Building an inclusive health system in Burma: Interview with Dr. Lian

Public health in Burma has deteriorated since the coup in 2021.

Meanwhile, decades of dictatorship and patriarchal norms have limited who has access to health care and who shapes health policy.

Dr. Lian sees these challenges first-hand as health secretary for Chinland, a self-declared autonomous state and traditional homeland of the Chin people in western Burma. In the wake of the coup, Dr. Lian helped develop Chinland’s first-ever health policy.

In September 2025, we brought Dr. Lian, and other health leaders from Burma we support, to Canada to meet with health organizations—including our counterpart, Canadian Health Coalition. They exchanged ideas on inclusive approaches to care that now feed into our Burma counterparts’ efforts to build health systems from the ground up.

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What are your takeaways from visiting Canada?

In Burma, the health system has been very top-down. Authorities don’t understand the context of different peoples, geographies or genders. In Canada, each province has its own health policy that reflects its culture, geography and population. Instead of authoritarian mandates, there are negotiations and discussions to find better solutions.

My main takeaway is that there is no perfect public health system. Public health is a long process of finding the best solutions through learning and adapting.

What does a more inclusive approach to health look like to you?

I grew up in a very patriarchal society where most leaders and breadwinners are men, and many women don’t know their rights when it comes to their own health. Too often, a man decides about a woman’s health. For example, a wife has to ask permission from her husband to use family planning. That is really sad, and it is one of the reasons I advocate for women’s health.

I work with many young Chin women, and each time we sit together, their perspectives often change our plans for the better. Our health minister is a woman. Her leadership style and mediation skills are very effective in a conflict- sensitive situation. She is not only shaping public health planning but also becoming a role model for many young girls and women in Chinland.

What gives you hope for achieving a fairer, more inclusive health system in Burma?

Our Chinland interim health policy is one step toward a fair, inclusive, minority-representative health system and toward federal practice in the health sector. As I learned in Canada, it is a long process of negotiation: staying firm on the principles of federalism, human rights, equity and diversity. It also has to be a huge team effort: well-planned and well-coordinated across sectors. The journey to a federal, inclusive health system is long, but step by step, if we all jump in together, I believe we can reach it.