2

CHRISTOPH GELSDORF, MD
livingwellmyanmar@gmail.com
A
BROAD term, healthy
living encompasses many
issues, from lifestyle to
medical care access to
public health initiatives to workplace
safety to urban infrastructure.
As Myanmar struggles with the
transition to a more participatory
society, all of these factors will
simultaneously contribute positively
and negatively to the populations
health and well-being.
Certainly there are reasons
to be hopeful that the general
health indicators evaluated by the
international community such
as productive life years, under-5
mortality, malnutrition, and infectious
disease incidence will all improve
over the next decade.
However there are also threats to
health that come with development.
Likely challenges include poor diet
and obesity in a growing middle class;
inappropriate medical interventions
from an undereducated and under-
supported medical workforce;
periurban crowding; and inadequate
food and land security for the rural
poor as the transition to corporate
agriculture occurs.
While there are ways for
responsible government and an
accountable private sector to promote
the good and mitigate the bad, the
challenges are signicant.
The perils of a narrow focus
An area where we certainly expect
to see improvement is the burden of
infectious diseases such as tuberculosis,
malaria and HIV. The international
aid community is extremely active
in infectious disease treatment and
containment, because global funding
networks are organised along these
vertical disease categories. And the
benets to afected portions of the
population are of course substantial.
But when INGOs and national
health ministries focus intensely
on specic diseases it threatens
to undermine the clinical and
preventative health care systems
development as a whole.
As nancial and, more importantly,
human resources are diverted away
from more broadly inclusive primary
care development, improvement in
the overall system inevitably sufers.
In fact the long-term maintenance of
infectious disease control relies on a
strong primary care workforce.
Whats more, from an administrative
and infrastructure standpoint
Myanmars national healthcare system
will not be able to aford multiple
disease and primary care delivery
mechanisms. Therefore participants
in this sector will be challenged to
simultaneously develop both disease-
based and generalised healthcare.
A likely demographic trend that will
impact health data in Myanmar is the
migration of the rural poor into peri-
urban manufacturing and industry.
Specic areas in which the new urban
workforce faces health challenges
include: exclusive breastfeeding of
newborns; exposure to respiratory
infections in the built environment;
and psychiatric illness associated
with relocation and separation from
extended family units.
The extent to which the government
is able to promote workplace safety,
establish minimum standards for
housing and community development,
and provide access to clinical care will
largely determine the extent to which
this population positively contributes
to Myanmars development index.
Hopefully this happens in tandem
with employer understanding that
a healthy workforce is critical to
sustained business growth.
Its hard to tell whether developing
societies sufer from a greater
incidence of mental health disease,
but we can say Myanmar faces a
shortage of psychiatric diagnostic
and treatment capacity. In 2006
an estimated 89 psychiatrists were
serving 50 million people.
Stigma is hard to quantify, but
Myanmar is far from accepting of
conditions like depression and anxiety.
In my experience, patients who would
be treated for depression in the US
are instead said to be sufering from
low blood pressure and abnormal
temperature intolerance in Myanmar.
As social upheaval is an accepted risk
factor for mental disease, the country
will benet from more qualied
practitioners in years to come.
Putting primary care first
The coming decade will see increased
access to doctors and hospitals for
much of the country. While this is a
generally positive trend, the specics
of where and how people interact with
the medical system will determine
how much benet is achieved.
Robust evidence indicates that
improving primary care is the single
most cost-efective health sector
intervention toward improving
population health. This has long been
known in most European countries,
is becoming apparent as the US
struggles with the nancing of its
healthcare system, and will be critical
in Myanmar as decisions are made on
where to spend limited resources.
Essentially all medical outcomes
improve as primary care capacity
is increased: maternal and child
health, chronic disease management,
preventive health education, early
cancer detection, and appropriate use
of specialist care and hospitals.
The challenge for Myanmar will
be to create a competent workforce
of primary care physicians that
makes medical decisions based on
clinical knowledge rather than patient
expectations or prot motive. This
will require addressing todays lack
of post-graduate medical training for
general practitioners, a process that
will require collaboration between the
GP Society of the Myanmar Medical
Association and the Ministry of Health.
Urgent needs, long-term goals
A fundamental driver of national
health indicators is the extent to which
public health measures are successfully
implemented. The most obvious
and high-impact interventions for a
developing country include access to
safe drinking water, community level
sanitation services and anti-tobacco
campaigns.
However Myanmar could also see
a quick benet from programs aimed
at trafc safety and low-quality
alcohol consumption (road accidents
and alcoholic cirrhosis are thought
to be top-10 killers in Myanmar).
From a medical perspective,
initiatives aimed at widening the
breadth and depth of childhood
vaccinations, encouraging cervical
cancer screening and combating
fake pharmaceuticals would lead to
reductions in sickness and death.
But public health programs
are quickly enveloped in political
posturing and systematic corruption,
so the efectiveness with which those
broader sociopolitical challenges
are addressed will impact how well
governmental health programs are
implemented.
Staff writers Shwe Yee Saw Myint,
Lun Min Mang, Fiona MacGregor,
Nandar Aung, Wade Guyitt, Tun Tun,
Aung Kyaw Nyunt, Nyein Ei Ei Htwe,
Mya Kay Khine, Myo Lwin, Ei Thant Sin,
Myat Noe Oo
Contributers Christoph Gelsdorf,
Jacquetta Hayes
Editors Myo Lwin, Wade Guyitt
Sub editor Mya Kay Khine Soe
Cover photography Aung Htay Hlaing
Photography
Aung Htay Hlaing, Yu Yu, Zarni Phyo
Cover design Ko Htway, Ko Pxyo,
Wade Guyitt
Page layout Ko Khin Zaw
For feedback and enquiries, contact
wadeguyitt@gmail.com, myolwin286@
gmail.com
Opportunities
and obstacles
What development may bring
Sidewalk sideline: Kids take a break from watching a street football match. Photo: Staff
SHWE YEE SAW MYINT
poepwintphyu2011@gmail.com
AN updated set of national dietary
guidelines will be issued in September,
the Ministry of Health says,
representing the rst update since
2003 and including advice tailored to
diferent age groups as well as those
living with specic diseases.
The current guidelines are over 10
years old so we need to update them
now, Dr Khin Mar Kyaw, assistant
director of the health ministrys
Nutrition Department, told The
Myanmar Times. The calculation of
nutritional values are missing [from
the existing guide] and havent been
updated. Especially we need nutrition
guidelines for non-communicable
diseases.
Dr Khin Mar Kyaw said diseases
like diabetes and hypertension are
on the increase because of lifestyles
changing in Myanmar.
The 2003 guidelines included 14
recommendations covering the whole
span of life, including: pregnancy and
breastfeeding; nutrition for everyone
from children and adolescents up to
elderly people; and consumption of
fruit and vegetables, fats, salts, water,
and so on.
To implement the new guidelines,
the ministrys nutrition and medical
research departments worked with
nutritionists from the United Nations
and the World Health Organization,
with a workshop held in September
2013 to discuss the issue.
Dr Kyaw Win Sein, nutrition
specialist at UNICEF, said the
organisation is supporting the
ministrys new guidelines. Our
main purpose is to boost childrens
nutrition for physical and mental
development. In our country, one
child in three sufers from under-
nutrition, so we need education
programs and development for them.
Most South and East Asian
countries face problems of under-
nutrition, the most common of which
are protein-energy malnutrition
and vitamin A, iron and iodine
deciencies.
According to a joint Ministry of
Health and UNICEF survey in 2010,
the major nutritional problems in
Myanmar are underweight (31.8
percent) and stunting in children
under ve years. The study also found
70 percent of women and children
under ve nationwide sufer iron-
deciency anaemia.
Dr Myint Oo, a doctor with 30
years of experience who runs a
private clinic in Kyeemyindaing
township, told The Myanmar Times
he sees a range of lifestyles and food
culture nowadays, each with their
own dangers.
People are more eating instant
food instead of fresh food, so theyre
not getting good nutrition from their
diet, Dr Myint Oo said. We have
many good food resources but the
people dont how to get nutrition
from food.
For example, our main food is
rice. Rice is nutritious but people
wash it two or three times before
they cook it so we dont get enough
nutrition from it, Dr Myint Oo said.
He also said he is worried that
rising consumer prices are preventing
poor people from getting enough
protein in their diet because they
cannot aford to eat meat.
At the same time, he said,
wealthy people are eating too
much meat and not getting enough
vegetables each day.
Most of the people coming to
my clinic have chronic diseases
like diabetes and hypertension. I
think these diseases are related to
unhealthy food. We need to give
people knowledge about how to eat a
healthy diet.
New dietary guidelines coming in September
3
G
LOBAL evidence
highlights that the rst
1000 days of a childs
life from conception to
the second birthday are the critical
window of opportunity for improving
nutrition outcomes and preventing
irreversible consequences on human
development.
In Myanmar, the traditional
diet, starting from early childhood,
includes a large proportion of rice
but few fruits and vegetables, which
are what provide the important
vitamins and mineral required for
optimal growth and development.
Malnutrition leads to numerous
problems later in life, including
learning difculties, increased risk of
chronic diseases and lower income-
earning potential in adulthood.
To counteract this, the Livelihoods
and Food Security Trust (LIFT)
Fund is promoting better nutrition
through its country-wide food
security and livelihoods programs,
and particularly through projects
like LEARN (Leveraging Essential
Nutrition Actions to Reduce
Malnutrition).
Implemented by Save the
Children, Action Contre la Faim and
Helen Keller International, LEARN
raises awareness on the importance
of nutrition and the long-term
consequences of malnutrition
throughout the country by helping
local and other organisations
to integrate nutrition into their
livelihoods projects.
One aspect of this is to teach good
nutrition from an early age. Teaching
children about a nutritious diet and
shaping their preferences is important
since it is much harder to change the
diets and habits of adults, says Leslie
Koo, LEARN project manager. Lack of
variety in the diet is a serious problem
in Myanmar, and it is one of the causes
of long-term malnutrition that we
need to address.
An innovative way to help young
children understand nutrition is
through school gardening, which
teaches children about the basics
of agriculture, environmental
management and nutrition in
particular the importance of fruits
and vegetables in the diet.
School gardening is a hands-on
form of learning that appeals to
young, open minds. In a recent UN
Food and Agriculture Organisation
report, school gardening was seen
to increase childrens preferences
to fruits and vegetables while
improving their attitude to their
natural environment.
CESVI, an Italian non-government
organisation, is piloting 20 school
gardens in Naung Cho and Kyauk
Mae townships in northern Shan
State with LIFT funding. In an
area where local food production is
insufcient to meet consumption
needs and where malnutrition is a
pressing concern, school gardens
grow nutritious food while raising
awareness of the importance of
variety in the diet among children,
parents, teachers and the community.
Learning takes place both in the
classroom and in hands-on outdoor
sessions, with garden plots on the
school grounds. The children get to
decide which fruits and vegetables
to grow, based on their preferences
as well as nutritional value, and the
crop is shared among the students at
harvest time.
Over 20 types of fruits and
vegetables have been planted so
far, with pumpkin, kidney beans,
watercress, eggplant, carrot, papaya,
strawberry and mango being the
favourites.
CESVI also supports School
Gardening Associations in
organising activities such as
community Harvest Lunch Days,
cooking demonstrations, and seed
fairs, spreading the word to other
members of the community and
making sure everyone shares in the
benets of better eating.
Planting the seeds of
healthier living
School gardens
are a good way
to promote, and
provide, better
nutrition, writes
the LIFT Funds
Jacquetta
Hayes
Malnutrition is a major public
health problem in Myanmar, with
one in three children sufering
from chronic under-nutrition.
Thats why LIFT and LEARN
have been involved in advocacy
at the national level through
participation in the Scaling Up
Nutrition (SUN) movement a
global initiative that Myanmar
signed onto in 2013 to show
its commitment to addressing
malnutrition.
During August, which is
Nutrition Promotion Month in
Myanmar, LIFT and LEARN
are focusing on the crucial rst
1000 days of life, especially by
promoting dietary diversity for
pregnant and breastfeeding
women and children from 6 to 24
months.
By integrating nutrition into
projects that aim to improve the
food security and livelihoods of
the poor, LIFT intends not only to
improve current livelihoods but
also to break the intergenerational
cycle of poverty and food
insecurity in Myanmar.
For more, please watch the 1000
Days video at www.lift-fund.org
The Livelihoods and Food Security
Trust Fund (LIFT) is a multi-donor
trust fund supported by Australia,
Denmark, the European Union,
France, Ireland, the Netherlands,
New Zealand, Sweden, Switzerland,
the United Kingdom and the United
States of America. School gardens
form part of one of the current 58
projects it supports to assist the
rural poor in Myanmar.
Nutrition
Promotion
Month
Teaching takes place in both classroom and garden plot sessions. Photo: Leslie Koo
At harvest time, vegetables are shared among the class. Photos: Leslie Koo
4
Top docs
W
E at The Myanmar
Times therefore
dedicate our Healthy
Living special to
Myanmars doctors. We cannot list
them them all gures as of 2012
listed 30,000 registered, of which
5381 were employed in the state
health system but we have polled
a number of experts to help us
assemble a list of 100 notable names
in the medical eld.
We print these names as a tribute
to all doctors, everywhere as
well to as all the nurses and other
healthcare workers who struggle
each day on the front lines of health
to keep our country safe.
Cardiology
Prof Daw Mi Mi Cho
Prof U Tint Swe Latt
Chest physicians
Prof U Kyaw Myint
Prof Tin Maung Cho
Prof U Win Naing
Prof Daw Yadanar Kyaw
Ear, nose & throat surgeons
Prof U Khin Maung Than
Prof U Myo Minn
Dr U Nyan Win
Prof U Thar Hlaing
Prof U Thein Tun
Endocrinology
Prof U Aung Than Batu
Prof U Khin Maung Htay
Prof U Khin Maung Maung Than
Prof U Minn Naing
Prof Rai Mra
Prof U San Lwin
Eye surgeons
Prof Khin Ohnmar Khine
Prof U Kan Nyunt
Prof U Ko Ko Tin
Prof Daw Lay Khine
Prof U Min Thane
Prof U Mya Aung
Prof U Myo Khine
Prof U Than Aung
Dr U Zaw Minn Din
Gastro-enterology
Prof U Myo Myint Aung
Prof Daw Than Than Aye
Prof U Thein Myint
Prof U Thein Saw
Prof Daw Tin Tin May
Neurology
Prof Daw Nwe Nwe
Obstetrics and gynaecology
Prof Daw Cherry Than Than Tin
Prof Daw Khin Myint Myint Than
Prof Daw Khin Mon
Prof Daw Khin Saw Hla
Prof Daw Khin Thein Oo
Prof U Myint Maung Maung
Prof Daw San Thi
Prof Daw San Yi
Prof U Soe Lwin
Dr U Tin Maung Aye
Dr U Win Sein
Oncology
Prof Daw Thida Sann
Prof Daw Shu Maw
Prof U Soe Aung
Orthopaedics
Prof U Aung Than Tun
Prof U Hla Min
Dr U Kan Tun
Prof U Khin Maung Han
Prof U Kyaw Myint Naing
Prof U Min Lwin
Prof U Myint Thaung
Prof U Nay Win
Prof U Thein Myint Tun
Prof U Zaw Wai Soe
Paediatrics
Prof Daw Aye Aye Myint
Prof Daw Aye Aye Thein
Prof U Aye Maung Han
Prof U Bo Htut
Prof U Hla Myint Tun
Prof Daw Kyu Kyu Khin
Prof U Saw Win
Prof U Thein Aung
Prof Daw Thein Thein Myint
Prof U Ye Myint Kyaw
Pathology
Prof Daw Aye Aye Than
Prof Daw Mie Mie Sein
Daw Saw Mya Yee
Physicians
Prof Daw Khin Yee
Prof U Khin Maung Win
Prof Daw Myint Myint Khin
Prof U Myo Thwe
Prof U Than Sitt
Prof U Tin Latt
Prof U Win Naing
Psychiatry
Prof Daw Sein Lwin
Dr Nyi Win Hman
Prof U Thu Ta
Radiology
Prof Daw Khin San Tint
Dr Saw Kyaw Aung
Prof U Myint Kyu
Prof U Saw Lwin
Dr Khin Swe Tin
Prof U Toe Win
Skin
Prof Khine Khine Zaw
Prof U Minn Swe
Prof U Swe Myint
Surgeons
Prof U Han Win
Prof U Khin Maung Aye
Prof U Khin Maung Lwin
Dr U Min Thu
Prof U Myint Thein
Prof U Norman Hla
Dr U Nyan Thein
Prof Saw Simon Tha
Prof U Than Aye
Prof U Toe Lwin
Prof U Win Myaing
Prof U Ye Myint
No occupation is more highly prized in Myanmar
than that of the doctor. And with good reason
they repair us when we are injured, heal us when
we are ill, reassure us when we are worried.
100 prominent names in the medical profession
YANGON
Private hospitals
Asia Royal General Hospital
14 Baho Street, Sanchaung
(01) 538055
asiaroyal@asiaroyal.com.mm
www.asiaroyalhospita.com
Aung Yadana Hospital
5/24, Thirigon Estate, Waizayantar Road,
16/2 Block, Thingangyun
(01) 8551355
aychospital@gmail.com
www.aungyadana.com
Bahosi Hospital
Bahosi Housing Complex, Wa Dan St,
Lanmadaw
(01) 2300502~30, 2300631 (hotline)
info@bahosimedical.com
www.bahosimedical.com
Parami General Hospital
60 New Parami Road, Mayangone
(01) 657228, (01) 651674 (hotline)
info@paramihospital.com
www.paramihospitalygn.com
Pun Hlaing International Hospital
Pun Hlaing Golf Estate Avenue, Hlaing
Tharyar, (01) 684323
enquiry.phih@spa.com.mm
www.punhlainghospital.com
Shin Par Gu Hospital
71-73 Banyardala Road at Pho Sein Road,
Bahan, (01) 549768, (01) 554805
Thiri Sandar Hospital
130 Thayagone Street, Insein
(01) 640259
thirisandar.ygn@gmail.com
Witoriya (Victoria) Hospital
68 Taw Win Street, 9 mile, Mayangone
(01) 9666141
info@witoriyahospital.com
www.witoriyahospital.com
Government hospitals
Central Womens Hospital
Min Ye Kyaw Swa Road, Lanmadaw
(01) 222804, (01) 222805
New Yangon General Hospital
Bogyoke Aung San Road, Lanmadaw
(01) 384493
Orthopaedic Hospital
132 Hanthawaddy Road, Kyeemyindaing
(01) 527088, (01) 530120
Yangon Childrens Hospital
2 Pyidaungsu Yeikthar Road, Dagon
(01) 222807~10
Yangon Ear, Nose & Throat Hospital
Corner of Byaing Yae Oh Zin Street and
Banyar Dala Road, Tarmwe
(01) 543888, (01) 557207~9
Yangon General Hospital
Anawrahta Street, Lanmadaw
(01) 281722, (01) 281440
Waibargi North Okkalapa Hospital
(Infectious Diseases Hospital)
Waibargi Street, North Okkalapa
(01) 690119, (01) 690174
Private clinics
Aung Yadana Medical Centre
1 Waiza Yan Tar Road at Yadanar Street,
Thingangyun
(01) 561878
Australian Embassy Medical Clinic and
Dental Surgery
Unit 206, Golden Hill Tower, 24-26 Kaba
Aye Pagoda Road, Bahan, (01) 558353
mark.hampson@dfat.gov.au or
aussieclinicyangon@gmail.com
Bahani Medical Centre
Bahani Housing Compound, Lanmadaw
(01) 212932-39
Green Cross Specialist Centre
101-A, Lanthit Street (near Mawtin
Junction), Lanmadaw
(01) 2300551, (01) 2300652~3
International SOS Clinic Yangon
Inya Lake Resort, 37 Kabar Aye Pagoda
Road
(01) 667879; (01) 667877 (24-hour hotline)
olivier.cattin@internationalsos.com
www.internationalsos.com/
Kembangan-Radiant Medical &
Aesthetic Centre
365/367, Bo Aung Kyaw Street,
Kyauktada
(01) 392484, (01) 392590
LEO Medicare
Inside Victoria Hospital, 68 Taw Win
Street, 9 mile, Mayangone
09-49218410 (24-hour)
info@leo.com.mm
www.leomedicare.com
http://www.gelsdorfmd.com/leo-
medicare.html
Mahar Myaing Medical Centre
308 Pyay Road, Sanchaung
(01) 504927, (01) 503825
Pacic Medical and Dental Care
81 Kabar Aye Pagoda Road, Bahan
(01) 548022
Paragu Clinic
140/144 Anawrahta at 48
th
, Botahtaung
Pinlon Clinic
9/1 Saya San Road, North Dagon
(01) 581329
Pun Hlaing International Hospital
Specialist Clinic
FMI Centre, 4
th
oor, 380 Bogyoke Aung
San Road
(01) 243010, (01) 243012
www.punhlainghospital.com/our-
satellite-clinic
Royal (Taw Win) Medical Centre
760 Mahabandoola Road (at 15
th
Street),
Lanmadaw
(01) 225787, (01) 225980
Sakura Medical Centre
23 Shin Saw Pu St, Sanchaung
(01) 510079, (01) 510186
Sedona Clinic
Room 1009, Sedona Hotel, 1 Kabar Aye
Pagoda Road, Yankin(01) 666900x7198
Shwegondine (SSC) Specialist Centre
7 Shwegondaing (East) Street, Bahan
(01) 544128, (01) 544116
shwegondinehospital@gmail.com
SML Medical & Diagnostic Centre
003/004, Dagon Tower, Kabar Aye
Pagoda Road, Shwegonedine Junction,
Bahan, (01) 554463-3
30
th
Street Clinic
191-193 30
th
Street, Pabedan
(01) 246177, (01) 286921
Yangon International Clinic
Summit Park View Hotel, 350 Ahlone
Road, Dagon
(01) 211888x180
Yangon Medical Center (YMC)
126-A Dhammazedi Road, Bahan
(01) 524851, (01) 524859
Eye specialists
Dr Zaw Minn Din, Myanmar Eye Centre
http://theeyetrust.org/the-team-in-
myanmar_73_3.html
Dr Than Win, NEO Vision Eye and
Optical Centre
141/149 Bagayar Condo, Myaynigone
(01) 518084/5
Dental clinics
Dr Aung Myint
32A Pyidaungsu Lane / Kokine Swimming
Pool Road, Bahan
(01) 556434, (01) 541770
Dr Tun Tun Thwe
2
nd
oor, Sakura Tower, 339 Bogyoke
Aung San Road, Kyauktada
(01) 255118
Mr Dentist and MiCasa Dental Clinic
MiCasa Apartments, 17 Kabar Aye
Pagoda Road, Yankin
(01) 650933
Mr Dentist
Room 245/246, Summit Parkview Hotel,
350 Ahlone Road, Dagon
(01) 211966x245, (01) 211888x245
MANDALAY
Mandalay Childrens Hospital
Corner of 30
th
and 74
th
streets
(02) 21508
Mandalay General Hospital
30
th
Street between 74
th
and 77
th
(02) 21041
Mandalay Orthopaedic Hospital
30
th
Street between 74
th
and 77
th
(02) 21511
Universities Hospital
Aung Mingala Ward, University Estate
(02) 21805
NAY PYI TAW
Bawga Theikddhi Hospital
Zabu Thiri
(067) 432361
Kembangan Skin and Wellness Centre
Ziwaka Medical Zone, Za 8, Thapyaygone
Market, Zabu Thiri
0973250244
Yezin General Hospital
937 U Bwar Street at Mg Khin Street,
Pyinmana
(067) 22400
Yezin Womens Hospital
11 Mg Khin Street, Pyinmana
(067) 22400
Healthcare guide
5
LUN MIN MANG
W
HEN you feel ill, do you go to the hospital or
to a private clinic? Most urban people who
can aford the service prefer private clinics
to government hospitals.
Some even go further, leaving the country entirely. In
April, Vice President Dr Sai Mauk Kham announced that
Myanmars lack of modernised medical equipment, medical
technicians and human resources leads to a patient drain to
neighbouring countries equal to US$200 million.
Information from the Ministry of Health shows how
private health expenditure vastly outweighs national public
expenditure. Shockingly, according to MOH data, the
governments average health expenditure in 1988 was just
K11.8 per citizen.
Total government health expenditure increased from
K461.1 million in 1988-1989 to K86,547 million in 2010-2011.
On January 7, 2014, the health budget increased from
3.15pc to 3.88pc of general government expenditures.
But after a quarterly meeting of government ministries,
two accusations emerged. The rst was bad management
caused poor performance and the second was too much
expenditure without cost-efectiveness.
On April 29, Vice-president Dr Sai Mauk Kham told
the National Health Committee that despite a four-fold
increase in health budget over the past three years,
there has been no signicant progress in the healthcare
standard provided to the public.
Patients themselves are therefore left footing the bill.
A proposal paper, Description of Action (2012-2016) by
3MDG (3 Millennium Development Goals) described the
situation as follows:
Inadequate funding for the health sector is the main
underlying challenge. Public expenditure on health is
very low, at less than US$1 per capita per year. Overall per
capita health expenditure, including donor support, public
and out-of-pocket expenditure, is less than US$8 per year.
International estimates for the cost of nancing an essential
package of health services range from US$12 to US$34 per
capita per year. Out-of-pocket expenditure represents more
than 80% of total health expenditure and relates to care-
seeking from both the public and private sectors.
Low funds, high costs
Financial
Year
Government Health
Expenditures as % of
Gross Domestic Product
Government Health
Expenditures as % of General
Government Expenditures
2010-11 0.20 1.03
2011-12 0.21 1.05
2012-13 0.76 3.14
Source: Financial Allocation to Social Budget, Social Protection Conference, June
25-26, 2012, Nay Pyi Taw
MYO LWIN
How many types of mental
illnesses are there?
There are at least 350 mental
disorders or illnesses, depending
on which classication system one
uses.
How are mental disorders
classied?
A common way of looking at
mental disorders is in terms of
severity. Traditionally they were
classied as neurotic disorders
(more-or-less mild disorders) and
psychotic disorders, which are
much more severe. There are also
disorders which are due to organic
causes (ie brain disease) as well as
mental disorders due to medical
conditions.
Which are most common?
The most common disorders are
anxiety disorders. Depression
disorders are also rising all over the
world, especially in the developed
world, and are predicted to be a
major public health problem in the
future by the WHO.
Where can we learn more about
mental health?
Online, www.beyondblue.org.au or
www.sane.or.uk are good resources
that can provide good information.
What about here?
Locally, as you may know, the
academic discipline of psychology,
like many other disciplines, had
been completely decimated in
the past half-century. We are now
trying to rejuvenate it.
One signicant step is the
formation of the Myanmar
Psychological Association (MPA),
founded by a group of former
psychology students. With the
help of a leading patron and
many others, these academics and
professionals are trying to revive
psychological healthcare.
For instance, we are trying to
incorporate what we call industrial
and organisational psychology,
which is concerned with
management, personnel selection
and placement for workplaces.
We also aim to undertake applied
eld studies and investigations
to evaluate social services run by
NGOs or the UN.
Training courses can also build
counselling and psychosocial
support. Later, if possible, my
aspiration is to set up a clinical and
mental health psychological (not
psychiatric) service.
Speaking of
Mental health, with Dr Nyi Win Hman
6
NANDAR AUNG
nandaraung.mcm@gmail.com
AS modern lifestyles become more
fashionable, women more than
men are increasingly pressured to
slim down, whether by taking diet
pills, changing their eating habits,
doing yoga or exercising at the
gym. Some of these plans work out
better than others.
The best weight-loss plan is
always working out at a gym,
says Ma Htet Htet, a 30-year-
old accountant. I used to take
medicine to lose weight but there
have some side efects like hair loss
and dry skin. So I stopped and did
yoga class instead.
She says the yoga helped her stay
calm and made her more exible,
but didnt help her lose weight. And
she said as the number on the scale
grew, her self-esteem dropped.
My work involves sitting all
day, and being busy with the
computer and with paperwork. So
everything I eat makes me bigger,
and gradually my slim body turns
to fat.
Without an active workout
routine, she found she was often
feeling out of shape, sweaty and
tired. She became stressed about
her body image and felt less self-
condent as a result.
Ma Htet Htet was in a position
many women share: She wanted to
exercise but wasnt sure the gym
was right venue for her. She had
been going to a co-ed gym, but
said as a single woman she felt
uncomfortable exercising in the
company of men.
Myanmar women are
traditionally expected to dress
modestly, meaning a full-length
longyi and a conservative top.
That outt doesnt work well for
activewear, though, and Ma Htet
Htet felt uncomfortable stretching
and exing her body in exercise
clothing while in the company of
men.
This problem stopped her from
going to the gym entirely but that
left her feeling worse about herself.
Thats why, when she found a
a women-only gym near her work
in January 2014, she registered at
once.
Women-only gyms are gaining
popularity in Yangon. As more
women are looking for tness
outlets but arent comfortable
working out with men, the gyms
create safe spaces in which
exercisers dont have to deal with
the hassle of who is watching, and
can instead focus on getting into
the zone a good workout requires.
I dont get annoyed by anything
while I exercise here, Ma Htet Htet
said. Now I feel comfortable when
exercising wearing a skinny jumper.
I will play here every day to get
my slim body back.
In keeping with the general
lifestyle changes in Yangon over
the past three years, the number of
gyms in the city has increased, says
Daw Win Ma Ma Kyaw, 41, who
runs a womens-only gym on 35
th

Street in Kyauktada township.
Men are not allowed without
permission, reads the large red
warning sign in front of Smart
Girl, Daw Win Ma Ma Kyaws
women-only gym, a 50-by-50 foot
apartment on the third story of the
building.
As a teenager, Daw Win Ma
Ma Kyaw learned aerobics from a
female trainer and exercises from
a male trainer. She clipped out
exercise pictures from magazines
and tried to emulate what she saw
in her routines.
Since starting her rst gym in
2005, she has opened two branches
in Yangon and two in Mandalay,
together employing over 30 female
staf. She says she trained girls who
had started working out around the
ages of 14 and were interested in
exercise, and taught them to turn
their hobby into a living.
She says the gym industry here
has the wrong approach overall
when it comes to co-ed workouts.
People think if they open a gym
for both genders they will make
more money, she said. But this
is wrong. Today women are taking
more care of their bodies and their
appearance than men are.
The four Smart Girls gyms
attract over 100 steady customers
with the latest equipment. But
there are also smaller women-only
gyms, like Beauty Sweet in Tarmwe,
which has operated since 2009.
Ive got 20 women who work
out monthly at my gym, says
Daw Wah Wah Shein, 44, a former
Ministry of Sport trainer who
opened her rst women-only gym
at the age of 21 in her hometown
of Pyay.
Daw Wah Wah Shein said it is
true that the number of gyms has
increased in Yangon, but she says
the city still needs more locations
just for women.
She also says that the tness
boom is actually squeezing smaller
neighborhood operators like hers
out of the business.
With the increasing number
of gyms in Yangon, I got fewer
customer every month, Daw Wah
Wah Shein says.
To keep on paying rent, its not
enough to operate as a gym only,
she says. Now shes diversifying her
oferings.
I opened a women-only gym
paired with a beauty salon and
a weight-loss business with
medications.
For her
eyes only
Women-only gyms offer a
comfortable space for exercise
FIONA MACGREGOR
newsroom@mmtimes.com
L
AUGHTER, so the saying
goes, is the best medicine.
And when it comes to
provoking a good belly
laugh, the slap-stick physical humour
associated with clowning is one that
can easily break through cultural
and linguistic barriers.
The great comic actor Robin
Williams, who passed away last
week, brought to the big screen the
story of Hunter Patch Adams, an
American physician and clowning
enthusiast who believes humour and
laughter play a vital role in keeping
people healthy in body and in mind.
You treat a disease, you win, you
lose. You treat a person, I guarantee
you, youll win, no matter what the
outcome, said the character of Patch
played by Williams in the 1998 lm,
Patch Adams.
Every year, the real Mr Adams
organises an annual clown trip in
which a group of volunteers travel
to diferent countries to perform for
sick and vulnerable people. And one
of his acolytes was recently inspired
to do some clowning herself on a trip
to Rakhine State.
I rst dipped my toe into
clowning for vulnerable populations
in Amman, Jordan, in October 2013,
recalls Nora Rowley, MD. I was at
a conference where Patch Adams
and his clown entourage presented
and attended. The entourage
came from various countries with
various organisations. Patchs is the
Gesundheit Institute.
The principle, she says, is simple:
Clowning for healing is sharing
positivity, fun and laughter.
On her next trip to Sittwe, the
Rakhine State capital, she was
inspired to put some of the skills
shed learned into practise at an IDP
camp for people made homeless by
communal violence which broke out
there in 2012.
Dressed in a tutu, tights, net
gloves and colorful clownish attire,
she admits she drew some odd
glances when she stepped out of her
hotel into the streets.
At the IDP camp with the kids,
there were so many, and they were
so excited, that I could not organise
them into a group activity, she
recalls of various ball games she
attempted to instigate.
I had just sprained an ankle and
the ground was uneven dried rice
paddy elds. So, my running was
funny looking which made the boys
howl with laughter: Any laugh is a
good laugh.
I struggled with many boys to get
a hold of and take the balls back and
I fell over while wrestling with them
a few times, which made them and
the adult crowd watching gasp and
laugh, which was the point!
Yet conditions in the Rakhine IDP
camps, where the Muslim people
who call themselves Rohingya are
denied access to sufcient food,
medical treatment and many
basic human rights, have horried
international observers. Can
clowning really help in such dreadful
circumstances?
Whether the beneciaries are
sufering primarily physical illness
or brutal apartheid human rights
abuses, sharing laughter, smiles
and joy even just a movement in
time and especially with someone
outside the community is healing
in bringing the beneciary a
sense of communal belonging and
love, rather than loneliness and
abandonment, Ms Rowley says.
And there is growing evidence to
back up the signicant benets of
laughter to both body and mind.
Numerous scientic studies have
associated laughter with a range of
health benets including healthy
circulation, a boosted immune
system, lower blood sugar levels
in those with diabetes, improved
relaxation and sleep, and pain
reduction.
And just in case anyone fails to
take it seriously, there is even a name
for the scientic study of laughter:
gelotology.
Nora Rowley brings comic relief to
children during a visit to Rakhine State
earlier this year. Photo: Supplied
Clowns without Borders entertains children in Rakhine State in September 2013. Photo: www.clownswithoutborders.com.au
Clowning around
Clowns bring laughter to those in need
even in impoverished Rakhine
7
In a recent article in Psychology
Today magazine, one of the pioneers
of gelotology, William F Fry, professor
emeritus at Stanford University,
described some of the ndings he and
fellow experts have made since they
began work in the 1960s.
Mirthful laughter has a
scientically demonstrable exercise
impact on several body systems, he
wrote.
Muscles are activated, heart rate
is increased, respiration is simplied
with increase in oxygen exchange
all similar to the desirable efects of
athletic exercise.
And when it comes to the
psychological benets of laughter,
Dr Fry believes laughter can be an
important therapeutic tool.
Stress is antagonised by humour
in both its mental or emotional aspect
and its physical aspect. Emotional
tension contributing to stress is
lowered through the cathartic efects
of humour. Mirthful laughter is
followed by a state of compensatory
physical relaxation, diminishing
physical tension, he said.
All of this certainly suggests that
clowning around can, in the right
circumstances, have some seriously
benecial side-efects.
And Ms Rowley is not the rst
person to bring the benets of
clowning to people in Myanmar.
Clowns without Borders is a
federation of clowning organisations
that aims to bring laughter to
relieve the sufering of all persons,
especially children, who live in areas
of crisis including refugee camps,
conict zones and territories in
situations of emergency.
The organisation has been active
in Myanmar since a group of French
clowns arrived 2004. After Cyclone
Nargis devastated the country in
2008, a broader efort to reach out to
afected communities was developed
with clowns from Sweden, Belgium
and US all participating.
Among these was American
Moshe Cohen, who took part in a
three-year CWB program which gave
clowning workshops and visited
schools with the aim of bringing
laughter to children afected by
poverty, orphans and those afected
by HIV/AIDS.
CWB says it recognises that
our work is made up of small
moments. Although small and
purely emotional, these moments
build upon each other staying with
children as they grow and support
their incredible resilience.
And, it acknowledges, We
are not doctors, psychologists or
social-workers, but together with
these professionals and community
participation we create joyful
experiences from which children and
their communities thrive.
The project succeeded in creating
waves of laughter in places where it is
really needed, concluded Mr Cohen
in his report on CWBs Myanmar
initiative and its achievements.
Now thats enough to put a smile
on anyones face.
WADE GUYITT
wadeguyitt@gmail.com
I
N 2006 the Satisfaction with
Life Index which paired
interviews with development
factors to determine a world
map of happiness ranked the
small landlocked Himalayan country
of Bhutan eighth out of 178. Nearby
countries ranked much lower: China
was 82: Bangladesh, 104; India,
125. (Myanmar was 130.) What sets
Bhutan apart from those around it?
The simple answer is that the
country measures its success not
with Gross Domestic Product but
Gross National Happiness. In 1972,
when King Jigma Singye Wangchuck
ascended the throne, the country was
extremely isolated and sufered some
of the highest rates of poverty and
child mortality in the world. It was
apparent the country needed to open
up, but the king was keen to do it on
his terms, for the good of the country.
A casual mention of gross
national happiness led to a
nationwide 7-hour survey being
conducted to measure the
populations well-being and to
determine what was needed. Four
pillars of gross national happiness
were born: sustainable development,
environmental protection, cultural
preservation and good governance.
Today, a Gross National Happiness
Commission reviews decisions and
determines how resources will be
spent, with the top priority being the
well-being of the people.
That shouldnt sound radical,
but it is and the results are too.
Bhutans literacy rate has climbed;
its child mortality rate has fallen.
Development has been slow but
steady. Gross national happiness
requires engagement with the
outside world in a way that protects
local culture. Its environmental
conservation has also been praised
no small feat when, in 2007, the
countrys economy was the second-
fastest growing in the world. Bhutan
is also the rst country in the world
to have banned tobacco sales, in 2010.
All of this made the king
immensely popular, but he still
decided to institute a switch
from monarchy to constitutional
monarchy, then to democracy, and
voluntarily gave up power in 2008.
His ideas, however, are spreading.
In July 2011 the United Nations
invited member countries to measure
the well-being of their populations.
In 2012 the prime minister of Bhutan
chaired a high-level UN meeting on
happiness and well-being. A World
Happiness Report was published
by the United Nations Sustainable
Development Solutions Network
(UNSDSN), followed by another in
2013. And the OECD (Organization
for Economic Cooperation and
Development) has set international
standards by which well-being can be
measured.
The core of the World Happiness
Report is the evaluation of two
distinct types of happiness: happiness
yesterday, charting recent emotions;
and happiness generally, in terms of
ones position in life.
This dual testing allows the report
to dig below the surface-level reports
of travellers to developing countries,
who are often amazed to nd people
there seeming very cheerful.
The good news is that the
second report nds that happiness
worldwide seems to be improving,
with more countries showing a climb
than a fall.
The bad news is that mental
health the single most important
determinant of individual happiness
is undervalued everywhere. About
10 percent of the worlds population
sufers severe depression or anxiety,
but even in advanced countries only
a third of those who need it are in
treatment.
One issue the report identies
is that in pre-modern traditions,
happiness was allied with moral
character. In the 1800s, however,
as the consumer society took hold,
happiness became associated with
material conditions, especially
income and consumption.
This is not to say that material
conditions should not be looked
at when seeking ways to boost
happiness, but rather that there is
not a clear one-to-one correlation
between happiness and wealth.
With that in mind, how happy
is Myanmar? Despite the tourist
perception of Myanmar people as
always smiling, the nation ranks only
121
st
out of 156 countries when it
comes to happiness. And despite the
shift to civilian rule, the gures say
national happiness actually dropped
between the periods of 2005-7 and
2010-2. Respondents in Myanmar
ranked their lives 4.4 out of 10, down
from 5.3 in the earlier survey, and
that was the third-biggest drop in the
world: Only Greece and Egypt fell
more, both having sufered political,
social and economic turmoil.
Perhaps the changes have alerted
people to how much better they
would like their lives to be, but have
yet to fully deliver on the promise.
Either way, it seems the smiling
image of Myanmar doesnt yet tell the
whole story.
Happiness, and
how to measure it
Exploring Bhutans gross national happiness
For more on the World Happiness Report,
including a link to download it, visit:
http://unsdsn.org/resources/
publications/world-happiness-
report-2013/
Just in case anyone
fails to take it seriously,
there is even a name
for the scientic study of
laughter: gelotology.
8
What mindfulness means for your body
What do you do to keep fit?
Religious practice aside, regular meditation brings a number of valuable health benefits
TUN TUN
newsroom@mmtimes.com
M
EDITATION is enjoying
a modern revival.
Experts (and others)
from a variety of
elds tout the supposed benets of
meditation, with claims ranging the
gamut from plausible through the
incredible. Healing, body temperature
control, work-life benets, levitation
and communication with cosmic
beings are just a few of the supposed
results. With meditation being
incorporated into a wider variety
of health, personal development,
education, and even penal programs
more and more people are turn
to meditation in their quest for
happiness and quality of life
improvement. As meditation gains
traction, understanding its benets
becomes more important. Is
meditation truly a silver bullet
for health and happiness, or
just another passing health
fad? Science may hold the
answer.
Though commonly
associated with
Buddhism, some of
the oldest records of
meditation outdate it,
and can be found in the
ancient Hindu Vedas,
commonly thought to
have originated around
1500 BCE. Meditation,
if dened loosely, is
present in almost all major religions.
Meditation is mentioned in the Torah,
practised in Su Islam and included
in some Christian practices. This
lack of inherent denition is one of
the major obstacles to the scientic
study of meditation: Diferent schools
of thought and practitioners advise
diferent practices, making it hard to
compare efects.
Meditation in a religious context
is often a personal and spiritual
experience, meaning that there
may be as many denitions of
meditation as there are people
practising. Meditation practices
vary by tradition and can include a
large variety of diferent steps. Some
common elements of meditation
involve: a focusing of attention, an
open attitude toward distractions,
attention to and control of breathing,
repetition of mantras or prayers,
maintaining particular poses, and
symbolic visualisation.
While varied traditions make
claims about the efects of
meditation, science has its own
way of measuring results. The
multidisciplinary study of
meditation has become more
popular of late, yet it remains
a eld still in its infancy,
and questions outweigh
answers. Extensive review of
scientic literature reveals
irreconcilable variance in
the methods and measures
used to study meditation. This
complexity clouds the reliability
of ndings, making it difcult for
scientists to compare and correlate
data for diverse studies.
Despite these challenges, decades
of study have both debunked some
proponents of more fanciful claims
and provided general support for
meditation and its positive efects on
mind and body.
Meditations most commonly
studied incarnation, Mindfulness-
Based Stress Reduction (MSRB),
was developed by a University
of Massachusetts professor in an
attempt to bring meditation into the
secular world of science by creating
a standardised mindfulness program
to be used in clinical and research
settings. While distinct from Buddhist
meditation, MBSR is inspired by
traditional Vipassana techniques
practised (and birthed) in Myanmar.
A typical MBSR program takes
place in a group over eight weeks
and incorporates breathing,
focus and Yogic body exercises.
Its founder, Jon Kabat-Zinn,
describes the practice as one of
cultivating moment to moment
non-judgmental awareness. MBSR
is today included in hundreds
of therapeutic programs, with
thousands of licensed instructors.
As Myanmar modernises, busier
work schedules, increased access
to technology and a shifting social
strata are sure to bring about more
stressful lifestyles. Readers looking
to avoid, mitigate and nd better
coping mechanisms for dealing with
stress should consider taking part in
mindfulness programs.
Comparative psychological
studies have shown that meditators
in highly stressful environments
are signicantly better at coping
with stress and reducing anxiety,
especially when meditating regularly.
Working memory, often used
synonymously with short-term
memory, allows us to keep chunks
of information in our mind and
use them a skill critical for ofce
and school success. Mindfulness
meditation has been positively
associated with working memory in
numerous studies, which suggests
that students and anybody seeking
to boost their cognitive performance
should consider mindfulness
programs.
Mindfulness is also strongly
associated with a reduction in
mind-wandering. When your mind
wanders, not only do you perform
poorly the task at hand, but you also
are more susceptible to negative
thoughts. Cultivating mindfulness
is a powerful way of reining in
your wandering mind, and appears
particularly efective for those who
are prone to distraction.
Finally, regular mindfulness
practice is associated with better
pain coping. Studies show patients
with chronic psychological and
physical pain were better able to
cope with pain when undergoing
regular mindfulness programs
compared with those who werent.
While these studies didnt show
an actual reduction in pain, the
lived experience of meditators was
nonetheless improved.
As with many healthy life
choices, meditation is best practised
regularly. Meditation centres
and courses are excellent ways of
learning techniques and gaining
experience, but the real benets will
come in time, with daily practice,
as part of a regular routine in the
course of your busy day. Think of
meditation as a form of exercise for
your mind you wont see results
overnight, but consistent efort will
yield benet over time.
People in Myanmar are
fortunate to have access
to a variety of Buddhist
meditation programs, centres
and communities. Readers
seeking secular programs
are encouraged to research
this online. The following are
helpful places to find out more
information in Yangon.
Dhamma Joti
Meditation Centre
Wingabar Yele Monastery
compound, Nga Htat Gyi Pagoda
Road, Bahan township
www.dhamma.org/en/schedules/
schjoti
Chanmyay Yeiktha
Meditation Centre
55A Kabar Aye Pagoda Road,
Mayangone township
www.chanmyay.org
Mahasi Meditation Centre
16 Sasana Yeiktha Road, Bahan
township
www.mahasi.org.mm
Weekly Yangon
Meditation Group
Tuesday morning meetings starting
in September, featuring meditation
sessions, teaching and discussion.
All levels welcome. Contact Stacy
at sgzumbroegel@gmail.com for
details.
U Thaung Nyunt
67, translator
I dont do any particular exercise. But I have walked
a lot, ever since I was young. It is good for all the
internal organs when you move. Walking is good for
blood circulation and your heartbeat. I walk around
Kandawgyi Lake. It is quite sufcient for health once
Ive nished going around the lake. I also walk on the
Inya Lake bank. But on rainy days I dont walk.
As a translator, the nature of my job is sedentary
and I need to be careful not to be sitting long hours
at a time. I take Centrum silver vitamins every day.
If I sit after dinner, the food doesnt digest well so I
I need to take a walk. I dont eat much now, as my
digestive power is getting weak. I also like jumping
rope and playing chinlone. There is a difference
between those who look after their health and
those who dont.
Aung Kyaw Nyunt
Translation by Myo Lwin
Ko Myo Htut
21, sailor
I think everyone should be
doing some kind of exercise
for health. I do some warm-
up exercises before taking
a bath. I go to a gymnasium
with my friends. Doing
exercise at the gym creates strong muscles and
increases stamina. Food is important to build up the
muscles. It wont be effective if we just do exercise
and dont eat well. I dont exercise to have big
muscles. I just want the sort of muscles that a man
should have. And then I also want to be looking
nice when I dress up.
Some try very hard to have more big muscles. They
also take medicine. It shouldnt be like that. And
also, doing exercise at a gym is not the only thing
we can do for our health. There are many other
forms of exercise to make you healthy.
Ko Thein Htoo Aung
22, bank employee
I dont do exercise regularly
like some other people. But I
play football with my friends
on weekends. I also swim and
play basketball. I think playing
football is good for health.
As we need to run almost all the time, it increases
my stamina. Swimming also has the same effect,
including good breathing exercise. Basketball reduces
fat dramatically. All sports are good for health. If time
permits, one should be doing at least one sport.
As I am working, I cant do any kind of sport during
the week. I can only do one of the sports on Saturdays
and Sundays. Actually, being in a hurry to be on time
at the ofce each day is a daily form of exercise. I dont
eat much food from outside. I choose clean and hot
food. We need to be careful with what we eat. Food
should be good for the stomach.
Ma Shwe Yi Myint Myat Aye
16, student
Previously, I did nothing for
my health. I used to be busy
with my school lessons. Only
after nishing matriculation,
I started going to the gym. I
like to trim down. I need to
get rid of the fat in my body. It didnt take long at the
gymnasium before I was able to start cutting down
extra pounds. Sometimes also I go out swimming
with my brothers.
Food is also important to keep the body in good
shape. I normally avoid fatty foods. Some girls
avoid certain foods or dont eat dinner at all so
they will look slim. That is not good. Its bad to not
eat regularly. Some even take medicines to keep
them slim and looking good. But I dont do that. I go
to the gym. I try to eat foods that are good for my
body. I dont take much fatty food. I do it like that.
9
Young
at heart
What do you do to keep fit?
Dance classes help people of all
ages relieve stress, stay active and
have fun
NYEIN EI EI HTWE
nyeineieihtwe23@gmail.com
A
S times change, lifestyles
change also, and though
living standards are
improving, many people
are also breathing polluted air,
eating more packaged or preserved
food, and facing increased stress
both physical and mental. Its
particularly difcult for middle-aged
people to stay healthy, as they dont
traditionally play sports or move
around a lot the way younger people
do.
To keep in shape, however, some
are nding ways to kick of their
stress and shake out their bodies by
dancing.
Daw Wint Maw, 50, has been
dancing for ve years. She says her
dance group makes her feel fresher,
healthier and younger.
I was fat and my skin was
loose when I started to dance, she
remembers. But soon after I felt
slimmer and started to lose weight.
Daw Mwint Maw rst got the idea
to take up dancing when chatting
with her closest friends. She says
its something they do together, and
though her husband supports her
its not something she wants to do at
home. Thats why shes glad to have
Queen Rose Dance Club.
I dance three times a week but
not in my home because I dont
want to dance in front of my family
members. So we found a place to
dance with my friends.
Exercise can sometimes be a chore,
and even the most committed nd
there are days that theyre just not
up for it. But Daw Wint Maw said
she always enjoys her dance sessions
because it gives her good results. She
looks at it as a healthy hobby, not
something that should add more stress
to her life.
I see my skin looking younger
and it has also reduced my
cholesterol. So I dont worry about
being able to dance every step
correctly, she said.
Her enthusiasm leads her to
encourage others her age to take up
dancing, because its low-impact,
social and enjoyable.
Ko Aung Min Thu, who teaches
adult dance classes, recommends
dancing an hour a day, three days a
week.
Their dance steps are not
heavy like with young people. It is
just basic and easy, so anyone can
dance, Ko Aung Min Thu said. The
routine is good for the knees, and
the music motivates the mind and
keeps things fun.
He said hes seen the number
of adult dancers increase over the
past ve years, and has had many
requests for private lessons.
The group environment, though,
is part of the enjoyment.
My adult dancers challenge me to
run up the stairs and even to dance
with them. They can dance well so I
dont need to force them to do more
steps, just help them by dancing
together, said Ko Aung Min Thu.
Daw Chaw Su dances six days a
week in Peoples Park, 6-7am except
during rainy season. She got motivated
two years ago when she was walking
by with her husband one morning and
saw a group of women her own age, all
dancing in unison. She said it was her
husband who initially suggested she
should join, and after considering the
idea she agreed, calling it the right
choice for me.
Four or ve groups dance
in the mornings in the park,
with Shwedagon Pagoda in the
background. As well as the physical
workout, its a stress-reliever too, as
during dancing time there is nothing
else to worry about except keeping
up with the music and the other
members.
And after the music stops, its a
good chance for socialising another
part of a healthy lifestyle.
Daw Chaw Su said her dance
friends seem diferent in appearance
and ways of thinking compared to
friends who dont dance.
They look happier and smarter
than other people, as they can reduce
their stress. They are more patient,
she said.
Now its raining a lot and we
have stopped dancing for the time
being. I hope to dance again soon.
WADE GUYITT
DID you know the United Kingdom
spends an estimated $62 million a
year treating 200,000 ip-op-related
injuries? Thats what its National
Health Service calculates and the
UKs weather is not exactly what
we would call ip-op-friendly. So
where does that leave us in Southeast
Asia, where its hot, humid and wet,
where its socially required to kick
of footwear before entering a home
or ofce, and where the majority of
people cant aford or cant access
supportive shoes?
One health concern for ip-
ops is that exposed feet and toes
are obviously more susceptible to
dangerous objects and imbalance on
uneven terrain (a familiar problem
for anyone tackling a Myanmar
sidewalk). But aside from blisters,
cuts and scrapes, researchers say even
walking on smooth surfaces in sandals
for prolonged periods carries health
risks.
A study presented at the 2008
meeting of the American College of
Sports Medicine and conducted by
researchers at Auburn University
videotaped people walking in ip-ops
and compared them to the strides
of those wearing more
supportive footwear. Those
wearing ip-ops tended to
press down or curl their toes when the
heel was lifted, to keep
the footwear in place.
This puts a burden on the
plantar fascia, connective tissue along
the bottom of the foot, and undue
plantar stretching can lead to anything
from tired feet to inammation or
pain, or even heel spurs.
Those wearing ip-ops also
change their way of walking. The
length of a persons stride becomes
shorter, and ankles are slightly turned
in. Researchers speculate this could
contribute to long-term ankle and hip
alignment trouble.
In Southeast Asias hot, wet climate,
however, ip-ops do provide benets
which researchers in the US and UK
did not need to consider. Closed-toe
shoes conne foot growth, pushing the
toes tightly together, which ip-ips
do not.They also allow quick drainage
and airing of the feet, crucial in rainy
season to avoid a build-up of mould
and allowing easy washing.
Theyre also afordable. Over
300 million children worldwide are
estimated to be without any footwear
at all, leaving them at far greater
risk of infection and disease. In
the developing world, where many
are living a subsistence existence,
economics trumps health every time,
and so we at MT salute the humble
ip-op. It may not be perfect, but
in these conditions, its better than
nothing.
Are ips a op?
Photo: Aung Htay Hlaing
10
LUN MIN MANG
lunminlm@gmail.com
I
N early 2005, three young
Myanmar women doctors and
friends decided they wanted to
give back what they had learned
to the community. In September of
that year, they turned their wish into
reality: a non-prot organisation
ofering afordable healthcare to
disadvantaged people. They called it
Better Burmese Health Care.
Dr Myint Myint Sein, Dr San San
Oo and Dr Jalin Sama had known each
other since their student days.
We wanted to give back to the
community, said Dr Sama. What were
we going to do? We asked one of our
teachers, U Tin Myo Win, who is the
personal doctor of Daw Aung San Suu
Kyi, and he gave us the most valuable
piece of advice: to found a clinic.
The group initially intended to
ofer services for free, but due to legal
restrictions they had to ask for a token
payment of up to K500. Those who
could not aford, however, were never
turned away.
We want to provide afordable
healthcare to the poor people of
Myanmar, Dr Sama said. Afordable
healthcare does not mean free-
of-charge health care. We try and
explain to patients that we, the BBHC,
cannot exist for long without enough
funding. Thats why, if the patients
are willing to accept it, we ask for the
amount they can aford. But if they
cannot aford to pay anything, it is no
problem. Its free for those who cannot
aford to pay.
At home and on the road
BBHC operates with ve main
objectives:
To provide poor people with a
sustainable basic healthcare system;
To provide basic health education
through clinics;
To provide continuing training
and education to the health care
professionals who run these clinics;
To establish a network of referral
systems for illness that are beyond the
capacity of the clinics;
To build an enduring healthcare
structure from the ground up that
truly provides for, and is provided by,
the local community.
The rst part of BBHCs mission
is to provide afordable health care
for the poor Myanmar who have
minimal or no access to health care.
To do this, BBHC currently runs two
daily clinics, one in South Dagon
township and another in Kanbeh.
They provide regular GP services
such as exams and tests (including
X-rays, urine tests, blood test,
blood-pressure measurements, and
blood sugar level testing), and give
treatments as required.
They also ofer monthly clinics.
Starting after Cyclone Nargis in 2008,
they initially serviced seven locations,
mainly in New Dagon township, and
ve other places, working as mobile
clinics. Later in the year they became
xed clinics, hosted by monasteries.
Five monthly clinics operate now,
focusing not just on treating illness
but on promoting a healthy lifestyle.
At monthly clinics, we usually
meditate and we call it non-religious
mindfulness practice. It is non-
religious, just a practice for the mind.
And then we do gentle stretching
exercises as a mean of de-stressing our
bodies. Each of the two exercises lasts
10 minutes each. All of us, including
medical staf and patients, participate
in the exercises, Dr Sama said.
The third step we do is an
interactive health discussion. Patients
ask questions on whatever topics of
health they want to know more about.
After this, the clinics begin medical
check-ups and treatment.
Dr Sama said that the clinics
initially functioned like normal GP
clinics, but post-Nargis they found
that the number of people sufering
from non-communicable diseases
was increasing. Because most NGOs
and INGOs focus on communicable
disease, BBHC decided to take a
diferent approach.
Non-communicable diseases such
as diabetes, hypertension, cancer
and asthma have become a threat
to the nation. Our focus changed to
those who are sufering from non-
communicable diseases, Dr Sama said.
Caring for healthcare itself
The second focus of BBHC is the
medical profession itself: to improve
the education of the local professionals
to promote long-term self-sufciency
in healthcare delivery, said Dr Sama.
BBHC has 25 staf members, with
20 doctors and ve support workers
including an accountant, a nurse,
a coordinator, a pharmacist and a
general assistant.
She says the doctors are being
trained and receiving skills and
experience which will help them and
their patients for the rest of their
careers.
By observing both the global
guidelines and national guidelines,
we have to set up the most suitable
guidelines in giving treatment to the
patients. Young inexperienced doctors
are trained to be good doctors, said
Dr Sama.
Doctors at BBHC also have a
chance to join the American College
of Physicians (ACP). Dr Than Win,
my brother, has partnered with Apex
Asia Medical Centre, which provides
sponsorship for the cost of the
scholarship program, she said.
BBHC selects one doctor a year and
has so far sent two doctors overseas.
After graduation from the ACP,
the doctors in return then serve as
supervisors with BBHC for three years,
giving back with the self-reliance,
perception, loyalty and accountability
they have cultivated.
Challenges and chances ahead
Fundraising is one of the necessary
pillars that allows the BBHC to provide
care and opportunities to patients and
staf. Donations are welcome, and Dr
Samas husband Robert takes a leading
role in fundraising programs.
Robert developed the idea of raising
money by auctioning art painted
on diferent mediums, specically
the traditional Myanmar umbrella,
or Pathein hti. Under the name The
Parasol Project, these traditional
umbrellas will be sold abroad by
auction on September 19, with proceeds
going to BBHC and its programs.
Dr Sama said a lack of nances
and the resulting under-training of
doctors are one big problem the
organisation, and Myanmar healthcare
generally, struggles with.
Still, BBHC is looking to expand.
They plan to establish a 24/7 clinic
within ve years, and the long-
term dream of the founders is a
private hospital. Dr Sara admits its
an uphill struggle and may be too
much to realise, but remains hopeful
nonetheless.
In the meantime, the immediate
focus is dealing with the problem of
education.
It is very hard to change peoples
thinking. It is high time we changed
our attitudes and behaviours. Changes
in attitudes and behaviours yield
practical feasibility. If there is no
practical feasibility, then nothing will
succeed.
For poor people and young doctors
Dr Jalin Sama of Better Burmese Health Care speaks to MT about treatment, training,
well-being and a colourful fundraising initiative
Myo Myint Aungs Market is one of the decorated parasols being auctioned to
promote the Better Burmese Health Care organisation. Photo: Supplied
For more on Better Burmese Health
Care, including more images from
the Parasol Project fundraiser, visit
www.betterburmesehealthcare.org
Asians, especially women, are at greater risk of osteoporosis
MYA KAY KHINE
mya.simpley@gmail.com
UNTIL we spot receding gums, lose
teeth, or even fracture a hip, we may
not realize how brittle and chalky
our bones have become. But the end
result of gradual erosion of the bone
structure is calcium-decient bones,
and they can even grow so weak that
a mere sneeze can crack a rib.
Dr Nay Win, a surgeon
specialising in osteoporosis (the
word comes from the Greek for
bone and porous or passage),
says women are at higher risk for
osteoporosis: one in three, compared
to one in seven to eight for men.
When women reach menopause,
oestrogen hormone is suddenly
down. Bone density decreases,
causing osteoporosis. Men dont
sufer from a sudden drop of the
oestrogen hormone because their
oestrogen hormone decreases slowly
over time, said Dr Nay Win.
Our bodies need calcium for
many vital operations, including
controlling muscular contractions,
blood clotting, transmission of nerve
impulses and other essential tasks.
Bones act as a bank of stored
calcium. When the body needs to
supply calcium to the blood for any
reason, a check is drawn on the
calcium bank, the bones, through a
series of biochemical reactions. The
body draws calcium from bones to
supply calcium to your blood.
But decreasing bone density is
hard to detect until too late, because
even for patients sufering from
osteoporosis the calcium level of the
blood is usually normal. Thats why
its important to prevent osteoporosis
rather than combatting it after onset.
He encourages men and women
but especially women to make
sure theyre getting enough calcium,
something the Myanmar diet
traditionally lacks.
Our bodys required calcium intake
is 1000-1500 milligrams per day.
Myanmars traditional diet includes
300 milligrams of calcium daily.
Milk, and milk products such
as yoghurt, are a good way to get
more calcium in your diet. Dr Nay
Win says a cup (8 ounces) of milk
has 300 milligrams of calcium, and
recommends one to two cups daily
But it is also possible to overdo
it on milk. Studies show up to 90pc
of Southeast Asians may be lactose
intolerant to some degree, meaning
their bodies reject milk and cheese
because they lack the enzyme called
lactase, which is found on the wall
of the intestines and breaks down
lactose. Other cultures experience
the same problem: The human
body, it turns out, is not designed to
process large quantities of milk after
weaning of breastmilk.
Thats why Dr Nay Win
recommends one or two cups only.
If that makes you ill, try yoghurt
instead of milk. You can even
consider a calcium supplement.
Dont rely on condensed milk,
though it is milk that has had the
water removed, but has been so
sweetened that its 40-45 percent
sugar, so the overall nutritional value
is negiligible.
Like most matters of health, the
best solution is a varied, healthy
diet. Many non-dairy foods contain
calcium. Other than milk, the top
calcium-rich foods are dark leafy
greens like kale and kason; seafood
like sardines and salmon; soybeans;
legumes and almonds; Chinese
cabbage, okra and broccoli; and
fortied soy products.
Eating a healthy, mixed diet
means your bones will stay strong
into old age. If an accident does
happen, however, its important to
seek professional medical treatment
immediately.
When bones break, it may causes
interior injuries, Dr Nay Win says.
That means you need to go to a
hospital immediately, rather than
relying on the kinds of old-fashioned
home-style cures of the past, all of
which cause more trouble than they
prevent.
When blood comes out from
a bone injury, Dr Nay Win says,
people used to press their injuries
with dust, leaves which were within
reach, sand and even engine oil
for drivers. All this can spread
germs into these wounds. Another
dangerous method is a tourniquet
being tied tightly on injuries. It can
cause the blood circulation to stop
and decomposing to begin on the
injured limb.
I have to warn patients to accept
treatment as early as possible. That
can prevent bad cases. If patients
come later, rather than [a bone
problem] being cured by a pin, it
must be cured by an axe.
Dont let that be you talk to your
doctor about whether youre getting
enough calcium in your diet today.
12
MYO LWIN AND
LUN MIN MANG
O
NE of the widely discussed
well-being issues in the
21
st
century is work-life
imbalance. Uncountable
numbers of families give more of
their day to work and less to home, in
order to provide a better life for their
relatives. Unfortunately, this leaves
elderly members of the family feeling
more isolated, as they are separated
from the rest of the family who are
working or studying. As relationship
gaps grow wider, the elderly may
nd themselves experiencing social
discomfort but unable to do anything
about it.
Not even doctors, who specialise
in well-being, are immune.
Fortunately, among the few social
welfare organisations in Yangon
which ofer care for elders is one
which ofers health and moral
support specically for aged doctors.
Located in Tarmwe township, the
Day Care Centre began on February
18, 2012, under the guidance of
the late Dr Myint Myint Khin,
who served as the president of
the Myanmar Medical Association
(MMA). It is a functional unit of the
Support Group for Elderly Doctors,
which is an umbrella organisation
under the MMA and the Myint
Myint Khin Foundation.
Older people may not always
need help nancially, but they
certainly need the social and moral
support that comes from feeling
valued, especially by youth, said
Dr Khin Oo Myint, the centres
manager. She said this outlook is
the centres guiding strength, and
reects the kindheartedness of its
founder, Dr Myint Myint Khin.
She always looked at the world
with a wider view, because she was
an educated person and had worked
in foreign countries where human
beings values are dignied and
respected. What she initiated is good
for the medical society, and we have to
keep it going, said Dr Khin Oo Myint.
The centre is open every day
from 9am to 5pm, so that the elderly
doctors can get out of the house
each day just as they did before they
retired, and wont be left alone when
their children are at work.
Gathering together with their
peers, they usually think back to
their younger days and tell stories
about them. Sometimes they play
board games like Scrabble. Buddhist
religious talks are held twice a
month at the centre. They eat lunch
together at midday.
When people grow older,
they want some friends or family
members who dont go away from
them, always look after them and talk
to them, said Dr Thein Thein Myint,
who took over as chair of the Support
Group for Elderly Doctors when Dr
Myint Myint Kin passed away in June
2014. When family members leave
an old person alone, he or she feels
the desolation intensely.
Dr Thein Thein Myint said that
leaving an elderly person alone
doesnt refer to leaving them at a
separate location, but rather any
situation in which they spend long
periods without interaction.
Although family members may
come and talk to the aged grandpa
or grandma, they cannot do this
all day long. They have to go to
work, to school, to ofce and to do
housework.
Thats where the day care comes in.
This place is nice for them
because they gather here and talk to
each other warmly. When they talk
about their old days, some freshness
can be seen in their faces, and they
feel young again, she said.
All members must be over 70
(though exceptions are sometimes
made), and must be doctors. But if
a doctor wishes to bring friends or a
spouse, this is also allowed.
The centre provides an electronic
massage chair; an exercise
program each Sunday, guided by
a physiotherapist; twice-yearly
screening tests (medical checkup,
ECG, blood test, X-ray) and periodical
vaccination programs (the u
vaccine, for example, during the
rainy season). One of Dr Myint Myint
Khins own initiatives was to ofer a
soup of ginger mixed with honey and
turmeric in order to delay ageing.
Since the centre does not
provide 24-hour care, it has few
daily visitors. About a half-dozen
consistent members come daily or
almost daily to enjoy the company
and the facilities. However,
according to manager Dr Khin
Oo Myint the centre sponsored
80 to 100 elderly doctors medical
checkups last year.
The centre also arranges home
visits and treatments for some
elderly doctors who are sick and
cannot go out. Other visitors
accompany the staf in these home
visits, so they bring social benets
and boost the mood of the recipient.
The visits also include a donation of
K100,000 to help with other medical
costs the sick elder may incur.
Providing such a range of
services, however, is a challenge.
Seven paid staf work at the centre,
and the second half of the apartment
is not owned but rented, Dr Thein
Thein Myint said. Donations help
keep the centre operating.
Many of todays medical experts
and specialists were once Daw Myint
Myint Khins students. They donate
money and we operate the centre
with that money, she said, singling
out Dr Khin Maung Lwin of FAME
drug manufacturing company as a
particularly strong supporter.
Though primarily funded by the
generosity of doctors who are well-
to-do, Dr Thein Thein Myint points
out that not all doctors can retire
comfortably. Nor can many elderly
of any profession. Thats why the
centre is necessary.
Not all the doctors are rich.
Some are poor. Daw Myint Myint
Khin had a dream. She wanted to
found an asylum [like Hninsigone
Home for the Aged] for various
kinds of aged people. This will need
a lot of doctors, nurses and funding.
Though it is not yet possible to
implement such good ideas, we will
try to make this dream come true.
The legacy of Dr Myint Myint
Khin continues to grow, like a green
tree that ofers shelter and shade for
the tired and weak who spent their
lives helping others.
A staff member chats with a visitor at the Day Care Centre run by the Support
Group for Elderly Doctors. Photo: Yu Yu
Caring for the carers
When families are busy, this organisation steps in to keep
elderly retired doctors happy, healthy and engaged with life
Dr Khin Oo Myint (left), manager, and Dr Thein Thein Myint, chair, discuss the Day Care Centre for elderly doctors, founded
by the late Dr Myint Myint Khin. Photo: Yu Yu
When they talk about their old days, some
freshness can be seen in their faces, and they
feel young again.
WADE GUYITT
WALKING backward may sound
quacky, like a health fad from a
distant century. But science says
it works. Several Asian cultures
have long recognised the benets
of walking backward, and the
West is catching on too. What
could seem goofy is rebranded as
retro-walking because nothing
says cool like retro.
So whats walking backward
good for? More or less everything,
it turns out.
Bad knees?
The stride puts less stress on your
joints than walking forward. Bad
back? The stride opens up your
pelvis, relieving pain.
Okay, so its good for
rehabilitation. But why should
an otherwise healthy and active
person think consider integrating
backward walking into an
exercise routine?
Balance this
One thousand steps of forward
walking, or 100 backward steps: It
turns out they produce equivalent
tness results.
Breathtaking facts
A person walking backward at
the same pace as someone else
walking forward next to them
will nd their heart is beating
at around 156bpm, while their
friends heart rate will be 106.
(One step backward, two steps
forward, trumpets the Asian
Heart Institutes website.)
This cross-training helps
ease strain on knees and other
joints, as well as keeping posture
more naturally upright, and
the unfamiliar muscle usage
strengthens shins and ankles.
Not neurotic, neurobic
And because the unfamiliar action
poses a challenge to balance and
locomotion, it keeps you on high
alert, stimulating your brain cells.
The experts label it a neurobic
activity: good for the body, good
for the mind.
Safety first
Backward running, by the way, is
also a thing, though we at MT are
loathe to suggest you try it given
the number of obstacles that
make any form of rapid progress
here treacherous.
Walking, though, is easy to
practise on a treadmill (go very
slowly, and learn to avoid clinging
to the handrails, as this changes
your posture and ruins the efect).
Or, grab a partner and hit the
outdoors: Peoples Park or the
shores of Inya Lake are popular
at open spaces for exercise. Your
friend can spot for you, and that
way youll look like youre just
having an eager chat rather
than being trapped in a backward
dimension.
Lets go for
a walk
backward
13
WADE GUYITT
W
HILE there are clear
dangers to repetitive
manual labour, desk
jobs bring less obvious
threats we need to watch out for.
Desk workers sit an average of
9.3 hours a day. Being stationary
for so long not only keeps you away
from active pursuits, but can be
detrimental itself.
As soon as you sit down, electrical
activity in your legs shuts of. Your
back collapses, and the way you
metabolise changes. Calorie-burning
drops to only 1 per minute. Fat-
burning enzymes drop 90pc. Two
hours later, your good cholestoral
levels have dropped 20pc. After 24
hours of sedentary (non-moving)
existence, insulin efectiveness
drops by 24pc, increasing risk of
developing diabetes.
Over the long term, people with
sitting jobs are twice as likely to sufer
cardiovascular disease. One study
nds sitting six hours a day for over a
year can lead to 1pc loss in bone mass
each year. Another says a sedentary
lifestyle in which sitting dominates
means 7 fewer years of quality living.
Your risk of prostate or breast cancer
increases 30 percent, and according
to a May 2010 study by Stephen Blair,
professor of public health at the
University of South Carolina men
who are sedentary more than 24
hours a week had a 64 percent greater
risk of death from heart disease
compared to men with less than 11
hours of sedentary activity per week.
But wait, you say, theres a gym
near me. Ill just hit the treadmill
after work! Thats a great idea we
all need 30 minutes of exercise a day
but a bout at the gym wont undo
the damage that 8 hours of slouching
non-activity brings. You need to ght
that damage on-site.
Get away from the desk
Spend at least 5 minutes every hour
not at your desk. Walking around
briey will get your body moving
and interrupt the efects described
above. Use this as an excuse to ll up
your water bottle regularly and youll
also nd yourself needing to get up
to visit the washroom more often. Its
a self-fullling health prophecy!
Stretch
Just because youre at your desk
doesnt mean you need to be sitting
down. Whenever you feel hunched
or tired, just push back that chair
and stand up. Its not as helpful as
walking, but you can shake yourself
out a bit, refreshing your body
and your concentration. Its not as
healthy as actually leaving your desk,
but its helpful if your job doesnt
allow you to wander about much.
Standing desk
Some push their chairs back
permanently and say it has made
all the diference. If you have control
over your space, consider a standing
desk. Dickens, Churchill, Jeferson,
Nabokov, Woolf and Hemingway
were devotees, and Mark Zuckerberg
as well as the folks at Google are big
on them today. You dont have to
stand all day, but switching between
sitting and standing will make a
big diference, by working diferent
muscles and not straining or
relaxing in a single pose too long.
Walking desk
If you have a really progressive
workplace or if you work at home
try a treadmill desk. Walking and
working increases energy expenditure
by 100 kcal/hr, which, if youre
overweight, can result in 20-30kg
of excess weight burned of over the
course of a year. Forget diets, forget
the gym: Thats a no-hassle guarantee.
Get a healthier chair
A well-designed conventional ofce
chair can make a big diference
to your day, but you can also try
another approach with a kneeling
chair (see below).
Adjust your workspace
Keep your feet at and thighs straight.
Keep your computer monitor straight
in front of you, 18-24 inches away, and
put the top just below eye level. Put
your keyboard at elbow level. Keep
your wrists straight when typing, and
move your whole arm, not just your
wrist, when using the mouse. When
youre not typing, rest your hands in
your lap, not on the keys.
Avoid eye strain
People staring at computers tend to
forget to blink, leading to dry eyes.
They can also get headaches from
focusing too long on one thing. Both
are temporary problems, but theyre
troublesome if youre getting them
every day. Try the 20-20-20 solution:
Every 20 minutes, take 20 seconds to
look at something 20 feet away.
Eat breakfast
Youll feel better all morning, and
wont be inclined to hit the teashop
for snacks. Likewise, having healthy
snacks nuts, fruit on hand will
keep you energised and prevent you
from buying something youll regret.
Bring your lunch
But dont eat it at your desk get
away somewhere else. Itll help with
your eye strain too.
Drink up
Stay hydrated with water, not
cafeine or soda.
Talk, dont email
Question for a colleague? Go ask
them. Sure, youre interrupting,
but so does an email, and at least
they get to focus their eyes on you
instead of their computer screen for
a moment. Good deed!
Consider a fitness routine
Bench-presses are probably not an
option in the workplace, but here are
a few low-key exercises you can do
through the day without attracting a
lot of attention. And if someone does
see you, dont be embarrassed maybe
you can inspire them as well.
Stretches
shoulder shrugs
neck roll
side bends
upper body twist
torso stretch
hip rotation
toe touch
Exercises
toe raises
seated leg extensions
wall push-ups
doorframe push
book curls and overhead press
stair climb
Top tips for office health
Office work pays you for your brain, but its your body that pays the price
EI THANT SIN
THE showroom of FXB International
displays a wide variety of handicrafts,
including cotton dresses, scarves,
stufed toys, bookmarks,
smokeless candles and candle
holders, pillows and cushions
and handmade cards. But it was
the backless
ergonomic
chair that
got me to
visit.
Backless
kneeling chairs are
popular worldwide
among those looking to
sit in a more healthy
position. But
theyre unusual
in Myanmar,
and tend to be
promoted by word
of mouth or, in the case of the colleague
who uses one in our ofce, sight of eye.
Mostly foreigners buy these chairs,
says Ma Thinzar Aung from the FXB
showroom. We get to sell about 10 to 15
chairs each year.
Conventional ofce chairs gradually
encourage slouching and the spine
becomes more concave the longer one
sits at the desk staring into a computer
screen (for more on what prolonged sitting
does to your health, see above). Kneeling
chairs, however, enforce a certain seating
position which ensures the spine remains
convex. It can be used as a regular seat or
a stretching station for the spine.
When asked if doctors refer patients to
such healthy chairs, Ma Thinzar Aung
replied that most customers come in
individually, either referred by friends or
colleagues, not from doctors. Locals, she
said, dont seem to be taking to the chairs,
which sell for K85,000.
There are various kinds of ergonomic
chairs worldwide but the one at FXB is
backless, the design enabling the person
to maintain an upright position while
seated, says Ma Thinzar Aung.
Ergonomic seating was developed
many years ago by pioneers such as
Niels Difrient who was named as the
granddaddy of the ergonomic revolution
by Forbes. This month deluxe ergonomic
chairmaker Herman Miller opened a
Yangon showroom. But FXB started
making healthy chairs back in 2002,
when a customer from Switzerland
brought one or two here.
From there, healthy chairs became our
regular products and we started accepting
orders to make them in our workshop.
FXBs version used to be xed, but the
design has since been altered to include
adjustable levers for diferent seating
positions and heights, wheels and brakes.
Its easy to care for too, as the cushion
covers are washable. Plus theyre made
from 100 percent cotton with acid-free dye.
The construction details are important,
because these chairs are locally made at
FXB workshops by FXB trainees, as part
of their vocational training courses for
youths in need.
FXB was rst established in 1989
and reached Myanmar in 1992 its 19
th

country. The initials stand for Francois
Xavier-Bagnoud, who was a helicopter
pilot and had a strong passion in
humanitarian aid. After Bagnoud died in
a helicopter crash in a rescue operation in
Mali at the age of 24, his mother, Albina
du Boisrouvray, and his friends and
family founded the organisation in his
name in 1989. They remain committed
to humanitarian works and rescue
operations, Bagnouds twin passions.
A colleagues unusual chair sparks a visit to the showroom of an exciting NGO project
Theyve got your back
To learn more about FXB, visit their
showroom at Hnin Si Myaing Residence,
21 Kabar Aye Pagoda Rd, Bahan or go to
http://fxb.org/programs/myanmar/
Any of these exercises can be done individually, or do all in a row, at maximum
intensity, for 30 seconds with 10 seconds between each. Graphic: Ko Htway
14
MYAT NOE OO
myatnoe.mcm@gmail.com
T
ONY Tun Tun gives new
meaning to the phrase
name brand. After all, he
puts his own name in front
of every one of his 23 beauty salons.
He also lends his name and his
quality control to his own line of
hair and skin products, all of which
are made in his own factories in
Thailand and Japan.
Most local beauty salons, he
says, simply buy popular branded
products to use in their shops. But
thats not hands-on enough for him.
I think the main factor for me is
that I can control the quality and I
can make the product I want, Tony
explains.
Hes at the original branch on
Kaingtan Street in Lanmadaw
township, which is where he spends
most of his time. All staf rotate
through this location regularly, so
quality control remains uniform in
every branch.
While some of his locations ofer
massage in response to customer
demand, his primary focus is on
beauty.
Focus on one job is the key to
success. If someone changes jobs, he
may think it will be more interesting,
but its not the way to be successful.
He likens himself to a PhD,
specialising in a close study of one
eld.
I think of this as a scholars job,
and myself as an expert in this eld,
he says. I can share information
to others who are interested in this
eld and I can also give them jobs.
When the beauty salon rst
started back in 1986, nancial
difculties abounded. There wasnt
enough money to buy good products
and keep the shop running. But
four years after the rst location,
he opened a second, and since then
there has been a new branch every
year or two, showing the steady
growth and solid fundamentals of
the company.
The decision to extend his
supervision to the entire supply
chain came later, he says, as he
worked to perfect his business
model.
First of all, I have difculties
getting good quality products [from
other suppliers]. And even if I like a
product, it wont always be available
because shops are cut of the
products sometimes, he said.
The product quality was
sometimes good and sometimes bad
and the smell was changing and I
couldnt buy one brand. The quality
was not good. I was not satised.
The decision to start his own
factories came after learning how
another successful business operated
albeit a diferent sort of business.
One of my friends from Shwe Pa
Zun restaurant told me he breeds
cows himself for milk, because the
milk available to buy from others
is not okay, not the same quality.
Therefore I had the idea that I could
make the product myself.
Tony Tun Tun hair products are
made in Thailand and the companys
skin care line is made in Japan.
He said the Hokkaido location is
particularly well-situated because the
cold climate is perfect for growth of
the raw materials for the products.
He says he has no plans to
produce here because of the lack of
reliable electricity and raw materials.
But the unique set-up seems to
work. One regular customer to the
salon said she keeps coming back
for hair and skin care because she
believes in the products they
use.
Tony trains his staf to
give only the highest,
international-standard
service to customers. In
response, he provides
them with impressive
compensation. Some of
his staf come from other
states or regions, and he provides
them with room and board, as
well as a ferry to work and back.
He says in all he has 200 staf, and
he tries to provide security and
education for all of them.
I think the staf are important
and I look after them myself. The
base salary, the minimum in my
salon, is K75,000 a month. The
highest is K700,000. That does not
include bonuses and customer tips.
And they do not need to cover the
cost of living and eating.
He says some owners of beauty
salons have trouble with high staf
turnover. Thats why he works hard
to keep an eye on everything and
make sure his staf are valued and
rewarded, he says.
I always govern the salons and
staf and always update the products
and technology.
He added that he has 7 siblings, at
a diferent branch of the salons that
carry their brothers name. So I can
trust the management and can live
without worry and care.
Whats next for Tony Tun Tun?
The lure of bigger markets abroad?
Not so, he says hes just getting
started here in Myanmar.
I opened one beauty salon in
Bangkok and I dont want to another
salon in other countries because I
have no time to manage it.
Instead, he says, he plans to
open a school for training. Hes also
interested in manufacturing chairs
and accessories for salons.
No doubt each will be made to
the same exacting standards as his
products and his haircuts.
The man behind the brand Tony Tun Tun
T
HESE photos capture early-morning moments from Inya Lake and Peoples Park last week. Yangon has a vibrant
outdoor exercise scene, and the enthusiasm, from all ages and abilities, is inspiring. So is the commitment
rise late and youll miss it, because it all happens in the couple of hours after dawn, the only way to beat the heat.
Focus on: Early morning exercise
A PHOTO ESSAY BY AUNG HTAY HLAING
Photos: Yu Yu