Multi-level partnerships to promote health services among internally displaced in eastern Burma

Abstract

Ethnic populations in eastern Burma are the target of military policies that result in forced labour, destruction of food supplies, and massive forced displacement. Despite international assistance to Burmese refugees along the Thai–Burma border, traditional humanitarian models have failed to reach these internally displaced persons (IDPs) within Burma. Nevertheless, through the cultivation of a model (cross border local-global partnerships) 300,000 IDPs in eastern Burma now receive critical health services where, otherwise, there would be none. We describe key elements of the partnership model's genesis in eastern Burma. The role of the local partner, Backpack Health Worker Team (BPHWT), is highlighted for its indigenous access to the IDP populations and its maintenance of programmatic autonomy. These local elements are potentiated by international support for technical assistance, training, resources, and advocacy. International policy and investment should prioritize support of locally-driven health initiatives that utilize local-global partnerships to reach not only IDPs but also other war-torn or traditionally inaccessible populations worldwide.

Keywords:

• Internally displaced persons
• local-global partnerships
• Burma
• human rights
• indigenous health workers

Acknowledgements

We would like to thank the dedicated villagers and health workers who are the foundation of the Backpack Health Worker Team partnership.

Notes

1. We do not suggest that support for refugees be limited, but that IDP support is insufficient. Both groups may benefit from an alternative approach.

2. In 2002, USAID referred to Burma as the ‘epicenter for HIV-AIDs in Southeast Asia’, estimating that up to 4% of the general population is infected (USAID 2002); other evidence finds that, ‘HIV/AIDS, tuberculosis, and malaria, are being transported across Burma's borders into China, India and Thailand’ (Lowenkron 2006). WHO estimates Burma's malaria incidence at 3.6 cases per 1,000 population (0.36%) annually; higher in the border areas. Over half of Burma's cases of malaria are reported from just 100 townships, which account for only 25% of the population (13.7 million people) (Beyrer et al. 2006).