Tee Tar

[Tee Tar]

Hello everyone,

It’s very nice to meet you all. My name is Tee Tar, and I usually go by my nickname, which I’d be happy to use here as it’s easier to address.

I work with an ethnic community-based health organization located in eastern Myanmar. My background in statistics includes basic SPSS training and managing organizational datasets. I currently use Power BI for data visualization and am more familiar with Stata for project work and organizational research, as well as Excel and pivot tables for routine project data analysis.

I’m very grateful for the opportunity to learn alongside all of you in this class, and I hope we can collaborate in the future to strengthen HMIS in low-resource settings like the ones we are working in now.

[Tee Tar]

I generally agree with the four recommended actions; however, their effectiveness depends on how well they are adapted to local political, social, and security contexts, such as those in ethnic areas of Myanmar.
First, open discussion on corruption is essential, as the problem cannot be addressed if it is ignored. However, in fragile and conflict-affected settings, fear and power imbalances often prevent health workers from speaking openly. Therefore, discussions on corruption must take place in safe, confidential, and non-punitive environments, with protection for those who raise concerns.
Second, prioritizing high-impact and feasible actions is crucial. In fragile settings, it is unrealistic to address all forms of corruption at once. Public health professionals should focus on practices that most directly harm vulnerable populations, such as informal payments, unfair access to services, and misuse of medical supplies, as addressing these issues can lead to visible improvements and increased trust.
Third, a holistic and multi-disciplinary approach is necessary. Corruption is closely linked to broader governance, social, and economic factors. Engaging communities, civil society, and local leaders helps identify root causes and develop realistic solutions, with public health professionals playing a coordinating and facilitative role.
Fourth, research and monitoring should be practical and context-appropriate. Simple approaches such as routine reviews, basic audits, community feedback, and transparent reporting can help identify risks and improve accountability without overburdening health workers or relying on complex systems.

In addition to the four recommended actions, while I agree with many points raised by others, I would like to reflect on several additional measures that, in my experience, may work better in ethnic and conflict-affected settings.

1. From my perspective, strengthening community engagement and accountability is essential, as empowering communities to safely monitor health services and raise concerns can improve transparency, trust, and local ownership.
2. I believe building local capacity and knowledge to develop context-specific policies and to apply community-level rules is critical for sustainable system strengthening and effective governance. Establishing strong human resource and organizational policies at all levels to set clear standards and serve as role models.

Furthermore, NGOs and INGOs should prioritize health system strengthening rather than fragmented, single-issue interventions. Programs should be designed with an understanding of how they influence the overall system and long-term sustainability. Implementing agencies and funders must demonstrate strong awareness of local context and work closely with local actors, providing not only technical assistance but also ethical leadership. Donors should focus on long-term, system-wide investments instead of short-term, output-driven funding. Transparency and fairness across all processes are essential to building trust and gradually reducing corruption.

In conclusion, I agree that the four recommended actions provide a strong foundation for public health professionals to fight corruption. However, in ethnic and conflict-affected settings like Myanmar, these actions must be applied in a context-sensitive, community-based, and system-oriented manner. Without trust, fairness, long-term commitment, and strong local capacity, anti-corruption efforts are unlikely to be effective or sustainable.

[Tee Tar]

Strengthening the health system in Myanmar is extremely challenging, mainly because of long-standing political crisis, fragmented authority, and low levels of trust. For more than seventy years, military rule and protracted conflict, particularly in ethnic areas, have severely weakened public health and education systems and led to the systematic neglect of ethnic communities.
As a result, health services in ethnic areas rely heavily on community-led and ethnic health organizations, which operate with limited resources, weak recognition, and constant security risks. These political realities strongly shape what is possible in health system improvement.

One important example of health system improvement in this context is strengthening disease surveillance at the community and primary health care level, particularly in conflict-affected and resource-limited ethnic areas. Disease surveillance is essential for early detection of outbreaks, timely response, and practical planning where communities are vulnerable and health resources are scarce.

In many ethnic health service areas, disease surveillance remains weak due to fragmented reporting systems, reliance on paper records, delayed data sharing, and limited feedback to frontline health workers. Strengthening this system may involve using simple standardized tools, basic mobile or digital reporting, regular data review, and clearer feedback links between community health workers, ethnic health organizations (EHOs), clinics, and coordination bodies. When done well, improved surveillance helps detect outbreaks earlier, supports better use of limited resources, and allows decisions to be based on real information from communities.

In practice, stronger surveillance improves coordination across the system. Community health workers can report priority diseases more quickly, clinics can respond sooner, and ethnic health authorities can plan activities based on up-to-date data. It also helps health workers see reporting as useful for improving services, rather than just paperwork.

However, in my personal point of view, several barriers have affected this health system improvement process:

1. Political and governance barriers:
Long-term military control, lack of rule of law, and ongoing conflict have weakened public institutions and accountability. Limited coordination between actors, parallel systems, and unclear leadership make it difficult to build and sustain a unified surveillance system.

2. Human resource and capacity barriers:
Many health workers in ethnic areas have limited training in data collection, analysis, and digital tools. Heavy workloads, insecurity, displacement, and high staff turnover reduce data quality and consistency.

3. Infrastructure and resource barriers:
Remote areas often lack reliable electricity, internet access, and reporting devices. Many ethnic health services depend on short-term humanitarian funding, which threatens sustainability when funding decreases.

4. Trust and data protection barriers:
Health workers and communities may fear misuse of data or political consequences, especially in conflict settings. Limited trust among different health actors and varying levels of digital and political understanding also reduce information sharing.

In conclusion, strengthening disease surveillance in Myanmar’s ethnic and conflict-affected areas is an important way to improve the health system and make better use of limited resources. However, success depends on addressing political, governance, capacity, infrastructure, and trust-related barriers. Technical improvements alone are not enough without long-term investment, inclusive governance, and sustained support for ethnic health systems.

[Tee Tar]

Good day everyone,

It is truly an honor and a privilege to be given the opportunity to study at Mahidol University. My name is Naw Pue Pue Mhote, and I am an ethnic Karen from Myanmar. I currently work with a community-based health organization located along the Thai-Myanmar border.
I am very enthusiastic about joining this program, as it aligns closely with my current role, which focuses on strengthening data and health information management systems for ethnic health organizations along the border. Together with my team and partner organizations, we are committed to improving these systems to better serve our communities.
I see this program as a valuable opportunity not only to deepen my knowledge through academic learning but also to connect with fellow students and professionals who share similar interests. I believe that the experiences and insights gained here will contribute significantly to the positive impact we aim to create in the underserved communities we work with. If you’d like to connect for a friendly chat or learning discussion, please feel free to reach out to me via phone at 063-029-7891 or email at teetarsway@gmail.com. I’d be happy to hear from you

[Author]

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