Gross human rights violations, including forced displacement, forced labor, attacks by soldiers on civilians, injury from landmines and destruction or theft of food supplies, have been widespread in eastern Burma (also known as Myanmar), with over half of households in displaced areas reporting incidents in the 12 months prior to a 2004 survey. The study, completed by researchers from the Johns Hopkins Bloomberg School of Public Health, Back Pack Health Worker Team and other institutions, is published in the October 2007 issue of the Journal of Epidemiology and Community Health.
"These study results highlight the impact that the oppressive military junta in Burma has had and continues to have on the vulnerable ethnic minority populations that have been specifically targeted by the military regime," said Luke C. Mullany, PhD, MHS, lead author of the study and an assistant professor with the Bloomberg School of Public Health's Center for Public Health and Human Rights.
The Back Pack Health Worker Team, a network of trained, mobile health workers who provide basic health care and conduct surveillance in eastern Burma, completed interviews and completed malaria testing in 1,834 households between October and December 2004. Resource and security constraints required survey modules, including basic malaria diagnostic tests, to be limited to one sheet of paper and only what could be carried inconspicuously and without survey respondent identifiers.
Fifty-two percent of respondents experienced one or more human rights violations during the previous 12 months. Over 32 percent of households reported forced labor, 25 percent reported theft or destruction of their food supply and over 8 percent reported forced displacement. Mortality risk for children under five years of age exceeded 200 per 1,000 live births. Malaria, diarrhea and acute respiratory infections were reported as the most common causes of death. Landmines injuries were reported at a rate of 13.3 injuries per 10,000 persons per year.
The key findings of the relationship between human rights violations and poor population-level health indicators include:
- The risk of death among children younger than five years was five times higher among households that reported multiple human rights violations
- There was a substantial increased risk of landmine injuries among households that reported forced displacement or food theft or destruction
- Poor nutritional status among children was associated with forced displacement and food theft or destruction
- Deaths at any age were more often reported by households that experienced forced displacement or food theft or destruction
"These data are from 2004, a period in which there was less active conflict in eastern Burma, relative to the current situation. In recent days, the international community has witnessed the military junta's violent crackdown against the non-violent demonstrations calling for the restoration of democracy led by Burma's revered Buddhist monks and nuns," said Mullany. "The Back Pack Health Worker's survey demonstrates the impact of this regime's policy of oppression against the Burmese people, especially displaced ethnic minorities in eastern Burma. Systematic human rights violations in these communities lead to high risk of mortality, infectious morbidity and malnutrition."
The study authors explain that combining the collection of data on human rights violations and population-level health outcomes allows for quantifying the relationship between abuses and health status, complementing qualitative methods and facilitating advocacy efforts.
"It is just this kind of hard evidence of the human toll of military misrule that the Burmese military regime has tried to suppress," points out study co-author Chris Beyrer, MD, MPH, who is director of the Johns Hopkins Center for Public Health and Human Rights.
Johns Hopkins researchers Luke C. Mullany, Voravit Suwanvanichkij and Chris Beyrer co-authored "Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma." Additional co-authors are Adam K. Richards with Montefiore Medical Center; Catherine I. Lee and Thomas J. Lee with the Global Health Access Program; and Cynthia Maung and Mahn Mahn with the Back Pack Health Worker Team.
The study uses the name Burma rather than Myanmar. Burma is the form preferred by the leaders of Burma's pro-democracy movement, the legitimate winners of the 1990 elections.