RANGOON — Opposition leader Aung San Suu Kyi’s plans to renovate Rangoon General Hospital will include the construction of a new 1,000-bed facility near the current hospital within the next year, a close confidante of the democracy icon said.
Dr. Tin Myo Win, Suu Kyi’s personal physician and a member of the project’s fund-raising committee, said Parliament had already allocated 5 billion kyat(US$5.3 million) to upgrade the century-old 1,500-bed hospital, among Burma’s biggest and best known,and that the new 1,000-bed facility would be built to accommodate patients during the renovation.
“We decided we need to build a new hospital, not very far from the old one, near the nursing university,”he told The Irrawaddy last week.“At present the space is being used for car parking, but we are going to complete [the new hospital] within eight months to one year.
“It will be part of Rangoon General Hospital, just a different building,” he added. “We will evacuate all the patients to the new building and then start renovation in the old building.”
Construction has not yet started, but a master plan is being developed and fund-raising efforts are continuing. The project could require $500 million, Tin Myo Winsaid as a rough estimate, adding that the final cost would depend on engineering requirements.
He said the decision to construct a second building came after Suu Kyi met last monthwith Shwe Mann, speaker of the Lower House of Parliament, along with Lord Ara Darzi, the United Kingdom’s former health minister, to discuss the larger hospital renovation project.
The opposition leader had earlier submitted a proposal to lawmakers for the renovation and is now leading a committee of officials, lawmakers and donors for the project.
“Aung San Suu Kyi put the motion in Parliament, and all of a sudden it was seconded by the minister of health,” said Tin Myo Win.
“The condition [at the hospital] is totally different from when I last visited,” added the doctor, who worked at the hospital prior to the 1988 pro-democracy uprising. “The building [foundation] is strong, but still the floor and ceiling, everything, we need to renew it.
“At the same time, we need to accommodate more patients,” he said, adding that the project would also include an upgrade of medical equipment and an investment in human resources.
He said he was raising funds with a committee that included a former medical superintendent of the hospital and a representative from the ruling Union Solidarity and Development Party (USDP). The group is also working with donors, including the Japan International Cooperation Agency (JICA), which coordinates development assistance for Japan’s government and is investing in a larger plan to develop the city of Rangoon.
The foundation stone for Rangoon General Hospital at its present site was laid in 1905, according to the University of Medicine 1-Yangon, a prominent medical school. The building was completed in 1911.
The hospital renovation project comes amid a larger push to reform Burma’s health care system, which was chronically neglected by the former military regime. The junta spent less than $1 per person on health care in 2007, according to the Health Ministry.
Private health spending constitutes the major share of health spending in Burma, according to National Accounts Data from the Ministry of Health in 2008-09, which said the Health Ministry was responsible for 10 percent of health spending while private households accounted for 82-85 percent, with additional funding from other ministries and NGOs.
Rangoon General Hospital, like many hospitals in the country, is prohibitively expensive for most of the public and is known for charging patients for the medical equipment used during care.
“You have to buy your own medicine for the operation, the bandages,” said Tin Myo Win, who now works at another hospital in Rangoon that provides health care free of charge.
Suu Kyi has made health care reform a priority since being elected to Parliament last year, and her National League for Democracy (NLD)party in February formed its National Health Network—led by Tin Myo Win—to consider the party’s health care policy more broadly and push for universal coverage.
Broader reform will be crucial in the coming years, doctors and activists say.
“With Rangoon General Hospital, the important thing to keep in mind is that yes, that is sort of the symbol of Burma’s health care system, but most people are not accessing it,” said Dr. Vit Suwanvanichkij, a public health researcher who has worked with Burmese migrants on the Thai border for more than a decade, and who visited hospitals in Burma under the former military regime and again last year.
“People who go there have to pay for everything—bed changing, IVs, medicine. It’s really what you can pay for, and the vast majority of Burma’s population, especially rural, is not going to access that.”
Midwives, health assistants and local healers provide the bulk of health care in rural areas, he said, but they are often overworked and lacking resources. He said in addition to improving facilities, it was important to build reliable data systems and ensure investment reaches rural areas.
“I think it’s great that Aung San Suu Kyi is highlighting general hospitals, and yes, there’s a need to upgrade them, but if the goal is to really improve public health, the emphasis must be on the public,” Suwanvanichkij said. “You can’t do it by just upgrading urban hospitals—you have to build the health system, and today I think that’s still neglected.”
Even so, he expressed optimism about the leaders of Burma’s health care reform—praising the efforts of Tin Myo Win as well as Health Minister Pe Thet Khin, whom he said understood that much work remained to improve Burma’s health system.
“There are so many other components to this, and these we cannot forget,” he said. Still, “You have to start somewhere.”