Ethics & Engagement across the Wellcome Trust Major Overseas Programmes

Challenges, delays, experiences and next step for 2018 bursary awarded project from Myanmar

Greetings from Myanmar after a long period.

I hope everyone is well and staying safe in this challenging time.

I would like to update you about my project and challenges I have experienced till now.

Firstly, I would like to remind you about the project because I think some of you might not know what it is about. So, I won a GHBN bursary award in 2018 with my project entitled "Ethical challenges related to offering pregnant women with chronic Hepatitis B short course treatment with Tenofovir disoproxil fumarate to prevent vertical transmission". The aim was to explore the ethical challenges through interviews and focus group discussions with pregnant women and health care workers at the Central Women’s Hospital in Yangon. This is my first award and first project as well in this research field.

The project obtained Oxford Tropical Research Ethics Committee's (OxTREC) approval as a minimal risk study soon after obtaining the bursary award.

Then we proceeded to local Institutional Review Board (IRB) submission.

The project was instructed to pass at one of the IRB. Unfortunately, we had to queue for 7 months for the review meeting as they were overloaded with submissions. 

After the meeting, we were informed we had to pass another IRB since the project is a qualitative study which introduced another delay. While waiting for another review date, our unit’s Memorandum of Understanding (MOU) with the Ministry of Health and Sports expired and the renewal process has been continuing until very recently. The MOU is a mandatory document for IRB submission in our country. 

Now Myanmar has been hit by the Covid wave and it is impossible to go to hospitals and meet with participants. Therefore, I have been doing a systematic review on a related topic in the meantime.

So it has been 2 years since I obtained the bursary award and the light at the end of the tunnel of getting to the project initiation stage still feels a very long way off, and may be out of reach.  Although I am still very interested and willing to conduct the project and see the results, I have come to the conclusion it is not possible in reality from past experiences. I have decided to focus on the systematic review which will be more feasible to do in the meantime and withdraw the project. 

I feel sad to make such a decision but I have had many good mentorships, networks and a lot of learning experiences from the project. 

When the opportunity arises again, I hope to conduct a similar study in the future with many collaborators and sites so that we could avoid the situation of being stuck in one place and explore many different perspectives from both collaborators and participants.

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Comment by Dina Rippon on November 6, 2020 at 14:26

Dear Htet Htet, 

Thank you so much for your blog post. I'm very sorry that you faced the delays and challenges with your project that you outline. I'm sure it must have been quite frustrating. And of course the pandemic doesn't help! Nonetheless, it's brilliant that you still are doing the systematic review, and it would be great to hear what you learn from that when you are finished. We were very happy to support you in trying this project, and although circumstances have made it impossible for you to continue with it, we look forward to supporting you in other ways as you continue to develop your career in this field! I wish you all the best of luck! 

Comment by Htet Htet Aung on November 9, 2020 at 3:29

Dear Dina,

Many thanks for your supports as always. Although the project didn't happen in reality, I am happy to share about the results of the systematic review on the project related topic in future.

Comment by Michael Parker on November 9, 2020 at 22:48

Dear Htet Htet,

Thank you very much for writing this blog. It is great to hear from you. I'm really sad to hear about all the delays various bureaucratic obstacles you have faced in trying to make this important project happen. I am sure it has been very frustrating for you. However, your commitment to the project and to your ideas has been incredibly impressive. Although this has been a difficult experience for you I feel very very confident that you have great things ahead. I am looking forward to reading the systematic review. Please do stay in touch and let me know if GHBN or I can do anything to help you. 

Comment by Htet Htet Aung on November 10, 2020 at 7:56

Dear Mike,

Many thanks indeed for your support and encouragement. It was a great learning experience. 

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