Building Peace through Community Health in Burma

April 5, 2013
PHI Curriculum Developer Amanda Martin in the Umpiem Mai refugee camp library

Life in a Refugee Camp — read Amanda Martin's keynote address at the Rotary International Peace Symposium in North Carolina April 5, 2013 below...

Community Partners International staffer — and Rotary International Peace Fellow alumna — Amanda Martin lives at Umpiem Mai refugee camp on the Thailand Burma border, teaching and adapting public health curriculum to refugees in the camp. 

PHI offers training and field fellowships for 20-24 students per year living in Umpiem Mai refugee camp  This first-of its-kind project grew out of our local partners’ needs and vision. For the more than 140,000 refugees in the camps along the Thailand-Burma border, opportunities for higher education are extremely limited. Further, there is a critical shortage of trained health workers in the conflict-affected region, exacerbating already high rates of maternal and child mortality and illness in eastern Burma.

We see the Public Health Institute as a long-term investment in building peace and civil society in Burma / Myanmar, strengthening the capacity of our partners, and providing refugees with population health skills in high demand along the Thai-Burma border.

The Three Rs:  Rotary, Refugees and the Ripple Effect
by Amanda Martin

I currently work in Mae Sot, Thailand, on the border of Burma, with the Global Health Access Program (under Community Partners International) as the Public Health Institute Program Development Coordinator. I spend half of my week living and teaching at the Umphiem Mai refugee camp, and the other half working in the GHAP office in Mae Sot.

Umphiem is home to 16,000 refugees from Burma. I live in a bamboo hut on top of a mountain, in section 10, Zone B of the camp. My hut is surrounded by the campus classrooms, and is a steep thirty minute hike from the highway up the mountain. I bring my books, computer, and warm clothing in my backpack every week, and after a day of teaching, I spend the star-filled evenings reading by flashlight under my mosquito net. The camp loudspeaker announcements, the Muslim call to prayer, and the gnawing of the rats on the bamboo hut posts are the only interruptions after dark.

Camp life is challenging in many ways. Electricity is rationed to two hours per day, and running water is not guaranteed throughout camp. I can enjoy this experience because I have the freedom to leave camp and return to town, unlike the refugees, who are not allowed to leave, under the policy of encampment.

I teach public health education, disease prevention, and health promotion at the first established public health college for Burmese refugees, under the administration of the Karen Refugee Committee Education Entity (KRCEE). The students come from conflict zones inside Burma, the majority from Karen state, which is home to the world's longest civil war (since 1948). They each have tragic stories of forced labor, internal displacement, military attack, soldiers raping their family members and resultant suicide, forced military recruitment, and many other human rights violations. Over the past 25 years, their families fled to Thailand to escape the violence against ethnic minorities.

The camp is high up in the mountains, just ten kilometers from the Burma border. The refugees live in bamboo huts with thatched roofs made of leaves. The sun beats down during the afternoon, but the cold mountain air requires a coat and blanket at night. Each registered refugee is allotted a monthly ration of food, including rice, oil, fish paste, and yellow beans. The rations were cut by 30% last year due to funding cuts. There is no formal employment in the camp; limited job opportunities with the NGOs offer refugee workers monthly stipend of under $100.

The problems in the camp stem from issues of powerlessness, lack of access to land, lost livelihoods, poor quality education, limited health services, poverty, gender inequality, discrimination, harsh conditions, unemployment, and confinement. The Public Health Institute addresses some of these issues by offering an advanced degree option for refugee students. The Karen Refugee Committee Education Entity and the Kah Lah Junior College have made this option possible by providing the space, resources, and support for this new specialized program that will prepare public health students to work on the border and inside Burma.

There are myriad projects and hundreds of NGOs and Community Based Organizations working here on the border; many have been here for ten to twenty years. What impact have they had? One peace-building tool that I often reflect on is Mary Anderson’s “Do No Harm” principle, which challenges humanitarian agencies to take responsibility for the impact of their aid that, inevitably, has unintended consequences in conflict zones. Foreign assistance can save lives, build houses, provide food, and access to healthcare. However, it can also create divisions (among those who receive the aid and those who do not) and create a culture of dependency. Currently, the refugees are wholly dependent on the NGOs for basic survival.

Prior to living in the camp, the refugees were village leaders, teachers, farmers, business owners, students, and traditional healers – proud and respected members of their ethnic communities. They governed their villages, grew their own crops, traded in local markets, procured building materials and cared for the sick, albeit while living in an impoverished and war-torn area.

This culture of dependency has contributed to the disempowerment 142,000 Burmese refugees on the border. As the current Burmese government shows signs of shifting towards positive democratic change, the future of the camps is uncertain. When the camps close down, the refugees will have to fend for themselves, either in Burma, in Thailand, or resettled in a foreign country.

I want to share with you an inspirational experience from my classroom.  In January, I taught my students about the UN Declaration on Human Rights. One of the best students shot his hand in the air, waving it wildly. “Teacher, teacher! I am very angry!” he shouted, emphatically. “Why has no one ever taught us this before? I am in college and I have never seen my 30 human rights until today!”

As we reviewed the 30 articles, the students became more incensed. “We are refugees. We don’t get human rights,” one of the young women said. I explained the 1951 UN Refugee Convention, and the special status of refugees. The students again cried out. “We do not get these refugee rights. We need to give a training on refugee rights to the camp commander; he does not know that we have these rights,” one student announced. I explained that none of Burma’s neighboring countries has signed onto the Refugee Convention, and thus, it is not enforceable in those countries, including Thailand. “How can we convince them to sign on?” they asked. We discussed the role of the UNHCR and how it has limited scope in Thailand due to its political agreement with the government.

In the words of Eleanor Roosevelt, “Where, after all, do universal rights begin? In small places, close to home - so close and so small that they cannot be seen on any maps of the world… Unless these rights have meaning there, they have little meaning anywhere. Without concerned citizen action to uphold them close to home, we shall look in vain for progress in the larger world.”

Daily challenges are enormous for a refugee. When tragedy strikes, the impact in a community that owns next to nothing is catastrophic. On February 23, 2012, a fire started in section nine of Zone B in Umphiem camp. A woman was frying a snack in her kitchen, and the thatched roof of her hut caught fire. Within two hours, 450 houses were burned to the ground. 4,500 people lost their homes, their clothing, their few possessions, including pots and pans, and their monthly food rations, distributed only a few days before the fire. Three mosques, two nursery schools, and a community center burned down. Several children were severely burned.

That night, the community organized to create temporary shelters in the two remaining mosques, a storage warehouse, and the camp hall. The outpouring of support for the fire victims was truly inspirational. For the next 14 days, truckloads of donations poured into the camp from the community in nearby Mae Sot, from individual donations and from the NGO warehouses. Refugees from all 16 sections of the camp came to help. People with homes invited fire victims to stay with them until their huts were re-built. In a two meter square hut already occupied by a large family, this was an exceedingly generous offer. For many refugees the fire triggered memories of forced displacement and being burned out of their previous camp by the Burmese Army. These victims received psychosocial support by trained community mental health workers, paired along with my public health students, to provide targeted assistance for the extremely vulnerable fire victims.

My work with GHAP, KRCEE and KLJC in establishing the first public health institute for refugee students is a step towards preparing trained public health professionals. The first cohort of students graduated in April 2012 and has just completed their year-long internship with community-based health organizations on the border. The second class graduated on April 1, 2013 and will begin their public health internship in June. I am convinced that their knowledge of and experience with the refugee situation, combined with their determination to improve the quality of life for the people of Burma, will help bring positive transformation to a region of the world with some of the worst health indicators.

For me personally, to play a role in this change, to participate in creating the possibility for refugee students to be trained as the next generation of public health workers for a new Burma, addressing the most remote, neglected areas of Eastern Burma, is inspiring and fulfilling. My work also includes creating a sustainable program that is driven by local needs, applicable to the local culture and to the surrounding environment, and is locally supported and managed.  When my work with GHAP, KRCEE and KLJC is done, I should be able to leave unnoticed, while the program continues to run smoothly and efficiently, under local management.

There are refugee problems throughout the world. Many of them involve gross violations of human rights. They do not attract the media coverage of the Arab/Israeli dispute or of disputes in other high profile areas such as Sudan or Somalia.  But they are very real and equally deserving of support and solutions.  Thank you for your attention and interest in my work.


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