Abstract
BackgroundDecades of conflict in eastern Myanmar have resulted in high prevalence of human rights violations and poor health outcomes. While recent ceasefire agreements have reduced conflict in this area, it is unknown whether this has resulted in concomitant reductions in human rights violations.Methods and FindingsWe conducted a two-stage cluster survey of 686 households in eastern Myanmar to assess health status, access to healthcare, food security, exposure to human rights violations and identification of alleged perpetrators over the 12 months prior to January 2012, a period of near-absence of conflict in this region. Household hunger (FANTA-2 scale) was moderate/high in 91 (13.2%) households, while the proportion of households reporting food shortages in each month of 2011 ranged from 19.9% in December to 47.0% in September, with food insecurity peaking just prior to the harvest. Diarrhea prevalence in children was 14.2% and in everyone it was 5.8%. Forced labor was the most common human rights violation (185 households, 24.9%), and 210 households (30.6%) reported experiencing one or more human rights violations in 2011. Multiple logistic regression analysis identified associations between human rights violations and poor health outcomes.ConclusionHuman rights violations and their health consequences persist despite reduced intensity of conflict in eastern Myanmar. Ceasefire agreements should include language that protects human rights, and reconciliation efforts should address the health consequences of decades of human rights violations.
Highlights
Decades of conflict in eastern Myanmar have resulted in high prevalence of human rights violations and poor health outcomes
Human rights violations and their health consequences persist despite reduced intensity of conflict in eastern Myanmar
Numerous prior studies have demonstrated strong links between human rights violations in this region and population-based health indicators. They found that forced displacement was associated with child malnutrition and child mortality, that theft and destruction of food supply was associated with malaria parasitemia and child malnutrition, and that those exposed to human rights violations had severely curtailed access to essential maternal health interventions. [12,13]
Summary
The sampling universe for the cross-sectional survey included adults and children living in clinical catchment areas served by BPHWT and KDHW in Karen state and adults and children living in three townships around Dawei town in Tanintharyi Region, eastern Myanmar (Fig 1). The survey questionnaire was designed to assess human rights violations, access to healthcare, and food security. The survey consisted of four modules: demographic/household listing, access to healthcare, food security and human rights violations each described briefly below. This module aimed to estimate household size, male to female sex ratio, age distribution, middle-upper arm circumference (MUAC), doi:10.1371/journal.pone.0133822.g001 night blindness and diarrhea of household members. If households reported a member who had night blindness or another severe health condition, surveyors referred that person to the nearest clinic. Religion, marital status and occupation of the head of household
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