The Truth is more important than the Facts

By Dr. Aung Soe @ Aung Kyaw Moe
Department of Myanmar Medical Research is holding its 45th; annual Congress from 9th to 13th January 2017 at Yangon, it is learnt.
Research in general means the discovery of new phenomena, the invention of new methods and the development of new concepts to explain the observed phenomena. It is not just the accumulation of facts and figures. Research is a learned behavior for generating new knowledge, using the scientific methods. It starts from basic education and is enhanced through higher education having the universities’ degrees and work careers.
All those researches related to prevention, cure and rehabilitation of diseases, and the promotion and maintenance of health would encompass by the term – Medical Research or Health Research.
Sir Alexander Fleming, a Scottish biologist (1928) noticed (because he is observant) while experimenting on influenza virus that a common fungus, Penicillium notatum had destroyed bacteria in a staphylococcus culture plate. Upon subsequent investigation, he found out that mould juice had developed a bacteria-free zone which inhibited the growth of staphylococci. This newly discovered active substance was effective even when diluted up to 800 times. He named it penicillin. He was knighted in 1944 and was given the Nobel Prize in Physiology or Medicine in 1945.
The following sayings are of utmost value for remembering the importance of honesty in research work.
” The cruelest lies are often told in silence.”
~ Adlai Stevenson
” Honesty is the first chapter of the book of wisdom.”
~ Thomas Jefferson
” The truth is more important than the facts.”
~ Frank Lloyd Wright
In the present day, as our country moves towards a democratic nation, the new government has encouraged national reform in the health sector especially in rural development. As with modern day population growth and sub-standard urbanization, the increase in communicable as well as non-communicable diseases becomes a huge problem. The Ministry of Health and Sports strives towards accomplishing the Sustainable Development Goals SDGs by promoting Maternal, Newborn and Child Health, finding solutions for priority health problems such as drug resistant malaria and tuberculosis, co-infections with HIV and TB, emerging and re-emerging infectious deseases resulting from climatic change and so on.
Research papers presented at the Myanmar Health Research Congress held annually could be considered as impact indicators of Research Capacity Strengthening actions by Ministry of Health and Sports Opportunities prevail to exchange innovative ideas and experiences, new knowledge and technologies as regards priority research needs of the country. Knowledge gaps are filled considering ethical principles: informed consent, privacy and confidentiality. Stringent ethical review, peer review and technical review procedures are essential leading towards quality research proposals. Inter-sectoral coordination and wider stakeholder involvement let evidence-based research findings more convenient to utilize in improvement of policies and programmes.
Health is the product of both living environment and social fabric of various cultures in which lifestyle reflects identities, norms and values of society. To study the culture of health related lifestyle in rural Skaw Kayin ethnic group, cross-sectional descriptive study with medical anthropology approach was conducted by emminent Myanmar researchers. In this study, (216) respondents were face-to-face interviewed by using structured questionnaire and in-depth interviewing with (14) participants to explorer the hidden culture of health related lifestyle. Regarding dietary habit, they mainly took cooked rice, vegetables and fish paste as a main source of energy and suitable for health and viewing vegetables as dietary treatment. Alcohol drinking was found in (25%) respondents and accepted that taking two or three cups of alcohol are good for health and believed as medicine (20%). Smoking (31%) and betel chewing were accepted as a custom. Self-medication (76.9%), buying from medical shop (67%(, seeking advice from quack (11.2%) and neighbor (1.4%) were consisted in health seeking behavior for acute illness. When suffering chronic illness, they went to rural health centre (39.8%), private clinic (26.9%), hospital (13.9%), traditional practitioner (14.8%), traditional healer (8.8%) and fortune teller (6.5%). Rural culture of Buddhism was statistically associated with traditional health seeking behavior involving the offering ancestral spirit (နတ္စားျခင္း) (35.6%), soul calling (လိပ္ျပာေခၚျခင္း) (14.8%), offering evil-spirit (ေခါပေတာင္းပစ္ျခင္း) (11.1%). As findings highlighted that cultural belief and practices influence on health related lifestyle, health personnel need to understand cultural aspects of specific ethnic group in order to deliver effective health care services.
Another Example :
A cross-sectional study was conducted in one Mon and one Shan village in 2011 with the objectives to identify access to media; communication routes used to receive health information; and preferred route and time. Face-to-face interview using a pre-tested structured questionnaire and Focus Group Discussions (FGD) were applied. A total of 301 in Mon and 280 respondents in Shan aged between 18 to 60 years were included. Many respondents (Mon : 45.1%; San: 62.8%) used to listen radio and watched TV (Mon: 65.8%; Shan : 61.6%). Health information was received through individual/ group talk (Mon: 63.8%; Shan 76.8%) and personal communication (Mon: 39.9%; Shan: 36.4%). Additional sources identified were announcement and TV advertisement in Mon; and radio and pamphlet in Shan. Most villagers shared the information they received at gathering places in both sites. Influential persons like monks and village leaders were key players for disseminating the health information. They preferred individual/group health talk as two-way discussion and most of them favored knowledge-based health information. Preferred times for health information were mentioned as 10:00-12:00noon and 6:00-8:00pm by Mon; and as 8:00-10:00am and 6:00-8:00pm by Shan respondents. They preferred to read health information in Myanmar Language since their reading skill for Myanmar is better than their own language. Dissemination of health information should be planned by considering the preferred time and route of local community. Findings from this study were utilized for broadcasting health messages in Cherry FM radio.
Third Example:
Since Pyin Oo Lwin has malaria transmission, numerous malaria patients are admitted to General Hospital every year. A study was conducted to describe the clinical profile of malaria adult patients admitted in Medical Unit of 300 bedded General Hospital during 2003 to 2012. Clinical records were reviewed. Out of 602 confirmed malaria cases, male constituted 68.8%. P. falciparum malaria in 84.9%, P . vivax in 4.8% and mixed infection of P. P. falciparum and P . vivax in 10.3% of the cases were examined. Increasing number of cases were found in 2003, 2004 and 2005 with 73, 77 and 112 patients, respectively. However, decreased incidence was observed in 6 consecutive years since 2006 with 68, 71, 69, 58, 23 and 30 patients per year. Peaks of admission were recorded in the months of July –August and November-December. Mean duration of fever before admission was 7 days. The common presenting symptoms were : fever (98%), chills (43%), rigor (38.5%), altered consciousness (11.8%), vomiting (11.6%), abdominal pain (10.6%), headache (9.5%), body ache (7.1%), convulsion (1.8%), diarrhoea and dysentery (1.8%), scanty urine (1.5%) and inability to sit or stand (0.3%). Mean duration of hospital stay was 5.5 days. Severe and complicated malaria were found in 28.9%. The common complications were cerebral malaria (13.6%), hyperpyrexia (6.8%) and severe anemia (6.1%). All patients were treated according to national anti-malarial treatment guideline. Hospital deaths were recorded in 50 cases (8.3%). Analysis showed that 45 years and above aged cases were more vulnerable to die from severe malaria than others.
Let us praise and honour studious Myanmar Health Researches and hail the 45th Myanmar Health Research Congress.

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