Reproductive health of an ethnic group on the margin of a militarized state: a case study of Chin women in avillage on the India-Burma border

Abstract

In the context of a militarized State such as Burma this research sheds light on the effects that military rule has had on reproductive health in ethnic areas such as Chin State. In 1997 the Burmese State ratified the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and has specific obligations in terms of health care and family planning. However until the present time, health care policies and delivery mechanisms are highly centralized and controlled by the military, which has affected reproductive health, with infant mortality rates that are substantially higher than regional and international levels. Moreover, with a lack of genuine ethnic participation in the planning and implementation of policies the existing health-care policies focus mainly on urban centers. Yet with over 70% of the population living in rural areas these policies do not reflect the needs of all the people. This is further compounded by a misallocation of State budgets which are allocated disproportionately to the military at the expense of public sectors such as health and education. The long-term ramifications of this in ethnic areas are sub-standard education systems, which restricts the number of potential students able to pursue higher education relating to public sector work. It is argued in this research that one of the unwritten policies of the State is to ensure ethnic areas do not become developed, which could potentially threaten the State’s control over the population. This research case study focuses on one village on the India-Burma border where 25 interviews were conducted with mothers, nurses and midwives. The findings highlight the logistical constraints on effectively targeting isolated areas and consequently the limited reproductive health resources available from various levels such as the State, NGO and community-based groups. The research also reveals a high rate of infant mortality through a lack of health resources, basic infrastructure, economic constraints and food insecurity. Yet it also reveals the coping mechanisms that the communities themselves have developed to provide limited reproductive health care. Fundamentally, the research reveals that due to the State’s prolonged militarization, there is a culture of impunity within the army and weak enforcement mechanisms which fail to hold accountable those in positions of authority. This has resulted in the Chin having little alternative but to seek safety in neighboring India