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Speaker is Doctor Zen Me, a, a dedicated humanitarian and visionary founder and technical supervisor of the digital health information recording system amidst the ongoing conflict in Myanmar. Doctor Z Mea has played a pivotal role in developing health, connect an innovative system designed to revolutionize healthcare delivery in combat zones. This talk today, health connect and resilience in Myanmar, creating health system support in combat zones will provide invaluable insights to how ingenuity and determination can overcome the atrocious circumstances. Please join me in welcoming Doctor Z Morning to everyone. Uh My name, um I'm the very honored to present today as the speaker here. Um uh I'm so very, thank you so much for the, the, the colleague sergeant for cooperation this event um Today, I'm what I would like to present about the chronic basil in. And uh in this presentation, I would like to highlight about the delivery of the high and the ongoing conflicts and the we uh highlighted about the challenges, you know, uh I implemented about the innovations of the our medical pro and here is one of the uh overview of the topic I will and I will present with a brief overview and key studies. What in the, and then reach into the challenges and why, how we revitalize the between the military coups and the uh uh it, it would be together with our such stories and a very forward plan and challenge us in the possible risk. OK. Uh Let's start with a brief overview of the conflict in Myanmar and to some extent, the military groups in the first of a trigger, the vice resilience um uh uh that include the se and the protests and again of the military group. And as of the 2024 around 6, 16,000 anti administrations are present in my and it is around the 60 thousands of the anti military group and the uh causing the over 8000 fatalities in Yanar. Um I would like to highlight a key studies on the display people in Myanmar. We have over the 3.4 millions of people in Yanar who are displacing as a intern display person. And because of the military coup and uh it can also raise the political about the 227,000 and then the cut of the loss of the civilian life over the 5900 and the military has attacked the system, attack on the our health care facilities and threat on the higher system. And so causing the to the 6464 number of killing of the individuals in my. Um so as the, the areas in Yanar, the pros and the challenges of the hiker during the military groups are the uh the, according to last through the military uh health care facilities and the supplies and the other, the uh the other things are the, we have the shortage of the trained healthcare professionals and also the mental health crisis or the uh civilians and also the mental health crisis of the mental trauma of the our healthcare professional. And then I would like to highlight about these time limitations and the more this uh uh about the issues in, in my previous slide uh compounded by the this geographic barriers and the language barriers and the isolated communities and is uh got variations. Uh Let me look to uh some personal but um I started from the FF 5 2021 with the co move. Uh my team, I uh transitioned into the delivery, the H in the April of 2021 and we moved to the elevated area and then you for the life of the second H I will share the story later. And uh in the December, I can uh we can expand this primary care as to the mobile hacker unit. And then we can achieve about over the 100% access rate. And in the 2022 there is a shortage and the discussion of the vaccination system in Myanmar. So we started in the uh the uh a health care organization, a control areas with the COVID-19 vaccination systems. And then uh we collaborated uh and update it into the uh expanded program immunization in the 2023. Uh I will highlight some about the uh some resilience about the Myanmar health care providers. Uh We call it ac over movement in Myanmar. And then it started about the, it started since the day of the military coup. And then we announced about the, it's as the national movement and the data, the fifth um this meaning is that we are not serving under the interested orders of the military. But we are trying and keeping moving forward to give the high care facility you in a various way. I will highlight how we are giving the, the uh the high care facility in this, in the next slide. And so uh uh two two handed the collateral damage of the CD MO movement. So we open the clinic so we are not set in the public hospital, but we opened the clinic and the basically the network in between the different center like the primary centers or the GB and then the other mm the volunteers and the local charity organization about the strategy offer us and the uh clinic consultations. OK. This is for the, when we open the clinic, we have three things, the things and they go for to the with the ambulance at the right area and then the uh they end up go the uh primary health care coverage and the damage go through something like that and then they uh carry the patient to the our base clinic. At that time, we could do the damage, go to surgery. And then we also escalate the matter if you needed to, the specialist and the specialists are in the clinic. And we also monitor these flows at the out and recording and reporting and coordinations. But the challenge is the military not permitted that we are open in the military areas at that period. So even they make the threaten order. And this photo is one why we are giving the hacker to the brought the protest. And so we have to switch away from the uh place where we were side it because of the security concerns. Um The agenda tried to make an arrest to us at uh since in March of 2021. So we moved to the different areas of Myanmar and then reach to the finally, we, we reached the ethnic government control on the 5th 2021 where we stay at the internal display person and we, we revert a secondary health care center. Um uh In doing this, we just get about the uh how do we revitalize the secondary health care center? Uh had the uh one of the clinics there and we just got about, we want to open a clinic there and we started at the outpatient department on the 20 of April 2021 and up to the inpatient department on the May and then a minor operation got started at that place on August 3031. Ok. Uh We use these implementation, fail us up on uh the implementations of the secondary services and we a with the local authorities. And then uh we also recruit the Medicare professional who will finally work with us and the for the service delivery. Uh the issue has the primary healthcare coverage and primary health care service package, but we upgraded into the Advance H System. Uh um And now we are ongoing development of the secondary H package uh that we are giving in the secondary er center of the organizations. Uh with the Supper Supply Change Management. Initially, we started with a local charity organization and then hopefully we got uh the likely we got a donation from the organization and we can run these services very well. But uh there is not a very uh not uh uh secure funding at the present moment but, but we are trying to catch it and the, the important P is heart inform it because we need to do the evidence based decision making process for the health care system implementations. So we started with the common paper based recording system and then, and then we get in, in indicated, incorporate it into the electronic health system of the E issue. OK. And then I about the guidelines from the through ho and then the uh national government man. And, and so we developed the local protocol about the case and because we have the very limited resource setting, uh if you can see here that, you know, we can use the, if we don't have the electricity as at the, at the first time. So we use the wi to make the uh ization of the instruments. So uh we need to modify about the uh protocol into the um AAP into the look to, to be used in the local web. Um uh This is uh mm I'm very happy to present this one. And in the first time we use the paper based recording system and then we advocate and collaborate with the other sets and uh the uh agree about their knowledge. So uh we can implement, successfully implement into the paper to the electronic uh electronic hyper system for the Secondary Center we have in the, since in November 2021. Um These are the challenges when uh we have involved in the um uh implementing this. Uh The first thing is the trade issue between the organizations and then the different system between the doctor Eho and the other governments and the of the other charity organization, we have to, we have to collaborate and uh uh coordinate them uh for the for uh it take, it takes very long time. And then I want to highlight about these mobile hacker service. Uh We go to the mobile hacker uh H as a H Mobile Hug, do the go areas because uh we cannot uh go do our clinic. So um in the Mobile Hug Unit, we started with the primary H and then the um and then, and design design uh with the uh pathway. So these are the photos that in our move. I we use a very limited results and they can use a so up here. And the I would like to share about this some story, a story here. And there's a like when a patient with severe can shock injury and it's come to our clinic while we are going to the story and it can shock severe bleeding. And we carry out damaged surgery at the clinic and we as to the specialist uh we when we are start at the hospital and we transport the uh the patient with a safer, very safer ways for the transportation for transportation. We have to collaborate with the local authorities about the the very safe transport way way of the transport. And so that's the, that's uh with the uh patient likely arrive to the clinic and the sleep and the other thing. But from the immediate surgery procedure and then the we have to about the enough and the replacement surgery and the patient have to undergone the four operation two day, it took for about three months durations. But after the operations and the physiotherapy likely the patients can get other thing as previously. So uh as a learning from this scenario, if the damage go to a surgery in the FZ can see some light as well as the limbs. And the also the blood transfusion in the yellow zone or the in the zone are the beneficial for the patient occur. And the connection between the uh the uh on me teams and the advanced team that the specialists are the uh uh we all uh all leads to the patient outcomes. Um If these are the some of the nurturing about the human resources, uh uh We build the versity building by knowledge showing sessions and the Basili and the uh uh the understand about the different like here. And so these are just some training photos. OK. Um I just want to highlight about the immunization during the Gulf. Um We started, we can start the immunizations during the gold. Um uh As I started time, the immunization system, the known as a expanded immunization system, the government system that cannot be stuck in the EHO alone. But uh whether at that time we can correct uh first eho uh lead immunization program with no relation with the so called government auto tree. Uh We have to try very differ, very difficult and very hard about the ABM this and we need to avo about the local authorities and trainees and then the supervising about the uh and uh because uh this is a very high quality services to be given in the uh affected areas. These are the helpful, I am very glad to share these photos as uh one of my colleagues um undergoing the immunization in a very hard to reach areas. And we achieve uh over the 54% of the immunizations and then over 87.5% of the PCG immunization and the uh uh the universal coverage for the number for PCG vaccination is 90%. And so we can achieve in the system and like this universal coverage. So these are the challenges between the uh uh implementation about the display population. We have the very migration, the fragility of the populations and they are ongoing and the ongoing escalation of the place. And there are so many climate change and the power uh and the the things is the power supplies and transportation difficulties we have to face uh uh these difficulties and Uber can. So uh let me share some things about the my way forward plan. Um So uh providing the professional, I guess in the area is like very cruz ways because um uh so we can achieve by the hybrid telecommunication and then by strengthening about the knowledge of the high care providers uh by means of the continuous learning activities and capacity reads and we can empower them to make the quality high care. Ok. So uh what we are going to do in the next future is that we will run with the, the, the first. This is the um and this slide is used when I was teaching about the about the heart informative system. To my um we were put into the specialist outpatient clinic with the Tele Jer and the tele Heart Clinic of the National United Government. More uh for the implementation, we need to uh ate about the engagement and the, the partnerships with the uh um about the secure find source and the resource allocations and the finding about the technical collaborations or collaboration with the family way to communicate. So, uh uh uh in the implementation of this, we were need to overcome these challenges about these security risks and the change in the political issues and some of the technical problems and difficulties. Uh The most important things we are facing in my is that internet, internet and communication program, we have to u again, this uh in the uh they are uh some, some sort of the internet in the, but they are too expensive and we cannot make sure that there, there is a cutaneous supply of these service to the patient. But if we, if we get the uh this uh connect between the uh on ground and the uh advanced hacker system, we can collaborate and the can get the most hybrid and professional h to the patients. OK. So uh uh with the possible mid risk mitigation uh strategies. Uh So we will need to uh double the con contingency plan for every issues and the how to, and the, how to uh do about the security issues like the barriers or the like the Aliva system about the air strikes or the secretly, OK, like underground uh under uh uh operation period or something like that. OK. And we can involve the other local authorities because they are very familiar with the local uh transportations. And so uh since the designing of the phase, we can, we need to involve the local authorities and wait at the capacity for the in of the individuals and them uh about the human resource. We need to be out the local community and we need to train about the local community about for the uh uh for heart knowledge and can produce the human for the heart. OK. And so, uh today, I would like to highlight about my presentations and despite the immense challenges in the new on the resilience and the courage of the high professional is the light of host and truly this innovative solutions above the mobile hacker or integrated h informatics. And then the community driven secondary h how we can demonstrate the hacker and the event in the crisis. And so we need to connect and engage between the board and the rown hacker, professional specialist and ruder and innovative methods to uh we are hoping to bring quality hacker for the people of the world. OK. So uh Thank you for uh giving me time for the, for my presentations. And now this is a, I welcome your questions and insights on how we can collaborate rate about the improve in the affected areas of Myanmar. Thank you so much.