Myaing Myaing Nyunt, MD, PhD, MPH, Assistant Professor in Clinical Pharmacology and International Health at the Johns Hopkins Bloomberg School of Public Health, has long been interested in developing bioethics training in her native Myanmar.*  When she learned that the Johns Hopkins Berman Institute of Bioethics (BI) would be holding intensive courses for the first time in June 2012, she met with BI director Ruth Faden, PhD, MPH, and Deputy Director for Public Health Nancy Kass, ScD, to discuss the prospect.


“Change is happening now in Myanmar. It’s a huge opportunity now with new doors opening up,” Nyunt says. “When I told Dr. Kass I wanted to bring bioethics to Myanmar, she said, ‘why don’t you start by bringing some scholars here for our intensive courses?’”


Even with the BI waiving tuition, Nyunt says it seemed impossible, with only weeks before the courses were to start, to arrange travel both logistically and politically.  But her passion was infectious, and with only a few phone calls the pieces began to fall into place.


“A lot of people worked together to make this happen,” Nyunt says.  She credits Johns Hopkins University President Ronald Daniels for supporting the effort and requesting expedited visas and passports for a group of health officials and academics.  She was also able to raise funds from the Open Society Foundations and the Malaria Group of the Howard Hughes Medical Institute at the University of Maryland.


“People wanted to help,” Nyunt says.


Four representatives from Myanmar’s healthcare field spent three weeks at Johns Hopkins and attended nearly 30 intensive bioethics classes:   Myint Htwe, MBBS, DP&TM, MPH, DrPH, chair of Myanmar’s Ministry of Health Ethical Review Committee; Myo Khin, MD, Director General, Department of Medical Research (Lower Myanmar); Nay Soe Maung, MBBS, MPH, Rector, University of Public Health; and Yin Thet Nu Oo, MIRB, Research Faculty, University of Public Health.  For Htwe and Khin, the trip marked a return to Hopkins, where both were educated.


In addition to attending every one of the bioethics courses offered, the group was invited to workshops with Johns Hopkins physicians and IRB members, including Catherine D. DeAngelis, MD, MPH, Professor at the School of Medicine and the Bloomberg School of Public Health and Editor-in-Chief Emerita of the Journal of the American Medical Association (JAMA).


The learning went both ways, as the scholars from Myanmar gave presentations across campus and shared firsthand accounts of health and bioethics in the developing world.


Oo says she appreciated the bioethics courses’ application of theories and principles to analysis of potential issues in different areas of practice, research, policy making.  Nyunt emphasizes the importance of having Oo, a junior faculty member, attend the courses.


“We have been living in the dark, cut off from the rest of the world,” she says, discussing the 20-year knowledge gap between older and younger generations, a result of intellectuals leaving Myanmar to work internationally.  She says it is crucial for the international community to realize just how much assistance young professionals in Myanmar will need to compete internationally, and how much less emphasis exists there on educating and training the next generation.


“We have had a ‘brain-drain’ in Myanmar for the past 20 years,” Nyunt says.  “Including younger people in these training opportunities is essential for long term change.”


As a group, the scholars reflected on their experience taking courses at BI: “These bioethics courses have broadened our knowledge horizon, led us to a clear thought process and sent us to greater heights of understanding, especially the importance of bioethics in the field of health, be it clinical, research or public health. This is because of the clear-cut explanation and interactive discussion, together with real-life scenarios exemplified by the experienced, knowledgeable, well-read and highly committed faculty of Berman Institute of Bioethics at Johns Hopkins University. [The experience was] highly appreciated, a time well spent.”


Their visit also provided an opportunity for Htwe and Khin to reunite with their former professor and mentor, Timothy Baker, MD, MPH.  For Khin, it had been 22 years.  Baker founded and built the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.  At a presentation shortly before the group’s departure, Baker nodded along with Khin as he described the former community of people from Myanmar at Johns Hopkins that had all but disappeared, and how good it was to be back collaborating with Hopkins professionals once again.


In his presentation, Htwe said, “Our number one take home message is that ethical issues must be at the forefront.” He also cited the class taught by Faden and her lesson

that bioethics in the developing world must consider the underserved.


“We are not in the infantile stage of bioethics, we are in the neo-natal stage,” Htwe said.


Khin echoed this sentiment and introduced a path forward by citing a far different American inspiration.  Announcing plans for a 3-day bioethics workshop in Myanmar starting September 17, 2012, he recalled Henry Ford’s assembly line.  “A big job isn’t so big when it’s broken into parts, and that’s what we will do.”



 


*Also known as Burma. For more on the dual name: http://transitions.foreignpolicy.com/posts/2012/07/05/burma_or_myanmar_the_name_game

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