Tuesday, November 20, 2007

HEALTH AND HUMAN RIGHTS

HEALTH AND HUMAN RIGHTS THE BURMESE REFUGEE EXPERIENCE

September 11,2007


The relationship between human rights and health is immediate, persistent and insistent. In the presence of poverty, health suffers. In the presence of a stable system for providing health care, lack of access to that system prevents cure and stifles prevention. Anguish accompanying loss of one’s family, alienation in another culture, removal of known support systems impairs the ability to withstand illness. Lack of documentation of one’s existence within a society creates a sense of isolation and abandonment that is productive of adverse emotional responses to stress. If one is unable to communicate with those providing health care, any potential positive effect of health care is blunted if not completely abolished. Epidemiologic studies over the past twenty years have firmly connected both income and social inequality with increased burden of disease, reduction of longevity, increased infant and population mortality rates. Absence of good sanitation and effective protection from environmental mediators (insects, changes in temperature, pollution) reduces the ability of families to optimally protect their children. Lack of adult education, especially for women, is perhaps the most important barrier to child health. All of these obstacles and challenges confront the many thousands of Burmese refugees who have come to Thailand in recent years.


We have been spending the last six weeks volunteering with Grassroots Human Rights Education and Development Committee (GHRE), a Burmese-initiated program in Phang Nga province serving Burmese refugees, many of whom are without work permits. Led by Htoo Chit, an experienced leader, GHRE provides a spectrum of programs and services meeting diverse needs of the Burmese people in the area, including programs to enhance migrants’ development, education, school and community health, mobile teaching services, empowerment of women, human rights education and advocacy. We are retired faculty members from the Department of Pediatrics (REG) of the School of Medicine and the Division of Community Health Nursing (MAG) of the College of Nursing of the University of New Mexico in the United States. We have been working to assist a remarkable staff in improving and expanding health programs for children and their families. We have visited Learning Centers and Nursery Schools, established by GHRE, in isolated communities, centered around fishing villages, rubber plantations, chicken farms and construction sites. We have participated in assessing health status of children in school settings. Based on our previous work focused on the relation between health and human rights, we have seen that relationship displayed in direct and meaningful ways within the Burmese communities.

A few examples will, hopefully, demonstrate the urgency of the plight of Burmese refugees. A 45 year old man was seen in a Temporary Shelter, maintained by GHRE for people who have lost their jobs or who have suffered a major family disaster, suffering from abdominal pain and fever. With findings suggesting a severe intra-abdominal process, he was taken by us to the regional hospital. On entry to the Emergency Room, a nurse insisted that he be taken back, and to return the following morning. On our insistence, he was admitted; however, he died four days later in the hospital. A young member of our staff was thought to be suffering from malaria. She was kept waiting for five hours before a blood test was drawn, making sure that only she remained to be seen, following provision of services to all waiting Thai people. Ultimately, the diagnosis of malaria was established. A 14 year old boy had a cleft lip and palate which had remained uncared for; an American tourist provided the financial support that was required in order for a surgical repair to be done. In the absence of such support, the boy would still be functioning with that significant functional and cosmetic defect. A six year old boy, seen on a rubber plantation, presented with an immense inguinal hernia which would have been surgically repaired in any developed country many years earlier. A five year old boy was seen with an extremely large spleen and anemia, awaiting evaluation for years for potentially correctable disease. A number of adults suffer from work-related injuries, unable to have them either evaluated or managed. The violations of human rights overtly accompanying the recent state of virtual martial law affecting migrants in six provinces within Thailand have expanded the potential direct relationship between compromised human rights and health. The above examples, which we have personally witnessed, are magnified and multiplied throughout the communities where Burmese refugees live and try to work.

Millions of Burmese people have been forced to flee their culture and their country because of the stultifying, devious and devastating consequences of the military regime that has plummeted a once shining society to its current abysmal state. The history of people living along the Thai/Burmese border is complex and long, reflecting, undoubtedly, different political processes even within a common religious experience. The adverse effect of nationalism submerges the Burmese refugee population who must try to find a viable place in the society of a neighboring nation. Sent away from their own land by political oppression or economic deprivation, Burmese people must try to find a way to re-establish their sense of cultural solidity and economic viability. GHRE represents an important and significant entity attempting to assist Burmese people in their quest. The primary importance of people having their human rights appreciated, validated and realized is summarized by the strident plea framed by GHRE: No human is illegal!

Robert Greenberg, M.D. & Maggie Greenberg. R.N., Ph.D. – Volunteer from American Jewish World Service (AJWS)

Robert & Maggie Greenberg are retired faculty members from the Department of Pediatrics (REG) of the School of Medicine and the Division of Community Health Nursing (MAG) of the College of Nursing of the University of New Mexico in the United States.

They have been with (GHRE) from July to August, 2007 volunteering to assist a remarkable staff in improving and expanding health programs for children and their families. They visited Learning Centers and Nursery Schools, established by GHRE, in isolated communities, centered around fishing villages, rubber plantations, chicken farms and construction sites. They have participated in assessing health status of children in school settings.


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