Israeli obstetricians bring Western know-how to Myanmar

Two top Israeli gynecologists spent two weeks in Myanmar this month helping local doctors in a rural hospital improve their treatments for common, easily-prevented and dangerous medical conditions.

On their first day on the job at the central hospital in the town of Pindaya, in the Shan state of western Myanmar, Michal Dishi-Galitzky and Ronit Almog, both senior gynecologists at Tel Aviv’s Ichilov Hospital, had already saved two lives.

A woman came into the hospital in an advanced stage of pregnancy and complaining of strange and severe pain, and Dr. Almog examined her.

Dr. Dishi-Galitzky explained in a report on Channel 10 on Monday: “We’re worried that the fetus is large, over four kilos (8.8 pounds). It will be hard to give birth, hard to pull the fetus out. There’s danger to the lives of the fetus and the mother from complications.”

Working with the local head of hospital, Almog punctured the amniotic sac with an amniocentesis needle brought from Israel and discovered meconium, or fetal excrement, in the amniotic fluid, which can enter and block a baby’s breathing tubes, endangering it after birth, and indicating possible stress on the baby’s part.

Dr. Ronit Almog, right, works with a local physician at a hospital in Pindaya, in the Shan state of western Myanmar, August 2018. (Channel 10 screen capture)

The doctors decided to expedite the birth.

“There’s no epidural here to reduce the pain” in the birth of a relatively large baby, said Almog. Instead, she instructed the staff on Israeli techniques for reducing the pain, including carrying out the episiotomy, or incision of the posterior vaginal wall to ensure the baby can exit, at the last possible moment, when the skin is at its most stretched and the pain and trauma are minimized.

The pregnancy still didn’t advance as it should, so the doctors decided on a vacuum extraction. A few minutes later, with the local hospital administrator leading the way and Almog instructing at his side, the baby was born, his breathing passages were vacuumed clean, and he was placed at the mother’s breast, while she thanked Almog profusely.

Nothing the Israeli team did for the woman was especially difficult or advanced by general Western standards. “These are simple pieces of equipment that we take for granted,” said Dishi-Galitzky. “They don’t have blood pressure devices to keep track of blood pressure during pregnancy. They don’t have any way of diagnosing gestational diabetes [diabetes during pregnancy], one of the most common complications in a pregnancy.”

Michal Dishi-Galitzky helps train local doctors at a hospital in Pindaya, in the Shan state of western Myanmar, August 2018. (Channel 10 screen capture)

The Israeli team’s mission was not to bring cutting-edge tech to Myanmar’s peripheries, but the sort of simple, widely available and cheap equipment and techniques that can make a huge difference without requiring a steep learning curve for local medical staff or vast costs to deploy in the field.

The team, sent by Ichilov Hospital, brought with them an old ultrasound machine considered obsolete in Israel that had sat unused in Ichilov. Almog spent part of her first day showing how to check pregnant women using the device — using it with one wide-eyed expectant mother to show her the fetus was male and to estimate its weight.

The Israeli effort to bring Western obstetric know-how to developing areas is part of broader global initiatives to combat high infant mortality rates in the world’s poorer regions.

Myanmar is 152nd in the world on the World Bank infant mortality list, with 40.1 deaths per 1,000 live births.

Infant mortality is a key dividing line between the developed and developing worlds. The South Asia average is 38.8 deaths, while the developed world of OECD-member states has a rate of just 5.9. The United States is at 5.6; Israel is at 2.9.

Dr. Ronit Almog hugs a child she treated at a hospital in Pindaya, in the Shan state of western Myanmar, August 2018. (Channel 10 screen capture)

The lack of knowledge and equipment also affects the mothers. Some 3,000 women die each year in childbirth in Myanmar.

Israel has faced criticism in recent years over arms sales to Myanmar, whose military has been accused by the United Nations, United States and others of carrying out ethnic cleansing starting last year against the Muslim Rohingya minority, with massacres and the burning of hundreds of villages by military forces and allied “vigilante” groups.

In November 2017, Israel’s Foreign Ministry categorically denied it was still selling weapons to Myanmar, but admitted it had sold such weapons in the past.

Activists against arms sales to the regime noted that the Israeli statement referred only to weapons sales, but made no mention of other security-related products, like surveillance technology or military training services.

Israel’s defense exports are largely secret, with the list of countries to which Israeli firms can sell weapons kept classified, but Myanmar itself has announced multiple acquisitions of military technologies from Israel over the years.

The Israeli medical effort, however, was not connected to these official ties, Channel 10 reported, as the medical team’s work was a private initiative of Ichilov Hospital.