This interview is the third of the mini-interview series featuring members of the 17th Council of the Asia Pacific Hospice Palliative Care Network (APHN).
This month, we interviewed Professor Myo Nyunt, the appointed council member from Myanmar. Prof Nyunt is the President of the U HlaTun (Hospice) Cancer Foundation.
How did you come to the palliative care field?
It was very unusual for a pathologist by profession to be involved in palliative care. It was sometime in 1994 when Daw Mya Sanda Tun, daughter of U Hla Tun, came to me for unexplained fever for investigation and treatment. I did a venepuncture and 26 parameter haematological test. In the blood film I found that there were some abnormal cells and further investigations including bone marrow examination revealed acute leukaemia/lymphoma. To cut the story short, she ultimately went to London for further management in view of a bone marrow transplant in 1995. Unfortunately, the transplant failed. U Hla Tun was very grief stricken and decided to build a hospice in Yangon, Myanmar, in 1998. Since then, I have become an executive member and worked in the hospice over the years until today, where I am the current President of the U Hla Tun Hospice Cancer Foundation. I am currently in charge of the medical affairs of the hospice in Yangon and Mandalay. The Mandalay hospice was established in 2003.
Please share with us more about the hospice work.
We have two hospices, one located in Yangon, and the other in Mandalay. We have resident doctors caring for the cancer stricken patients. Our hospices care for cancer patients that are the poorest of the poor and cases that are beyond treatment. When our patients are unable to afford cycles of palliative chemotherapy, radiotherapy, we do cover the costs for some of them to complete their treatment. We also cover the costs for surgery in some cases. However, we are still mainly providing palliative care services. The staff nurses and nursing aids attend to patients’ various needs. Specialists from various disciplines like medicine, surgery, anaesthesiology, OBGY, dental surgery, clerics and social workers also form part of the team and conduct ward rounds on designated days.
What do you think are the current opportunities and challenges in Myanmar in developing palliative care?
The challenges in Myanmar in developing palliative care are considerable, especially due to the availability of oral morphine and morphine syrup. We now have a pharmaceutical factory which is ready to supply the amount needed for hospices. However, specific procedures are not yet available for the purchase and processing of the medicine. In this area work is still work in progress.
We are glad that we have trained staff who have already attended the training of trainers’ course under the Lien Collaborative for Palliative Care project.
How will you hope to see the APHN collaborating with relevant stakeholders in Myanmar?
APHN has a strong presence in Myanmar involving both the public organisations, like Pain Society, and private organisations like the U Hla Tun Hospice Cancer Foundation, Shwe Young Hnin Si Foundation, the Oncology Society and the Myanmar Medical Association.
The APHN representatives have met with the Minister of Health and officials from the Ministry of Health and Sports. They have also given lectures and hands-on training in Naypyidaw, Yangon and Mandalay. Most of the palliative care doctors and nurses in Myanmar are familiar with them.
In terms of policy, I think we do need to raise more awareness on the subject of palliative care and its necessity. We also need to have better community involvement.
If you were to choose a colour to represent your journey in palliative care, what will it be and why?
The colour I chose will be the evening tide (light purplish blue) colour. The colour is often used by hotels. I feel that it is not dull, yet cheerful and peaceful enough, as if the name implies it is set for a “quiet night’s sleep”. Out of so many philanthropic works, I chose to be an APHN Council member because I hope to be a role model for the younger generation of physicians in Myanmar and incite them to continue in this noble work.
The APHN Council consists of 7 members to be appointed by sectors on a rotation to be determined alphabetically according to the name of the sectors (Constitution 12.2a), 7 elected members, and 6 Co-opted member