| The
World Health Organization ranks the SPDC at 190 (of
191 countries) for delivery of health services. Increased
costs, severe under-funding, widespread corruption,
and the concentration of private facilities in urban
areas, mean that health care is inaccessible and unaffordable
for most. The SPDC spends US$5 per person on health,
compared to an average amongst other ASEAN nations of
$137. In public hospitals, patients have to pay “special
fees” for consultations, and purchase their medicines
at black market prices. The deteriorating education
system is failing to provide medical graduates with
the skills they need. Facilities, in particular laboratories,
are ill-equipped and inadequately staffed. Medicines
are often cheap counterfeits, and put the health of
patients at risk, as well as increasing the risk of
virus mutation. In conflict areas, health outcomes are
worse, with failed or non-existent healthcare provision,
widespread poverty, food insecurity, landmines and violence.
The dismal state of the health of the people of Burma
can be seen in the following statistics: |
| •
There are 0.36 physicians per 1000 people, 0.38
nurses and 0.6 midwives; and only 137 pharmacists
for the entire population of more than 50 million
people. |
| •
The under-5 mortality rate is 105 per 1000. 56%
of child deaths are attributable to the effect
of malnutrition and infection. |
| •
Maternal mortality is 360 per 100,000 live births,
and one third of pregnancies end in abortion. |
| •
Official rates of multi-drug resistant TB are
double the average of in Southeast Asia. |
| • Malaria is
the leading cause of morbidity and mortality, and
the leading killer of children under five. 80% of
reported cases in 2004 were the drug resistant strain
plasmodium faciparum. |
| • Other mosquito-borne
infections including filariasis (elephantiasis),
dengue fever, fever and Japanese encephalitis are
endemic and spread unchecked. |
| • Seasonal
cholera and anthrax outbreaks go unreported, hepatitis,
typhoid, rabies are all prevalent. |
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Best estimates are
that in mid-2000 there was an overall prevalence of
3.46% of HIV/AIDS in Burma. Since then, failure by
authorities to either take or publish HIV/AIDS surveillance
data means that this figure cannot be updated. Poverty,
high levels of mobility and displacement, lack of
knowledge, scarcity of health care services, a growing
sex industry, injecting drug use and sexual violence
are all contributing to the spread of HIV/AIDS. In
border towns, trade routes for the trafficking of
women, drugs, and disease, all intersect. Sexually
transmitted infections that increase the risk of contracting
and transmitting HIV are common in Burma. However,
detection and treatment are patchy and riddled with
misinformation.
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| •
The SPDC spent less than US$22,000 on treatment and
prevention for HIV/AIDS in 2004 (not enough to treat
150 people, let alone make an impact on the spread of
the virus). |
| •
Access to counseling, medication, and other support
services is restricted. AIDS treatment is highly politicized.
Community based initiatives are shut down unexpectedly,
and activists have been imprisoned. |
| •
One in three sex workers tested positive for HIV in
Rangoon in 2005, one in four in 2004. |
| •
Outside major cities, infection rates vary greatly –
from nothing to 7.5% - prevalence rates are highest
in Shan and Kachin States, bordering Thailand and China. |
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| Despite a national
surplus of rice, whole communities are going hungry
because the regime confiscates, forcibly sells, prevents
from being traded, rice and other essential commodities.
In areas with a military presence, villagers are forced
to supply troops with food supplies. Where villages
have been destroyed, food supplies have also been burnt,
and fields landmined to prevent displaced persons from
returning. Food insecurity not only increases the risk
of malnutrition but also increases the chances of landmine
injuries and malaria, as people are forced to forage
in the jungle. Medical workers and others cross from
neighboring countries into the most isolated and most
needy areas of Burma carry “backpacks” of
emergency food, medical and other supplies. These workers
have been attacked by SPDC troops, had their supplies
stolen or destroyed, and in some cases have been killed. |
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| •
The proportion of people living under the poverty
line increased from 23% to 32% between 1997 and 2001.
The UNDP estimates that an increase in food prices
of 15-20% would increase this number to “well
over 50%”. |
•
In Northern Arakan State, 60% of the population is
malnourished. |
•
Among internally displaced populations, one in six
children under the age of five is acutely malnourished. |
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| The first confirmed
outbreak of the H5N1 virus within Burma began in mid-February
2006, (ending 2 years of speculation from Burma’s
neighbors as to how (or whether) Burma was maintaining
its “flu-free” status.) |
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| •
A failing health system and in most areas non-existent
laboratories, mean that bird flu can be present for
some time before being identified, and the risk of
virus mutation, and spread to humans, is further intensified.
International agencies and neighboring countries have
come to the SPDC’s aid with expertise, pesticides,
laboratory equipment, medicine and finances.
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•
Health authorities in India, Bangladesh and Thailand
have all stepped up border controls and trade restrictions. |
•
A second outbreak was detected in Rangoon in late
February 2007, and traces found in at least 10 townships. |
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