We have returned to the Thai Burma border once again. This trips affords us the opportunity to connect with our friends in the Backpack medics. We learn quickly that the postiive news out of Burma is only partially accurate.

On the positive side, many in the eastern Karen state feel it is easier to move around. The Regime is providing travel documents, allowing them to travel within Burma. At the same time, Army units do extract a tax, complicating necessary travel.

What is missing from the reports is the violence that the Burma army continues to inflict in the eastern states, where a ceasefire is more an allegation than a reality.

In Y_____ village of Mantong township, Burmese soldiers raped two women in April. Nearby, in Tangyan township, a number of people were forced to act as guides and/or porters for army units. Three young girls, under the age of 16, were forced to lead a patrol to a new village. The trek lasted overnight and the girls were given no food or shelter. A few days later, a group of 5 villagers were forced to guide and porter for an army unit. To ensure they didn’t escape, the 5 were tied together. As the soldiers camped over night, they ordered the villagers to fetch water.

One young boy reported the tragedy that followed: “When we went to fetch water, my father stepped on a landmine and died. immediately in front of me. My friend’s father also died. There was nothing I could do.”

Death visited those in the east in other forms. Also in April of this year, three soldiers from one of the ethnic group’s militia returned to their village in Namsan township to help with the harvest. Despite the donditions of the ceasefire, the Burma army arrested all three and tortured and killed them.

Faced with this level of violence and the regime’s attitude toward the Karen, Kachin and others, the people of eastern Burma still are confronting violence and instability. The only health care provided to them comes from the backpack medics, who brave the risks to care for their own.

On Monday, April 22nd, the European Union considered a permanent lifting of sanctions on the Burma regime. Citing promising signs of freedom, European leaders feel the end of restrictions on the regime is warranted.

Yet, just last week, the regime’s army wrecked havoc in Eastern Burma. On April 14th and 15th, the Burma soldiers arrested and beat 15 adult men – beating several until they were unconscious. The soldiers destroyed one man’s vehicle and robbed another. During this same time, an army unit fired 10 mortar rounds into Loi Zay village – injuring a 20 month of boy and an 8 year old boy. Further south, another army unit fired 40 shells into the village of Mong Kay, damaging the school and numerous homes. Apparently, not satisfied with the destruction it caused, the soldiers indiscriminately fired automatic weapons into numerous homes.

As a result, in the first weeks of this month, more than 400 villagers have fled their homes, seeking sanctuary in other villages or the jungle area. They are cut off from their food supplies, meager medical support and schools – not to mention economic livelihood.

Sadly, all this occurs far removed from the media spotlight. It creates a permissive atmosphere for the brutal regime to act with impunity. The EU’s action only reinforces and encourages such activities for their failing to hold the regime accountable.

This reality reinforces why cross border organizations, like BHM’s Backpack Health Worker Teams, remain as critical today as they’ve been for the past 14 years.

Where there is violence, we shall bring compassion and care.

My thanks to those who support us!

This past week, the nation’s most popular marathon sold out in record time: 30,000 bibs gone in 2 hours and 27 minutes. Incredible. A lot of runners, however, were frustrated as the registration website crashed on them and they couldn’t get into the race. Countless folks felt cheated out of the chance to run the Marine Corps Marathon. Well, there are still thousands of opportunities to run: charity teams.

Why joint a charity team? I’ve run a dozen marathons. My first 6 marathons…I ran for myself. Lots of pride. Lots of people encouraging me. Then I started running for charity. It changed the marathon. People respected me for taking on the challenge of a marathon. When I asked folks to support my run…they extended a warm degree of admiration…to give meaning to my miles and transform my run into doing something to help others. Whether they gave $10…$100…or nothing but kind words…their support was unlike the casual comments of support when I ran just for me. Then, during my training runs…during the marathon…when it got tough…I recalled those supporting me. I couldn’t and wouldn’t let them down They were now part of the marathon…and my legs were their legs to get to a shared finish line of 26 miles, 285 yards…and helping others. An when it got really really tough, I thought of those I was helping…the pain they endure…how often they were forgotten and had no hope. I kept running…because I and all my supporters had NOT forgotten them.

So, hit up the charity page for the Marine Corps marathon…or your local road race. You’ll find a cause that speaks to your heart. Every one of them is good.

And, if you do have a bib…join a team anyway! Most will extend to you their special perks/benefits.

You don’t have to run the Marine Corps marathon…or any marathon. You can run for charity in any road race….of any length….any where.

Burma Humanitarian Mission has bibs for the Marine Corps marathon. We also have a team in the San Francisco Marahton, Half Marathon and 5k on June 16th and will join the Rock ‘n’ Roll Marathon and Half Marathon in Arizona in January of 2013. Come join us!

Put a reason in your run. You will not be the same…nor those who support you and those you are helping.

See you at the start line…and finish line!

The most recent list of U.S. companies seeking to access to Burma for development and business is stunning: Chevron, General Motors, Target Corp., ConocoPhillips, Caterpillar, General Electric International, Honeywell and eBay. These are just a few of the 50 plus U.S. corporations meeting with Burma regime officials over the next two weeks as they start to move into Burma.

Such a line-up reinforces an incongruous image of Western societies, the icons of human rights and liberties, are now colluding with the Burma regime, which continues to abuse and kill ethnic minorities living within Burma.

In Karen State, where a cease-fire has been in the works for the past year, the Burma army is reinforcing its forces with soldiers, ammunition and food. They have set up additional checkpoints along key roads, extorting ‘taxes’ on Karen as they transit.

The real harsh measures, though, were captured by a Burma Humanitarian Mission supported backpack medic. He recently shared that “Even though there’s a ceasefire in our area, the Burma army is still sending more soldiers, food, weapons and supplies and are building more camps. They are confiscating land from villagers while providing little to no compensation.”

Thus what U.S. companies see as an ‘opportunity’ is a catastrophe for many Karen villagers who have nothing but their land.

Impoverished, cut off from their land, the Karen continue to struggle against disease, illness, and malaria. Add malnutrition and these simple conditions are a lethal concoction to infants, children and their mothers.

To support the Karen, Burma Humanitarian Mission recently provided nearly half a million doses of medicine and drugs in addition to some 20,000 pieces of critical medical supplies. We anticipate similar if not more support within the next few months, as the demand is clearly not decreasing.

Meanwhile, further north in Kachin State, the Burma army is demonstrated the brutality once reserved for the Karen. Another backpack medic reported that, “in the IDP [internally displaced person] clinic in my area, most of the patients I see are trauma patients suffering from bomb, landmine and gunshot wounds due to the ongoing attacks by the Burma army. Despite the Burma army closing in, I will continue working with the Kachin affected by conflict and provide the best medical treatment I can.”

The promises of a Burma army ceasefire extending to Kachin state turned out to be empty, as the army attacked villages within hours of it going into effect. Roughly 100,000 men, women and children have fled their homes, seeking sanctuary in the jungles or make-shift camps along the border with China.

Sadly, the violence appears spreading to other states. In the Palaung area that straddles the Kachin and Shan state areas, a backpack medic shared that Burma army attacks have increased in 2012. She went on to state that “this past November, cowards from a Burma army battalion used villagers as human shields to advance on the opposing forces’ position. They also use 4-5 people from each village as human minesweepers when they come through a village.”

It’s not surprising that Karen National Union leaders have told the Burma regime that the time is not right for development to continue or start.

Will General Motors, Caterpillar, Target and others get the message? If they do, will they care?

One constant remains encouraging: the compassion of individuals from so many communities who have the courage to support the medics. Your support is matched by the courage of the medics to continue their selfless service to their people.

Edith Mirante has travelled extensively into some of the most remote corners of Burma’s war zones, which is courageous beyond anything most of us ever imagine.  Her books about the people of Burma share a deep love and respect for the people of Burma.  Her book, Down the Rat Hole, chronicles her travels in Kachin State offering insights to the military repression the people of Burma have endured.  And back in the 1990s, Edith encouraged the founding members of BHM to travel to the Thai-Burma border, so in many regards she is the reason we came to be.   For all of these reasons, Edith Mirante is my personal hero.

I am so honored that Edith has shared her thoughts about the current situation in Burma in the following Q & A.  I highly encourage everyone to read her books.  They’re not only great to learn about Burma, but well written travel stories, from which you’ll come away both inspired and blown away by her sense of courage and adventure.

Q: One of the themes of Burmese Looking Glass is freedom and self-determination. In the book, the quest of the ethnic groups’ of Burma for self-determination in the face of extreme human rights violations and repression is juxtaposed against your journey as an empowered young woman to explore the world and your choice to use your freedom to advocate for the self-determination of others. How does the concept of freedom and self-determination differ from the concept of democracy?

A: I think democracy is a well-defined system of government, with the public having some level of control through elections. This of course can be corrupted and manipulated in various ways, but at least it provides some level of protection against rule by military or aristocratic elites. In Burma, there was complete domination by the military, from 1962 to 2011, when a parliament with a lot of military men in it took over. Now there’s more representation from outside of the military, but they are still the majority in the “civilian” government. Self-determination is complex and and involves the ability of groups of people to decide for themselves from the ground up about various things that affect their lives. For particular ethnic groups, this has often been denied in favor of larger national or colonial entities. That’s especially true in Burma, which led to a lack of freedom on many levels — speech, religion, movement. Now there are improvements in some areas, like freedom of the press, but not as much in self-determination for ethnic groups.

Q: For years, people have rallied for democracy in Burma and the personal freedom for Aung San Suu Kyi and others. Now, significant numbers of political prisoners have been released, nascent individual freedoms are emerging in urban areas and new political parties are appearing. What do you see as the impacts of these developments on the lives and future of the Karen, Kachin, Shan and other ethnic groups? Do you feel that the ethnic minorities of Burma are closer or farther from realizing their dream of self-determination now that Burma is a burgeoning democracy?

A: The Burmese or Burman people are the largest ethnic group in the country, but if you add up the other ethnicities, that comes to a bigger share of the population. So they don’t like to think of themselves as “minorities” but as “ethnic nationalities” who should have equal rights and local autonomy in a much looser arrangement than the current very Burman-centric state which has existed since independence from Britain. It would probably be a federal system, and that is not recognized in the current constitution which the military devised for the country. So that’s some ways off, but at least now there can be open discussion of these issues and organizing around them.

Q: The Burma army waged a 60-year campaign of violence against the Karen, but then offered a ceasefire with them a year ago. Meanwhile, the regime has now broken a 17-year ceasefire in Kachin State. How do you think the minorities should view the sincerity of the regime’s overtures toward peace? Can they trust the regime? Should they trust the regime?

A: The appalling war against the Kachins, with the same pattern of human rights violations against civilians as had always been going on, is proof that the government should not be trusted. Other groups with ceasefire arrangements are very aware of this and proceed with caution, although they do hope for an eventual political settlement resulting in a federal system. I was in Laiza, Kachinland, a year ago — that’s the town under siege by the government’s artillery, jet fighters and helicopter gunships. They’ve held out for a long time, and that shows the Kachins’ extraordinary resilience and courage.

Q: Conflict and violence in Rakhine State has erupted recently. Why is this happening? What do you understand is going on?

A: The Muslims of western Burma are no threat to anybody and have been there throughout history, but they have become the target of ethnic cleansing. There is huge anti-Muslim prejudice among Buddhists in Burma. Somehow that is considered acceptable even though Buddhism teaches tolerance and compassion. The Muslims are usually very poor and look different, so they are easily bullied and scapegoated. Respected Buddhists like Aung San Suu Kyi who could stand up for them and discourage violence against them, don’t bother to help them. The Rakhine Buddhists who used to live with the Rohingya Muslims as neighbors, now get manipulated into trying to drive them out of the country.

Q: What are your concerns now that sanctions are being lifted and US corporations can now do business with the regime? Do you feel there is reason for caution? What role do you feel US activists can play?

A: There has been a major US corporate presence throughout the rule by the junta, which had a joint venture with Unocal, then Chevron. So even with sanctions, a US petroleum multinational helped finance the regime. And of course there has been investment by China and other countries all along, in resource extraction. So this is nothing new. What has changed is the ability of people in Burma to protest and publicize the effects of such investment without getting jailed or killed for it. Right now most of those protests involve Chinese investments, but if US companies come under the same objections, we can certainly add pressure through shareholder actions, boycotts and other means. One thing to be particularly aware of is land-grabbing for agribusiness like palm oil plantations, as well as mining and logging. Investments that could have a positive impact might include alternative energy, sustainable development, telecommunications and healthcare.

Q: Would you encourage or discourage your friends to visit the country of Burma at this time? If they do visit, what would you want them to pay attention to?

A: There’s no longer a tourism boycott. If travelers go, they should certainly look for ways to support the local peoples’ efforts in sustainable development, new media, architectural preservation, environmental protection, or the arts (traditional or avant garde.) People in Burma are always interested in foreigners and now you don’t have to smuggle in books or music, you can have a much more free and open exchange of ideas. But just because things seem pretty great in the cities now, don’t forget that there is awful poverty, especially in rural areas, and a terrible war going on in the north. An acquaintance is going on a bicycle tour of Burma soon, and I’ll encourage him to support the peace movement (against the war in Kachinland) perhaps by wearing a peace t-shirt and talking about it with people he meets. Of course supporting the outstanding work of Burma Humanitarian Mission is something I always suggest – donations can be made by anybody, whether or not they visit Burma or the neighboring countries.

Q: What are you working on now?

A:  I’ve just done a new Project Maje report on the use of air strikes in the war against the Kachins, and I continue to distribute information on the situations in northern and western Burma, as well as particular issues like mining and logging effects. My new book, “The Wind in the Bamboo: Journeys in Search of Asia’s ‘Negrito’ Indigenous Peoples” will be out soon from Orchid Press. It’s not about Burma but it is about other, very ancient, indigenous peoples of Asia who have been marginalized and discriminated against, and need their land rights protected. I traveled in Malaysia, the Philippines and India’s Andaman Islands to meet them and it was amazing.

In 2010-12, the Burma regime undertook a series of overt measures suggesting they had reformed their oppression of the people of Burma.  Nobel Prize winner, Aung San Suu Kyi, was allowed to travel internationally and series of personal restrictions were removed on the urban population.  Seeking geo-political influence in the region, the US and western nations removed sanctions on Burma, prompting a surge in corporations seeking access to Burma’s natural resources (gems, teak, gas, ports, etc).

Ahead of the international companies, the Regime broke a 17-year cease fire in Kachin State in order to seize territory for the ruling elite’s benefit.  Another 100,000 men, women and children have fled their villages seeking sanctuary in IDP camps, refugee sites and similar locations.  The violence and associated horrific, lethal health conditions now has come to the Kachin as it once was endemic to the Karen.

Recently, the Regime announced a ‘cease-fire’ in Kachin State  yet there are wide-spread reports of military violence.

The following is a letter from a colleague living in Kachin State written on January 25th:

Dear People,

I write to you from northern Kachin State on the border of Burma and China. For days I have listened to sustained heavy mortar and artillery fire from the Burma army as it slowly closes in.

The Kachin are targeted, however, by the Burma army on the basis of what constitutes their identity: their religion and their ethnicity.

The first point that should be made is that there has been no ceasefire and there is no ceasefire . On the morning of Saturday the 19 of January at 6.00 a.m., the time the ceasefire was due to commence according to President Thein Sein’s order, I stepped outside my house to be soon greeted with the sound of mortar and artillery fire.  This was not sporadic small arms fire, but systematic heavy shelling from the Burma army.  It was replicated elsewhere in Kachin State, but only a small fraction of it has been captured and transmitted by the media.

The third point is that in such an eventuality there may be not just a humanitarian disaster, but the infliction of widespread crimes against humanity. The civilians are likely to resist because they have nowhere to flee.  Part of my time here has been spent listening to testimonies of violently displaced Kachin people. They are some of the worst I have heard in all my time in Burma.

One young mother of a seventeen day old baby was reported by her father to have been bayoneted to death: another gang raped to death; another woman was shot in her village while her young son hid watching in a sugar cane field. A woman described her husband being shot in the stomach, then facially grotesquely mutilated.

Effective action must therefore be taken very quickly to avoid repetition of previous disasters. The UN has carried out studies of its failures in Rwanda, Yugoslavia and Sri Lanka and described at least one of them as amounting to “Complicity with evil”.  The same fatal passive complicity may result in a disaster in northern Kachin State. This letter is thus the gravest appeal to the outside world to stop it from happening. This is not a “communal riot” : this is a massive military attack on the Kachin ethnic group which is trying to resist in the limited territory it controls.

The following should therefore be implemented::

1. Appointment of an effective UN envoy, genuinely committed to the principles and articles of The Charter, mandated by the Security Council with the right to unhindered access to all areas of Kachin State and especially to internally displaced people. If the military controlled government refuses access, it could be facilitated by China which is supportive of a ceasefire and does not wish to be flooded with refugees. Some of the most threatened Kachin areas are, it should be noted, adjacent to China;

2. A ceasefire, preferably mandated by the Security Council, supported by the Chinese and US governments, the EU, and relevant UN organs, monitored by an effective UN observer group, should be declared.

3. A just and lasting peace, with the objective of establishing real autonomy within the context of a genuine Federal Union, should be negotiated and implemented, if the so called reform process is to have any validity.

4. A firm reminder to the military controlled government that sanctions were suspended, not cancelled, and in the event of a refusal to implement a ceasefire they will be re-imposed.  If a genocidal attack on civilians occurs an appropriate response will be made.

Guy Horton
School of Oriental and African Studies
University of London
Northern Kachin State
25 January 2013

One of our donors wanted to understand the opportunities available for girls in Burma/Myanmar who want to attend college and attain professional careers.  A correspondent from Girl Determined replied.   I wanted to share her response with you.  You can make a donation to empower girls in Burma on our website here.  Just check the box for Girl Determined under the heading “My Reason for Donating.”

From Girl Determined:

“The issues surrounding strict gender role norms and discrimination against the girl child start very young, some would say at birth, and, at puberty are exacerbated.  This leads to a high level of drop out for girls in lower secondary school, particularly in poor communities – both rural and urban.  Many boys also drop out of school from 5th grade through the end of high school.  However, the consequences of drop out on a girl’s life tend to be dire compared to boys.

“So, let’s imagine that a girl does make it through to the end of high school, 11 years of education, which means she is about 16 or 17 years old.  She must then pass the matriculation exam.  Even in the best city-based schools, only about half of the students pass the matriculation exam.  And, the score on the matriculation exam determines the subject you will enter in university.

“This is also a gendered process.  Girls have to score about 10% higher on their matriculation exam to be accepted to pursue a degree in medicine, the most sought after school.  And, at certain levels of exam attainment, girls and boys are sorted into different degree paths.  So, for the same score, if you are female you will be sent to the school of basic education and your male counterpart will become a veterinarian.

“The public universities have no autonomy and these realities are prescribed by national policy.  High achieving girls are at a particular disadvantage and all students lose out by not being allowed to select their own path of higher education study.

“On top of all this, the university system is broken.  The quality of education certainly does not prepare a student for an exciting career.  For women, families largely emphasize one’s reproductive role.  Though many women certainly make money, there are few families, and husbands that will manage any burden of the reproductive role to assist the woman in achieving any career goals.

“In my observation, this seems to have meant that women interested in higher level business position simply do not marry or really have much of a personal life and will live with their parents until they pass away.  Such women are highly criticized.   In office work, most women are found in supportive roles with much lower salary scales.

“The education system is broken before students reach university and so, though no reliable figures exist, we can say that fewer than 25% of people will attend university.  And, then the university quality of education is incredibly poor and terribly gendered, so perhaps not of much use to creating a productive and fulfilling life.

“There is a bill currently in front of parliament that is pushing major changes in higher education.  If it passes, it will be a good step.  But, then we will need to work at every level of schooling to ensure that gender equality exists and students are learning important critical thinking and analytical skills.

“Part of our work at Girl Determined is to assist girls in re-thinking some of the more dangerous manifestations of the gender role norms they have internalized.  Girls have learned that they are ‘shy, obedient and not-so-smart’ by nature.  Our weekly activities really help them to unpack these ideas and think honestly about their own characteristics and what they want to be and how they want to develop.  This is part of their individual thinking process that allows them to come up with new ideas for their lives and to really avoid falling into the traps of decisions made by other people about their own lives – early marriage, dropping out of school, exploitative labor etc.”

Click on this link to read the newsletter:   Minmahaw Newsletter

You can read the full proposal here: 2013 BPHWT Proposal

Burma is a very ethnically diverse country with dozens of indigenous ethnic groups. After independence in 1948, marginalized ethnic groups began to take up arms in the country’s border regions in pursuit of increased autonomy. In addition to long-running instability in these areas, a military coup in 1962 led by General Ne Win marked the start of almost six decades of military rule. The subsequent military regimes, holding power in Burma, have been widely considered to be among the world’s most oppressive governments due to the denial of democratic freedoms; the widespread and systematic perpetration of human rights abuses against its own people; and the persecution of its ethnic minority groups. Despite recent internationally heralded “reforms” undertaken by President Thein Sein’s government, these changes have not yet manifested into substantial sustainable change on the ground.

The seventeen-year old ceasefire between the government of Burma and the Kachin Independence Organization was broken in 2011 and has driven the displacement of over 70,000 internally displaced persons (IDPs) and refugees to the China-Burma border. Even as intense fighting continues in Kachin State, the government of Burma has pursued preliminary ceasefire and peace agreements since the end of

2011 with various ethnic groups in Chin, Arakan, Mon, Karen, Karenni and Shan States. Incidences of armed conflict have decreased significantly since the signing of these initial peace agreements, but fighting has continued in some ceasefire areas, particularly in Shan State. The government of Burma has prioritized development over political dialogue and inclusion, with the lull in fighting prompting incidences of land confiscation to increase exponentially in the ethnic resource-rich regions. Burma Army and their allied armed groups have been forcibly displacing civilians from their homes and confiscating land from villagers at a rapid rate for development projects and/or military camps, while providing the villagers with little or no compensation. The bulk of the development projects are resource extractive projects (i.e., hydropower dams, logging, mining, etc) and are proceeding often without the consultation of local community members and without valid environmental, health and social impact assessments, which is causing legitimate concern among community members that these projects will negatively affect them over the long-term.

In the conflict and current ceasefire areas, the Burma Army (Tatmadaw) and its allied armed forces continue to routinely commit widespread human rights violations against ethnic civilians. These widely documented abuses include forced labor, confiscation and destruction of food supplies, arbitrary taxation, torture, land confiscation, rape, and extrajudicial execution. These ongoing abuses demonstrate that the peace talks have not significantly improved the situation on the ground and that in order to achieve a meaningful, durable peace, the Burma government must be committed to resolving the underlying political and socioeconomic issues driving conflict in the ethnic border regions. The BPHWT recognizes the fragile nature of the peace process and how previous peace agreements have broken down; consequently, BP health workers will continue to take security precautions while traveling and providing health services until a genuine political dialogue and change occur.

(ii) The General Health Situation in Burma

Public health is another casualty of decades of military rule and ethnic oppression. Burma’s current rulers have not deviated from the negligent socioeconomic policies of the past and continue to chronically disregard basic essential social services. Despite almost $20 billion of approved foreign direct investments in 2011, which is more than the

previous two decades combined1, the regime spends around $17 per capita in 2010 on health, amongst the lowest in the world. According to the United Nations Development

Program’s development index, Burma spent less than 2% of total GDP in 2010 on health, leaving Burma in the 149th position in the United Nation’s Development Program’s Human Development Report for 20113. Burma is thus lagging far behind the UN’s Millennium Development Goals (MDGs).

Today, Burma’s health indicators for child, infant, and maternal mortality rank amongst the worst in Asia. Burma’s infant mortality rate was estimated by UNICEF at 50 per 1,000 live births in 2010, with an under-five mortality rate of 66 in the same year4.

These figures also suffer highly unfavorable comparisons with the recorded infant and child mortality rates of Thailand for 2009 at 11 and 13 respectively5.

The main causes of morbidity and mortality in the country are overwhelmingly preventable from disease entities such as malaria, malnutrition, diarrhea, acute respiratory illnesses, tuberculosis, and HIV/AIDS. Burma continues to register the greatest number of malaria deaths and the highest malaria fatality rate of any country in Southeast Asia.

The Health of Internally Displaced Persons:

While the health indicators of Burma’s population rank amongst the poorest globally, the health of IDPs within Burma is even more serious cause for concern. Health indicators for the rural ethnic populations in eastern and southeastern areas are demonstrably worse than Burma’s national rates. IDPs face harsh living conditions in the jungle: their means of survival are a constant challenge. In addition to dealing with the burden of protracted conflict and the high frequency with which they are forcibly displaced, access to state healthcare systems is either extremely limited or non-existent. This situation has resulted in mortality rates which are comparable with some of the world’s most volatile countries at war as shown in the following table:

Eastern Burma’s demographics are characterized by high birth rates, high death rates, and the significant absence of men under the age of 45. These patterns are more comparable to recent war zones, such as Sierra Leone, than to Burma’s national demographics.

In 2010, BPHWT published a report entitled Diagnosis Critical, which demonstrates that a chronic health emergency exists in Eastern Burma. The survey-based report, covering 21 townships and 6,372 households in both ceasefire and non-ceasefire areas, brings to light a legacy of longstanding, official disinvestment in health coupled with protracted civil war and the abuse of civilians. The data showed that among the rural Eastern Burma population, child mortality rates are twice as high as the national average. Furthermore, 60% of deaths in children under the age of 5 are caused by preventable and treatable diseases (for example, acute respiratory infection, malaria, and diarrhea). Infectious diseases are the primary cause of death for both children and adults, with malaria accounting for almost half of all deaths. Moderate to severe malnutrition is also prevalent within IDP populations, at levels consistent with those found in Africa. 41.2% of children under five are acutely malnourished. A water and sanitation survey conducted by the BPHWT indicated that more than 56% rarely or never boil their water and that access to and use of latrines are low.

The estimated Maternal Mortality Rate within the IDP population ranks amongst the highest in the world. One in twelve women in Eastern Burma is at risk of death as a result of pregnancy or childbirth, a rate three times higher than the national average. Since most causes of maternal death are preventable within a functioning health system, this is strongly indicative of the lack of reproductive health-related care and services.

In a survey conducted in 2010 across the States and Divisions in which the BPHWT medics operate, 88% of births were shown to take place at home instead of in a hospital or clinic, usually only with the assistance of a traditional birth assistant (TBA). In unstable environments, it is not uncommon for internally displaced women to deliver their baby in the jungles located deep inside Burma, while hiding from the Burma army patrols. Overall, only 4% of IDP women had access to emergency obstetric care. Many also lack awareness of the dangers of pregnancy complications and how to avoid them. For example, the survey showed that only 41.1% received any iron supplements during their previous pregnancy.

Back Pack Health Worker Team

The BPHWT was established in 1998 by Karenni, Mon and Karen health workers to provide healthcare to IDPs, living along the eastern border of Burma, affected by many decades of civil war. In 2012, the BPHWT provided primary healthcare in 20 field areas with 95 teams to a target population of over 200,000 people. There are currently over 1,500 health workers, living and working in Burma, connected with the BPHWT consisting of 331 medics, 780 TBAs and 403 village health volunteers (VHVs).

As depicted in the Organizational Structure, the BPHWT is governed by the Leading Committee which is elected every three years by the BPHWT members. The Leading Committee is comprised of 13 members who serve a three year term. The Leading Committee appoints an Executive Board of 10 members. This Executive Board is required to meet monthly and make decisions on current issues and planned activities of the BPHWT. The BPHWT has a range of documents that guide the leadership, management, healthcare delivery, health information systems, and human resources of the organization. Full copies of any of these documents are available upon request.

The BPHWT Constitution: The Constitution provides the framework for the operation of the BPHWT through thirteen articles that define: the organization’s name, vision, mission statement, organizational identification, symbol, goals, objectives, policies and principles, actions and implementation, monitoring and evaluation, membership, election of the Leading Committee, amendments to t h e Constitution and organizational restructuring, employment of consultants, and job descriptions for positions.

Vision: The vision of the Back Pack Health Worker Team is that of a healthy society in Burma through a primary healthcare approach, targeting the various ethnic nationalities and communities in the border areas and remote interior regions of Burma.

Mission: The Back Pack Health Worker Team is organized to equip people with the skills and abilities necessary to manage and address their own healthcare problems, while working towards the long-term sustainable development of a primary healthcare infrastructure inBurma.

Goal: The goal of the Back Pack Health Worker Team is to reduce morbidity and mortality, and minimize disability by enabling and empowering the community through primary healthcare.

Financial Management and Accountability: The BPHWT has written financial policies and procedures guiding the Leading Committee, Executive Board, p r o g r a m coordinators, and field staff about financial management and accountability; the production of annual financial reports; and the requirement for an annual, independent audit. These documents establish the financial records to be kept; the management of bank accounts; the procedures for cash withdrawals, deposits transfers, receipts, disbursements and general administration funds; and liquidation of cash assets. There are also regulations for payments for board, lodging, travel and honorariums for services rendered.

Service System: Since 1998, the Back Pack Health Worker Team has been working towards developing an accessible, community-based, primary healthcare service system within the BPHWT field areas based on the health access indicators.

Here are BHM members Mike and Mehmet with the leadership of LMTC taken in January of 2012.

Saw Arthur, the administrator of the Leadership and Management Training College at Mae La Refugee Camp, Thailand sent a letter to BHM for emergency funding for scholarships for youth from Burma.

For the past two years, we have supported approximately a dozen students completing classes at the LMTC.  The college provides university level education in physics and English to ethnic minorities who fled Burma out of fear for their lives and have no other higher education opportunity available.  Even if they could gain admission to a University in Bangkok (which is daunting given they have no formal passport from Burma and are refugees), college costs are beyond their means.

Thus, LMTC fills a critical gap to help educate the next generation of democracy leaders for the ethnic minorities and Burma.  The operating costs of the school are sponsored by the organization Child’s Dream, but CD is not able to provide the funding for the living expenses for the students.

These students come from the several hundred thousand Karen, Mon, Kachin, Shan and other minority groups who live in Thailand without formal documentation or legal status.  These students live in adhoc dormitories where they are safe and supervised.   The scholarships we’ve provided pay for their basic necessities like rice and cooking oil, and $3.00/month pocket money for the students.   It costs under $350 per year to support a student.

The emergency funding request to is support 20 students to complete their senior year over the next 4 months at $70.00 per student.

One of the things that is so compelling about this request is that the girls who need scholarships have written to us, sharing their stories.  Here is an excerpt from one of the girls:

“Before I came to Mae La refugee camp, I used to live in Karen state. I lived three for four years and because of the civil war I had to flee and then I came to live in tham Hin camp since 1997. I lived in Tham Hin camp for 12 years and passed high school in 2009. then I come to Mae La Camp for my further study because at that time in Tham Hin camp, we didn’t have college or post ten schools. I chose LMTC for my further study because it is leadership and Management training college. I don’t have my relative so I stayed in LMTC hostel. I love to live in LMTC hostel and I don’t have any problems with my study and accommodation. but this years our donors reduce their donation for the dormitory students. Because of your kind donation we can overcome every challenge we have to face this year.

“This year is my last year in college. After graduation I will find the way or my scholarship program for my further study. if I have a chance , I will continue my study. if not , I will serve for people along Thai and Burmese and my community through teaching or being a community leader. I hope I wouldn’t only be helping the children in education, but I could as well as be able to educate adult through family planning, health care and build prosperous life for them.”

Our heartfelt thank you to to the 8 people who have already pledged to sponsor these students!  If you are interested in sponsoring a student or would just like to read more of their stories, please email Jen at jzurick @ burmamission.org.

Students at LMTC