The World Health Organization (WHO) is the technical agency responsible for health within the United Nations system. Its principle job is to provide technical advice and support to the Government of Mongolia and the Ministry of Health. Also, WHO work closely with other partners to promote the global and regional health goals to prevent and protect humankind from devastating ill health in an era of globalization with increasing interdependencies between countries.
We interviewed with Dr Soe Nyunt U, WHO Representative in Mongolia.
-You are working in Mongolia as country representative since 2012. What is the priority health issue of Mongolia?
-When you look at mortality and mobility issues, top causes of deaths in Mongolia are noncommunicable diseases. Mongolians are still dying of heart attack at first (cardiovascular diseases). Second are the cancers. Mongolian death rate from liver cancer is highest in the world. Also, we have common stomach cancer. Third we have road traffic accident, violence and injuries. Even roads are getting better and better in terms of connection, but because of the weather during the winter is very dangerous. Also, during summer in Mongolia, people drink lots of vodka and they ride. Because of this, lots of car accidents happen and many young adults die. Diabetes, chronic respiratory diseases are popular among Mongolians.
-How about communicable diseases?
-Mongolia still has a lot of communicable disease among the population. Notable is tuberculosis and sexually transmitted infections (STI) among the young adults. We have pneumonia due to we have very cold winter. Since March 2015, we have measles outbreak. Also, foodborne disease outbreak or food safety problem and drink safety problems are common in Mongolia. Even last weekend, we have alcohol poisoning. We still have issue with hygiene and hand hygiene. Because of this, hydro or foodborne diseases are happening in the school canteen.
Moreover, we have 60 plus millions of animals, zoonotic diseases are important. But not in terms of frequency, in terms of outbreak, sometimes we get brucellosis and anthrax outbreak.
-What STIs are common in Mongolia?
-Gonorrhea is popular among young adults of Mongolia. Many people treat it without proper prescriptions, they treat it themselves buying medicine. Not properly treat, but later infections become resistant to all this antibiotics.
Second is syphilis. Because many pregnant mothers got syphilis and they pass it to their newborn babies. We call it congenital syphilis. If a baby is born with syphilis, the baby has many sign and symptoms of congenital syphilis. Normally a woman in her pregnancy should go to care center for screening. If their syphilis positive, they should get a full treatment. If both partners are treated, they should not be any problem and their baby will be born without syphilis. But sometimes mothers do not come to hospital.
In 2015, we have 52 cases of babies born with congenital syphilis. We do not want any baby born with any infection. We can prevent mother to child transmission. As long as the mother is coming to the health care and get properly tested, we can treat and cure them together with the partner and prevent infection from innocent child. Infectious disease is heavy problem in Mongolia, but our main problems are noncommunicable diseases.
STI, by itself does not kill a person, but you will have several symptoms and you will have complications. Later you might have serious disease like cervical cancer.
In terms of the percentage, about 32 percent of all infectious diseases are STI, which is one third of all infectious disease.
Not only in Ulaanbaatar city but also other rural areas, STI is popular among the young adults. It does not mean that rural areas are completely free from STI. Now the road network has became really good. In the next couple year, every aimags will be connected with each other with roads. So we have to be careful that even STI is spreading. In terms of the percentage, about 32 percent of all infectious diseases are STI, which is one third of all infectious disease.
In Mongolia, if the woman is sexually active almost 100 percent of those women already have human papillomavirus (HPV). It does not produce serious symptoms. But ten years later, it causes cervical cancer for woman and genital cancer in man. Mongolia is already among the leading country in Asia Pacific countries with cervical cancer. In 10 years from now, our cervical cancer may go up even higher. If you do not do proper screening and the prevention in the next 10 years, you have a chance of developing cervical cancer.
I want to advice any woman definitely about the age of 30 to do the examination every three years.
-I think the epidemic proportion of STI among young adults are because of they have not enough health education. What do you think?
-Mongolian literacy rate is high. However knowledge about protective health behavior is low. In Mongolia, understanding about condom use is not very high. When it comes to behavior using condom for sex, no one is using condom.
In country like Thailand, Cambodia, we promote “no condom, no sex”. Now it with all education and help promotion, HIV incidents and unwanted pregnancy and STI in those countries has dropped. Also, we have to prevent young adults from alcohol abuse.
Ministry of Health and Ministry of Education need to collaborate with each other. Mongolia is the only country among the other developing countries in Asia-Pacific region where every school employ medical doctor. Those doctors in the schools have to do health education and promotion, not just treating students when they got injure. If they provide the appropriate health education at appropriate age, children can grow without any infection or disease. Even we should start at kindergarten from hand hygiene after going to toilet. If you start this kind of appropriate health behavior training from kindergarten, you do not have to this anymore.
-What is the major cause of other noncommunicable diseases?
-Everyone say that no family in Mongolia has person without liver cancer. The cause of cancer is Hepatitis B and C. It leads to liver cirrhosis and later liver cancer. Now we have drugs for Hepatitis B and C. Liver is very fantastic organism. Regeneration of liver is so good. If you cure the Hepatitis viruses, liver damage will be stopped and the liver will regenerate. But the drug is still expensive in Mongolia. The Government is now planning to use their budget and social insurance contribution for the medical expense. As a result, we can make the medicine available to the poor patients. Combine with this treatment, we have to do prevention and control. In this way we can bring down the liver cancer rates. In regards, many stakeholders are collaborating and we are increasing the availability and treatment of those drugs to many people.
Stomach cancer is related to H pylori infection. H pylori infection is related to hygiene, sanitation and food safety issue. If food outlets, dormitory, food stores are not properly hygienic, they can spread H pylori infection to many people. If you have a chronic H pylori infection, you can end up with a stomach cancer. Now Ministry of Health put screening for both noncommunicable and communicable diseases as a priority.
-I think maybe the major cause for those diseases are caused by smoking and alcohol abuse?
-Now the average life expectancy of Mongolians is 68-69. We want to reduce the gap between the men and women`s life expectancy from current 10 years to 8 or 7. Mongolian men are died ten years ahead of the women. Ten years is too much.
Mongolian men are died ten years ahead of the women.
Two things are very common, smoking and drinking. The Ministry of Health wants to increase the tobacco and alcohol taxes. Cigarettes are very cheap in Mongolia. Mongolia has one of the cheapest cigarettes in Asia. Even students can afford the cigarettes and start smoking. Alcohol is very cheap too. Unfortunately, when we have very cheap alcohol and cigarettes, medicine price are very high. We are looking for possibility to reduce the drug price.
I had the same problem in Philippine before I came to Mongolia, they had cheap cigarettes and very expensive drugs around 2007. Ministry of Health and many stakeholders worked really hard to increase the tobacco and alcohol price by increasing the tax by 20-30 percent. Now Philippine is different from Mongolia.
-Could you name the positive changes that have occurred in Mongolian health sector?
-We have great achievement in maternal and child health. Mongolia has become one of the nine countries that achieved Millennium Development Goals, especially in maternal and child health.
Almost 100 percent of Mongolian mothers deliver their babies in the health facilities. We have a very high delivery rates in health facilities attended by skilled professionals who are trained for a safe delivery. Developing countries like Indonesia and Philippine, 40-50 percent of deliveries are still happening at home. Those countries have higher maternal death and higher infant death.
Also, Mongolian sportsman and woman are winning Olympic medals and World Championship medals. Many Mongolians are having some issues with health behavior. Thus, it is great for them to use those role models as inspiration and start training by not ending up with drinking and smoking.
-Thank you for the interview.
The World Health Organization (WHO) is the technical agency responsible for health within the United Nations system. Its principle job is to provide technical advice and support to the Government of Mongolia and the Ministry of Health. Also, WHO work closely with other partners to promote the global and regional health goals to prevent and protect humankind from devastating ill health in an era of globalization with increasing interdependencies between countries.
We interviewed with Dr Soe Nyunt U, WHO Representative in Mongolia.
-You are working in Mongolia as country representative since 2012. What is the priority health issue of Mongolia?
-When you look at mortality and mobility issues, top causes of deaths in Mongolia are noncommunicable diseases. Mongolians are still dying of heart attack at first (cardiovascular diseases). Second are the cancers. Mongolian death rate from liver cancer is highest in the world. Also, we have common stomach cancer. Third we have road traffic accident, violence and injuries. Even roads are getting better and better in terms of connection, but because of the weather during the winter is very dangerous. Also, during summer in Mongolia, people drink lots of vodka and they ride. Because of this, lots of car accidents happen and many young adults die. Diabetes, chronic respiratory diseases are popular among Mongolians.
-How about communicable diseases?
-Mongolia still has a lot of communicable disease among the population. Notable is tuberculosis and sexually transmitted infections (STI) among the young adults. We have pneumonia due to we have very cold winter. Since March 2015, we have measles outbreak. Also, foodborne disease outbreak or food safety problem and drink safety problems are common in Mongolia. Even last weekend, we have alcohol poisoning. We still have issue with hygiene and hand hygiene. Because of this, hydro or foodborne diseases are happening in the school canteen.
Moreover, we have 60 plus millions of animals, zoonotic diseases are important. But not in terms of frequency, in terms of outbreak, sometimes we get brucellosis and anthrax outbreak.
-What STIs are common in Mongolia?
-Gonorrhea is popular among young adults of Mongolia. Many people treat it without proper prescriptions, they treat it themselves buying medicine. Not properly treat, but later infections become resistant to all this antibiotics.
Second is syphilis. Because many pregnant mothers got syphilis and they pass it to their newborn babies. We call it congenital syphilis. If a baby is born with syphilis, the baby has many sign and symptoms of congenital syphilis. Normally a woman in her pregnancy should go to care center for screening. If their syphilis positive, they should get a full treatment. If both partners are treated, they should not be any problem and their baby will be born without syphilis. But sometimes mothers do not come to hospital.
In 2015, we have 52 cases of babies born with congenital syphilis. We do not want any baby born with any infection. We can prevent mother to child transmission. As long as the mother is coming to the health care and get properly tested, we can treat and cure them together with the partner and prevent infection from innocent child. Infectious disease is heavy problem in Mongolia, but our main problems are noncommunicable diseases.
STI, by itself does not kill a person, but you will have several symptoms and you will have complications. Later you might have serious disease like cervical cancer.
In terms of the percentage, about 32 percent of all infectious diseases are STI, which is one third of all infectious disease.
Not only in Ulaanbaatar city but also other rural areas, STI is popular among the young adults. It does not mean that rural areas are completely free from STI. Now the road network has became really good. In the next couple year, every aimags will be connected with each other with roads. So we have to be careful that even STI is spreading. In terms of the percentage, about 32 percent of all infectious diseases are STI, which is one third of all infectious disease.
In Mongolia, if the woman is sexually active almost 100 percent of those women already have human papillomavirus (HPV). It does not produce serious symptoms. But ten years later, it causes cervical cancer for woman and genital cancer in man. Mongolia is already among the leading country in Asia Pacific countries with cervical cancer. In 10 years from now, our cervical cancer may go up even higher. If you do not do proper screening and the prevention in the next 10 years, you have a chance of developing cervical cancer.
I want to advice any woman definitely about the age of 30 to do the examination every three years.
-I think the epidemic proportion of STI among young adults are because of they have not enough health education. What do you think?
-Mongolian literacy rate is high. However knowledge about protective health behavior is low. In Mongolia, understanding about condom use is not very high. When it comes to behavior using condom for sex, no one is using condom.
In country like Thailand, Cambodia, we promote “no condom, no sex”. Now it with all education and help promotion, HIV incidents and unwanted pregnancy and STI in those countries has dropped. Also, we have to prevent young adults from alcohol abuse.
Ministry of Health and Ministry of Education need to collaborate with each other. Mongolia is the only country among the other developing countries in Asia-Pacific region where every school employ medical doctor. Those doctors in the schools have to do health education and promotion, not just treating students when they got injure. If they provide the appropriate health education at appropriate age, children can grow without any infection or disease. Even we should start at kindergarten from hand hygiene after going to toilet. If you start this kind of appropriate health behavior training from kindergarten, you do not have to this anymore.
-What is the major cause of other noncommunicable diseases?
-Everyone say that no family in Mongolia has person without liver cancer. The cause of cancer is Hepatitis B and C. It leads to liver cirrhosis and later liver cancer. Now we have drugs for Hepatitis B and C. Liver is very fantastic organism. Regeneration of liver is so good. If you cure the Hepatitis viruses, liver damage will be stopped and the liver will regenerate. But the drug is still expensive in Mongolia. The Government is now planning to use their budget and social insurance contribution for the medical expense. As a result, we can make the medicine available to the poor patients. Combine with this treatment, we have to do prevention and control. In this way we can bring down the liver cancer rates. In regards, many stakeholders are collaborating and we are increasing the availability and treatment of those drugs to many people.
Stomach cancer is related to H pylori infection. H pylori infection is related to hygiene, sanitation and food safety issue. If food outlets, dormitory, food stores are not properly hygienic, they can spread H pylori infection to many people. If you have a chronic H pylori infection, you can end up with a stomach cancer. Now Ministry of Health put screening for both noncommunicable and communicable diseases as a priority.
-I think maybe the major cause for those diseases are caused by smoking and alcohol abuse?
-Now the average life expectancy of Mongolians is 68-69. We want to reduce the gap between the men and women`s life expectancy from current 10 years to 8 or 7. Mongolian men are died ten years ahead of the women. Ten years is too much.
Mongolian men are died ten years ahead of the women.
Two things are very common, smoking and drinking. The Ministry of Health wants to increase the tobacco and alcohol taxes. Cigarettes are very cheap in Mongolia. Mongolia has one of the cheapest cigarettes in Asia. Even students can afford the cigarettes and start smoking. Alcohol is very cheap too. Unfortunately, when we have very cheap alcohol and cigarettes, medicine price are very high. We are looking for possibility to reduce the drug price.
I had the same problem in Philippine before I came to Mongolia, they had cheap cigarettes and very expensive drugs around 2007. Ministry of Health and many stakeholders worked really hard to increase the tobacco and alcohol price by increasing the tax by 20-30 percent. Now Philippine is different from Mongolia.
-Could you name the positive changes that have occurred in Mongolian health sector?
-We have great achievement in maternal and child health. Mongolia has become one of the nine countries that achieved Millennium Development Goals, especially in maternal and child health.
Almost 100 percent of Mongolian mothers deliver their babies in the health facilities. We have a very high delivery rates in health facilities attended by skilled professionals who are trained for a safe delivery. Developing countries like Indonesia and Philippine, 40-50 percent of deliveries are still happening at home. Those countries have higher maternal death and higher infant death.
Also, Mongolian sportsman and woman are winning Olympic medals and World Championship medals. Many Mongolians are having some issues with health behavior. Thus, it is great for them to use those role models as inspiration and start training by not ending up with drinking and smoking.
-Thank you for the interview.