List of Acronyms

AI Amnesty International

ARV Antiretroviral Treatment

ASEAN Association of Southeast Asian Nations

BPHWT Back Pack Health Worker Team

CAC Children and Armed Conflict

CEDAW UN Committee on the Elimination of Discrimination against Women

CNF/CNA Chin National Front/Chin National Army

COHRE Centre on Housing Rights and Evictions

DKBA Democratic Karin Buddhist Army

DVB Democratic Voice of Burma

ERW Explosive Remnants of War

FBR Free Burma Rangers

GBV Gender-Based Violence

HREIB Human Rights Education Institute for Burma

HRW Human Rights Watch

ICBL International Campaign to Ban Landmines

ICG International Crisis Group

ICRC International Committee of the Red Cross

IDMC Internal Displacement Monitoring Centre

IDPs Internally Displaced Persons

ILO International Labour Organization

INGO International Nongovernmental Organization

KHRG Karen Human Rights Group

KIO/KIA Kachin Independence Organization/Kachin Independence Army

KNU/KNLA Karen National Union/Karen National Liberation Army

KWO Karen Women’s Organisation

LM Landmine Monitor

MIMU Myanmar Information Management Unit

MRM Monitoring and Reporting Mechanism

MSF Médecins Sans Frontières (Doctors Without Borders)

NGO Nongovernmental Organization

NLD National League for Democracy

NSAG Non-State Armed Groups

OCHA UN Office for the Coordination of Humanitarian Affairs

OMCT World Committee against Torture

PAB Provincial Admissions Boards

RI Refugees International

SCR Security Council Resolution

SLORC State Law and Order Restoration Council

SPDC State Peace and Development Council

SSA-S Shan State Army South

STI Sexually Transmitted Infection

TBBC Thailand Burma Border Consortium

TCG Tripartite Core Group

UN United Nations

UNAIDS Joint UN Program on HIV/AIDS

UNDP UN Development Programme

UNHCR UN High Commissioner for Refugees

UNICEF UN Children’s Fund

UNSC UN Security Council

USCRI U.S. Committee for Refugees and Immigrants

USDA Union Solidarity and Development Association

USDOS U.S. Department of State

WHO World Health Organization

WLB Women’s League of Burma

Indicators

Note: The UN statistical data primarily relies on the SPDC’s statistics because the SPDC has generally barred the UN and other international organizations from conducting or publishing independent surveys and assessments. The UN and other credible sources have repeatedly questioned the validity of SPDC data in describing the true situation in all regions of Myanmar, including the conflict-affected ethnic regions.[1] This indicator table juxtaposes UN statistical data, if available, with statistics generated by nongovernmental organizations (NGOs) working directly with affected communities.

INDICATORS	Myanmar (Burma)
Population	Estimated 48.4 million people, of which approximately one-third are children, as of 2006 (WHO, 2008)
Gross National Income (GNI) per Capita	US$281 in 2006 (UN Statistics Division, 2008)
Refugees and Internally Displaced Persons (IDPs)	At least 451,000 IDPs in rural areas of eastern Myanmar excluding IDPs in urban areas or in other parts of the country, but numbers likely to be higher (TBBC 2008); proportionally there are more children in Myanmar’s displaced population than in its general population (IDMC 2004). Approximately 191,256 refugees from Myanmar as of end 2007 (UNHCR 2008). More than 1 million refugees from Myanmar in the neighboring countries of Thailand, China, Bangladesh, Malaysia and India (RI, 2007).
Infant Mortality	74/1,000 in 2006 mainly based on data from central Myanmar (World Health Statistics 2008, WHO) 91/1,000 in 2006 among eastern Myanmar’s displaced population (BPHWT, 2006)
HIV/AIDS	0.7 percent estimated national adult HIV (15–49) prevalence rates as of 2007 (UNAIDS, WHO and UNICEF, 2008) 3.4 percent estimated national HIV prevalence rates as of 2000 (Johns Hopkins Bloomberg School of Public Health, 2006)
Education	Estimated 90 percent national net enrollment rate in primary school and 37 percent in secondary school; near gender parity in primary and secondary school (UNICEF, 2008). Fewer than 55 percent of enrolled children complete the primary cycle (UNICEF, 2008). In conflict or ceasefire areas of Kayin (Karen), Kayah (Karenni), Shan, and Rakhine (Arakan) States, only one out of 10 children are able to attend primary school (All Burma Federation of Student Unions, Year 2004 Education Report, February 2005).
Gender-Based Violence (GBV)	Rape and gang rape are reportedly committed by Myanmar Armed Forces in Chin, Shan, Kayin (Karen), Kayah (Karenni), Mon, Kachin and Rakhine (Arakan) States, according to women’s groups operating in Myanmar. Other conflict-related GBV includes trafficking, sexual exploitation, early marriages and sexual harassment (WLB, 2008).
Trafficking	Children from Myanmar’s border areas are regularly trafficked to Thailand, China, India, Bangladesh, India, Pakistan, Malaysia, South Korea and Macau for commercial sexual exploitation, domestic servitude and forced or bonded labor (USDOS 2008).
Landmines and Explosive Remnants of War (ERW)	Extensive use of landmines by Myanmar Armed Forces and non-state armed groups (NSAGs); continuing and ongoing landmine and ERW contamination, particularly in the eastern states on the Thai border (LM 2008)
Small Arms	No reliable estimates are available.
Child Soldiers	Thousands of children recruited by Myanmar Armed Forces; recruitment and use of children by most NSAGs, albeit on a much lower scale than the Myanmar Armed Forces (The Coalition, 2008)
Abductions and Disappearances	Myanmar Armed Forces and proxies have abducted children to subject them to a range of violations, including forced recruitment, forced labor, rape and trafficking (HREIB, 2008).
Attacks on Humanitarian and Human Rights Workers	No comprehensive data available; frequent reports of attacks by the Myanmar Armed Forces or of mines injuring or killing local aid workers in conflict-affected areas; imprisonment of local aid workers involved in cyclone relief efforts and human rights workers (BPHWT 2006; FBR 2007; HRW 2008)

International Standards[2]

International Treaties Signed (S)/ Ratified (R)/ Acceded (A) (Year)

International Treaties Not Signed

• Convention on the Rights of the Child (A, 1991)

• The Geneva Conventions I, II and III of 1949 (R, 1992)

• Convention on the Prevention and Punishment of the Crime of Genocide (R, 1956)

• Convention on the Elimination of All Forms of Discrimination against Women (A, 1997)

• International Labour Organization (ILO) Convention 29 on Forced Labor (R, 1955)

• ILO Convention 87 on Freedom of Association and Right to Organize (R, 1955)

• Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime (A, 2004)

• Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict

• Optional Protocol to the Convention on the Rights of the Child on the sale of children, child prostitution and child pornography

• The Geneva Convention IV of 1949 (relative to the Protection of Civilian Persons in Time of War)

• The 1977 Additional Protocols

• ILO Convention 182 on the Worst Forms of Child Labor

• Rome Statute of the International Criminal Court

• 1951 Convention relating to the Status of Refugees and its 1967 Protocol

• Convention on the Prohibition of the Use, Stockpiling, Production and Transfer of Anti-Personnel Mines and on their Destruction (“Mine Ban Treaty”)

• Convention on Cluster Munitions

• Protocol against the Illicit Manufacturing of and Trafficking in Firearms, Their Parts and Components and Ammunition, supplementing the United Nations Convention against Transnational Organized Crime

• Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

• Optional Protocol to the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment

• International Covenant on Civil and Political Rights

• International Covenant on Economic, Social and Cultural Rights

UN Security Council Actions Relating to Children and Armed Conflict in Myanmar

UN Security Council Resolutions on Myanmar	Myanmar on Security Council’s formal agenda since September 2006; no Security Council resolutions on Myanmar to date; Security Council Presidential Statements (S/PRST/2008/13 ; S/PRST/2007/37)
UN Security Council Resolutions on Children and Armed Conflict (CAC)	1612 (July 2005), 1539 (April 2004), 1460 (January 2003), 1379 (November 2001), 1314 (August 2000), 1261 (August 1999)
UN Security Council Working Group Conclusions on CAC in Myanmar	S/AC.51/2008/8

Executive Summary

In the midst of Myanmar’s enduring political and socioeconomic turmoil, thousands of children also experience the devastating consequences of protracted armed conflict in parts of the country. For decades Myanmar Armed Forces and associated armed groups have engaged in low-level armed conflict with opposing non-state armed groups (NSAGs) in parts of Kayin (Karen), Kayah (Karenni), Shan, Mon and Chin States. Even in so-called ‘ceasefire areas,’ some NSAGs have retained their arms and in some cases acted as proxy forces of the State Peace and Development Council (SPDC), wreaking havoc on children and their communities.

The high occurrence and brutality of reported human and child rights violations make it impossible to deny that Myanmar Armed Forces and NSAGs commit grave violations against children in Myanmar’s armed conflict. The SPDC must no longer deny these children access to sufficient and lifesaving humanitarian assistance. Finally, the UN Security Council and the international community must not deny the urgency of protecting children from violence, maltreatment and abuse in Myanmar’s ongoing armed conflict.

No More Denial: Violations against Children in Armed Conflict

Children living in Myanmar’s conflict zones are often caught in indiscriminate shelling and attacks against villages. As a result of the high demand for new recruits, children as young as nine constantly face the threat of forced or coerced recruitment by security forces and civilians, even in public places such as bus or train stations and markets. In fact, the recruitment and use of children has turned into a profitable business for soldiers, civilian brokers and the police, who receive money or food from recruiters for each new recruit. Myanmar Armed Forces have also allegedly committed grave acts of sexual violence, including rape, against women and girls from ethnic minorities. Furthermore, Myanmar Armed Forces have occupied educational facilities for military purposes, recruited teachers and students for forced labor and planted landmines close to schools or on the paths to schools. In international fora the SPDC has presented such human rights violations and the diversion of public resources to the military sector as necessary measures to fight armed groups opposed to a unified state.

NSAGs, particularly those associated with the SPDC, have also committed violations against children and other civilians, including child recruitment, extrajudicial killings, rape and extortion. Most NSAGs have reportedly recruited and used children in their armed groups, albeit on a much lower scale than the Myanmar Armed Forces.

In addition to these violations, various other violations such as forced displacement, abductions, forced labor and trafficking continue to be committed by Myanmar Armed Forces and NSAGs against children and their families in areas of Myanmar.

Despite ample evidence, widespread impunity and non-accountability leave perpetrators unpunished and deprive victims of their right to justice and fair remedy. Even in highly publicized rape cases, perpetrators are generally not brought to justice. On the contrary, in some cases survivors have themselves been threatened or punished for speaking out. Similarly, penalties for underage recruitment are weak. In 21 cases of recruitment verified by the UN between September 2007 and December 2008, punishments included official reprimands, monetary fines and, in one instance, loss of one year of military seniority. As a result of these weak penalties, local commanders often choose to commit the crime of child recruitment rather than fail to meet recruitment quotas imposed on them, which carries harsher penalties. In general, impunity combined with a lack of adequate medical, legal and psychosocial assistance discourages survivors and their families from reporting violations and seeking assistance or redress.

No More Denial: Humanitarian Assistance

International organizations are not allowed to access the active conflict zones and some ceasefire areas in the East due to restrictions imposed by the SPDC. As a result, children and their families living in these areas face military attacks, landmine injuries and widespread epidemics without sufficient and lifesaving humanitarian assistance. In active conflict zones children are rarely immunized against common diseases. Similar to situations in D.R. Congo and Afghanistan, approximately one in five children in the eastern conflict areas dies before reaching the age of five years primarily due to treatable diseases. Moreover, poor or nonexistent prenatal and postnatal care make giving birth extremely risky for both mother and child in Myanmar, particularly in the conflict-affected areas.

Despite pressing humanitarian needs, many donors have refrained from providing funding to Myanmar, questioning the effectiveness of their assistance given the limited operational space for humanitarian organizations. Official Development Assistance (ODA) to Myanmar is the lowest per capita worldwide among the least developed countries, according to the Organization for Economic Cooperation and Development (OECD). Some international organizations that operate in Myanmar argue that low funding levels prevent them from taking advantage of the limited access that the SPDC grants and prevent them from pressing for greater access. While sustained and increased assistance is definitely needed for organizations operating in Myanmar and from across the neighboring borders, it is important that assistance is committed with assurances that minimum standards will be met and independent monitoring permitted.

No More Denial: Urgent Actions Needed

In accordance with UN Security Council Resolution 1612 (2005), a UN-led Task Force on Monitoring and Reporting in Myanmar was established in June 2007 to monitor and report on six grave violations against children in armed conflict using information from the UN in collaboration with NGOs. In support of these in-country efforts the Thailand-based Working Group on Children Affected by Armed Conflicts, feeds information to the Task Force in Myanmar, effectively acting as its counterpart. Since that time, the Task Force in Myanmar has achieved the release of a number of children from the Myanmar Armed Forces and has initiated dialogue with SPDC authorities and, with the support of the Task Force in Thailand, with two NSAGs on action plans to end the recruitment and use of children in armed forces and groups. At the same time, the 2007 Secretary-General’s report on children and armed conflict in Myanmar noted that there are also serious challenges that prevent the Monitoring and Reporting Mechanism (MRM) from fully functioning in Myanmar.

Among other issues, the Task Forces in Myanmar and Thailand are unable to fully engage with NSAGs and are constrained in their ability to monitor and verify violations in conflict areas due to restrictions imposed by the respective authorities. Moreover, the Task Forces have not collaborated effectively with NGOs, and the Task Force in Thailand has cited its inability to verify NGO information due to access restrictions. The effective protection of victims and complainants also remains a recurring challenge for the Task Force in Myanmar as persons have been harassed, sanctioned or arrested by the SPDC for filing a complaint to the ILO on child recruitment in violation of agreements between the International Labour Organization (ILO) and SPDC.

Moreover, actions taken by the UN Security Council demonstrate an unwillingness to fully admit to the grave situation of children affected by Myanmar’s armed conflict. Instead of calling for sanctions for one of the most persistent perpetrators of child recruitment named by the UN Secretary-General for over five years, the 2008 Security Council Working Group on Children and Armed Conflict’s conclusions on Myanmar did not even acknowledge that the Myanmar Armed Forces recruit and use children, despite ample, reliable evidence received from the UN and other sources.

Urgent Recommendations

No More Denial calls upon all armed forces and groups in Myanmar to immediately halt all violations against children, comply strictly with all international commitments and uphold international human rights and humanitarian law, with particular attention to the Convention on the Rights of the Child and the Optional Protocol on the Involvement of Children and Armed Conflict. Additionally, all actors must take immediate action to protect children in Myanmar from further abuse and to find ways to assist and support those who have suffered the consequences of decades of armed conflict.

The following are key recommendations from Watchlist’s report:

1. Take effective measures to prevent violations against children in armed conflict and end impunity

The SPDC and NSAGs should immediately cease all new recruitment of children, immediately release all children currently in military services and give those recruited before age 18 the option to leave. In this process they should closely coordinate with the relevant UN Country Team in Myanmar and/or Thailand to release children to their families or interim care centers.

The SPDC and NSAGs should work with the UN Country Teams in Myanmar and Thailand to devise action plans that are in line with international standards for halting the recruitment and use of children. This includes unrestricted access for humanitarian personnel to military installations to identify children and support their release, reintegration and rehabilitation.

The SPDC and NSAGs should prosecute personnel accused of child recruitment, rape, killing and other serious crimes and subject those found guilty to the full penalties prescribed by national law.

With support from UNICEF, the SPDC should immediately develop appropriate reintegration policies and programs for children released from armed forces and groups. Children currently held in detention for desertion must be immediately released and transferred either to their families, alternative caregivers or appropriate child welfare service providers.

The UN Security Council should call on the SPDC and relevant NSAGs to immediately end all recruitment of children into their armed forces, to immediately release all children from their forces; and to set a specific deadline for bringing their action plan into compliance with international standards. If tangible progress is not achieved within the specified time frame the Security Council should impose targeted measures, in line with Resolutions 1539 and 1612.

The UN Security Council Working Group on Children and Armed Conflict should review the situation in Myanmar immediately and issue strong conclusions utilizing the full capacity of its toolkit.

The MRM Task Forces in Myanmar and Thailand should use every available channel to engage in direct dialogue with parties to Myanmar’s armed conflict, including NSAGs, for the purpose of developing action plans to end violations against children.

The Association of Southeast Asian Nations (ASEAN) should make the promotion and protection of the rights of the child a priority of ASEAN’s policy and take effective measures to ensure that all ASEAN members protect children from the effects of armed conflict, to end the use of children in armies and armed groups and to end impunity.

Governments hosting refugees from Myanmar should allow the UN and international NGOs (INGOs) to engage in dialogue with parties to Myanmar’s armed conflict, including NSAGs, for the purpose of developing action plans to end violations against children.

Other governments should apply targeted legal, political, diplomatic, financial and/or material measures against parties to conflict that consistently violate the security and rights of children in Myanmar, including the recruitment and use of children as soldiers.

2. Provide humanitarian access and programs to assist survivors of violence

The SPDC and NSAGs should provide humanitarian actors with unrestricted and secure access to all areas of Myanmar and guarantee all civilians safe, unimpeded and sustained access to humanitarian assistance.

The SPDC should significantly increase the proportion of the national budget allocated to the realization of children’s rights, making social services to assist children in areas under government control and ceasefire areas a priority.

The SPDC, ASEAN and the UN should continue to fully support the Tripartite Core Group (TCG) mechanism as an effective model to address critical humanitarian concerns and expand it beyond areas affected by Cyclone Nargis, including conflict-affected areas.

UNICEF should increase its field presence and capacity along the Thai-Myanmar border to oversee protection programs and coordinate efforts to ensure implementation of the MRM.

The humanitarian community should increase collaborative efforts among local and international aid organizations inside Myanmar and working across the borders to address the pressing needs of children affected by armed conflict in Myanmar. Services should be provided with a view to strengthening the capacities of local communities and civil society.

The humanitarian community should ensure monitoring of aid delivery and on-the-ground presence of aid organizations when conducting campaigns to ensure that aid is delivered in line with humanitarian standards.

Donors, while maintaining prohibitions on direct budgetary support for the SPDC, should substantially increase aid to support programs in Myanmar and those operating from across the borders that protect and assist children in the conflict-affected areas or from these areas, particularly unaccompanied and separated children, out-of-school youth and others who may face higher risks of violence, exploitation, abuse and neglect. Any assistance given to Myanmar should strictly follow Sphere standards and take into account the ongoing armed conflict and human rights violations and the widespread concerns about government accountability, transparency and civil society participation.

Governments hosting refugees from Myanmar should accede to the UN Refugee Convention and recognize the primacy of the principle of the best interests of the child in all asylum or immigration decisions, procedures, practices or legislative measures affecting children. At a minimum, all host countries should ensure that the basic needs of refugee children are met.

Governments hosting refugees from Myanmar should support the UN and NGOs in developing and strengthening protection and support mechanisms for children affected by armed conflict from Myanmar, particularly former child soldiers and survivors of rape and other forms of sexual violence.

Other governments should influence the Myanmar authorities to lift blockages and allow aid, expertise and materials to reach all civilians in need of humanitarian aid in Myanmar.

3. Strengthen monitoring and reporting on all violations committed against children affected by armed conflict

The SPDC and NSAGs should support the MRM and fully cooperate with the Task Force in Myanmar or, as relevant, the Task Force in Thailand on its implementation; they should welcome international teams for fact-finding missions and dialogue for protection and promotion of child rights.

The UN Security Council should request the Secretary-General to provide information on all grave acts against children, reflecting the breadth and depth of documented cases, in close collaboration with Burmese local organizations and networks.

The MRM Task Forces in Myanmar and Thailand should clarify their respective roles and responsibilities in monitoring, reporting and following up on cases. This will require urgent efforts by both Task Forces to ensure full functionality with dedicated leadership from the UN Resident Coordinator.

The MRM Task Forces in Myanmar and Thailand should cooperate with Burmese NGOs with years of experience in monitoring and reporting on violations of children’s rights, especially in areas where the UN does not have an active presence. This would include strengthening their technical and financial capacities and working in close partnership with them to ensure that the information submitted to the UN follows UN reporting standards.

The ILO should strengthen its complaints mechanism on forced labor and child recruitment to ensure the confidentiality and protection of victims, witnesses and complainants and that all reporting and complaints are handled with concrete follow-up actions. This also includes raising public awareness of the existence and workings of the mechanism, and using the media and other communication channels.

The UN Country Teams and NGO partners should actively engage with the MRM by facilitating complaints to the Task Force in Myanmar or, as relevant, to the Task Force in Thailand and providing relevant information to them.

The humanitarian community should reinforce the child protection capacity of the UN Country Teams in Myanmar and Thailand with additional personnel focused on monitoring, reporting and advocacy.

Donors should provide adequate funding to strengthen the efforts of the UN Country Teams, INGOs and local groups in Myanmar and Thailand to monitor, report on and respond to violations against children affected by Myanmar’s armed conflict and to facilitate their increased coordination and collaboration.

Context

The Armed Conflict

Myanmar’s independence from British colonial rule in 1948 instigated an armed conflict between various ethnic groups and the central government.[3] These opposition armies have accused the Burman-dominated government of discriminating against the non-Burman ethnic population, which makes up at least one-third of the total population.[4] While many ethnic groups originally fought for independence from Myanmar, almost all have accepted the Union of Myanmar as a fact and are seeking increased autonomy within a federal structure.

Fighting between Myanmar Armed Forces and associated groups and opposing non-state armed groups (NSAGs) has largely concentrated in Myanmar’s states bordering Bangladesh, India, China, Laos and Thailand, where most of Myanmar’s ethnic minorities live. By the late 1980s, several NSAGs had formed “quasi-states” in territories under their command with their own administration, schools, hospitals and foreign relations.

In the 1990s, the Myanmar government—the State Law and Order Restoration Council (SLORC) or, since 1997, State Peace Development Council (SPDC)—entered into uneasy cease-fires with most of the NSAGs (see Appendix 1). However, these cease-fires have not resulted in a political resolution of the conflict as part of a peace agreement or put an end to the widespread human rights abuses in these areas. The military wing of many of the ceasefire groups, notably the Kachin Independence Organization/Kachin Independence Army (KIO/KIA), the United Wa State Party/ United Wa State Army (UWSP/UWSA) and splinter groups of the ceasefire groups, have retained their arms and continue to operate along the eastern and western borders. In some cases, ceasefire groups such as the Democratic Karen Buddhist Army (DKBA) have been accused of aligning themselves with the army forces against the remaining armed opposition groups or against the civilian population.

In addition, the Karen National Union/Karen National Liberation Army (KNU/KNLA), the Karenni National Progressive Party/Karenni Army (KNPP/KA), the Shan State Army South (SSA-S) and the Chin National Front/Chin National Army (CNF/CNA) remain in low-level armed conflict with the SPDC in parts of Kayin (Karen), Kayah (Karenni), Shan and Chin States. The KNU/KNLA, the KNPP/KA and the SSA-S operate in territories bordering Thailand and China in the East, and the CNF/CNA in areas bordering India in the West.[5]

International engagement in Myanmar’s armed conflict between the SPDC and ethnic minorities has been limited. Thus far, there has not been an international peace initiative to resolve the armed conflict between the SPDC and ethnic minorities in Myanmar. In particular, Asian countries have opposed any political involvement in the armed conflict, which they consider Myanmar’s internal affair.

Pro-Democracy Movements

After the military seized power in 1962, the new leadership took the form of a one-party ‘socialist’ dictatorship under Prime Minister Ne Win and sought to solidify its power by force. After violently crushing nationwide pro-democracy demonstrations in 1988, it regrouped as a military government. The government’s tight military rule gave rise to pro-democracy movements calling for its replacement by a freely elected government. In 1990, the SLORC leadership agreed to hold a national election under the belief that it could win the election and legitimize its power. When the main opposition party, the National League for Democracy (NLD), won the election, the SPDC refused to recognize the results. The party’s leader, Aung San Suu Kyi, has been in prison or under house arrest from 1989 until 1995, from 2000 until 2002 and from 2003 to the present.

In 2003, the then-Prime Minister Khint Nyunt announced plans for national reconciliation, the “seven-step road map to democracy,” which envisioned the drafting of a new constitution and eventually elections. The National Convention, which first convened in 1993, was reassembled to formulate basic guidelines to draft the country’s constitution. However, outside observers have accused the SPDC of using the “road map” to consolidate its rule without allowing for more democratic governing structures. The NLD has refused to attend the National Convention, arguing that the Convention does not allow for meaningful participation by delegates. Although some ethnic political parties associated with ceasefire groups have been involved in the National Convention, the SPDC has—to date—refused to negotiate any political issues with these groups or consider any of their alternative proposals or amendments put forward during the drafting process, according to various sources. This includes any requests for more autonomy of the minority groups under a federal system.

As the SPDC considers public criticism a threat to its leadership, it has reacted with excessive force to peaceful demonstrations. Most recently, in September 2007, the SPDC brutally cracked down on demonstrators, including monks, women and students, who had peacefully protested against the SPDC’s unannounced removal of fuel subsidies and violations of their rights. The security forces arrested between 3,000 and 4,000 in September and October and killed at least 15 people, according to the Report of the Special Rapporteur on the situation of human rights in Myanmar, December 7, 2007 (A/HRC/6/14). The Rapporteur recorded in his report 74 forced disappearances, incidents of torture, and numerous other human rights violations connected to the crackdown.[6]

Following strong criticism by the UN Security Council, the UN Human Rights Council, the Association of Southeast Asian Nations (ASEAN) and several individual governments, the SPDC agreed to allow the UN Secretary-General’s Special Representative, Mr. Ibrahim Gambari, to visit the country to pursue the UN’s good offices mandate. During his visits, Mr. Gambari demanded from the SPDC the release of all political prisoners, including Aung San Suu Kyi, and the inclusion of opposition and ethnic groups in the constitution-drafting process on Myanmar, as demanded by UN General Assembly resolutions and Security Council statements. The former UN Special Rapporteur on the situation of human rights in Myanmar, Mr. Paulo Sérgio Pinheiro, for his part, denounced the human rights violations committed during the SPDC’s crackdown after his visit to Myanmar in November 2007, and demanded punitive action against those responsible.

In order to keep the focus of the international community on Myanmar following the September 2007 protests, a Group of Friends of the Secretary-General on Myanmar has been formed at the UN, involving the permanent five members of the UN Security Council, Singapore as ASEAN chair, Indonesia, Vietnam, Thailand, India, Japan, Australia, Norway and the EU presidency. The UN Secretary-General regularly convenes the Group to review the situation in Myanmar in informal discussions and to urge the SPDC to comply with UN Security Council resolutions by releasing public statements.

In spite of this international pressure, initial prison sentences of political activists have ranged between two and 65 years for their involvement in the protests in September 2007. As of December 2, 2008, more than three-quarters of the 1,072 people arrested for political activities since August 2007, when the protests first started, had yet to go before a judge or complete their trials, according to the Assistance Association for Political Prisoners (AAPP), a Thailand-based group that monitors the situation of political prisoners. Several UN Special Rapporteurs focusing on issues related to human rights openly criticized the trials of the political activists for their lack of independence and impartiality, according to Reuters, “UN Rights Experts Condemn Myanmar Activist Trials,” November 19, 2008.

Human Rights Violations

The SPDC has presented human rights violations and the diversion of public resources to the military sector as necessary measures to fight armed groups opposed to a unified state. Myanmar Armed Forces and related security forces have perpetrated extrajudicial killings, summary executions, torture, rape, arbitrary arrest, forced displacement, forced labor, extortion and child recruitment, as documented by the UN and numerous human rights organizations.[7] The 2008 report of the UN’s Special Rapporteur on the situation of human rights in Myanmar condemned the excessive use of force and fire arms and severe abuses against unarmed civilians by the SPDC to counter opposition groups (A/HRC/7/24).

The SPDC and allied NSAGs have directly targeted civilians in areas of armed conflict in the East regardless of their actual links with other NSAGs that are fighting against the SPDC. Many of these attacks are linked to the SPDC’s ‘four-cuts policy,’ which specifically aims to prevent NSAGs from receiving food, funding, information and recruits from communities, according to the Internal Displacement Monitoring Centre (IDMC), “Myanmar (Burma): No End in Sight for Internal Displacement Crisis,” February 14, 2008. Myanmar Armed Forces reserve the right to shoot on sight, indiscriminately and without prior warning, any person found in these “black zones.”[8] The Thailand Burma Border Consortium (TBBC), an NGO network providing assistance to displaced people from Myanmar, has documented the destruction, relocation or desertion of at least 3,000 villages in the East between 1996 and 2006. Satellite pictures verify the presence of burnt-out villages, increased military presence and growing populations of displaced people in these areas, according to the American Association for the Advancement of Science (AAAS), High-Resolution Satellite Imagery and the Conflict in Eastern Burma, Summary Report, September 28, 2007.

NSAGs have also committed human rights violations against civilians such as child recruitment, extrajudicial killings and extortion regardless of whether they have agreed to cease-fires with the SPDC. Some NSAGs who had ceasefire agreements with the SPDC have been accused of acting as proxies to the SPDC in committing human rights violations.[9] Yet, reports of Human Rights Watch (HRW), Amnesty International (AI) and numerous local organizations indicate that the vast majority of human rights violations are committed by Myanmar’s security forces, which include Myanmar Armed Forces and the police.

On December 23, 2008, the United Nations General Assembly adopted a resolution on human rights in Myanmar expressing concern about the grave violations of international humanitarian law, the continuing discrimination and violations against ethnic minorities and attacks by military forces and NSAGs on villages in Kayin (Karen) State and other ethnic minority states in Myanmar (A/63/430/Add.3). Based on these and other human rights violations, the resolution specifically called on the SPDC to put a halt to these major violations of international human rights and humanitarian law.

Military Control, Corruption and Impunity

These human rights violations are often linked to the SPDC’s ever-increasing control of all aspects of civilian life and the militarization of society in Myanmar. According to official SPDC data, more than 24 million citizens joined the Union Solidarity and Development Association (USDA), a state-supported mass organization, through its aggressive and coercive recruitment campaign.[10] The USDA has at times cooperated with the security forces to squelch public protests.

Massive investment in military equipment and recruitment has taken resources away from public services. Current intelligence data suggest that the SPDC spends an estimated 40 percent of its total budget on the military, according to the Council on Foreign Relations, Understanding Myanmar, October 4, 2007. To supplement its military budget, the SPDC has confiscated land, used forced labor, extorted money and other contributions from communities in ethnic states for major energy development projects.[11] China is the biggest supplier of military equipment to the SPDC, followed by Russia, Serbia and Ukraine, according to the Stockholm International Peace Research Institute (SIPRI)’s Arms Transfers Database of major conventional weapons between 1988 and 2006.

A weak judicial system and rampant corruption have undermined the rule of law in Myanmar, making way for abuse of power by SPDC officials, the police and the military. Moreover, widespread impunity and nonaccountability leaves perpetrators unpunished and deprives victims of their right to justice and fair remedy. Together with Iraq, Myanmar was ranked the second most corrupt country in the world in Transparency International’s 2008 Perceived Corruption Index. Corruption permeates every level of the SPDC’s administration due to very low public service salaries and a general sense of impunity. Criminal markets, including drug trade and smuggling, have been thriving under these conditions, particularly in the ethnic areas bordering neighboring countries.

Cyclone Nargis

On May 2 and 3, 2008, Cyclone Nargis struck Myanmar, affecting some 2.4 million people living in the Ayeyarwady (Irrawaddy) and Yangon (Rangoon) Division, with almost 140,000 people killed or missing, according to the UN Office for Humanitarian Affairs (OCHA), Myanmar: Cyclone Nargis, OCHA Situation Report No. 50, October 9, 2008.[12] Despite the extent of the humanitarian crisis resulting from Nargis, the SPDC initially restricted international assistance and limited the access of foreign aid workers, saying that it had the capacity to respond itself. At the same time, the SPDC also decided to proceed with its plans of holding a constitutional referendum on May 10, 2008, just days after the cyclone hit. Two months after the cyclone, HRW noted that only 1.3 million out of the 2.4 million people severely affected by the cyclone had received any form of international humanitarian assistance, “Letter to Donors on Reconstruction after Cyclone Nargis,” July 22, 2007.

The international community, led by the UN Secretary-General, responded by voicing strong criticism against the SPDC’s slow response and reluctance to allow the delivery of supplies by international humanitarian groups. Simultaneously, governments sought to engage the SPDC leadership in the relief efforts by creating the Tripartite Core Group (TCG), consisting of ASEAN, the UN and the SPDC, which served as an important mechanism to address critical humanitarian concerns and coordinate relief efforts in response to Cyclone Nargis.[13] By late July 2008, the SPDC had eased restrictions on international relief workers visiting affected areas and for conducting their aid operations, according to reports by the International Crisis Group (ICG) and Refugees International (RI). Most international aid organizations in Myanmar have reported more humanitarian access to the cyclone-affected areas than in other parts of the country, according to OCHA representatives in the region as of December 2008.

On the other hand, low international funding levels and the SPDC’s constant interference in aid efforts have continued to undermine relief and reconstruction efforts, according to The Irrawaddy, an independent news agency focusing on Myanmar, “Regime Still Impeding Relief Efforts,” October 20, 2008. As of November 2, 2008, only 53.3 percent of the Revised Flash Appeal of US$484 million were raised for Cyclone Nargis, according to the TCG. At the same time, AI recorded 40 accounts of Burmese soldiers or local officials diverting, confiscating or misusing aid intended in the context of assistance to cyclone victims two months after the cyclone, “Myanmar Government Puts Cyclone Survivors at Increased Risk,“ June 5 2008. In addition, Burmese civilians, including business people, artists and writers, have been detained and sentenced to long prison terms for attempting to deliver aid directly to cyclone victims, according to reports by various human rights organizations.[14]

Humanitarian Access

Operational Space for International Humanitarian Organizations

Humanitarian organizations in Myanmar have regularly struggled with the bureaucratic and at times intrusive administrative procedures imposed by the SPDC. After the dismissal of General Khin Nyunt as Prime Minister in October 2004, the new SPDC leadership assumed a more hard-lined approach in the political sphere and towards internationals operating in Myanmar. Its ensuing policies tightened restrictions on the humanitarian and development operations of UN agencies, INGOs and local groups.

In February 2006, the SPDC issued a set of bureaucratic guidelines for UN agencies, international organizations and INGOs/NGOs intended to constrict operational space and activities. These guidelines rendered all new employment, travel, visa, imports and workshops subject to prior approval by several ministries and local aid committees. The English and Burmese texts varied initially but were harmonized in favor of the less restrictive English version at the beginning of 2008. While the presence of the guidelines has stirred much concern and even resentment by aid organizations, they were never implemented or strictly enforced with the exception of travel restrictions on expatriate staff, according to some aid organizations operating inside Myanmar cited by RI.

The September 2007 military crackdown on civilian protesters caused the SPDC to view any in-country international pronouncements or statements with a very critical eye. On the occasion of UN Day (October 24, 2007), the UN Country Team drew attention to the plight of the people of Myanmar by issuing a joint statement along with NGOs, highlighting the urgent socioeconomic needs facing large parts of the population. UN Resident Coordinator Charles Petrie was asked to leave the country shortly after the release of that statement. Subsequently, the SPDC temporarily limited the provision of visas for “western” international staff, instead favoring Asian internationals.

After the first tense weeks following Cyclone Nargis, when the SPDC restricted access to an appropriate number of international aid experts, the UN Secretary-General reached an agreement with the SPDC that permitted visas be granted to aid workers irrespective of their nationalities. Since then, international aid organizations in Myanmar have reported increased levels of access to the cyclone-affected areas. Yet, this has not necessarily translated to progress in areas outside the Nargis-impacted Delta, including the conflict-affected areas, or fundamentally changed the generally difficult operational environment for humanitarians.[15]

International humanitarian organizations in Myanmar continue to struggle with high transaction costs, procurement delays and restrictions in accessing vulnerable population and collecting relevant data. For example, some aid organizations must plan eight months in advance to import medicine, wait three months for obtaining visas for entering the country and pay 300 percent taxes to purchase a vehicle. Furthermore, international staff are required to obtain SPDC approval and to have SPDC officials accompany them, which makes it almost impossible for them to conduct independent, confidential assessments. INGOs must also negotiate memorandums of understanding (MoUs) with the SPDC, including detailed descriptions of their planned projects, every year. Meanwhile, they are faced with highly unpredictable and constantly changing SPDC policies and regulations affecting their operations. The government’s move from Yangon (Rangoon) to Naypyidaw has also made communication with the SPDC officials more difficult for aid organizations.

In spite of this adverse environment in 2008, some humanitarian and development organizations in Myanmar noted substantial progress in their ability to work openly, with permission, on certain issues, including education, health, HIV/AIDS and human trafficking, often depending on the counterpart SPDC official and ministries. International aid organizations were able to provide some assistance in 300 of Myanmar’s 325 townships, including in Northern Rakhine (Arakan), Kayin (Karen), Kayah (Karenni), Kachin and Mon States, as of March 2008, according to RI, “Key Facts on the Working Environment for International Agencies,” March 26, 2008. However, this does not include conflict zones and some ceasefire areas, which continue to be off-limits to them.

Denial of Humanitarian Assistance

Citing security concerns, the SPDC has denied international organizations access to the active conflict zones and some ceasefire areas in the East, according to the Internal Displacement Monitoring Centre (IDMC), “No End in Sight for Internal Displacement Crisis,” February 2008. The International Committee of the Red Cross (ICRC), the only remaining international organization with access to ongoing conflict zones, closed three of its five field offices, one in Mon State and the other two in Shan State in May 2007, citing constant interference by SPDC officials in its prison visits and its monitoring and protection activities in the sensitive border areas. In the same year, the ICRC also reduced the number of its expatriate staff from 56 to 16. Similarly, the French section of Médecins Sans Frontières (MSF) decided to end its operations in Myanmar in 2006, stating that it was no longer possible to carry out its malaria programming in Kayin (Karen) and Mon States due to restrictions on travel and interactions with beneficiaries and local health authorities. However, MSF Holland and MSF Switzerland are still operating in the country.

The consequences of these humanitarian restrictions for children and their families living there are far-reaching and severe. Many face military attacks, landmine injuries and widespread epidemics without sufficient and lifesaving humanitarian assistance. Moreover, in the absence of in-country aid organizations in active conflict zones, help is often delivered by cross-border groups operating from Thailand. While the legal aspects of such activities are hotly debated, the efforts—though small-scale—address some vulnerability and gaps. Nevertheless, an overall, detailed picture of the humanitarian circumstances facing civilians in these areas remains elusive and the access challenges prevent an adequate national and international response.

Increasing humanitarian access with SPDC permission to areas where civilians are evading Myanmar Armed Forces is a contentious issue. Most aid organizations in Myanmar are not able to work openly on protection concerns, according to information shared with Watchlist. Some human rights organizations thus contend that increased humanitarian access could actually harm civilians, as this could entrench displacement and extend SPDC authority over civilians in the absence of international human rights monitoring. At the same time, much depends on the access conditions and the ability of aid organizations to gain access that allows them to conduct independent human rights impact assessments of their projects.

Risks for Local Groups

As international aid organizations are unable to access most conflict-affected areas, they often work with community-based and local organizations to provide aid to vulnerable groups in conflict-affected areas that are off-limits to them. Some of these local organizations operate from Myanmar mainly assisting communities in the government-controlled and ceasefire areas, according to the IDMC, “No End in Sight for Internal Displacement Crisis,” February 2008.

A UN official in Myanmar explained to Watchlist that local groups face severe risks when carrying out humanitarian work unless they are directly affiliated with the SPDC. Once the SPDC perceives local groups as politically motivated, it may put them under Government surveillance and is reported to have at times harassed, interrogated, detained and even convicted and sentenced them to prison on unrelated and questionable charges. Other groups that are seen as politically neutral have to beware of sharing information on their work and the humanitarian situation with the international media, according to the same source. Local groups have faced some pressure by the SPDC to work with USDA, a government-affiliated mass organization that has become known for its close association with Myanmar’s security forces, according to ICG. In order to operate freely and evade the government’s restrictions, some local organizations working from inside Myanmar are forced to conduct their activities in secrecy and minimize their communications to their international partners.

The humanitarian activities in the areas of ongoing armed conflict are generally organized as cross-border operations in Thailand. Local aid workers report taking great risks during efforts to deliver humanitarian aid in areas where opposition groups are still operating against the SPDC. Between 1998 and 2006, attacks by the Myanmar Armed Forces or mines killed seven medics and one traditional birth attendant from the Back Pack Health Worker Team (BPHWT), a local aid organization based in Thailand, according to their report Chronic Emergency: Health and Human Rights in Eastern Burma, May 2006. More recently, Free Burma Rangers (FBR), a local aid NGO working on the Thai-Myanmar border, reported that a member of their relief team was interrogated, tortured and killed by the Myanmar army on April 10, 2007, according to its report, Burma Army Executes Captured Relief Team Member, April 27, 2007.

This highly dangerous working environment has led some cross-border aid organizations to cooperate with NSAGs active in the area, which provides them with intelligence, transportation, logistical support and, in some cases, physical protection. Some international organizations argue that this direct cooperation between local aid organizations and NSAGs conflicts with humanitarian principles and may undermine their credibility for reporting violations against children and other civilians. However, the SPDC’s access restrictions for the UN and INGOs often makes it impossible for them to deliver aid to these areas without such support.

Some villagers have refrained from accepting much-needed assistance from cross-border groups, fearing potential sanctions under the Unlawful Association Act, according to the Human Rights Education Institute for Burma (HREIB), a Thailand-based Burmese human rights organization, Forgotten Future: Children Affected by Armed Conflict in Burma, November 2008. The act stipulates that anyone supporting political dissident groups is to be considered an enemy of the state and to be punished accordingly.

Lack of Data and Surveys on the Humanitarian Situation

There is a severe lack of basic data on the humanitarian needs and priority responses required in Myanmar. The SPDC has been apprehensive of data collection or surveys being conducted in Myanmar. The 2007 report of the U.S. Government Accountability Office (GAO)[16] describes SPDC guidelines explicitly banning any surveys that have not been previously approved in the original project documentation. For example, the SPDC refused an external assessment team to review Myanmar’s response to HIV/AIDS in conflict zones or mining areas where HIV prevalence rates are high, according to a landmark health study on Myanmar by the Human Rights Center, University of California, Berkeley and Johns Hopkins Bloomberg School of Public Health (JHSPH), The Gathering Storm: Infectious Disease and Human Rights in Burma, July 2007. Health professionals usually are not able to openly speak about or publish the SPDC’s health policies, according to the same study. As a result, some UN agencies and NGOs do not publicly share data gathered from their service provision programs due to concerns for a potentially negative reaction by the SPDC.

This adverse environment has made it difficult for aid organizations to devise adequate responses to the needs of children and their communities in Myanmar. However, in an effort to address this gap, the UN established the Myanmar Information Management Unit (MIMU) in Yangon (Rangoon) in June 2007 to service the Interagency Standing Committee (IASC) Country Team, comprised of the UN and NGOs. MIMU’s aim is to establish a common, comprehensive and objective overview of the country’s humanitarian priorities.

Funding Implications

Many donors have refrained from providing funding to Myanmar, questioning the effectiveness of their assistance given the limited operational space. Moreover, the question on the provision of humanitarian aid has become extremely politicized as many donor states want to avoid providing assistance to a country to whose leadership they are opposed. Official Development Assistance (ODA) to Myanmar is the lowest per capita worldwide among the least developed countries, according to the Organization for Economic Cooperation and Development (OECD).[17] Myanmar only receives US$2.88 per person in overseas development assistance, whereas other countries with similarly repressive governments such as Sudan and Zimbabwe have received US$55 per person and US$21 per person, respectively. Some international organizations that operate in Myanmar argue that low funding levels prevents them from taking advantage of the limited access that the SPDC grants and prevents them from pressing for greater access.

Following SPDC-imposed limitations on monitoring and implementation of programming in 2005, several donors withdrew funding support for Myanmar. The Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, which was supposed to start at the end of 2006, cancelled its activities in Myanmar, citing excessive and other restrictions.[18] Other major donors such as the World Bank, the Asian Development Bank and the International Monetary Fund have not approved new loans to Myanmar in more than twenty years, according to GAO, International Organizations: Assistance Programs Constrained in Burma, April 2007.

New funding initiatives for cyclone victims have allowed aid agencies to gain more humanitarian access in the cyclone-affected Ayeyarwady (Irrawaddy) Delta, according to Refugees International, “Burma: Building upon Success,” September 4, 2008. Sustained and unimpeded assistance will be needed to address the urgent needs of civilians suffering from the effects of the cyclone and other vulnerable populations.

Killing and Maiming

Military Attacks

The boundaries between civilians and combatants have become extremely blurred in Myanmar’s armed conflict. Within an environment of increasing militarization, Myanmar Armed Forces and NSAGs regularly commit human rights violations. The Myanmar Armed Forces have shelled villages to encourage forced relocation or to depopulate areas, according to AI, “Crimes against Humanity in Eastern Myanmar,” June 5, 2008. Human rights organizations have also frequently documented children caught in indiscriminate attacks and shelling against villages in conflict zones. The 2007 Secretary-General’s report on children and armed conflict in Myanmar was not able to verify credible reports of attacks by Myanmar Armed Forces against villagers committed between 2006 and 2007 in Kayin (Karen) State due to access constraints. According to these unverified reports, children had been killed or seriously injured in the attacks (S/2007/666).

In one case, a 3-year-old child and a young man were killed in artillery shelling on Sit Hmudan Haung Asu village near the border town of Myawaddy in Kayin (Karen) State during fighting between the Democratic Karen Buddhist Army and the KNU/KNLA, according to Democratic Voice of Burma (DVB), a Norway-based nonprofit media organization, “Two People Killed during Karen Rebel Clash,” June 11, 2007. In another incident, on September 12, 2008, a 15-year-old boy was killed when Myanmar Armed Forces shelled Klay Soe Kee village in northern Kayin (Karen) State, according to a report by FBR, Killing of Villagers, Deadly Landmines, and Women Forced to Work for the Burma Army, September 2008. On the same day, the troops also shelled a nearby plantation, seriously injuring a 14-year-old boy, according to FBR.

The SPDC’s shoot-on-sight policy sanctions the direct targeting of anybody who breaks movement restrictions by remaining in designated “black zones” or by leaving SPDC-controlled villages and relocation sites.[19] As a result, Myanmar Armed Forces have at times even killed or injured babies or small children as enemies of the state regardless of their age. For example, Myanmar Armed Forces killed villagers, including a mother and her 2-month-old baby and 7-year old child in Toungoo District in northern Kayin (Karen) State in April and May 2007, according to the Karen Human Rights Group (KHRG), an independent group documenting the human rights situation of people in rural Myanmar, “Landmines, Killings and Food Destruction: Civilian Life in Toungoo District,” August 9, 2007. The SPDC’s indiscriminate attacks against civilians suspected of links with NSAGs have even caused some villagers to seek the protection of NSAGs, according to reports of local organizations serving this population.

Some children from ethnic minorities have also been arrested and tortured by Myanmar Armed Forces who accuse them of complicity with NSAGs belonging to the same ethnicity. In November 2005, a 17-year-old Chin boy was arrested and tortured by Myanmar Armed Forces for speaking with a member of Chin National Army (CNA), according to Christian Solidarity Worldwide Hong Kong, Fact-Finding Report, March 2006. While pressing the boy for more information, the soldiers beat him to the point of unconsciousness and cut him with a knife into his back.

Following such attacks, victims and witnesses may suffer from trauma and psychosocial dysfunction, according to HREIB, Forgotten Future, November 2008. However, others have shown remarkable resilience in the face of such attacks and abuses by the military and developed resistance strategies, including the monitoring of troop movements and employing advanced warning systems to alert villagers of approaching army patrols, according to KHRG, Village Agency, Rural Rights and Resistance in a Militarized Karen State, November 2008.

Landmine Explosions

At least five boys and three girls were either injured or killed by landmine explosions in 2007, according to the International Campaign to Ban Landmines (ICBL), Landmine Monitor (LM) 2008 (see below: Landmines and ERW). In one case, the landmine blew off the lower portion of a girl’s right leg. A 13-year-old boy was blinded and had his face and upper torso wounded by a landmine placed by Myanmar Armed Forces in Lay Kee village in northern Kayin (Karen) State, according to FBR, “13-year-old Boy Blinded by Burma Army Landmine,” December 5, 2007. The boy’s 8-year-old sister was nearby and was also injured by the explosion. In a more recent case, in March 2008, a 16-year-old girl stepped on a landmine planted by Myanmar Armed Forces in Htee Baw Kee village, Kayin (Karen) State, according to KHRG, “Burma Army Attacks and Civilian Displacement in Northern Papun District,” June 12, 2008.

Other Violence

Children in Myanmar also face other brutal violations that may lead to injury or death. On July 27, 2008, some SPDC soldiers allegedly brutally raped and killed a 15-year-old girl in northern Myanmar, near the border with China, according to Asian Human Rights Commission (AHRC), “Urgent Appeal Case: AHRC-UAC-224-2008,” October 9, 2008. Similarly, on December 28, 2008, a 7-year-old girl was allegedly abducted, raped and killed by a soldier of the Myanmar Armed Forces in a village in Nyaunglebin District, Kayin (Karen) State, according to Karen Women’s Organisation (KWO), “Urgent Statement by the Karen Women’s Organisation,” January 2, 2009 and FBR, “Burma Army Threatens and Attempts to Bribe Parents of Raped and Murdered 7-year-old Girl in Karen State,” January 25, 2009. In both cases, no action has been taken to bring the perpetrators of these incidents to justice despite strong evidence and eyewitness accounts. Rather, some members of the security forces tried to force the families into accepting an extrajudicial settlement. In the case of the 15-year-old girl, this was allegedly done with the assistance of local officials. In some of these cases, it is difficult to distinguish when these incidents are conflict-related or are due to pervasive impunity enjoyed by armed forces and groups.

Refugees and IDPs

Internally Displaced Persons

General Situation

The SPDC does not recognize the existence of IDPs or armed conflict in Myanmar but views IDPs as illegal economic migrants or members of resistance groups, according to the 2008 Report of the Special Rapporteur on the situation of human rights in Myanmar (A/HRC/7/18. para. 42f). No survey has been conducted to date to assess the full scope and nature of current conflict-induced displacement in Myanmar. However, at least 451,000 people were estimated to be displaced in the rural areas of eastern Myanmar as of October 2008, according to TBBC, Internal Displacement and International Law in Eastern Burma, October 2008.[20] These statistics gathered by TBBC and its partners are based on surveys from rural areas of 38 townships in the East that were most affected by forced displacement. TBBC researchers were not able to survey urban areas or mixed administration areas. In addition, large numbers of IDPs are displaced in other parts of the country, especially in Kachin and Shan States, western Myanmar, and some parts of Kayin (Karen) State, according to the Centre on Housing Rights and Evictions (COHRE), Burma Country Report: Displacement and Dispossession: Forced Migration and Land Rights, November 22, 2007. The estimated number of IDPs in Myanmar at present is therefore likely to be over 1 million, according to COHRE. Many of these IDPs have been forced to flee multiple times inside Myanmar and, after exhausting all further options and coping mechanisms, have been forced to cross the border into neighboring countries in search for human security.

Armed conflict and related human rights violations are fuelling displacement mainly in Kayin (Karen) State, in eastern Tanintharyi (Tenasserim) Division, southern Mon State, southern and eastern Kayah (Karenni) State, southern Shan State and parts of Chin State and Sagaing Division, according to COHRE. In these areas, many civilians have directly fled military attacks or were no longer able to sustain their human and food security. In addition, military predation and land confiscation has caused displacement in many other parts of the country, particularly in Rakhine (Arakan) and Kachin States, according to the same source. SPDC exploitative policies and mismanagement have also undermined the ability of people in remote and underdeveloped regions in Myanmar to sustain a livelihood and has forced many civilians to flee for economic survival.

Many IDPs in eastern Myanmar face serious protection concerns in ceasefire areas and SPDC-run relocation sites or when hiding in the contested areas. Based on TBBC’s estimates, most IDPs, an estimated 224,000, live in areas administered by the political wings of NSAGs that have a ceasefire agreement with the SPDC as of October 2008. The SPDC has allied with some of these ceasefire groups, such as the DKBA, using them as proxies to fight NSAGs and to expand control over the population, according to KHRG.

An estimated 126,000 IDPs have been forced into SPDC-run relocation sites where they are often exploited to provide forced labor, food, money and other supplies, and exposed to violence and abuse by Myanmar Armed Forces, according to TBBC. While the SPDC coerces them into the relocation sites, civilians are expected to provide for their own housing, food, health and education facilities, safe water supplies and other needs, according to KHRG.[21] Movement restrictions also prevent villagers from earning a living and accessing schools, health care and other public services outside the designated areas. In addition, the proximity to the military in relocation sites exposes IDPs to exploitation and abuse by Myanmar Armed Forces. However, living conditions at relocation sites and villages vary, according to HRW, “‘They Came and Destroyed Our Village Again’: The Plight of Internally Displaced Persons in Karen State,” June 9, 2005. Some sites, particularly those that have been established for longer periods of time, have schools and offer some paid work. Some residents prefer to stay in these sites even when they have the option of leaving, according to HRW.

An estimated 101,000 IDPs have remained in contested areas outside relocation sites against SPDC orders, according to TBBC. These villagers live in constant fear of being discovered by Myanmar Armed Forces, who are instructed to shoot—on sight—any person remaining in the designated “black zones.” As a result, villagers often resist the abuse and maintain a life in hiding in the jungle despite the difficult circumstances they face there. Remaining within their home areas means being constantly prepared to move to escape human rights violations by Myanmar Armed Forces and armed groups associated with them.

Most relocation sites are also blocked from external assistance, according to COHRE.[22] As a result of SPDC’s restrictive policies, assistance to IDPs is limited and few international organizations in Myanmar are able to focus on their specific concerns, according to the Department for International Development, UK (DFID), “DFID Assistance to Burmese IDPs and Refugees on Thai-Burma Border,” July 25, 2007.

Specific Issues Relating to IDP Children

In many cases, families try to protect their children from abuses by the Myanmar Armed Forces by choosing to flee into hiding. Once in hiding, villagers often set up schools to ensure continued education for their children. These are commonly under trees, using rock faces as blackboards or blackboards salvaged when fleeing from the village. In more stable hiding sites, local organizations may provide educational material and teacher training (see below: Education).

IDP children in hiding are also affected by malnutrition, inadequate water and sanitation facilities, and exposure to mosquitoes and malaria when sleeping outside or in makeshift shelters.[23] The instable conditions also explain the high death rates of displaced children due to preventable diseases (see below: Health). Some local organizations have deployed mobile health units to serve the people’s immediate needs. While these mobile assistance programs are currently only able to reach limited numbers of people and at irregular intervals, they are often the only medical assistance programs available in these areas, according to Canadian International Development Agency (CIDA), Children Caught in Conflicts: The Impact of Armed Conflict on Children in Southeast Asia, March 2007.

In some relocation sites, the health and educational situation for IDPs appears even more precarious. The IDPs, including children, usually have to construct the sites themselves, and must comply with other SPDC demands for labor and resources. Even though medical and educational opportunities in the sites are limited, children are not allowed to go to neighboring villages to access these services, according to KHRG, Growing Up Under Militarization: Abuse and Agency of Children in Karen State, April 30, 2008.

In the rush of fleeing their homes, families often scatter and children are left behind or lost in the process, according to the same source. Other children lose their parents during attacks and fighting among armed forces and groups, according to the same source. Many separated and orphaned children manage to link up with other villagers who may help them locate their family or who informally or temporarily adopt them, according to anecdotal information shared with Watchlist.

Besides the forced separation of children, some families from ethnic minority groups also actively decide to send their children to live with relatives in more stable areas, or in refugee camps where they can evade state control and can more easily access educational and other services (see below: Refugees in Thailand).

Refugees

More than one million people have fled discrimination, violence and fighting in Myanmar to claim refuge in the neighboring countries of Thailand, China, Bangladesh, Malaysia and India, according to RI, “Military Offensive Displacing Thousands of Civilians,” May 16, 2007. Of these host countries, only China has signed and ratified the UN Refugee Convention. Thailand, Bangladesh, Malaysia and India are thus not legally obliged to provide protection for those people fleeing from Myanmar and may not recognize refugees despite their legitimate claims. While governments still have an obligation under international customary law not to send refugees back (principle of non-refoulement), the lack of recognition of a person’s refugee status has resulted in protection concerns for many refugees from Myanmar.

In some cases, host governments have also used the presence of a cease-fire to justify the forced repatriation of refugees to Myanmar despite continuing insecurity in their states of origin. For instance, Thai authorities forcibly repatriated approximately 12,000 Mon refugees by 1996 after the New Mon State Party signed a cease-fire with the SPDC. Most of these refugees did not return to their areas of origin but became IDPs inside Myanmar, according to MSF, “Supporting Ethnic Minorities’ Efforts against Malaria in Mon State Ceasefire Zone: Myanmar,” March 28, 2008.

Refugees in Thailand

Reflecting the extent of abuse, attacks and armed conflict in the bordering Kayin (Karen), Kayah (Karenni), Shan and Mon States, and Tanintharyi (Tenasserim) Division, Thailand has received the largest number of recognized refugees from Myanmar. As of February 2008, the camp population stood at approximately 116,997 persons comprising 111,104 registered refugees, 3,236 persons with pending refugee status before the Provincial Admissions Boards (PAB)[24], the government-owned screening mechanism for Myanmar asylum seekers, and 2,657 students, according to UNHCR. Those admitted by the PAB are not officially recognized as refugees by Thailand, but receive legal permission to reside in the refugee camps.

Most asylum seekers from Myanmar who arrived since the beginning of 2004 have not been able to receive any form of protection in Thailand, according to “Burmese Asylum Seekers in Thailand: Still Nowhere to Turn,” in Forced Migration Review 30, “Burma’s Displaced People,” April 2008. The PABs have significantly slowed down their processing of cases in recent years due to the large increase of asylum seekers who entered into the camps along the border without undergoing prescreening at the border, according to UNHCR.[25] However, the Thai government is expected to implement a prescreening pilot project for the unregistered persons in four camps in four provinces in early 2009, according to UNHCR.

Many asylum seekers from Myanmar who would qualify for refugee status currently live as unregistered migrants in Thailand with no access to services, legal protection or opportunities for resettlement. The lack of legal protection also renders them vulnerable to discrimination, exploitation and other forms of abuse.[26] However, few of the estimated 1.5 million migrants from Myanmar in Thailand are expected to apply for legal status due to the cumbersome administrative procedure, according to Migration News, Southeast Asia, Vol. 14, No. 4, October 2008. Since September 11, 2008, Thai authorities have also required illegal migrants from Myanmar in Thailand to submit an application for legalization that is shared with the Burmese authorities for selection of workers to be legalized in Thailand. The selected candidates then have to return to Myanmar to obtain temporary passports from the SPDC and work permits from Thai service centers along the Thai-Myanmar border. By making themselves known to Burmese and Thai authorities, migrants, asylum seekers and refugees risk being fined, detained and punished, according to Migration News.

Most registered refugees in Thailand live in one of the nine official refugee camps close to the border to Myanmar, according to UNHCR. The management and infrastructure of camps are usually well developed but the camp population is extremely isolated from the resident population of Thailand. The Thai government rejects local integration of refugees and does not permit refugees to move freely or work outside the camp. Despite these restrictions, some refugees still work illegally outside the camps in agriculture, factories and domestic work, often at the risk of being arrested, deported and losing their right to resettle, according to the findings of the Women’s Refugee Commission’s[27] field mission to Thailand, Living in Limbo, May 2008.

As most refugees cannot return to Myanmar or start a new life in Thailand, resettlement seems the only viable option for many after years and sometimes decades in the camps. In 2005, the United States agreed to a massive resettlement program, pledging to resettle approximately 60,000 refugees in Thailand in the United States by 2010. The program is limited to those who currently reside in the camps and can claim fear of persecution by SPDC or its proxies.

This U.S. resettlement program has caused some concern among aid organizations working on the Thai-Myanmar border as operations in refugee camps in Thailand are largely run by the affected communities. The massive movement has drained camps in Thailand of some of the most educated and skilled people involved in camp management, including teachers, health workers and camp management staff, according to TBBC, Programme Report: January to June 2008.

Due to the situation of protracted displacement, some of the refugee children from Myanmar have never known a life outside the camp. Despite the longevity of displacement, the Thai government does not accept local integration into Thai society as an option for the refugees it hosts. Refugee camps have reported that some older children might become frustrated, and at times violent, as they face a bleak outlook on a life without hope for leaving the camps, according to CIDA, Children Caught in Conflicts: The Impact of Armed Conflict on Children in Southeast Asia, March 2007. In one case, reported by a senior Kayin (Karen) leader, this frustration caused some boys to leave the camp to volunteer to fight with an NSAG in Myanmar, according to CIDA (see below: Child Soldiers). Other youth have reportedly turned to alcohol, drugs and gang violence, according to anecdotal reports shared with Watchlist.

The outlook is even dimmer for those refugee children who have been denied refugee status in Thailand due to ethnicity or arrival after November 2005. These children are subject to arrest and deportation as illegal immigrants and, depending on their ethnicity, may face difficulties entering the mainly ethno-specific refugee camps. In contrast to refugee children, the majority of school-age migrant children miss out on school and other social services. Of the 93,000 registered migrant children in Thailand under the age of 15, only 14 percent were enrolled in school as of 2003, even though national laws specify a right to schooling and prohibit employment for migrant children, according to the International Organization for Migration (IOM), International Migration in Thailand, 2005. Physicians for Human Rights, an INGO, noted that illegal migrants, particularly children, have become an easy target for smugglers and traffickers in Thailand, No Status: Migration, Trafficking and Exploitation for Women in Thailand: Health and HIV Risks for Burmese and Hill Tribe Women and Girls, June 2004.

As an important step towards protecting children who are in Thailand, including those of migrants, asylum-seekers and refugees, Thailand passed a Civil Registration Act on February 25, 2008, allowing children to register and obtain a birth certificate regardless of their status. This birth registration allows migrants to pay into the health insurance scheme for their children and more easily access health and education services. In addition, some schools for migrant children on the Thai-Myanmar border operate unofficially.

Children separated from their families, either forcibly or intentionally as a protection strategy against violence in Myanmar, usually stay with relatives or foster families, or in boarding houses in Thailand. In some cases, children being sent to refugee camps for schooling move in and out of camps for regular visits during school breaks, according to UNICEF, Situation Analysis Report: Strengthening Alternative Care Options for Refugee Children, A Report for UNICEF Thailand, December 2006. In practice, it is difficult for children to maintain such close ties due to the cost of travel, the fear of abduction on their way to or from their families, the constant displacement of families due to the conflict, and other obstacles, according to UNICEF. In some cases, young children may forget where they had come from, posing problems for their eventual reunification, according to CIDA, Children Caught in Conflicts: The Impact of Armed Conflict on Children in Southeast Asia, March 2007.[28]

Refugees in India

An estimated 60,000–80,000 Chin people have fled to India, mainly to the northeastern state of Mizoram, in order escape persecution and armed conflict in Myanmar, according to Forced Migration Review 30, “Burma’s Displaced People,” April 2008. The lack of protection has exposed many of these refugees to discrimination and forced return to their countries of origin, according to RI, “Burmese Refugees in New Delhi: Self-Sufficiency Goals Not Being Met,” June 6, 2006.

The Indian government has also not permitted UNHCR to operate in the northeastern border region where most refugees from Myanmar live. In order to apply for refugee or asylum status or assistance, the refugees must therefore undertake a costly journey to the UNHCR office in New Delhi, where long waiting times expose them to severe risk, according to the U.S. Committee for Refugees and Immigrants (USCRI), World Refugee Survey 2008 – India, June 19, 2008. Delays in registering and processing Chin asylum seekers by UNHCR have caused problems among mothers and children in particular who are in need of food and shelter and education for children, according to a Chin Human Rights Organization (CHRO) press release, “Asylum Seeking Mother and Children at Risk,” March 6, 2008.

Refugees in Bangladesh

Ethnic discrimination and religious persecution has caused 250,000 Muslim Rohingya to flee to Bangladesh since the early 1990s. Since 1982, the ruling authorities in Myanmar have refused to accept the Rohingya as Burmese citizens, turning them into stateless people in their own country, according to RI, “Rohingya: Discrimination in Burma and Denial of Rights in Bangladesh,” July 21, 2006.[29] Many are denied basic rights to freely move, work or marry without an official permission. At the same time, SPDC officials have exploited refugees for forced labor during the day and forced sentry duty at night without any form of compensation, according to RI.

While most of the Rohingya refugees in Bangladesh have been forcibly repatriated to Myanmar, many returned to Bangladesh because the situation in Myanmar was not safe for them. Approximately 26,300 Rohingyas still live in two camps in the southern Cox’s Bazar area, according to the USCRI, World Refugee Survey 2008 – Bangladesh, June 19, 2008. An additional 100,000 to 200,000 live as unregistered refugees outside the camp areas, according to the same source. Since 2006, the Government of Bangladesh has allowed UNHCR to construct new shelters for refugees in both camps and allow other UN agencies and NGOs to run programs in the refugee camps. In addition, a very small number of Rohingya refugees have been able to resettle to a third country.

Refugees in Malaysia

Malaysia officially hosted nearly 70,000 refugees from Myanmar, including 25,000 ethnic Chin, 20,000 Mon and 12,000 Rohingya as of 2008, according to the USCRI, World Refugee Survey 2008 – Malaysia, June 19, 2008. The actual number of refugees from Myanmar is likely to be considerably higher, according to RI. While RI was not able to obtain confirmed numbers, recent estimates indicate that there are as many as 70,000 Rohingya alone in Malaysia, which makes up approximately half of the entire Myanmar refugee population in the country. The Government of Malaysia has not signed the Refugee Convention and has expelled refugees back to Thailand, the entry point of many refugees, according to the University of New England Asia Center (UNEAC) Asia Papers, No. 18, 2007, “Refugees and Refugee Policy in Malaysia.”

Refugees in Malaysia are frequently harassed or detained by Malaysian authorities or the People’s Volunteer Corps, or RELA, a group of civilian volunteers authorized by the Malaysian government to arrest undocumented migrants, according to the USCRI, World Refugee Survey 2008 – Malaysia, June 19, 2008. On June 25, 2008, for example, Malaysian security forces arrested and detained 230 Chin refugees, including 30 children and 5 pregnant women, in a large-scale raid targeting a refugee center for Chin and two neighborhoods where Chin refugees lived, according to Chinland Guardian, “Tensions Rise as More Chin Refugees Arrested in Malaysia,” June 29, 2008.

Malaysian authorities also arrested and detained eight Chin women and 13 children in October 2008, according to the USCRI. Burmese women refugees and asylum seekers have also reportedly been arrested and detained when trying to register their newborn babies with local authorities, according to RI, Malaysia: “Government Must Stop Abuse of Burmese Refugees and Asylum Seekers,” May 23, 2007. The detention centers for illegal immigrants are usually overcrowded, unhygienic and unsafe, and lack sufficient access to food and health services, according to the USCRI. These raids are increasing in frequency and aggressiveness, according to RI.

Refugees in China

There is no statistical data available on the number of refugees from Myanmar in China and very little information on their situation. Most of these refugees are members of the Kachin ethnic group.

Health

Health Care: Investment and Access to Services

In 2005 Myanmar was spending 2.2 percent of its GDP on the health care sector, which is less than US$ 0.70 per person annually, according to World Health Statistics Report 2008. This investment is considerably lower than in any other country in the southeast Asia region. Furthermore, local military units and officials have repeatedly been accused of confiscating drugs and other aid materials for their own use or to sell and to stop villagers from being able to maintain a life outside of SPDC control. In one case documented by KHRG in 2006, soldiers confiscated a child’s medicine from a woman, which partially led to the death of the 3-year-old child. Some local army personnel have also closed down village-run clinics and prohibited the personal possession of medicine under the pretext of keeping NSAGs from obtaining medical supplies, according to KHRG, Submission for the UN Secretary-General’s Report on Children and Armed Conflict: Incidents from September 2007–October 2008, January 2009.

Myanmar also receives extremely little external funding to improve its health care system as poor governance and constraints in the delivery of aid discourage many from investing in the country (see above: Humanitarian Access). This underfunding of the health sector inevitably puts additional strains on the people of Myanmar, who already struggle to make a living under trying circumstances.

The lack of political will and financial investment by the SPDC starkly contrast with the current needs of the health care system in Myanmar. There is a serious lack of skilled medical staff, equipment and supplies, according to the Center for Public Health, Responding to AIDS, TB, Malaria, and Emerging Infectious Diseases in Burma: Dilemmas of Policy and Practice, March 2006. Many physicians and health professionals have not received adequate training and are susceptible to corruption because of the low salaries paid. In some semi-urban and rural areas in Kayah (Karenni) State, civilians are often forced to pay self-employed nurses who are not adequately trained and often engage in unsafe practices, including reusing needles, according to Burma Issues, a Burmese human rights NGO, Living Ghosts: The Spiraling Repression of the Karenni Population by the Burmese Military Junta” March 2008. Moreover, health professionals risk being arrested if they are seen as criticizing the SPDC health policies.

The SPDC has contributed to a deterioration of the health situation in many conflict-affected areas by destroying the livelihoods of villagers, forcing them into displacement and preventing aid organizations from moving freely in all parts of Myanmar. In some areas of Kayin (Karen) State, for instance, medical support systems are often managed with extremely limited resources by communities, mostly health and social workers, with some financial and technical assistance from cross-border organizations.

Child Mortality and Prevention of Infectious Diseases

Infant and under-five child mortality remain high in Myanmar, despite some progress in recent years. The infant mortality rate stands at 74 deaths for every 1,000 live births, according to World Health Statistics 2008. Approximately one in 10 children in Myanmar dies before reaching the age of five years, the highest child mortality rate in Asia after Afghanistan, according to World Health Statistics 2008. The under-five child mortality rate may be twice as high among children living along the eastern conflict zones, according to a household survey by BPHWT, which was conducted among 2,000 households in eight regions of Kayin (Karen), Karenni (Kayah), Shan and Mon State, and Tanintharyi (Tenasserim) Division in 2004.[30] The child mortality rate for under-five IDPs from these ethnicities was reported as 22.1 percent, compared with Myanmar’s average of 10.6 percent, according to the report.

Infectious diseases pose the biggest threat to the survival of children in Myanmar. Malaria is the leading cause of death for children under five in Myanmar, and tuberculosis rates among children are among the highest in the world, according to World Health Statistics 2008.[31] A 2006 survey of the BPHWT found that almost half of the child-related deaths among IDP communities were attributable to malaria. UNICEF vaccination campaigns for children resulted in moderately high levels of national immunization rates for common diseases as of 2005, according to the World Health Organization (WHO).

In spite of this, the nationally reported progress in preventing the spread of infectious diseases does not necessarily reflect the situation in the conflict-affected areas. Most children and mothers in ethnic minority states along the Thai-Myanmar border continue to die of infectious diseases that could be both prevented and cured, according to the report of the Human Rights Center, University of California, Berkeley and Johns Hopkins Bloomberg School of Public Health (JHSPH), The Gathering Storm: Infectious Disease and Human Rights in Burma, July 2007.

Measles remains one of the main causes of death for children under five in Myanmar despite the existence of effective vaccinations, according to the World Health Statistics Report 2008. Following a major outbreak in several districts of Kayin (Karen) State, 512 people were infected by measles and four died, according to The Irrawaddy, “Myanmar: Measles Outbreaks Highlight Regime’s Irresponsibility,” November 6, 2008. A cross-border immunization campaign reaching over 7,700 children prevented the further spread of the virus, according to The Irrawaddy.

Particularly in active conflict zones, children are rarely immunized against common diseases since aid organizations face difficulties in administering vaccinations in Myanmar’s eastern border areas due to displacement and restrictions on movement of aid workers, especially if multiple vaccinations are required. Yet, monitoring and on-the-ground presence of aid organizations is critical when conducting campaigns to ensure that populations benefit from the assistance. In some cases in Kayin (Karen) State where SPDC health staff conducted vaccination campaigns, the SPDC required villagers to pay fees to join the parastatal Myanmar Women’s Affairs Federation before they could receive vaccinations, according to KHRG.

Widespread malnutrition in Myanmar also weakens the ability of the children’s immune system to resist potentially lethal diseases. One child in three under the age of five suffers from malnutrition, according to United Nations agencies present in the country cited in the 2008 Report of the Special Rapporteur on the situation of human rights in Myanmar (A/HRC/7/18). The 2004 BPHWT’s health and human rights survey in eight regions of Kayah (Karenni) State, Kayin (Karen) State, Mon State, and Tanintharyi (Tenasserim) Division revealed that 15 percent of displaced children suffered from malnutrition, Chronic Emergency: Health and Human Rights in Eastern Burma, September 2006. Food shortages and restrictions on the movement of food have aggravated the threat of hunger and malnutrition in Myanmar. Moreover, the abuses of civilians by the SPDC troops have forced villagers in Karen State to abandon their farms and fields and has seriously disrupted regular planting cycles of residents, thereby contributing to a food crisis in the region, according to KHRG, “Attacks, Killings and the Food Crisis in Toungoo District,” August 2008.

Maternal Death and Reproductive Health

Poor or nonexistent prenatal and postnatal care makes giving birth to a child a risky and at times lethal endeavor for both mother and child in Myanmar, particularly in the conflict-affected areas. Maternal mortality rates in Myanmar stand at 380 deaths for every 100,000 live births, according to World Health Statistics 2008. In the eastern ethnic states, approximately 27 percent of adult female deaths are pregnancy-related, according to DFID, “DFID Assistance to Burmese IDPs and Refugees on Thai-Burma Border,” July 25, 2007. Many mothers suffer from malnutrition and vitamin deficiency and have insufficient time to recover following the birth of the child. Some have to hide in the jungle giving birth under unsafe unsanitary conditions and without the most basic assistance, according to KHRG. In Myanmar, only 57 percent of children are born with a skilled medical practitioner present, according to the World Health Statistics 2008. This statistic does not account for the situation in conflict-affected areas.

HIV/AIDS

Trends

Myanmar has one of the worst HIV/AIDS epidemics in Asia, with an estimated national HIV prevalence rate of 0.7 percent among people between the ages of 15 and 49, according to the 2008 Epidemiological Fact Sheet on HIV and AIDS, produced by the Joint UN Program on HIV/AIDS (UNAIDS), WHO and UNICEF.[32] HIV has lowered life expectancy by 1.7 years in Myanmar, according to UNAIDS, 2008 Report on the Global AIDS Epidemic. Substantial national efforts to curb the spread of the epidemic through education and prevention activities have led to a significant reduction of prevalence rates between 2001 and 2007, according to the 2008 Epidemiological Fact Sheet on HIV and AIDS.

Myanmar remains, nonetheless, at the core of the HIV/AIDS crisis in southeast Asia. Rates of HIV infections tend to be highest in China, India and Thailand in the areas bordering Myanmar, according to a report of the universities of Berkeley and Johns Hopkins, The Gathering Storm: Infectious Disease and Human Rights in Burma, July 2007. These high prevalence rates can be attributed to the high number of at-risk groups, including drug users and sex workers, due to illegal drug trade and human trafficking.[33] The researchers further revealed genetic analysis that shows that certain strains of AIDS prevalent in India and China originated in Myanmar. All of this indicates that the HIV/AIDS crisis in Myanmar might be far more severe than reflected in official data, according to Berkeley and Johns Hopkins universities.

National HIV statistics may not reflect the situation of people living in the ethnic border areas, which are most at risk due to migration, human and sex trafficking and drug trade. When reviewing Myanmar’s national AIDS programs in 2006, the assessment teams of the National AIDS program did not include Mon, Kachin and Kayin (Karen) States when collecting data, according to WHO, 2006 Review of Myanmar National AIDS Program. HIV/AIDS prevalence rates are likely to be considerably higher in the eastern border areas, according to according to The Gathering Storm, July 2007. While there are ‘pockets’ of very high infection rates across the country, local organizations have recorded infection rates in some areas of Shan or Kayin (Karen) States that are three or four times as high as national rates, according to the same study. In many remote areas, however, HIV and AIDS are not diagnosed as such due to the limited health services available and the general lack of awareness among communities.

Prevention and Assistance

After years of denial, the SPDC has more recently yielded to increasing pressure from Asian neighboring governments and donors to acknowledge the HIV/AIDS crisis and made HIV one of its priority health concerns, next to tuberculosis and malaria. A multisectoral National Strategic Plan 2006–2010 guides the work of the SPDC with UN agencies and some selected NGOs. This commitment has translated into more support and access for UN and INGOs in carrying out their HIV/AIDS-related activities, such as public awareness-raising programs, condom distribution and HIV-testing, according to ICG, “Myanmar, New Threats to Humanitarian Aid,” Asia Briefing No. 58, December 8, 2006. The Three Diseases Fund (3DF), replacing the Global Fund to Fight AIDS, tuberculosis and malaria, provides critical funding to support HIV programs in Myanmar.[34]

Despite the expansion of an antiretroviral (ARV) treatment program in recent years, only an estimated 15 percent of an estimated 242,000 people, including 1,495 children living with HIV, received life-prolonging ARV therapy, according to the recently released report by Population Services International Myanmar, Save the Children and the UN Joint Team on AIDS in Myanmar, “HIV Programming in Myanmar,” HPN, Humanitarian Exchange, No. 41, December 2008. An estimated 28 percent of pregnant women living with HIV receive ARV to prevent mother-to-child transmission as of 2008, according to WHO and UNAIDS. INGOs reportedly contribute 85 percent of the treatment as of 2008, according to the UN Special Rapporteur on the situation of human rights in Myanmar (A/HRC/7/18 para. 26). Only a small percentage of those living with HIV and AIDS can afford to pay for ARV treatments themselves. The lives of an estimated 240,000 people who are currently living with HIV and AIDS thus depend on sustained funding for the programs in 2009, according to MSF, “A Preventable Fate: The Failure of ART Scale-Up in Myanmar,” November 25, 2008.

In addition, organizations working on HIV programs in Myanmar have noted a lack of HIV programs for SPDC security forces and in closed settings such as prisons, as well as insufficient use of mass media for educational purposes, according to the 2008 report by Population Services International Myanmar, Save the Children and the UN Joint Team on AIDS in