Relief International Board Member and Medical Director, Doctor Hernando Garzon, Reports from the Field in Myanmar

June 5, 2012


Relief International Board Member and Medical Director, Dr. Hernando Garzon, reflects on his visit to the field in Myanmar.


As a member of the board of directors and as a physician involved with Relief International health program operations in the field, I have wanted to make site visits to each of the ongoing Relief International health programs.  In conjunction with another board member, Chip Duncan, we’ve had the privilege of making such a visit to Myanmar. 

With the existing Relief International health program as the focus of our visit, our trip was designed to facilitate the development of additional and more comprehensive health programs, including the possibility of establishing a program to have U.S. health care volunteers spend time teaching local providers and providing care in under-served areas.  Our visit included trips to the rural delta outposts where substation clinics are manned only by a single midwife and suffer from lack of essential medical supplies, to meetings with the deputy minister of health, the director of foreign affairs, and the dean and faculty leaders of the premiere medical university in Yangon.  

The health care status of Myanmar looks much like that of a developing country with under-served medical needs.  Myanmar spends an average of $14 per person a year on health care. Compare this to the $44 per person a year the World Health Organization says is the minimum required to provide basic health services (The U.S. spends $7,960 per person a year). With $14 per person, Myanmar simply cannot provide basic medical services for its population! In addition, Myanmar is behind schedule in achieving the health related U.N. Millennium Development Goals (MDG’s) by 2015 (MDG #3: Reducing under age five child mortality; MDG #4: Improving maternal health; MDG #6: Combating HIV/AIDS, Malaria, and other diseases). 

Myanmar has only 4.6 doctors and eight nurses/midwives for every 10,000 people. Compare this with the U.S. which has 24.2 doctors and 98.2 nurses per every 10,000 people. I could go on and on, but this alone should be enough to see that the challenges Myanmar faces in providing adequate basic health care for its population are huge.


Dr. Hernando Garzon, third from left, pictured below.

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Getting to “experience” these statistics in action and seeing the reality of health care delivery in this limited resource setting was a very moving experience. The substation clinic medication cupboards are bare, medical equipment is antiquated or broken and non-functional, and huge gaps exist in supplies, staffing, and training.  Although I have seen poor patient outcomes from such limited resources before, perhaps the most difficult part of my trip came during a routine tour of a township hospital.  During our tour, a third trimester pregnant mother of seven arrived to the hospital hemorrhaging, and we witnessed the initial stages of her evaluation and treatment.  With no blood bank system as we know it in the United States, they immediately called several volunteers from their pool of “live blood bank donors.”  They responded quickly to what is certainly an innovative and somewhat risky solution to provide an emergency and potentially life-saving blood transfusion.  In the end, neither mother nor baby survived – and I continue to struggle with the idea that “if only” adequate resources were available, both would have made it.           

Relief International is coordinating very well with the ministry of health and the national plan for improving maternal and child health and basic comprehensive medical care in Myanmar.  In addition to health programs, Relief International is also involved with livelihoods and agriculture programs.  The work being done by the Relief International Myanmar staff is exceptional and I am very hopeful that Relief International will continue to make a difference in the health and economic development for the people of Myanmar.

Dr. Hernando Garzon