Dr. Zin, a medical officer at the Myanmar Liver Foundation’s Than Sitt Charity Clinic in Yangon, Myanmar. (Lwin Phyu Phyu Kyaw/CPI)
Hepatitis B in Myanmar is a significant public health issue, and many people are unaware that they carry the virus. One year after her mother died of liver cancer, Ma Myint went for a hepatitis B test at a clinic in Yangon, supported by Community Partners International (CPI). The test came back positive.
“When I first heard my diagnosis, I was afraid.”
“After my mum passed away,” explains Ma Myint, “I wanted to check my health because I looked after her until she died. I came to the Than Sitt Charity Clinic because it costs less than private clinics. That was when I discovered I had hepatitis B.”
An estimated 3.5 million people in Myanmar live with the hepatitis B virus (HBV). The disease is often referred to as the “silent killer” as many people are unaware that they are infected. Those who remain untested and untreated face a significantly higher risk of liver disease, including cirrhosis and liver cancer.
The Than Sitt Charity Clinic, based in Sanchaung Township in Yangon, is run by the Myanmar Liver Foundation, a CPI partner. The clinic provides prevention, screening, and treatment services for hepatitis B and C. Opened in 2017, it enrolls approximately 1,000 patients in care each year. It aims to make its services accessible to all.
“We use a cost-share model,” explains Dr. Zin, a Than Sitt Charity Clinic medical officer. “Half of the patients who can afford it cover their treatment fees. The other half receive free services supported by CPI and other organizations. We ensure that all patients can access the necessary services at a lower cost than private health care providers.”
When patients visit for the first time, the clinic tests them for hepatitis B. “Test results usually come back within two hours,” confirms Dr. Zin. “If the patient tests positive, we conduct further tests, including liver function, viral load, and abdominal ultrasounds. We decide whether to provide antiviral treatment based on the results and other factors.”
“Reaching communities presents challenges, particularly due to stigma.”
Catching hepatitis B early is vital to minimize impacts on health. Ma Myint was one of the lucky ones. “When I first heard my diagnosis, I was afraid,” she reveals. “But the doctor explained that the disease was at a very early stage. The clinic immediately provided me with a three-month course of medication.”
As a seamstress living with her sister’s family and working from home, Ma Myint worried about treatment costs. “The clinic staff told me that I may need long-term treatment. I didn’t know how I could afford it,” she revealed. “But the clinic staff told me I didn’t have to pay for treatment because donations covered it.”
The Myanmar Liver Foundation (MLF) has to counter misconceptions and stigma in their work to prevent, diagnose, and treat hepatitis B. “Reaching communities presents challenges, particularly due to stigma,” explains the MLF’s President, Dr. Khin Pyone Kyi. “People with hepatitis B are concerned about discrimination. In the past, it was a reality. People didn’t want to stay or eat with them because of misconceptions about transmission.”
“Some patients have misconceptions about Hepatitis B,” echoes Dr. Zin. “Some falsely believe having blood type B increases the risk of contracting the virus. It’s crucial to educate people with accurate information.”
CPI’s support to MLF helps people overcome the cost barrier. “CPI helps us provide free services to 100 patients annually,” confirms Dr. Zin. “We base our decision on their health status, financial circumstances, and genetic predisposition to liver cancer. Patients receive a three-month supply of medication at first. They return every three months for ongoing monitoring and care until their situation stabilizes. Then, we see them every six months or annually.”
“At the last follow-up, the clinic couldn’t detect any virus in my blood.”
Travel in Myanmar has become more difficult since the COVID-19 pandemic, making communities hard to reach. “For those in remote areas, we’re exploring ways to improve access to medication and services,” explains Dr. Zin. “For example, they can conduct blood tests locally and share results via messaging apps for virtual consultations with us.”
“We measure our success by the treatment outcomes of our patients,” continues Dr. Zin. “If their viral load is undetectable and their liver function improves after six months, we are satisfied.”
Despite her fears, Ma Myint’s decision to get tested and treated for hepatitis B has a happy ending. “I did worry if I could be cured,” she admits. “At the last follow-up, the clinic couldn’t detect any virus in my blood. I was thrilled to hear that. And none of my family members have tested positive.”
As well as supporting the Myanmar Liver Foundation, CPI also leads pioneering research to prevent mother-to-child transmission of hepatitis B during childbirth, the most common way that the virus is transmitted. Watch our video, “Stopping Hep B at Birth”, to learn more.
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