mainly for people with skin diseases and respiratory tract infections; 550 were for pregnant women.
Not all of MSF’s project activities had restarted by the end of 2014.
HIV and tuberculosis (TB)
Working in collaboration with the Ministry of Health, MSF remains a key provider of HIV/AIDS and TB care in Myanmar, supplying antiretrovirals (ARVs) to more than half of the 70,000 people undergoing treatment. MSF treats patients co-infected with TB and HIV through integrated programmes in Shan and Kachin states, as well as in Yangon and Dawei in Tanintharyi region. These programmes also offer treatment for sexually transmitted infections, health education, psychological and social support and prevention of mother-to-child transmission of HIV. In November, MSF inaugurated its newly renovated clinic in Insein Township in Yangon. The largest HIV/AIDS and TB clinic in Myanmar, it is currently treating approximately 10,000 HIV/TB patients.
In late 2014, MSF also started supporting three HIV testing and counselling centres in Dawei and the surrounding area, focusing particularly on harder-to-reach groups, such as sex workers, migrant workers and men who have sex with men. MSF counsellors also conduct support groups within these communities.
A landmark development occurred in 2014 for the treatment of cytomegalovirus (CMV) retinitis, an HIV-related infection that causes blindness. Approximately one in four severely ill HIV/AIDs patients in Myanmar develops CMV. Following many years of price negotiations with a pharmaceutical company, MSF began providing its patients in Dawei with valganciclovir, a single daily pill taken orally. Although it has been available in high-income countries since 2001, this is the first time MSF has been able to use the drug; patients previously had to endure uncomfortable injections directly into the eye.
Emergency mobile clinics
When active fighting resumed in northern Shan and Kachin states in April, MSF began to operate mobile clinics to bring healthcare to displaced people.
No. staff in 2014: 1,146 | Expenditure: €14 million | Year MSF first worked in the country: 1992 | msf.org/myanmar
MA* – diagnosed with advanced HIV and CMV and was the first MSF patient to take valganciclovir.
If I had not [attended] the clinic in Dawei, I would probably be dead. For the CMV, the doctor said that when he looked into my eyes, he could see a lot of lesions in my retina through the lens. But after four months of treatment, that has improved. I have not felt any side effects and I am feeling better now. Before, it was not like that, and I had to lie down all the time. Now I can go everywhere by myself. I even got my vision back and can read the text messages on my mobile phone.
If I hadn’t got the treatment on time, I might have lost my vision within three months. I feel very lucky that I got the chance to take this oral treatment.
* Name has been changed