IN PROFILE: Myanmar

While the world flocked to Bali, Thailand and other South-east Asian destinations, Myanmar (or as many prefer, Burma) was closed to the rest of the world for over half a decade.

A tourism boycott put in place in 1996 was lifted four years ago when pro-democracy leader Aung San Suu Kyi was released from house arrest. The democratic reforms that followed the 2010 elections have seen some thawing in relations between the ruling military junta and foreign powers, opening the door to investment and development – including tourism.
On the plus side, years of isolation meant Myanmar escaped being ‘over loved’ by visitors. Its people are friendly, crime is low, and scams few. 
Dotted with magnificent Pagodas, Myanmar retains a sense of the mysterious Orient, while retaining architectural reminders of Old Burma’s British colonial past.

Visitor arrivals rising 

On the down side, the demand for hotel rooms far outstrips supply (making accommodation relatively expensive) and Myanmar’s tourism infrastructure remains under-developed. These and other shortcomings are gradually being addressed through the Tourism Master Plan, which is aiming to lure 7.5 million overseas arrivals by 2020.
Some pro-democracy advocates say the much-needed tourism-generated revenue has come on the back of the junta's forced labour programs. Others argue that, done responsibly, tourism brings much-needed income to local communities and small businesses.
However, there’s no doubting that the world is quickly discovering Myanmar. In 2012, 18,261 Australians arrived at Yangon International Airport, around 3% of the 593,391 visitors. Reported government figures revealed the number of foreign visitors arriving by air and land reached just over 2 million in 2013. 
Clearly, the time to see the authentic Myanmar is… SOON.

Vaccinations for Myanmar

There are no REQUIRED (mandatory) vaccinations: Yellow fever is NOT a requirement, unless you arrive from an endemic country of Africa or South America.
Updating your childhood vaccinations is considered ROUTINE before any overseas trip. Check with your GP and, if necessary update measles-mumps-rubella (MMR), diphtheria-tetanus-pertussischickenpox, and polio. Also ensure you are protected against seasonal influenza, the most common vaccine-preventable illness among international travellers. 
Heading the list of RECOMMENDED vaccinations is Hepatitis A, considered a moderate risk for all travellers, regardless of the length of stay or type of accommodation. Hepatitis B is especially relevant for young singles, frequent flyers, and those heading ‘off the beaten track’ where medical facilities are scant. There’s a moderate risk of typhoid in Myanmar and vaccination is recommended for even short stays, especially if planning to visit towns or villages. Cholera is NOT a risk in Myanmar. (Read about Rabies and Japanese encephalitis below).

Malaria and mozzies

Myanmar’s annual malaria death toll is one of the highest in Asia. (India, Myanmar, Bangladesh, Indonesia, and Papua New Guinea account for around 93% of the region’s malaria fatalities, according to figures from the Roll Back Malaria initiative.) The cities of Yangon (formerly Rangoon) and Mandalay, and locations above 1000m elevation, are considered to be malaria-free. However, the mosquito-borne disease remains a SIGNIFICANT RISK in rural areas of the country, most notably the provinces of Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi. America’s CDC ranks the overall malaria risk as ‘moderate’ and warns that 90% of cases are the potentially fatal P. falciparum strain. (Adding a more dangerous dimension to the malaria risk is the multi-drug resistance that is now widespread along much of the Myanmar-Thailand border.)
Malaria medication: For Australians, the most commonly prescribed anti-malaria chemoprophylaxis (taken before potential exposure to prevent malaria) includes Doxycycline or MalaroneMefloquine (Lariam) is also effective everywhere except the provinces of Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi. 
Whether or not you take medication to prevent malaria or treat it is a decision you should make after discussing your travel itinerary with a doctor, ideally one experienced in travel medicine. Your doctor will determine whether taking prevention medication or carrying a drug to treat malaria at the first sign of infection would be best for you, based on your itinerary, length of stay, and level of exposure.

Other reasons to pack repellent

Dengue fever infection is even more common than malaria in Myanmar, while its ‘cousin’, the Chikungunya virusoccurs there, too. Both are spread by two species of day-time feeding mosquitoes, Aedes aegypti and Aedes albopictus. Unlike the mainly rural-dwelling mosquitoes that spread malaria, the Aedes mozzies are equally at home in the biggest cities or the smallest villages – anywhere, in fact, people live.
Two other mosquito-borne diseases that are present but much less common among travellers are lymphatic filariasis, a parasitic disease caused by thread-like worms, and Japanese encephalitis (JE). JE is thought to occur countrywide in Myanmar, with most human cases reported from May to October. However, JE is rare among travellers and vaccination is usually reserved for those spending an extended period in rural farming areas, those living in endemic areas, or those staying in locations where outbreaks are occurring. (Outbreaks of human disease have been documented in several states, with antibodies also detected in both humans and animals in other areas.)

BYO repellent and bed net

Effective insect repellent can be hard to obtain in Myanmar, so bring enough from home to last the duration of your stay. Some guesthouses and hotels don’t have mosquito nets either so, once again, if you plan to stay in budget accommodation, pack your own permethrin-impregnated net. 
(In fact, don’t rely on air-conditioning to keep your room cool/warm or free of insects. Power outages are common, making air-conditioning problematic – even in upmarket hotels. As a result, many hotels and shops run generators 24 hours, while others only run them for a few hours at night and/or in the morning. That means you may need to open windows that may not be screened…)

Beware other ‘bities’, too

Mozzie bites aren’t the only ones to be wary of. The rabies risk in Myanmar is rated ‘high’ although, as with Japanese encephalitis, vaccination is usually recommended for long-stay expats or those travelling in rural areas, especially if on on bicycle tours, camping, or hiking etc. However we advise that you discuss rabies vaccination with your doctor, as at-risk bites are also reported in the first couple of weeks of travel. In addition, Myanmar has one of the highest incidences of death from snakebite in the world: tread warily when walking in tall grass or forests.

Be prepared for traveller’s diarrhoea

The risk of traveller’s diarrhoea (TD) in Myanmar is also rated ‘high’, which makes it important to follow the rules of personal hygiene – especially regular hand washing – and selecting the safer food and beverage options. TD often clears up without specific treatment, but it’s wise to keep oral rehydration fluids on hand to replace lost fluids and electrolytes. Travellers who pass three or more loose bowel motions in an eight-hour period, especially if there are other symptoms like nausea, vomiting, abdominal cramps, fever, or blood in stools should consider taking a course of antibiotics. Ask about the appropriate medication and dosages during your pre-travel medical consultation. If diarrhoea persists despite therapy, see a doctor – the cause may be a parasitic infection. Learn more about traveller’s diarrhoea and how to avoid it

WHAT TO PACK

Insect repellent – Apply repellent containing an active ingredient, such as DEET (30-50% formulations for adults, or up to 30% for young children aged from 6 months), Picaridin, IR3535, or oil of lemon eucalyptus when outdoors. Read more on avoiding biting insects.
https://www.travelvax.com.au/holiday-traveller/travel-tips/insect-protection
A treated bed net – Permethrin is an insecticide that is safe for humans, but kills insects that come into contact with material treated with it. You can buy a net that’s already treated or make up the solution and treat your net, clothing, hats etc.
Sunscreen – To ward off the tropical sun’s UV rays, take a 50+ sunscreen and apply it to all exposed skin as directed when outdoors. 
First-aid kit – In case of an accident, it’s reassuring to know you have a travel first-aid kit containing syringes, needles, sutures etc. that local medical personnel can use, along with basic first-aid items you might need from day to day. The standard of medical facilities in Burma is extremely limited, particularly outside Rangoon. Travellers are advised to avoid surgical procedures, (including dental work) due to the danger of hepatitis, HIV/AIDS and other infections from unsterile dental and medical instruments. 
Finally, read more on the importance of comprehensive travel insurance, areas to avoid, and local conditions on Smartraveller, the Australian Department of Foreign Affairs’ website for Australian travellers. Australia’s embassy in Myanmar is located at 88 Strand Road, Yangon. Telephone: (95 1) 251 810, Fax (95 1) 246 159, Email: austembassy.yangon@dfat.gov.au. Website: http://www.burma.embassy.gov.au/ 
(In a consular emergency if you are unable to contact the Embassy you can contact the 24-hour Consular Emergency Centre on +61 2 6261 3305 or 1300 555 135 within Australia.)

For more expert, no-obligation advice on staying healthy on your next overseas trip, or to book your pre-travel medical consultation at a Travelvax Australia clinic, please call 1300 360 164 (toll-free for landlines).