Public health in Burma: Anatomy of a crisis

The Protection and Promotion of Human Security in East Asia

“…Indeed, globally the national health system is ranked 190th out of 191 (Mullany et al, 2008. p. 45). In addition to the low level of public health spending, the escalating cost of private health care may interrupt access to health services (Oehlers, 2005). Therefore, despite marked increases in the number of public health care personnel as well as health facilities, infant and maternal mortality rates have not shown significant improvement.…”

Negotiating authoritarian law and (dis)order: medicines, drug shops, and regulators in a poor Yangon suburb

“…Many commentators have argued that Myanmar's State as a whole has and continues to give precedence to the expansion and maintenance of its sovereignty, security, and integrity over the fulfilment of universal human rights and equality, improving standards of public health, welfare, and infrastructure for all those that reside within its borders (Oehlers, 2005;Prasse-Freeman & Latt, 2018;Skidmore & Wilson, 2008). While this is most evident for residents of Myanmar living in areas where the military continues to engage in civil wars or in negotiated and forced ceasefires, in many ways it is also the case for the majority of people living in Myanmar.…”

“…While this is most evident for residents of Myanmar living in areas where the military continues to engage in civil wars or in negotiated and forced ceasefires, in many ways it is also the case for the majority of people living in Myanmar. During the military's absolute authoritarian rule , increased investment and development of military resources and institutions paralleled the gradual run-down and fragmentation of state infrastructure and institutions (Oehlers, 2005;Perry, 2007). While this certainly was the consequence of a weak state, scholars have also described not only deliberate negligence (Oehlers, 2005), but the military's active denial of development and improvements to urban settlements and state infrastructure to ensure populations would not come to threaten their pursuit of 'law and order' (Perry, 2007;Sanchez, 2020;Seekins, 2005;Seekins, 2009).…”

“…During the military's absolute authoritarian rule , increased investment and development of military resources and institutions paralleled the gradual run-down and fragmentation of state infrastructure and institutions (Oehlers, 2005;Perry, 2007). While this certainly was the consequence of a weak state, scholars have also described not only deliberate negligence (Oehlers, 2005), but the military's active denial of development and improvements to urban settlements and state infrastructure to ensure populations would not come to threaten their pursuit of 'law and order' (Perry, 2007;Sanchez, 2020;Seekins, 2005;Seekins, 2009). The military accompanied such authoritarian means of social control with the threat of violence and state surveillance, all of which served to create a pervasive sense of fear, distrust, and paranoia amongst Myanmar's citizens, as well as the military, civil servants, and state officials themselves (Skidmore, 2003).…”

“…Gadaw practices have become an accepted norm for patients to essentially pay for services in the public sector that are otherwise unavailable, contributing to partially privatising the public sector. Furthermore, Myanmar's citizens cope with the shortcomings of state institutions' provision of health care through visiting street vendors and black markets for more affordable medical equipment and medicines (Oehlers, 2005). The lack of a national health insurance means that the majority of health financing occurs through out-of-pocket payments in the private sector (World Health Organization, 2014).…”