Book Review: The Politics of Aid to Burma

By David Scott Mathieson 8 May 2017

With the looming repatriation of 100,000 refugees from camps along the Thailand-Burma border after decades of civil war, to the escalating armed conflict in Kachin and Shan states, there is no better time to pursue debates on the politics of humanitarian aid to civilians displaced by war inside Burma.

Anne Décobert’s finely detailed study of the Back Pack Health Worker Teams (BPHWT) which operate in conflict areas of Eastern Burma serves as a salient historical study that informs current debates and donor decisions on aiding civilians caught in the maelstrom of modern war.

The author begins the book with her arrival in the hub of Burmese émigré intrigue and resistance, the Thailand-Burma border town of Mae Sot, where she soon became embedded with BPHWT pursuing a participatory observer role in the group as a doctoral student. Back Pack is an innovative collective of community health workers who venture into active conflict areas in Eastern Burma to provide services to displaced civilians, at times several hundred thousand people, and gather data on health conditions for advocacy on donor support and human rights promotion. It did so often in conjunction with insurgents of the Karen National Liberation Army (KNLA), the world’s oldest rebel movement and with its own sophisticated civilian support administration.

Back Pack was at the eye of the storm that became known as ‘cross-border assistance,’ the basing of humanitarian actors on the Thailand side of the border that ventured deep into Burmese sovereign territory to assist civilians denied services by the government and routinely the target of systematic human rights abuses by the Burmese military.

The tensions over humanitarian principles were ever present in Back Pack’s modus operandi, “politicized and polarized” as Décobert succinctly describes the debate. She notes “it is frequently at the margins of sovereignty and of state definitions of legality that some of the political and ethical dilemmas of humanitarianism become most pertinent” (p.4). Back Pack made international donors and humanitarian actors extremely nervous, and incensed many who derided them as a rebel support service.

The book’s first chapter is an important contribution to debates on humanitarian action with special reference to Back Pack that should be required reading for any new aid worker arriving in Burma. The second chapter is an admirably balanced historical overview of the broader conflict context in Burma from which Back Pack emerged. This too should be requisite reading for any recent arrival in Burma who casually derides the contributions of the “border” to keeping people alive and the documentation of atrocities and humanitarian needs high on the international agenda.

Chapter three overviews Back Pack’s origins from 1998 as a backroom operation in the celebrated Mae Tao clinic of Dr. Cynthia Maung in Mae Sot to an innovator in cross-border aid, soon with its own expansive compound nearby and unique deployment of numerous mobile teams and trainers inside Karen State who saved tens of thousands of civilians. (Full disclosure: I visited this compound with great regularity and received unstintingly valuable, if often understandably irascible, assistance from its staff during my time working on the border).

Décobert does justice to the people she encountered during her research in the following two chapters, with finely drawn portraits of medics and victims, of people caught up in war, repression, and poverty doing the best they can. Any cynic of cross-border aid should be compelled to read these stories, or even better, speak to people in these situations, before making easy judgments on the dilemmas they face. Many of the medics deployed were from the communities experiencing war, and many were directly targeted by Burmese army troops who deemed them participants in the conflict, which marked the operational strength but also the international suspicion of Back Pack. The author summarizes that “as victims of the military regime, they could not be neutral” (p.223). “For them,” she writes “neutrality translated into indifference to injustice, oppression and suffering.” Fusing practical assistance with evidence of abuses and advocacy was Back Pack’s strengths.

The approach of BPHWT eventually collided with more conventional international aid providers such as the United Nations and INGO’s around the response to Cyclone Nargis in 2008 in which 140,000 died and several hundred thousand were displaced and destitute in the Irrawaddy Delta, and the violence in Karen State following the 2010 elections when fighting broke out between the Burma military and factions of the Karen armed resistance, displacing thousands. Décobert carefully describes the disputes over who actually provided the ‘real’ aid to communities, and the polarizing international debates which privileged either statist or subaltern claims to genuinely “humanitarian” action for disaster and conflict relief in the context of ongoing military rule in Burma.

These were bitterly contested narratives, and advocacy over the legitimacy of approaches became almost attrition warfare in itself over several years, played out in Rangoon, Mae Sot, Bangkok and key donor capitols, effecting millions of people in Burma. In the end, cross-border assistance lost to an exponentially expanded international aid and development complex based in Rangoon and supportive of the post-2011 reforms led by former President U Thein Sein.

Décobert’s book deserves a broad readership inside Burma not just because it provides detailed background to the humanitarian struggles along the eastern border, applicable now to providing aid to displaced civilians in the north, but as international donor priorities shift from humanitarian support to development and peace-building initiatives. The politics of humanitarianism in Burma are still in conflict.

David Scott Mathieson is a Rangoon-based independent analyst, who was based along the Thailand-Burma border from 2002 to 2012.