Corruption Under the Medical Services Directorate

Thet Paing | ယခုဆောင်းပါးကို မြန်မာဘာသာဖြင့် ဖတ်ရှုရန် ဤနေရာတွင် နှိပ်ပါ

Cite as: 
Thet Paing. (2025). Corruption Under the Medical Services Directorate. Independent Journal of Burmese Scholarship, 5. https://ijbs.online/?page_id=5279


Abstract

The Medical Services Directorate (MSD) has 60 organs, including three major training institutions: the Defense Services Medical Academy, the Defense Services Nursing and Paramedical Academy, and the Defense Services Medical Training School. This article lists these organs and their bed capacities and provides individual overviews of these three training institutions, before explaining how the MSD is fundamentally corrupt. Although the MSD has tribunals and laws in place, low-ranked soldiers and other military personnel do not receive their entitlements—let alone the civilians. The Myanmar military is a scheme whereby officers and senior personnel are always looking for ways to personally benefit, rather than seeking to improve the country. If it continues in this way, the military will only further ruin the nation, and the people of Myanmar will continue to suffer.

Introduction

Nearly every nation has an army and every army needs military hospitals, a medical corps, and so on. In Myanmar, the defense services medical corps was formed alongside the country’s attempt for independence. In 1941, when the Burma Independence Army (BIA) entered Myanmar with its three military divisions, the pre-existing nursing corps in Dawei joined it as the nascent country’s first medical corps. Patriotic doctors and medical students joined the military units near where they lived and served alongside them. The BIA was then able to open military hospitals and later, from 1962 to 1988, the military was able to expand and organize a formal medical corps, now known as the Medical Services Directorate (MSD), alongside many more military hospitals and training schools. If an individual wants to serve in one of the many varied roles of the medical corps, they can join training schools like the Defense Services Medical Academy (DSMA), the Defense Services Nursing and Paramedical Academy (DSNPA), or the Defense Services Medical Training School (DSMTS), to learn the relevant subject areas. This article first presents an overview of all the organs of the MSD, and then discusses these three particular institutions, their admission requirements, areas of study, and so on. Note that the provisions described are merely the official ones on paper and are not always practiced by the military. The article finishes with a discussion of corruption within the MSD.

The Medical Services Directorate

According to the current structure of the Myanmar military, the MSD falls under the direct management of the Office of the Commander-in-Chief (Army). The current Director General of Medical Staff is Major General Ko Ko Lwin, and the Deputy Director General is Brigadier General Kyaw Zeya. These are the medical organizations under the MSD and their general locations:

  1. Defense Services Medical Academy, Mingaladon.
  2. Defense Services Nursing and Paramedical Academy, Mingaladon.
  3. Defense Services Medical Training School, Hmawbi.
  4. Defense Services Medical Research Corps, Nay Pyi Taw.
  5. No. 1 Defense Services General Hospital (1,000 bedded), Mingaladon.
  6. No. 2 Defense Services General Hospital (1,000 bedded), Nay Pyi Taw.
  7. No. 1 Military Hospital (700 bedded), Pyin Oo Lwin.
  8. No. 2 Military Hospital (700 bedded), Aung Pan.
  9. No. 1 Military Hospital (500 bedded), Meiktila.
  10. No. 2 Military Hospital (500 bedded), Yangon.
  11. Defense Services Orthopaedic Hospital (500 bedded), Mingaladon.
  12. No. 1 Defense Services Obstetrics, Gynecology, and Child Health Hospital (300-bedded), Mingaladon.
  13. No. 2 Defense Services Obstetrics, Gynecology, and Child Health Hospital No. 2 (300 bedded), Nay Pyi Taw.
  14. Defense Services Rehabilitation Hospital (300 bedded), Mingaladon.
  15. Military Hospital (300 bedded), Myitkyina.
  16. No. 2 Military Hospital (300 bedded), Ann.
  17. No. 3 Military Hospital (300 bedded), Keng Tung.
  18. No. 4 Military Hospital (300 bedded), Monywa.
  19. No. 5 Military Hospital (300 bedded), Mawlamyine.
  20. Health and Disease Control Unit, Nay Pyi Taw.
  21. No. 1 Medicinal Supplies Storage Unit, Nay Pyi Taw.
  22. No. 1 Field Medical Battalion, Mandalay.
  23. No. 2 Field Medical Battalion, Taunggyi.
  24. No. 3 Field Medical Battalion, Taungoo.
  25. No. 4 Field Medical Battalion, Pathein.
  26. No. 5 Field Medical Battalion, Mawlamyine.
  27. No. 6 Field Medical Battalion, Hmawbi.
  28. No. 7 Field Medical Battalion, Monywa.
  29. No. 8 Field Medical Battalion, Sittwe.
  30. No. 9 Field Medical Battalion, Khollam.
  31. No. 10 Field Medical Battalion, Lashio.
  32. No. 11 Field Medical Battalion, Bhamo.
  33. No. 12 Field Medical Battalion, Keng Tung.
  34. No. 13 Field Medical Battalion, Myeik.
  35. No. 14 Field Medical Battalion, Taikkyi.
  36. No. 1 Military Hospital (100 bedded), Monghpyak.
  37. No. 2 Military Hospital (100 bedded), Hpa-An.
  38. No. 3 Military Hospital (100 bedded), Inntaing.
  39. No. 4 Military Hospital (100 bedded), Bahtoo.
  40. No. 5 Military Hospital (100 bedded), Myeik.
  41. No. 6 Military Hospital (100 bedded), Pyay.
  42. No. 7 Military Hospital (100 bedded), Loikaw.
  43. No. 8 Military Hospital (100 bedded), Namhsan.
  44. No. 9 Military Hospital (100 bedded), Lashio.
  45. No. 10 Military Hospital (100 bedded), Kalay.
  46. No. 11 Military Hospital (100 bedded), Mong Hsat.
  47. No. 12 Military Hospital (100 bedded), Dawei.
  48. No. 13 Military Hospital (100 bedded), Kawthoung.
  49. No. 14 Military Hospital (100 bedded), Laukkai.
  50. No. 15 Military Hospital (100 bedded), Than Daung Gyi.
  51. No. 16 Military Hospital (100 bedded), Magway.
  52. No. 17 Military Hospital (100 bedded), Sittwe.
  53. No. 18 Military Hospital (100 bedded), Bokepyin.
  54. No. 19 Military Hospital (100 bedded), Homalin.
  55. No. 20 Military Hospital (100 bedded), Thabeikkyin.
  56. No. 21 Military Hospital (100 bedded), Hpapun.
  57. No. 22 Military Hospital (100 bedded), Thanlyin.
  58. No. 1 Frontline Medicinal Supplies Storage Unit, Mandalay.
  59. No. 1 Mobile X-Ray Facilities Unit, Nay Pyi Taw.
  60. Workshop Medical Unit, Yangon.

Defense Services Medical Academy, Mingaladon

Before 1992, the Myanmar army mostly recruited doctors and dentists from civilian medical universities to serve as medical officers in the military. Doctors who were assigned to the army had to attend basic military training for several months. After the 1988 uprising, the military shut down civilian universities and schools for a long time. Because of that, after a certain period of time, the military faced a perceived shortage of medical experts. Instead of recruiting civilian doctors, the military established the DSMA on 19 November 1992 with the purpose of training its own medical experts and eliminating civilian scrutiny. The army declared when the DSMA was established that it would “appoint medical officers for the Myanmar army.” Its slogan is “to bring up efficient, skillful medical officers with courage and high morale for the Myanmar armed forces.” When founded, there were only forty-seven trainees, and after six years of study, these individuals had to work as in-house surgeons. But by 2010, the DSMA was accepting close to four hundred students every year.

The difference between the DSMA and other universities is that there are more steps in the admissions process. Everyone who wants to join the DSMA must be male, pass particular admissions exams, pass physical and psychological evaluations, and before 2010, they also needed to have high matriculation exam marks equivalent to that for admission into other civilian medical universities. After 2010, individual interviews became more important for admission rather than grades. From 2010 onward, the DSMA only accepted one hundred students (or less) per year. In the 2012 academic year, there were only forty students who passed all requirements for admission. 

Similar to the civilian medical universities, the DSMA offers studies in a dual Bachelor of Medicine/Bachelor of Surgery program, a Master of Science Education program, as well as other specialist training courses, all of course alongside military training. As soon as students graduate, they are assigned to serve at lieutenant level in the military as either medical officers or medical platoon commanders. They are deployed by the office of the MSD to the front lines, battlefields, and other remote rural areas (where there is very little healthcare available). After serving in an infantry battalion for three years, they are then transferred to a field medical battalion. Medical officers who serve within the field medical battalion, following three years of service, are then transferred to a military hospital.

Defense Services Nursing and Paramedical Academy, Mingaladon

With the establishment of the DSMA, the military became able to train and deploy a sufficient number of medical officers, however, it still needed experts from other medical disciplines. Therefore, on 24 February 2000, the military opened the new Defense Services Nursing Academy with the help of the University of Nursing, Yangon, and the University of Nursing, Mandalay. In 2002, pharmacy and medical training courses were added to the list of courses available, and the name of the academy was changed to the DSNPA. Females were permitted for admission to the DSNPA, a key difference to the DSMA. Its courses included Bachelor of Nursing, Bachelor of Pharmacy, Bachelor of Medical Laboratory Technology, Bachelor of Medical Physiotherapy Technology, Bachelor of Medical Imaging Technology, Bachelor of Prosthetics and Orthotics, and so on.

DSNPA graduates are assigned as nurses and medical specialists in the medical staff corps under the MSD. Also, if suitably qualified, they can pursue relevant further study such as master’s and doctorate degrees. Scholarships are available to study said advanced degrees abroad in countries such as Russia, China, and India. After an individual has served as a nurse or medical specialist (3rd class) for a year, followed by two years as a senior nurse or medical specialist (2nd class)—a total of three years‘ service—they may then be approved for second lieutenant (senior nurse or medical specialist [2nd class]) status, if promotion to the role of gazetted officer is recommended.

Defense Services Medical Training School, Hmawbi

At the DSMTS, individuals can attend training in medical assistance, nursing, medical laboratory skills, radiology, surgical skills, dentistry, physiotherapy, midwifery (a two-year diploma), women’s nursing assistance, and women’s nursing. After the completion of training, individuals can go on to study in other related and advanced courses while serving in any of the relevant departments under the MSD.

I now discuss incidents of corruption, such as exploitation of power and bribery, that I personally witnessed or experienced in the MSD and its organs.

Corruption Within the Training Departments and Military Hospitals

Corruption is the very first step of joining the MSD, whether being admitted to the DSMA, DSNPA, or DSMTS. It slowly became increasingly difficult to gain admission to the DSMA in particular, with people bribing academy management to gain entry. Prior to the 2021 coup, most students admitted to the DSMA were either children of high-ranked military personnel, individuals related to businessmen who worked with the military, or others with close military ties. When these new special students graduated, they were considered ‘privileged ones’ within the medical corps, treated differently for their connections to high-ranked officials elsewhere in the military. At this time, the chances for civilians on the outer getting into the academy was lower than ever.

As mentioned, newly graduated DSMA medical officers must serve at infantry bases, then field medical battalions, and then military hospitals in turn, under the rank of lieutenant. This means at least one deployment to the front lines. Obviously, everyone would prefer to remain in the safety and comfort of military hospitals rather than serve at risk in field medical battalions (where their skills are actually more urgently needed). This results in medical officers at military hospitals bribing their superiors to not be transferred to the front lines and instead be allowed to continue their comfortable service at the military hospitals, even long after their time for transfer has passed. Some do not need to directly bribe and keep their positions at military hospitals because of their high-ranked military family members. Consequently, ordinary graduates without such connections, family backgrounds, or wealth must suffer the risk of repeatedly going to battlefield bases and serving at the front lines.

Turning to the DSNPA, females with positive relationships with higher-ranked officials from any of the different departments are often selected to serve at military hospitals straight after their training. On the other hand, female nurses who have years of experience and training without these companionships are continually sent to battlefield bases. Some are even sent to military livestock farms—such as chicken farms and pig farms—to serve. Higher-ranked officials use their power to exploit nurses’ knowledge and education, gained from years of study; these women are exploited only because they do not have family connections, and therefore, can be sent to positions irrelevant to their training.

In recent years, individuals with money or friendships with senior officials even transition back to civilian roles, working at advanced hospitals like Kan Thar Yar Hospital, owned by the military-controlled Myanmar Economic Cooperation (MEC).1 Military corporations like the MEC and Myanma Economic Holdings Limited (MEHL) own dozens of businesses such as factories, telecommunications companies, banking institutions, hotels, hotel resorts, and other travel-related businesses, as well as alcoholic beverage and tobacco businesses. Brigadier generals and colonels are assigned as directors of these various businesses. The MEHL and MEC Patrons Group is led by the Commander-in-Chief and the Deputy Commander-in-Chief, as Chairman and Deputy Chairman respectively.

All military personnel are mandated to buy MEHL shares using their personal monthly salaries, unlike civilians who can choose where to invest their money. The dividends gained on these shares is 30 percent, but the shares bought by the military personnel are kept as savings supposedly to be provided as benefits upon retirement. However, the dividends only ever go to the officers—the money does not flow through down to the lower-ranked soldiers.

According to military rules, eligibility for master’s and PhD courses requires achieving certain grades or having prior qualifications. However, in fact, the most important thing is just being friendly with senior officials and bribing them. It is mostly people with money for bribes and connections that are allowed to attend these sought-after courses. Those who are eligible on paper but do not have bribe money and connections forego the exact kind of education aligned with their skills and achievements. When those who fail the basic eligibility criteria for these esteemed graduate degrees utilize bribes and connections to be admitted to them, and then go on to finish their courses, often abroad in foreign countries, graduating to become military professors and senior consultants, they in fact do not possess the skills needed for their newly acquired positions and specializations.

Basically, in the military, “praise the above and press the below” behavior is now widespread, and bribery and the exploitation of power is only increasing. “The principles are good, but the people behind these principles are not good.” Those with approved family backgrounds and/or those who are wealthy end up serving in the desired ‘good’ positions within the military. This has come about because of clear violations of principles and laws and the huge growth in bribes and nepotism.

Corruption Within the Medicinal Storage Department

The Office of the Commander-in-Chief allocates US $1 billion annually to the MSD as its budget for the procurement of medical equipment and supplies. That sum of money is deemed an adequate amount to ensure that the Myanmar military’s medical matters meet international standards. However, the flow of funds from this allocation leans more towards personal gains than development for the nation. Although it is said that the US $1 billion is allocated to buy medicine and medical equipment, when the money is distributed to the MSD, it does not actually receive the entire sum. There are officials from the Office of the Commander-in-Chief who abuse this distribution for their own interests.

In their reports on medical supplies and records, these officials report that they purchase their supplies from places like India, the United States’, and South Korea—all known for their high-quality medical products. However, in reality, these officials usually import cheap, poor-quality supplies from China. These may cost only US $300,000, with the remaining US $700,000 kept for use by these corrupt officials from the Office of the Commander-in-Chief. Some of them use these state funds to establish and carry out businesses under fake names. Such exploitation is well-known, with many officials benefiting from these actions, and it can be evaluated that essentially all such officials misappropriate state funds in some way.

On top of all that, in this instance the US $300,000 that is actually used to buy the medical supplies is not even fully spent on those items. The MSD also has ‘buyers’ who bribe officers to misuse and misappropriate the medical supplies and money. From these buyers to the senior officials, every level is manipulating the allocated state funds and spinning it into their own money. To launder this ill-gotten money into ‘legitimate’ money, they then put these funds into MEHL and MEC businesses by buying shares, or by starting their own businesses, building factories, and so on—thereby transforming all of it into their own money. The military-founded MEHL and MEC are simply enterprises for illegally laundering state funds originally collected from taxpayers for the gain of corrupt military officials.

Additionally, MSD officers then open their own private pharmaceutical stores outside of military purview and stock these with medicines imported with state funds—these supplies are sent directly to the private pharmacies for their own benefit. Such acts of corruption are widespread among the military’s medical community, yet there has been no action taken against any of these people. This is because the officials with a remit to take action against such corruption are usually directly or indirectly involved in the schemes themselves. There are even cases where medicine supplies sent to bases on the front lines are misused or misappropriated. Each field medical battalion needs to distribute medical supplies to relevant bases under regional commands, which must keep supplies at a set minimum stock level. An example list of such medicines is shown in figures 1 and 2.

Figure 1
Example list of numbers 1-27 of 45 medicines for distribution to bases.



Figure 2
Example list of numbers 28-45 of 45 medicines for distribution to bases.



Medicine that needs to be sent to front line medical bases and medicine supply storage units are set up and recorded in accordance with international standards; however, the actual medicine that is sent to these places does not even cover basic healthcare. When sending drugs to the front lines, the medical officers from the medical bases on the ground usually send expired medicine, illegally selling the newer drugs on the ‘outside’ for their own financial gain. Consequently, lower-ranked soldiers at the front lines suffer— they do not receive quality medicine, any diseases suffered take hold without proper treatment due to the use of expired drugs, they then become more resistant to these lower-quality drugs (like antibiotics), and so on.

Additionally, while official reports state that the military only supplies types of medicine approved by international standards and regulations, in reality, they use drugs banned by the United States’ Food and Drug Administration (FDA). For example, in April 2020, the FDA banned ranitidine, a drug that reduces the amount of acid the stomach produces, for containing N-Nitrosodimethylamine, a carcinogenic chemical. Some severe side effects of ranitidine usage include stomach cancer, esophagitis, nasopharynx-related diseases, and bladder-related diseases—all good reasons to ban ranitidine products. However, sales representatives from pharmaceutical companies continue to bribe Myanmar medical officers, and they still import these drugs to this day. If medical officers order the placement of these drugs into the military clinics, no one can object to these orders. These exploitative practices and banned drugs imports harm both the public and the military. By accepting bribes, high-ranked military personnel are just looking out for their own good.

The Absence of a Doctors’ Code of Ethics

The military promotes and showcases itself on air—of course, on military-owned television channels—as providing free healthcare to villages located in the ethnic states. Sometimes, international media outlets and other TV channels will also broadcast these ‘news’ pieces and even praise such actions. In such clips, high-ranked military officials themselves lead medical and nursing units around and provide assistance to people. However, behind these media video clips, there is military corruption.

In the videos, everything is presented as being noble and admirable—people being cured of their diseases, patients requiring surgery getting registered and checked in at the military hospitals, provision of free health assistance, and so on—but in reality, it is nothing like that. The military instead often provides civilian patients with a date to attend surgery, with the promise that it would be free-of-charge, but when the patient turns up at the hospital, they are asked to pay—or forego the necessary surgery. Even specialist surgeons and those with doctorates use excuses not to operate on patients if they do not receive extra fees—they say the required medicine or equipment has not arrived, and so on. Patients who can afford to pay bribes are prioritized and consequently looked after very well.

These corrupt individuals are not only ignoring their sworn duty to protect citizens, as a member of the military, but are also ignoring the code of ethics that doctors adhere to in caring for their patients. They also directly insult the public by not giving them the service they deserve as taxpayers. Civilians are not the only ones exploited in this way, but so are other military personnel, who arrive at hospitals, either due to injury or disease, to be discriminated against and treated differently depending on their background and financial situation. I have personal experience in this matter.

I knew a sergeant injured in battle and he had to undergo surgery because he dislocated his entire hip bone. But, because he was not in a very strong financial situation, he could not bribe the doctors. His surgery date was then postponed time and time again, as the doctors would only operate on those who could pay. Later, after his condition had already deteriorated, this sergeant had to borrow money from other people to bribe the surgeon with approximately 5 million Myanmar Kyat—only then would they operate on him.

These scenarios continue to often occur. With the public’s tax money, the military are only causing problems for the people, and are also openly violating the rights of low-ranked soldiers. They are complicit in acts of bribery and openly exploit their positions and power as if such abuse were in accordance with the law, rather than the opposite—completely against the law.

Conclusion

It can be said that the Myanmar military has sound structural rules and policies in relation to the medical sector. Within the organizational structure, they are able to provide adequate medical bases and ground medical units for all divisions and states. When it comes to medical training, there is not only “good” education, but some individuals are even sent abroad to further their studies. In terms of medical technology, Myanmar even has a military-owned pharmaceutical manufacturing factory. The military has laws in place that provide both physical and psychological support to the family members of both amputee and killed soldiers.

However, those provisions and laws only exist on the books, and in real life, said provisions and laws are being openly and explicitly violated by military officers. Even with a military-owned pharmaceutical manufacturing factory, basic medications are being imported from overseas, using up a lot of state funds. Said funds are not being well used for military or national purposes, as higher-ranked individuals and officers are also using them for their own benefit and openly exploiting their power. Although there are MSD tribunals and laws in place, many low-ranked soldiers and other military personnel do not receive their entitlements—let alone civilians. Due to propaganda, these low-ranked soldiers do not recognize that their lives are being trampled on for the benefit of high-ranked military officials. As such, the Myanmar military is a scheme whereby officers and senior personnel are always looking for ways to personally benefit, rather than seeking to improve the country, causing many problems for the nation. If it continues in this way, the military will bring about more ruin for the nation, and the people of Myanmar will continue to suffer immeasurably.

Endnotes

1 However, because Kan Thar Yar hospital is special, if anyone causes problems while serving there they can be sent to the front lines as punishment.