Human rights abuses and counter-insurgency campaigns in Chin State, western Myanmar, are causing a "health catastrophe", says a new study, results which echo an earlier survey in the eastern state of Shan.
"The indirect health outcomes of the abuses likely dwarf the actual killings by the military leaders," said Richard Sollom, deputy director of the US-based NGO Physicians for Human Rights (PHR) and author of a recent medical study on Chin State.
Persecution of civilians has resulted in a "man-made health catastrophe" in ethnic areas, according to Vit Suwanvanichkij at the Johns Hopkins Bloomberg School of Public Health in the US.
In eastern Myanmar, the child mortality rate is almost double and maternal mortality triple the national average (122 per 1,000 live births and 380 per 100,000 live births, respectively, according to World Health Organization, WHO), which is related to the "epidemic" of human rights abuses committed against ethnic groups in that area, said Suwanvanichkij.
"Public health indicators in ethnic areas are similar to that of long-term war-torn countries like Rwanda and Sierra Leone," said Debbie Stothard, coordinator of the Bangkok-based Burma rights advocacy group, Altsean.
Nearly one-third of all households in Shan State in eastern Myanmar reported one or more human rights abuses from 2009 to 2010, according to a separate 2010 health survey, conducted by community health organizations.
"Consistently, the minority of deaths are directly from violence. Far more... lose their lives indirectly from the malign neglect of the Burmese military regime," said Suwanvanichkij.
Not only does the government invest the least worldwide in its healthcare system - less than 2 percent in 2009 according to the WHO - but rights groups say it also obstructs healthcare in conflict areas.
"The military actively prevents healthcare workers from doing their jobs by destroying healthcare facilities controlled by communities or insurgent groups," said David Scott Mathieson, Myanmar's senior researcher for Human Rights Watch.
Six out of 10 deaths among internally displaced persons in the east are from preventable illnesses, said Suwanvanichkij.
Babies and hunger
Shan State researchers found the occurrence of human rights abuses in a household increased the odds of an infant dying by up to 50 percent.
In Chin State (western Myanmar), almost 92 percent of households experience forced labour and reported the military stealing or destroying their family's food stock.
"With already amongst the worst food insecurity in the world, such predatory practices by the government can easily push families over the brink - worsening poverty, increasing malnutrition, and further barring access to healthcare," said Suwanvanichkij.
Forty-three percent of families in Chin State reported moderate to severe household hunger to PHR.
Families in Chin State whose food was destroyed or seized reported hunger levels more than six times higher than those left alone, according to PHR.
"If people are forced to give food to the military out of fear, have household crops destroyed or their food stores stolen and livestock stolen or killed, they are obviously going to be more likely to suffer from hunger," said Sollom.
Displacement and disease
Displaced families are about three times more likely to have acutely malnourished children, according to PHR. Almost half a million people are displaced in Myanmar, according to the Mae Tao Clinic in Mae Sot, Thailand.
"Being on the move in the rainy season without access to clean water leaves them vulnerable to malaria and diarrhoea - a major killer of children under five," said Stothard.
Local health workers continue to risk their lives in conflict zones to bring much-needed healthcare to the displaced, but as long as human rights violations continue, the health crisis will not improve, Stothard added.
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