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Pediatric nephrology staff from the Yangon Children’s Hospital, the Children’s Hospital in Mandalay, and the National University Hospital in Singapore, and pediatrician and nurse trainees from district hospitals at a PD training workshop 2019

A ten-year ISN Sister Renal Centers (SRC) trio collaboration between Myanmar’s two leading pediatric nephrology centers and the National University Hospital (NUH) in Singapore has delivered a measurable impact on child kidney care in Myanmar. From capacity building to launching the country’s first transplant service, this partnership, jointly supported by the ISN and the Asian Pacific Society of Nephrology (APSN), demonstrates how targeted mentorship, training, and advocacy can overcome systemic barriers in low-resource settings.

Nurses receive hands-on training at one of the workshops

Developing local expertise

In the partnership’s early phase, the Singapore team delivered hands-on training and mentorship at the Yangon Children’s Hospital (YCH) and the Mandalay Children’s Hospital (MCH). The teams worked together to conduct unit audits, establish a comprehensive patient database, and markedly raise nursing standards.

Pediatric acute peritoneal dialysis (PD) was previously unavailable in Myanmar outside major centers, and community doctors lacked basic training in early kidney disease detection and management, with no specialist renal nurses in the workforce. To strengthen regional pediatric acute kidney injury (AKI) care, the team from NUH ran targeted workshops on AKI management and PD for paired pediatricians and nurses from district hospitals, as part of the ISN Saving Young Lives Initiative. By decentralizing expertise and training local clinicians, the program has improved early intervention and decreased AKI-related child mortality, especially from snakebites, as well as incidences of chronic kidney disease due to delayed management.

Children from the pediatric kidney ward at the Children’s Hospital in Mandalay

From no transplants to a fully independent program

Prior to 2015, no pediatric renal transplants were performed in the country. Children on chronic dialysis often remained hospitalized for years due to the distance needed to travel for treatment.

With support from the NUH, a pediatric transplant program was established with an independent multidisciplinary pediatric renal transplant team, including specialist renal nurses who trained in Singapore through the program. Local surgeons, nephrologists, and nurses can now lead transplant operations without external supervision.

Nephrologists, transplant surgeons, and other specialists from the NUH assisted the Myanmar teams to successfully perform their first seven transplants, freeing children from indefinite hospital stays. Four more transplants were completed before the COVID-19 pandemic.

Read more about Myanmar’s first pediatric transplant

One of the first pediatric transplants in Myanmar is performed

Securing infrastructure and funding

Through targeted advocacy — engaging with the Minister of Health and key pediatric care leaders — the Singapore team secured official backing for the transplant initiative in Myanmar. As a result, MCH opened a dedicated ICU and transplant operating theatre, and YCH built a new ICU to support its emerging renal transplant program. A local charity now covers the costs of dialysis supplies and transplant medication, strengthening the transplant program’s financial foundation.

Lasting impact amid setbacks 

Though progress was slowed by the COVID pandemic and ongoing civil unrest, the collaboration has left a strong legacy: improved local expertise, the foundation of a transplant service, and a growing network of trained providers extending care beyond the capital. A continuing program of teleconsultations and weekly pediatric nephrology meetings with emerging centers has helped sustain and build on this progress.

Hui Kim Yap, a liaison officer from NUH, commented, “The joint support provided by the ISN and APSN has enabled the Singapore-Myanmar trio to make significant strides in enhancing pediatric nephrology services and improving health outcomes for children.” She added, “The SRC program is highly beneficial to the emerging countries. We could see how the units were transformed and how they were effective in ensuring the young patients received effective treatment. It was heartwarming to meet one of the transplant patients a year later and see how she was the first in her family to enter university with a better quality of life following her kidney transplant!”

This partnership is a powerful example of how ISN-supported collaborations can drive sustainable improvements in kidney care — even in challenging contexts.