Ethnic Health Organizations Suffer from Withdrawal of International Aid

By Lawi Weng 29 January 2019

Representatives of nine ethnic health groups from across Myanmar recently held a three-day meeting at the Thailand-Myanmar border to discuss how to deal with challenges they face in delivering medical assistance to people in need as an increasing number of international aid groups withdraw programs from the Thailand-Myanmar border.

Health organizations from Karen, Shan, Mon, Karenni and Burmese communities—including representatives of the Mae Tao Clinic—formed a joint collective called the Ethnic Health System Strengthening Group. The organizations are all based along Thailand-Myanmar border and carry out essential medical programs in their respective conflict zones. An Ethnic Health Committee was formed at the meeting to develop health policies and information systems about the health conditions of ethnic communities.

Saw Nay Htoo, a member of the Burma Medical Association who was appointed joint secretary of the committee, told The Irrawaddy on Tuesday about the meeting, which was an annual gathering.

“We discussed the difficulties faced by those in our organizations and we tried to find solutions to the difficulties,” he said.

Since Myanmar began to undergo political reforms in 2010 under then-president Thein Sein and international non-governmental organizations (INGOs) who had been giving aid at the border were granted permission to work inside Myanmar, medical aid for those displaced at Thailand-Myanmar border has decreased dramatically.

The health organization representatives reported a lack of access to medicine and long delays in receiving aid from the organizations which continue to work in the area.

In the past, UK Aid was the main donor of medical assistance to health care organizations at the Thailand-Myanmar border. They used to support the health organizations directly, but today they operate through the United Nations Office for Project Services (UNOPS), according to sources in the organizations.

Saw Nay Htoo said that the medical supplies which their health organizations need are not readily available to them in Myanmar, a problem which did not affect them in the past when the international groups were working at the border and got supplies from Thailand.

The organizations also have human resource issues, including a lack of skilled workers. At the meeting, they discussed ways of alleviating the problems and upgrading essential healthcare skills of the members of the group. The areas in which the health groups operate have been the locations of violence between the Myanmar Military and various ethnic armed groups for over six decades. An outcome of the conflict is that the ethnic communities lack education centers for the training of medical professionals and so the health organizations lack personnel to administer treatments and medical advice to those in need.

The meeting attendees discussed the Myanmar government’s 2017 plan to implement a universal health coverage project which aims to give every individual in the country full access to health care by 2030. They argued that the government should use a decentralized system in carrying out this plan in order for it to be really effective.

“The government will not succeed on their project if they do not implement a federal health system,” said Saw Nay Htoo.

Currently, health organizations operating along the border do not receive any help from the Myanmar government, and continue to rely on a diminishing number of INGOs.

As a result, their health organizations are often underfunded and local people sometimes have to pay out of their own pocket for the treatment which deters the poorer among them from seeking medical treatment, he said.

“Treatment is a burden for them sometimes,” he said.

Misunderstandings of the political transition

“We want international NGOs to understand the real political situation in our country. Our country has not yet reached yet a transitional period. It just started an interim period,” Saw Nay Htoo said.

He said that it is necessary to work as two different health systems during this period.

International NGOs should donate to programs both inside Myanmar and to those displaced in ethnic areas. If they support only one side, ethnic health care projects will die out, he said.

It is important for international NGOs not to be biased when they give donations, he said.

By supporting two sides, it will also support the peace process in Myanmar. At the moment, in ethnic areas, only ethnic people can effectively deliver healthcare, he said.

Nai Banya Mon, a member of the Mon National Health Care Committee who is also the vice chairperson of the group, reiterated the need for INGOs not to act so quickly on the idea of a political transition.

“For our health organizations, it is an interim period. From the interim period, it could go to a transition. From transition, it could go to a federal system. International NGOs believe it is transition time,” he said.

He feels that international aid organizations have abandoned the ethnic people at the border areas who have depended on them for a long time, and jumped the gun by transitioning to work directly with the government health organizations and those working inside Myanmar only.

According to Nai Banya Mon, it will take a long time for the peace process to reach its goal and so international groups must continue to offer health aid to those at the border.