Sunday, May 06, 2012

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Request letter to take care of Phyo Wai Aung illness...........6 May 2012

1.Officer-In-ChargeInsein Prison, Yangon 
2.Medical Officer-In-ChargeInsein Prison, Yangon 
Date: 26 April 2012 
Regarding to: To do necessary investigations and to refer Phyo Wai Aung, whose health isdeteriorated due to Liver Disease, to Specialist

Regarding to the above subject,Dr.HtetWaiAung, holding MedicalRegistration number-30682, Brother of Phyo Wai Aung, submits as follow;1.
My brother, Phyo Wai Aung, have been detained at Insein Prison since two years ago byaccused him in involving in 2010 X2O bombing by Special Brach of Police.2.
Phyo Wai Aung had been once under Liver operation for liver abscess. And he has Hepatitis Bviral infection. In this regards, the request letter was submitted to Insein Prison officials on 24May 2010 to allow to take the prescribed medicines and to refer him to hepatologist. Prisonofficials only allowed him to take liver support medicines and did not show him to Liverspecialist.3.
On April 2011, he had severe back pain and he was diagnosed as mild lumber spondylosis byInsein Prison medical officer after X-ray had been done. NSAID (non-steroidal anti-inflammatory drugs) was prescribed.4.
On mid-January 2012, he had got regular evening rise in temperature and requested Prison tobe seen by medical officer. Only 15 days later- 30
January, he was seen by medical officer.After doing chest X-ray for one time and sputum for AFB (Acid-fast bacilli) for two times, hewas diagnosed as Pulmonary TB (although negative sputum AFB) and planned to treat withAnti-TB drugs. As family knows he had pulmonary TB years ago and he was successfullytreated, my aunt (she is also medical doctor) and me suggested that antibiotics should be startedand his illness was treated.5.
Later on, he had suffered severe pain starting from Upper Right side of abdomen (RightHypocondruim) and then to the whole abdomen and chest. But any medical officer did not seehim for one month. On 5
March 2012, he was seen by prison medical officer and ultrasoundwas done on 9
The findings were said that there was liver enlargement and livertumor. And then blood test was done and elevation of liver enzyme was found. He wasdiagnosed as mild hpyertitis and treated only treated with antibiotics and PPI (Protom pumpinhibitor- Omeprazole). But he did not feel better. On 20
March, he was prescribed by liversupport drugs and NSAID. Since severe pain in abdomen, chest a
nd back was not better,medical officer prescribed only diclo injection (analgesics). During that month and until now,
he could it only for a short period of time because of severe pain and he needs to lay down allto the time. During trials, he needed to request Judge to break the trial and to allow lay down inthe room next to court room. On 2 April, he was injected with diclo injection. On 6 April, twoliver enzyme were found elevation as per blood test. Until now, prison officials haven
t referredhim to specialist, specialist physician or consultant hepatologics.6.
On 13th
April 2012, he was hospitalized to prison hospital because of gastritis (stomachache)for 5 days. (Long term anagelsics can cause gastritis). On 18
April 2012, radiologist fromInsein General Hospital came to Insein prison and he was done by ultrasound. But radiologistsaid that she could not give the findings because the machine did not work well and the rightside could not be seen. Then Prison official took her superior and she also said that she couldnot give findings. She also suggested to do ultrasound at Insein General Hospital. And it waslearnt that she told prison staff,
It is the one you said who cannot be taken to public fromprison
. But until now, prison did not take him to the public in which there is good ultrasoundmachine or to consultant specialist.7.
The Standard Minimum Rules for the Treatment of Prisoners (Resolution 2076 LX11) Article22(2) describes as the below;
(2) Sick prisoners who require specialist treatment shall be transferred to specialized institutions or tocivil hospitals.
My father was passed away due to Hepato-Cellular Carcinoma (Liver Cancer) caused byhepatitis B virus. Therefore family so much worried about him because of having hepatitis B,liver enlargement, liver tumour, elevated liver function test and severe pain in abdomen andchest. His wife, Htay Htay, met Prison-officer-in-charge on 26
March 2012 and she requestedhim to do all necessary investigations for Phyo Wai Aung and show him to specialist. But he(Prison OIC) replied that
s health is not related to administrative side and medicalofficers did not refer Phyo Wai Aung because it was not necessary.9.
No doctor will regard a patient who has hepatitis B viral infection, enlargement of liver,liver tumour, elevated liver function test, severe pain and ill general condition (GC) asnormal person
. Every doctor will see him as sick patient and do all necessary investigationand treatment as per medical ethics. Every doctor knows how many percentage of liver tumorsare malignant (cancer). When two radiologist instructed a patient to do radio-imaging at publichospital, no GP (general practitioner) will say it is not necessary. Only if all necessaryinvestigations are done, correct diagnosis can be made and correct treatment can be prescribed.
No matter how much NSAID (analgesic) are given to a patient who had severe pain due to liverenlargement and hepatitis, it will only result in gastritis (stomachache) and upper gastro-intestinal bleeding instead of cure the underlying disease.
His (Phyo Wai Aung
s) justice, right to get free and fair public trail had been destroyed byPolice as labeling him as
Prisoner who cannot taken out from Prison
. And again, his absolutehuman right, right to health, should not be destroyed by prison OIC and prison medical officer-in-charge as labeling him as Prisoner who cannot be taken out from the prison.
Family has already informed the prison officials that family can pay the expenses for thenecessary treatment if prison did not. I cannot guess when prison official refer a patient whosegeneral condition is very back to a specialist. Insein prison is central prison which is located inYangon in which there are the highest numbers of tertiary hospitals and specialist. GP (generalpractitioner) should not be keeping symptomatic treatment to a patient who could not bediagnosed by him for any reason (instructing by Special branch of Police or prison officials)
instead of referring the patient to respective specialist who is accessible within 30
drive. Even Final Part-1 medical student know whether the patient has severe disease orhysteria by examination his general conditions. If a doctor knows his patient is very ill and it isbeyond his limit, it should not be that he
didn’t refer 
the patient to the specialist.
I would like to respectfully made the below request for my brother
s health as per the UNStandard Minimum Rules for the Treatment of Prisoners and the norm of a democratic nationwhich value human being as human being.
To take Phyo Wai Aung to a public hospital which had a good untralsoundmachine and
To refer him to consultant hepatologist
Respectfully(Signed)Dr. Htet Wai Aung14/ AhGaPa (N) 161936(Brother of Phyo Wai Aung)73A, Thida Street, Tamwe Township, Yangon0973079754, 0950485241)
President, the Republic of the Union of Myanmar, Naypyitaw2)
Union Minister, Minstry of Home Affairs, Naypyitaw3)
Chairman, Pyithuhluttaw (House of Representative), Naypyitaw4)
Daw Aung San Su Kyi, Chairperson, NLD party5)
Mr. Thomas Oeja Quintana, Special Rapportuer on human right situation in Myanmar6)
Ms. Stacy May, Foreign Affairs Officer, US Department of State, Bureau of Democracy,Human rights and labour,MAYSA2@STATE.GOV 7)
Office copy


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