October 30, 2015 |

Monks, mobile phones, and motorbikes: tradition and change in SE Asia

Booming economies and rapid change in Myanmar and Vietnam create new opportunities for innovation to improve health.
Woman sitting outside flower stall smiling with smartphone in hand.
In rapidly modernizing Myanmar, many women still wear traditional thanaka paste on their faces. This woman is selling offerings outside the ancient Botahtaung Buddhist pagoda while passing the time between customers by browsing the newly available Internet on her smartphone. Photo: PATH/Minzayar.

A typical girl in Myanmar grows up hearing that menstruation makes her unclean and inferior to boys. Her clothes must be washed, dried, and ironed separately to avoid soiling the clothes of her male relatives.

Sexuality remains a taboo subject. She can’t ask questions at home about her changing body or learn the basics about sex at school.

Imagine, then, the quiet revolution taking place at the office of Akhaya Women, a grassroots women’s rights organization in Myanmar.

Daw Htar Htar and her small staff lead weekly discussion groups on female sexuality that have attracted hundreds of women, from housewives and maids to health workers and nuns.

The goal: to empower women to challenge gender stereotypes and advocate for gender equality and safer communities.

“Women need to know their bodies—clean and powerful and giving life,” she says.

If women learn the facts about their bodies, they will have more confidence, which they will pass along to their daughters, she says. “And once women feel empowered, you cannot stop them.”

Daw Htar Htar standing in front of shelf holding books and handmade necklaces.
Daw Htar Htar is an emerging voice for women’s rights in Myanmar. Photo: PATH/Jolayne Houtz.

Myanmar—one of PATH’s newest country programs—abounds with new possibilities and stubborn contradictions like this.

Earlier this month I was part of a PATH story-gathering team that visited some of our projects in Myanmar and Vietnam to document health challenges in the region and the impact of our work.

In both countries, we found fascinating contrasts, profound health needs, and innovative thinking that is opening the door for new opportunities.

Young woman behind counter at Dairy Queen offers an ice cream cone.
Shopping malls and Western chains are rapidly changing the face of Vietnamese commerce as the economy booms. Photo: PATH/Matthew Dakin.

Vietnam, where rickshaws pedal past Kentucky Fried Chicken

Our travels started in Vietnam, home to PATH’s oldest country program. Since our work began here in 1980, Vietnam has transitioned from one of the world’s poorest countries to a solidly lower-middle-income economy brimming with entrepreneurial energy.

At the same time, lifestyle changes are fueling a sharp rise in the burden of chronic diseases such as hypertension and cardiovascular disease even as the country continues to struggle with infectious diseases such as tuberculosis and HIV.

In Hanoi, we admired the community culture of exercise in the parks, with scores of people meeting together in the mornings and evenings to participate in yoga, tai chi, ballroom dancing, badminton, soccer, and other forms of exercise.

Men and women ballroom dancing in a park.
At 6:30 a.m., although the heat and humidity were already stifling, we found scores of Hanoi residents gathered in parks for morning exercise, including this ballroom dance class. Photo: PATH/Matthew Dakin.

At the same time, the health impacts of rapid economic change were all around us. Streets that were once crowded with bicycles are now jammed with motorbikes. Coming from the United States, where smoking has declined sharply, the prevalence of cigarette smoking was notable.

One evening, we joined in the local custom of drinking bia hoi. Streetside cafes offer light beer and snacks in the evening, and at the tables around us, almost everyone was smoking.

Table shown from above strewn with snacks, beers, and cigarette packs.
Enjoying a few lightly alcoholic, locally brewed bia hoi beers and some snacks with friends is a common way to pass the early evening in Hanoi. Photo: PATH/Matthew Dakin.

PATH works closely with the Vietnamese government, private-sector partners, and civil society organizations on a wide range of innovative health projects that are helping the country tackle both infectious and noncommunicable diseases. That includes a new Communities for Healthy Hearts initiative that is encouraging people to get screened for hypertension and improving the quality of referral, treatment, and follow-up care.

Girl and her mother sit at a market stall in Myanmar wearing traditional face powder.
Myanmar is undergoing a rapid transition, with old customs and traditions being challenged by new technology and ways of thinking. Advertisements for the emerging mobile phone sector (shown here with the wild-haired youth) seem to cover every available surface. Photo: PATH/Minzayar.

“The giant waking-up” of Myanmar

In Myanmar, the dawning opportunities and daunting challenges ahead seem even more pronounced. Political and economic reforms over the past four years and a loosening of nearly 50 years of military control have created new hope and signs of economic progress.

On November 8, the country will vote in what is being touted as the first free national elections in 25 years. On the streets, freshly cut wood frames hold up new campaign signs for various political parties, including Nobel Peace Laureate Aung San Suu Kyi’s National League for Democracy party.

Sandii Lwin, a local board member for PATH, recently returned to Myanmar after many years working abroad. She describes it as “the giant waking-up” of her country.

Campaign signboard of the National League for Democracy party, led byAung San Suu Kyi, in downtown Yangon.
Opposition billboards (illegal until recently) and an influx of new cars signal change in Myanmar, while monks provide an omnipresent reminder of the ancient cultural traditions and long history of the country. Photo: PATH/Minzayar.

Yangon, the country’s commercial hub, is a city in transition—and gridlock. Mobile phone use has exploded since the government allowed private companies to enter the market. Import restrictions on cars have eased, prices have dropped, and the city’s too-few arterials are now clogged with traffic throughout the day.

Myanmar, too, is grappling with the double health burden of infectious and noncommunicable diseases. The country has some of the poorest health indicators in the region. Grinding poverty, overtaxed health systems, and unequal access to health care, especially in rural areas, leave too many people vulnerable to disease and illness.

Technician with mask inspects rice on a factory conveyer belt.
As lifestyles and diets change in Myanmar, PATH is working with the government and local private-sector partners to address nutritional issues through strategies that include the introduction of fortified rice. Photo PATH/Minzayar.

Since we opened our country office in Yangon in 2013, PATH has partnered with the government, businesses, and civil society organizations to improve nutrition and newborn care; support women’s and reproductive health; strengthen immunization; and lay the groundwork to introduce new vaccines.

Healthy communities start with healthy women and children

On our team’s last day in Myanmar, we traveled outside Yangon to visit a rural monastic school, where founder and headmaster Bhaddanta Indaka provides free basic education for 825 low-income students as well as health care services for their families and people in more than a dozen neighboring villages.

Schoolchildren eat lunch on school steps.
At Saddhimma Jotikarun Monastic Educational School, more than 800 low-income students are receiving an education as well as free meals. Photo: PATH/Minzayar.

The green school buildings, most built with private donations, are clustered around a tree-shaded courtyard filled with the sounds of students reciting lessons, singing, laughing. When Indaka enters their classrooms, they stand and fold their hands respectfully in front of them.

Good health and education go hand in hand, says Indaka, who recently opened a health clinic at the school. Healthy children grow up to become well-educated adults who can support themselves, their families, and their communities.

We believe this, too: Better health unlocks human potential. By empowering countries and communities in Southeast Asia to tackle their greatest health needs, PATH is reaching vulnerable women and children with innovative solutions they can use to transform their own health, their futures, and their countries.

Buddhist monk standing in classroom full of children.
School founder and headmaster Bhaddanta Indaka. Photo: PATH/Minzayar.

Editor’s note: Look for more content from PATH’s story-gathering trip to Asia in the coming weeks.

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