HEALTH AND EDUCATION

Burma is today in the midst of a health and educational crisis. All social services in Burma, including the country's health and educational systems, have suffered terribly under the thirty-nine years of military dictatorship since 1962. Basic infrastructure has been neglected, while priorities have been decided and funds allocated on military-ideological bases rather than genuine need. Since the current military junta reasserted direct army rule in 1988, health services have further deteriorated, and universities have been closed for most of the last thirteen years.

Like many developing countries, Burma faces an enormous task of bringing modern medical care, sanitation standards, and basic health education to a predominantly poor and rural population of about 50 million people. In many areas, preventable or treatable maladies such as malaria and malnutrition are rife. Outbreaks of plague are still reported. And according to the World Health Organization (WHO), over 530,000 people may already be HIV-positive in a spreading pandemic spurred by intravenous drug use.

Yet very few of the country's resources are being directed to improvements in this area. Burma's military junta, the State Peace and Development Council (known from 1988-1997 as the State Law and Order Restoration Council, or SLORC), has made the social welfare of Burma's peoples a low priority. In its ''World Health Report 2000,'' the WHO ranked Burma next to last -190th of 191 countries surveyed -in terms of overall health system performance. This is in line with United Nations statistics that show the regime spends over 200% more on its military expenditure than for health and education combined. Only a few countries in the world, such as Iraq and Syria, have a worse ratio. These UN figures might in fact underestimate the junta's military spending; the regime is still expanding an army whose main role is to suppress domestic demands for democracy. Of 174 countries rated in the United Nations Development Programme's (UNDP) Human Development Index for 2000, Burma ranked 125th, placing it barely ahead of the impoverished and resource-poor African states of Equatorial Guinea and Lesotho. Forty percent of Burmese have no access to safe water, and sixty percent lack basic sanitation. Since 1991, a handful of international non-governmental organizations have begun work in Burma. However, the regime's controls over health assistance programs are so strict that many others refuse to operate in the country. This is effectively crippling crucially-needed AIDS awareness programs, which are already in full swing in neighboring Thailand and India, which also face HIV crises.

The AIDS epidemic is most intense in Burma's northeast, which suffers the combined effects of HIV spread both by intravenous heroin use and sexual transmission. In both areas, the military regime has failed to act to stem the epidemic. The junta's cease-fire agreements with some ethnic groups allows the production and trading of heroin. Burma's border areas are awash with cheap supplies of the drug, which is also plentiful in the country's largest cities, Rangoon and Mandalay. Heroin is far cheaper than the syringes required to inject it, and so addicts routinely share needles.

The epidemic is also spreading through sexual contact. Many young women from Burma's diverse hill peoples have been forced or lured into prostitution in Thailand. As many as 40,000 may be in the trade at any given time. Tragically, a large percentage become HIV-positive within a few years. Here, too, the Burmese military has at best taken no action to ameliorate the trafficking of women into prostitution, and local commanders are accused of abetting the trade.

These and other health problems are exacerbated by the military junta's brutality and repression. Torture, other physical mistreatment, and the casualties and additional consequences of long years of warfare with armed ethnic opposition groups are obvious problems. The Burmese army is also one of the last in the world to use landmines. Less apparent is the lack of accountability and free expression that prevents people from obtaining information or demanding that their government meet their needs.

There is no free press in Burma, and the few independent publications that comment on social issues are heavily censored. Criticism of the regime or its polices is not tolerated. In this atmosphere, Burma's peoples are neither informed nor educated regarding health matters and have no say in how these problems are addressed.

The lack of freedom of expression is even more evident in the educational arena, where army efforts to suppress dissent and even mild criticism of its rule and policies has led to the evisceration of what was once a strong and expanding education system. For instance, teaching English in schools was banned by decree from 1966 until 1980. Nearly all Burma's universities and colleges have been shuttered for extended periods since students helped lead the 1988 democracy movement, and they were closed for almost four years after student protests in December 1996. Some are now partially reopened, but on a highly restricted basis, and almost entirely without academic freedom. Most curricula are out of date by decades. University course syllabi require military clearance, and all campus activities are very closely monitored by military intelligence.

Yet Burmese students who reach university are a lucky elite. On the primary level, only about one-third of the one million children who each year begin their school careers will finish four years of school. Prospects for further education are few. Some educators have been imprisoned or dismissed for non-violent political activities. Others have quit teaching out of economic necessity; on average, a teacher's pay is equal to only about US$5 monthly. Some teachers have also left their positions to avoid mandatory political indoctrination sessions.

Access to education is most restricted in impoverished rural areas where families cannot afford official and unofficial fees demanded of students. In ethnic minority areas along Burma's frontiers, army offensives have also disrupted normal life, and children are often forced to serve as laborers or even as military porters in combat areas. Hundreds of thousands of people have fled their homes. Even where schools exist, the ethnic-Burman dominated army has often banned teaching in local languages, raising fears of a "cultural cleansing" of non-Burman peoples who make up 40% or more of the population.

Among at least 250,000 Burmese refugees who are today in Thailand, India, and Bangladesh, health and educational services are even more limited. The National Health and Education Committee (NHEC) which includes representatives of 27 groups opposed to military rule, was created in 1995 to serve refugees and people inside Burma who could be reached from border areas. The NHEC is seriously constrained by a lack of resources and uncertain security along Burma's frontiers. Its efforts have emphasized basic literacy and primary health care for people almost entirely without social services.

The junta remains largely in denial regarding the scale and urgency of Burma's AIDS crisis. Universities are seen as an enemy, rather than an engine for development. The military regime's spending priorities focus on procuring weapons and expanding its army. Until Burma enjoys a responsible and accountable government, significant change is unlikely.

FOR FURTHER INFORMATION, CONTACT:

Burma Project, Open Society Institute
400 West 59th Street, 4th floor
New York, NY 10019 USA
tel: (212) 548-0632 fax: (212) 548-4655
e-mail: burma@sorosny.org; http://burmaproject.org

Action Contre la Faim (Action Against Hunger)
4, rue Niepce 75014 Paris France
tel: (33-1) 4335 8888
e-mail: acf@acf.imaginet.fr; http://www.acf-fr.org

875 Ave. of the Americas, Suite 1905
New York, NY 10001 USA
tel: (212) 967-7800 fax: (212) 967-5480
e-mail: aah@aah-usa.org

Médecins sans Frontières (Doctors Without Borders)
8, rue Saint-Sabin 75544 Paris Cedex II France
tel: (33-1) 4021 2929 fax: (33-1) 4806 6868
e-mail: office@paris.msf.org; http://www.msf.org

6 East 39th Street, 8th Floor New York, NY 10016 USA
tel: (212) 679-6800 fax: (212) 679-7016
e-mail: doctors@newyork.msf.org; http://www.doctorswithoutborders.org

United Nations Development Programme (UNDP) Regional Bureau for Asia and the Pacific One United Nations Plaza
New York, NY 10017 USA
tel: (212) 906-5828 fax: (212) 906-5825
e-mail: shantiballo@undp.org or asia-pacific@undp.org; http://www.undp.org

UNICEF Asia Section,
Programme Division
3 UN Plaza New York, NY 10017 USA
tel: (212) 326-7000 fax: (212) 887-7465/7454
http://www.unicef.org

World Concern
24/A Aung Min Gaung Avenue Kamayut Township,
Rangoon, Burma tel: (95-1) 511 440 fax: (95-1) 511 440
e-mail: worldconcern@crista.org; http://www.worldconcern.org/

World Vision PO Box 9716 Federal Way, WA 98063-9716 USA
tel: (253) 815-1000 fax: (253) 815-3446 1-800-511-6596
http://www.worldvision.org

PUBLICATIONS:

Article 19. Fatal Silence: Freedom of Expression and the Right to Health in Burma. London: Article 19, 1996.

Article 19. Our Heads are Bloody but Unbowed: Suppression of Educational Freedoms in Burma. London: Article 19, 1992.

Beyrer, Chris. War in the Blood: Sex, Politics and AIDS in Southeast Asia. New York: Zed Books, 1998.

Beyrer, Chris. "Accelerating and Disseminating Across Asia." The Washington Quarterly (Winter 2001), pp. 211-225.

Human Rights Watch/Asia. A Modern Form of Slavery: Trafficking of Burmese Women and Girls into Brothels in Thailand. New York: Human Rights Watch/Asia, 1993.

Smith, Martin. Burma (Myanmar), Academic Freedom 3: Education and Human Rights. London: Zed Books, 1995.

Southeast Asian Information Network. Out of Control: The HIV/AIDS Epidemic in Burma. Chiang Mai: Southeast Asian Information Network, 1995.

UNICEF. Children and Women in Myanmar, A Situation Analysis 1995. Rangoon: UNICEF, 1995.

United Nations Development Programme. UNDP Human Development Report 2000. New York: United Nations Development Program, 2000.

United Nations Programme on HIV/AID and the World Health Organization. Epidemiological Fact Sheet: Myanmar. Geneva: UNAIDS/WHO, 2000.

World Health Organization. World Health Report 2000. Geneva: World Health Organization, 2000.