An article in the Irrawaddy has this curious paragraph: "Secretary Clinton outlined a strategy to create an “AIDS-free generation” in her speech on global HIV/AIDS a few weeks ago at the US National Institutes of Health. It was a factual, practical and encouraging speech that addressed challenges as well."
Secretary Clinton said nothing in this speech about sterile needles. How factual and practical is that?
[him] moderator
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Hope and Health in Burma
Myat Htoo Razak
Irrawaddy
December 1, 2011
After decades of repeated disappointments, the people of Burma are entering into an exciting endeavor. The National League for Democracy has re-registered as a political party and will participate in by-elections early next year.
US Secretary of State Hillary Clinton is visiting Burma. People, both inside and outside the country are cautiously optimistic about the changes taking place. As global citizens, we are entitled to be excited and optimistic for Burma, but we are also wise to be cautious.
Under the military dictatorship the once-prosperous country became one of the world’s least-developed countries. This decline occurred despite nationwide resistance and protests for the last six decades. So far, glimmers of hope have not been realized. We can only hope this time will be different.
The people of Burma have a leader who is highly respected and trusted, both nationally and globally. Daw Aung San Suu Kyi has clearly demonstrated that, for the betterment of the country, she can work with anyone, including those who put her under house arrest for most of the last 22 years.
Her messages are clear, cognizant and conciliatory for the sake of the country and the people of all ethnic, regional, social, economic, and political backgrounds. She and the people of Burma are seeking pragmatic approaches to move the country forward from the long impasse and atrocities under successive military rulers. They know that it will not be an easy path. They have lived their lives under such circumstances in the country for many decades.
We, “the outsiders,” should provide all the support that Daw Suu and the people of Burma need at this critical time. Enthusiasts, cynics, or those who still undecided about the current changes can provide different types of support for the people of Burma.
Continue the pressure on the Myanmar government to improve the democratic process and human rights policy, including the release of political prisoners. Explore opportunities to work with the government or national and international agencies to help the people inside, or express your thoughts through the Internet or other communications channels. Whatever we decide to do, we must listen to the people who struggle every day inside Burma and along its borders.
The recent cancellation of the Myitsone dam construction (a Chinese-financed plan to construct a huge dam on the Irrawaddy River) by the Myanmar government provides an important example of how collaboration at local, national, regional and global levels can bring about change inside Burma.
The seemingly impossible task of opposing China was successful (for now) because of the unity, strategy and tireless work of many people and groups from inside and outside Burma.
Secretary Clinton’s visit has raised expectations for increased humanitarian assistance from the United States and other Western countries. People are asking what kind of assistance? To whom? By whom?
There is no doubt that increased humanitarian assistance is much needed for the majority of the people in Burma and along the borders. Humanitarian groups and agencies, especially the local and community groups, have been working in Burma for decades under challenging circumstances imposed by the military junta, with very limited assistance from international donors. Their voices must be listened to, heard, and responded to directly by Secretary Clinton and her top officials.
The current global financial difficulties will require potential donors to set clear priorities for any humanitarian assistance to Burma. Health must be a priority because healthy people are essential for economic growth, security, peace, prosperity, and democracy.
Burma was once an example of a good health system in Southeast Asia. However, health services have declined in recent decades. Patients, families and doctors have described overcrowded public hospitals with empty medical cabinets and overworked and underpaid staff.
Although modern private hospitals have become available in Burma, most people who cannot afford the fees have to rely on public hospitals and clinics. Smaller states and rural areas have even less favorable services.
In a short-term approach, humanitarian assistance in health should be considered in three key priorities:
Improve service delivery on the top five most common diseases in both urban and rural areas, through sufficient support of trained health workers, medicines and supplies. Local and national organizations can implement the services with support from communities and international donors through re-programming of existing activities.
Enhance capacity of the health workforce with on-the-job training that reflects the actual needs of the population. International support can be provided through local and national health professionals to improve the quality of service delivery.
Explore practical approaches that would provide structural support, such as health care financing, timely distribution of medicine and supplies, and health equity for gender and ethnic groups.
One good example of effective service provision is a health center in Mae Sot led by Dr. Cynthia Maung. Since 1988, she has steadfastly provided much-needed health care for thousands of displaced people. She herself is a displaced person who left Burma after the brutal crackdown in 1988.
She and her team have provided care and trained health workers with support from donors and the help of many international health workers. Advice and suggestions from Dr. Cynthia and her team will be essential in developing and implementing services along the borders.
Many health workers in Burma have worked with community organizations, national and international NGOs, the Ministry of Health and other related groups to provide necessary humanitarian assistance to the population inside Burma and along the borders.
In addition, there are experienced health professionals from Burma who have worked as staff of the United Nations or other international organizations abroad on health and development in developing countries.
Some of them are back in Burma. Knowledge, experience and supervision of health workers in Burma—together with the communities’ input and participation—must be included as essential parts of any plan and implementation of humanitarian assistance on health.
They are more likely to be ready to participate under favorable and collaborative political and social environments such as now.
Secretary Clinton outlined a strategy to create an “AIDS-free generation” in her speech on global HIV/AIDS a few weeks ago at the US National Institutes of Health. It was a factual, practical and encouraging speech that addressed challenges as well.
She gets her first taste of Burma on Dec. 1, which is World AIDS Day. HIV/AIDS is a major challenge in Burma that requires pragmatic humanitarian assistance. We hope Secretary Clinton will have a chance to meet with people with HIV/AIDS, families, health workers and social organizations, and have the chance to listen to them and to share her thoughts and encouragement.
No matter the type of government (democratic, dictatorship, or somewhere in between) in Burma, a sound, effective health system must be established so that the people can be healthy enough to build a peaceful and prosperous country.
It will not be an easy task for the international community to help the people of Burma turn their hopes into reality. Daw Aung San Suu Kyi and the people of Burma appear ready to try and cooperate with the Myanmar government.
Are we prepared to support them effectively this time? Let’s hope Secretary Clinton and her team will be able to discuss with diverse groups in Burma and contribute to explore an effective strategy for Burma to move forward as an integrated, peaceful and contributing member of the global community sooner.
Dr. Myat Htoo Razak is a Burmese physician who left Burma in 1989 following the brutal military crackdown on pro-democracy protesters. He has worked in Africa and Asia on HIV/ AIDS research, and now lives in the United States where he works on global health issues.
Copyright © 2008 Irrawaddy Publishing Group | www.irrawaddy.org
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