Opium Pathways: Mountains, Mules and Resource Extraction in Shan State, Myanmar

Mae Sai is a major northern Thailand-Myanmar border town opposite from Myanmar’s1 Tachileik, which is linked to southern China via Myanmar’s R3B route. Throughout history, this border town has been a diverse cultural landscape with a multiplicity of ethnic people pursuing translocal trade for their livelihoods. These various peoples, which include Tai Yuan (the native Tai in this area), Tai Lue, and subethnic Tai from Shan state and Yunnan, and Yunnanese Chinese,2 have all been very mobile in northern mainland Southeast Asia. Horses and mules were used for short- and long-distance caravan trading along overland routes through mountainous areas3 prior to the emergence of modern transportation and sovereign nation-states in Southeast Asia and China. Mae Sai has also been affected by the migratory history of the Han Yunnanese in the border area, particularly the movements of Chinese Nationalist Army troops (or Kuomintang, KMT) into Myanmar and northern Thailand after the Chinese Communists took power in China in the 1950s. Han Yunnanese people settled in northern Thailand, including the town of Mae Sai and nearby mountainous areas. People from southwestern China, Yunnan and Shan and Kachin states have come for economic pursuits in ordinary times and for political refuge in times of unrest. Some of them have crossed back and forth from Shan and Kachin states in Myanmar or from Yunnan province.

This paper explores transnational trade carried out by the Tai, an ethnic nationality spread across the border area between Shan State in Myanmar and Dehong Prefecture in Yunnan province in China. The Tai who live in this border region belong to a linguistic group that has long shared cultural and linguistic traits with the Thai in Thailand and other Tai-speaking groups in Vietnam, Laos and other parts of Southeast Asia. This paper focuses on the Tai peddlers who conduct trade between Thailand and Shan state in commodities such as Thai and Tai traditional clothing and entertainment VCDs featuring Shan and Thai songs. The focus is on peddling in traditional Thai dress styles that are popular with Dehong Tai customers. The author contends that dress practices have gained a meaning and status in displaying acquired wealth, and this has resulted in shifting status hierarchy among members of Dehong Tai society. Wearing certain clothes becomes a self-identification that the Dehong Tai use to manifest their social position in public. This in turn helps them to destabilize both their lower-status position in the Han-dominated Chinese society and the cultural imbalance between themselves and the Chinese.

Introduction

This essay considers the case of uneven humanitarian aid distribution along the Thai-Myanmar border, where forcibly displaced migrants from Myanmar have been abandoned by the UNHCR and international humanitarian organizations. Based upon long-term ethnographic fieldwork along the Thai-Myanmar border amongst Tai migrants from the Shan State in Myanmar, I attend to the effects of the inequitable distribution of rights and privileges in an international humanitarian system that is predicated on the neoliberal logic of uneven development. After two centuries of British colonial occupation and later Burman authoritarian rule, the ethnic minority groups along the Thai-Myanmar border are now facing another crisis – that of abandonment as NGOs search for new and more pressing humanitarian disasters elsewhere. The essay addresses a concept I call uneven humanitarianism as a neocolonial condition for peoples living in the Thai-Myanmar borderlands by specifically focusing on Tai peoples who are living in unofficial refugee camps that lost foreign funding in 2017. I argue that the ad hoc treatment and eventual abandonment of these vulnerable groups – that are currently in the midst of the world’s most protracted civil war and displacement situation – constitutes a failure of the “responsibility to protect” humanitarian project.

Instead of criminalizing the opium economy or seeing it as a natural occurrence, opium production must be acknowledged as a basis for political and economic exchanges, which either unites or divides relevant stakeholders. This study employs an analytical framework called embedded governance to analyze opium production in Shan State, Myanmar in a new light. An alternative reading reveals a tripartite interdependency between the central government, ethnic armed groups and rural poppy growers; and marks a significant contribution to existing research which is largely focused on the elite-bargaining between armed actors and the government. We demonstrate that the opium economy delivers basic services and higher income for rural households, expands business conglomerates and civil society, and provides incentives for ceasefire negotiations. Nevertheless, the opium economy is also a basis for land-grabbing, forced taxation and public health crisis arising from drug addiction.

Civil wars in Africa are now the leading contributory cause of vulnerability of rural communities. Understanding vulnerability during civil war is critical for humanitarian response and post-conflict rehabilitation planning. The lack of understanding of vulnerability has led existing studies to make sweeping generalizations, either by equating the dynamics of vulnerability during civil wars with vulnerability in other risk events, or by projecting people in the 'war zones' as unable to cope and subsequently becoming vulnerable. This paper is an attempt to gain a more nuanced understanding of the dynamics of vulnerability during protracted civil war. It shows that during civil war the non-poor are not necessarily less vulnerable than poor households. The idea that people caught up in civil war are all vulnerable is not supported by the findings of this paper. It shows that the 'standard' pattern of vulnerability to drought is similar to that during exogenous counter-insurgency warfare, while a different pattern of vulnerability to endogenous shocks is identified.

The emergence of artemisinin-resistant Plasmodium falciparum in the Greater Mekong Subregion threatens both the efficacy of artemisinin-based combination therapy (ACT), the first-line treatment for malaria, and prospects for malaria elimination. Monitoring of ACT efficacy is essential for ensuring timely updates to elimination policies and treatment recommendations. In 2014-2015, we assessed the therapeutic efficacies of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) for the treatment of uncomplicated P. falciparum at three study sites in Rakhine, Shan, and Kachin states in Myanmar. Patients presenting with uncomplicated P. falciparum malaria were enrolled, treated, and followed up for 28 days for AL or 42 days for DP. Both AL and DP demonstrated good therapeutic efficacy at all three study sites. The 28-day cure rate for AL was > 96% across all study sites, and the 42-day cure rate for DP was 100%. Parasitemia on day 3 was detected in 0%, 3.3%, and 3.6% of participants treated with AL at the Rakhine, Shan, and Kachin sites, respectively. No participants treated with DP were parasitemic on day 3. No evidence of P. falciparum k13 mutations was found at the Rakhine study site. A high prevalence of k13 mutations associated with artemisinin resistance was observed at the Kachin and Shan state study sites. These results confirm that ACT efficacy has been resilient in therapeutic efficacy study (TES) sentinel sites in Myanmar, despite the presence at some sites of k13 mutations associated with resistance. Studies are ongoing to assess whether this resilience persists.

The potamid freshwater crab genus Shanphusa Yeo & Ng, 2007, currently contains two species from Shan State in Myanmar (= Burma): S. browneana (Kemp, 1918) (type species) and S. curtobates (Kemp, 1918). A third species, S. ywarngan sp. nov. is described from a cave in the region. The new species can easily be distinguished from its congeners by various carapace features, shape of the male telson, and structure of the male first gonopod.

BackgroundRapid diagnostic tests (RDTs) for malaria enable proper diagnosis and have been shown to reduce overuse of artemisinin combination therapy. Few studies have evaluated the feasibility and use of RDTs in the private sector in Myanmar. The objectives of the study were to: 1) understand the acceptability of using RDTs in the informal sector in Myanmar; 2) examine motivations for use among informal providers; and, 3) highlight decision-making and knowledge of providers for diagnostic testing and treatment.MethodsQualitative interviews were conducted with 30 informal providers. Purposeful sampling was used to enrol study participants in the Mon and Shan State in Myanmar. All interviews were conducted in Burmese, translated into English, and two researchers coded all interviews using Atlas ti.ResultsMajor themes identified included: 1) informal provider and outlet characteristics, including demographic and background characteristics; 2) the benefits and challenges of using RDTs according to providers; 3) provider experiences with using RDTs, including motivations for using the RDT; 4) adherence to test results, either positive or negative; and, 5) recommendations from informal providers to promote increased use of RDTs in their communities. This study found that introducing RDTs to informal providers in Myanmar was feasible, resulting in improved provider empowerment and patient-provider relationships. Specific challenges included facility infrastructure to use and dispose RDTs and provider knowledge. This varied across the type of informal provider, with itinerant drug vendors more comfortable and knowledgeable about RDTs compared to general retail sellers and medical drug representatives.ConclusionsThis study found informal providers in Myanmar found the introduction of RDTs to be highly acceptable. Providers discussed improvement in service quality including provider empowerment and patient-provider relationships. The study also highlighted a number of challenges that informal providers face which may be used for future development of interventions.

<p>This study explored how to maintain Drum Ensemble (“saing wain:” in Myanmar) as Myanmar cultural heritage. The paper described especially relationship between spirit propitiation ceremony (“nat pwe” in Myanmar) and drum ensemble. Yangon Region is presumed to be the most developed place in the country that it could be very much liable to any infiltration of foreign culture and music. But fortunately, it was found that Big Drum Ensemble is still being used in some downtown areas and some adjacent area in Yangon region. Therefore, study sites were chosen some wards and villages of some Townships in Yangon Region to collect information and data regarding with the usage of drum ensemble. The three studied groups of the community were divided as follows: (1) The drum ensemble members of musicians whose livelihoods depend solely upon Bamar drum ensemble (2) appropriation ceremony (“na´ kana:” in Myanmar) professionals consisted of a woman or a sissy said to be chosen as consort by a spirit (spirit medium) (“na´ gado” in Myanmar), a leader of spirit medium (“kana: si:” in Myanmar), and other followers and (3) the audience. Then the audience comprised the doers and related persons, people who sponsored expenditure of ritual event (“kana: pwe:” in Myanmar) and people who come to watch entertainment. Again it could be classified two categories of audiences who came and watched drum ensemble entertainment. The first said to be the ones who are coming to watch according to their hobby who watch and listen with artistic ears and the remaining groups represent the ones who come and see just for fun. Field ethnography, focus group discussion (FGD), key informant interviews (KII), in-depth interview (IDI), informal conversation (IC) and direct observation (DO) were used for data collection. For qualitative data, information gathered by focus group discussion, key informant interviews, in-depth interview, informal conversation were transcribed and organized on the basis of emerging themes and subthemes. And then some people from village and wards in the study areas were general participated and using in drum ensemble (“saing wain:” in Myanmar) at auspicious and inauspicious ceremonies, direct observation was conducted with them. Observation was carried out at the ceremonies accompanied with drum ensemble, some data of Bamar traditional musical instruments especially, library of Department of Anthropology, Yangon University and Internet libraries. Moreover, data relating to Bamar traditional musical instruments were collected from newspapers, journals and magazines. Taking photographs and recording of music played with Bamar drum ensembles were conducted.<br>\n </p>

SummaryBackgroundArtemisinin-combination therapy (ACT) is recommended as first-line treatment of falciparum malaria throughout the world, and fixed-dose combinations are preferred by WHO; whether a single gametocytocidal dose of primaquine should be added is unknown. We aimed to compare effectiveness of four fixed-dose ACTs and a loose tablet combination of artesunate and mefloquine, and assess the addition of a single gametocytocidal dose of primaquine.MethodsIn an open-label randomised trial in clinics in Rakhine state, Kachin state, and Shan state in Myanmar (Burma) between Dec 30, 2008, and March 20, 2009, we compared the effectiveness of all four WHO-recommended fixed-dose ACTs (artesunate–mefloquine, artesunate–amodiaquine, dihydroartemisinin–piperaquine, artemether–lumefantrine) and loose artesunate–mefloquine in Burmese adults and children. Eligible patients were those who presented to the clinics with acute uncomplicated Plasmodium falciparum malaria or mixed infection, who were older than 6 months, and who weighed more than 5 kg. Treatments were randomised in equal numbers within blocks of 50 and allocation was in sealed envelopes. All patients were also randomly assigned to receive either a single dose of primaquine 0·75 mg base/kg or not. Patients were followed up for 63 days. Treatment groups were compared by analysis of variance and multiple logistic regression. The primary outcome was the 63 day recrudescence rate. This study is registered with clinicaltrials.gov, number NCT00902811.Findings155 patients received artesunate–amodiaquine, 162 artemether–lumefantrine, 169 artesunate–mefloquine, 161 loose artesunate–mefloquine, and 161 dihydroartemisinin–piperaquine. By day 63 of follow-up, 14 patients (9·4%; 95% CI 5·7–15·3%) on artesunate–amodiaquine had recrudescent P falciparum infections, a rate significantly higher than for artemether–lumefantrine (two patients; 1·4%; 0·3–5·3; p=0·0013), fixed-dose artesunate–mefloquine (0 patients; 0–2·3; p<0·0001), loose artesunate–mefloquine (two patients; 1·3%; 0·3–5·3; p=0·0018), and dihydroartemisinin–piperaquine (two patients 1·3%; 0·3–5·2%; p=0·0012). Hazard ratios for re-infection (95% CI) after artesunate–amodiaquine were 3·2 (1·3–8·0) compared with the two artesunate–mefloquine groups (p=0·01), 2·6 (1·0–6–0) compared with artemether–lumefantrine (p=0·04), and 2·3 (0·9–6·0) compared with dihydroartemisinin–piperaquine (p=0·08). Mixed falciparum and vivax infections were common: 129 (16%) had a mixed infection at presentation and 330 (41%) patients had one or more episodes of Plasmodium vivax infection during follow-up. The addition of a single dose of primaquine (0·75 mg/kg) reduced P falciparum gametocyte carriage substantially: rate ratio 11·9 (95% CI 7·4–20·5). All regimens were well tolerated. Adverse events were reported by 599 patients, most commonly vomiting and dizziness. Other side-effects were less common and were not related to a specific treatment.InterpretationArtesunate–amodiaquine should not be used in Myanmar, because the other ACTs are substantially more effective. Artesunate–mefloquine provided the greatest post-treatment suppression of malaria. Adding a single dose of primaquine would substantially reduce transmission potential. Vivax malaria, not recurrent falciparum malaria, is the main complication after treatment of P falciparum infections in this region.FundingMédecins sans Frontières (Holland) and the Wellcome Trust Mahidol University Oxford Tropical Medicine Research Programme.

The new species Paraboea babae D.J.Middleton from Shan State in Myanmar is described and illustrated.

A new species, Luisia verrucosaKurzweil, Nob.Tanaka &amp; Ormerod, from Shan State in Myanmar is described and illustrated. It is very distinct in the genus, characterised by (1) light pinkish and purple-marked navicular sepals which are coarsely verrucose on the outside, especially in their distal part, (2) light pinkish and irregularly pink-dotted lorate-elliptic petals with yellow tips, and (3) a lip with a comparatively large, oblong-elliptic, maroon-purple epichile with prominent callosities in the form of massive bulges. Because its lip does not have a constriction or prominent boundary line between hypochile and epichile, it is superficially similar to Luisia brachystachys (Lindl.) Blume, but the new species differs by having considerably larger flowers with verrucose sepals and pronounced lip ornaments.

Two new species of predominantly Australasian genus Austrelatus Shaverdo et al., 2023 are described and illustrated: Austrelatus mirai sp. nov. from Selangor State in Peninsular Malaysia is similar in habitus to the South Indian species A. boukali (Hendrich &amp; Balke, 1998) and A. davidi (Wewalka, 2017); however, the shape of the male genitalia suggests that it is closely related to Austrelatus species from Kalimantan. Austrelatus riberai sp. nov. from Shan State in Myanmar is most similar to Sino-Japanese A. parallelus (Zimmermann, 1920). Findings of Austrelatus species in continental Southeast Asia fill the gap in the distribution area of the genus between India, China and Japan on one side, and the Sunda Islands on the other side.

This is a thesis portfolio submitted for a Master’s Degree in Public Health from Chulalongkorn University. The aim of the thesis is to raise awareness of the reproductive health issues among migrant populations and the importance of understanding them in the broader context of their lives and surrounding environments. There is limited information available on the reproductive health realities and needs of migrant populations. This is a growing concern given the increasing migration occurring throughout Asia (and the world) and migrant’s reproductive health vulnerabilities and needs. The components of this thesis explore reproductive health issues among migration populations within and from Myanmar in neighboring countries. A comprehensive definition of migrants is used in this thesis to include all people who have moved from their homes for any reason either internally or across borders. This thesis portfolio contains an essay, research proposal, data collection exercise, presentation summary and annotated bibliography. The essay presents the need for recognizing the impact of migration on reproductive health and focuses on migrants from and within Myanmar as a case example. The research proposal aims to assess the reproductive health perspectives, concerns and realities among female migrants from Myanmar in Thailand. Phase one of the research proposal was carried out among migrants from Shan State in Myanmar working on construction sites in Chiangmai, Thailand as the data collection exercise. A summary of the thesis presentation given on the above three components will follow next. Finally, an annotated bibliography of the materials most influential in preparing the various aspects of this thesis portfolio is provided. The thesis highlights how migration impacts women’s reproductive health and the need to consider this population and their particular vulnerabilities and needs in research and policies. The research findings explain how migrants are unable or limited in their ability to access health services due to their isolation, illegal status and/or the high levels of violence in their lives. A strategy for addressing key reproductive health issues in the broader context of the lives of migrants within and from Myanmar is provided as a case example. This strategy emphasizes the critical role international and non-governmental organizations have in raising the issues surrounding migration and reproductive health and bringing them to the attention of governments.