Myanmar simultaneously faces multiple armed conflicts and crises, each with its own challenges. In Rakhine state, the government’s persecution of the Rohingya people has led to massive displacement, as have decades of armed conflict in Kachin and northern Shan states. Combined with chronic underdevelopment, these humanitarian crises have left people without access to adequate healthcare, leading international humanitarian actors to step in.
The public health system in Myanmar is generally poor, and government funding for health services is among the lowest in the world. There are wide discrepancies in health services between rural and urban populations and between central and peripheral states. In Rakhine, there are only nine public health workers per 10,000 people, and access to secondary and tertiary healthcare is limited. Community-based or ethnic health organizations provide primary healthcare in many areas without government facilities. In crisis-affected areas, UN agencies and international and local NGOs play an important part in providing healthcare services. However, international action can be unbalanced both regionally and medically. In many areas, health actors have focused on responding to diseases like malaria, HIV/AIDS, and tuberculosis, leaving a critical gap in mental health services and clinical health responses to sexual and gender-based violence. Likewise, funding has been imbalanced, with Rakhine state receiving more funding than Kachin or northern Shan.
This paper looks at the state of healthcare in Rakhine, Kachin, and northern Shan states, the role of humanitarian actors in the provision of health services, and the trends and challenges affecting the humanitarian health response. It provides several recommendations for improving the humanitarian health response in Myanmar, including:
- Adjust the scope of the humanitarian response;
- Advocate for better humanitarian access;
- Strengthen local capacities, and;
- Address the dilemmas inherent in providing aid amid a development and human rights crisis.