Gross human rights violations, including forced
displacement, forced labor, attacks by soldiers
on civilians, injury from land mines and destruction or
theft of food supplies, have been widespread in
eastern Burma (also known as Myanmar), with more than half
of households in displaced areas
reporting incidents in the 12 months prior to a 2004
The study, completed by researchers from the Johns Hopkins Bloomberg
School of Public
Health and other institutions, is published in the
October issue of the Journal of Epidemiology and
"These study results highlight the impact that the
oppressive military junta in Burma has had
and continues to have on the vulnerable ethnic minority
populations that have been specifically
targeted by the military regime," said Luke C. Mullany,
lead author of the study and an assistant
professor with the Bloomberg School's Center for Public
Health and Human Rights.
The Back Pack Health Worker Team, a network of mobile
health workers who provide basic
health care and conduct surveillance in eastern Burma,
completed interviews and malaria testing in
1,834 households between October and December 2004.
Resource and security constraints required
survey modules, including basic malaria diagnostic tests,
to be limited to one sheet of paper and only
what could be carried inconspicuously and without survey
Fifty-two percent of respondents said they had
experienced one or more human rights
violations during the previous 12 months. More than 32
percent of households reported forced labor,
25 percent reported theft or destruction of their food
supply, and more than 8 percent reported
forced displacement. Mortality risk for children under 5
years of age exceeded 200 per 1,000 live
births. Malaria, diarrhea and acute respiratory infections
were given as the most common causes of
death. Land mine injuries were reported at a rate of 13.3
injuries per 10,000 persons per year.
The key findings of the relationship between human
rights violations and poor population-level
health indicators include the following:
The risk of death among children
younger than 5 years was five times higher among households
that reported multiple human rights violations.
There was a substantial increased
risk of land mine injuries among households that reported
forced displacement or food theft or destruction.
Poor nutritional status among
children was associated with forced displacement and food
Deaths at any age were more often
reported by households that experienced forced
displacement or food theft or destruction.
"These data are from 2004, a period in which there was
less active conflict in eastern Burma,
relative to the current situation. In recent days, the
international community has witnessed the
military junta's violent crackdown against the nonviolent
demonstrations calling for the restoration of
democracy led by Burma's revered Buddhist monks and nuns,"
"The Back Pack Health Worker survey demonstrates the
impact of this regime's policy of
oppression against the Burmese people, especially displaced
ethnic minorities in eastern Burma," he
said. "Systematic human rights violations in these
communities lead to high risk of mortality,
infectious morbidity and malnutrition."
The study authors explain that combining the
collection of data on human rights violations and
population-level health outcomes allows for quantifying the
relationship between abuses and health
status, complementing qualitative methods and facilitating
"It is just this kind of hard evidence of the human
toll of military misrule that the Burmese
military regime has tried to suppress," pointed out study
co-author Chris Beyrer, who is director of
the Johns Hopkins Center for Public Health and Human
Johns Hopkins researchers Mullany, Voravit
Suwanvanichkij and Beyrer co-authored the study.
Additional co-authors are Adam K. Richards, of Montefiore
Medical Center; Catherine I. Lee and
Thomas J. Lee, of the Global Health Access Program; and
Cynthia Maung and Mahn Mahn, both of the
Back Pack Health Worker Team.
The study uses the name Burma rather than Myanmar.
Burma is the form preferred by the
leaders of Burma's pro-democracy movement, the legitimate
winners of the 1990 elections.