Myanmar : getting closer to the victims
08-04-2003 Operational Update
The ICRC has steadily expanded its activities in Myanmar, gaining greater access to the victims of conflict. It now has some 220 staff around the country, working from five bases.
The ICRC began working in Myanmar in 1986, when it obtained the agreement of the authorities to start up a project to support the work of the National Rehabilitation Hospital in the capital. The aim was to bolster the work already being done by introducing affordable technology for artificial limbs and to upgrade the professional skills of local technicians and physiotherapists.
Within a few years the programme had extended to other government facilities, including two military rehabilitation hospitals in Yangon and Mandalay. Today, the ICRC supports artificial limb centres at five state hospitals, providing imported raw materials and parts, helping with maintenance and providing professional training.
What happens when amputees live in remote villages, where no services are available and hospitals are too far away? In cooperation with the local Red Cross and the Ministry of Health, ICRC runs an outreach programme to provide artificial limbs to people who would otherwise have little hope of receiving them. Patients are referred to one of three ICRC-supported centres; the service is free of charge. Since the project began in 1990 nearly 4,000 people have benefited.
In 2002 the ICRC and the Myanmar Red Cross opened an orthopaedic centre at Hpa-An, east of Yangon. This is the first such structure in the conflict-a ffected southeast of the country, and can accommodate up to 30 patients. Training is provided for 25 local technicians; the maximum annual production rate of 600 artificial limbs is expected to be reached within two to three years.
ICRC-supported programmes are thought to provide 90 per cent of all artificial limbs fitted in Myanmar; since 1986 some 15,000 limbs have been produced.
Talking to all sides in the trouble spots
The ICRC continually aims to reinforce its protection and assistance activities for people affected by conflict. Outside the main delegation in Yangon, delegates are based in four field offices – Kaing Tong (Shan State), Mandalay, Hpa-An (Kayin State) and Mawlamyine (Mon State).
In recent months the ICRC has gained access for the first time to some areas of eastern and southern Shan State. At the same time it has continued to expand its field activities in the southeast of the country (Mon and Kayin States, Taninthayi Division).
“We believe that the mere fact of being present in conflict-affected areas and repeating our visits to the people there can have a preventive protection effect,” says ICRC’s Myanmar head of delegation, Michel Ducraux.
This presence is also a confidence-building exercise, allowing the ICRC to establish contact with local authorities, the civilian population and the various armed groups, to explain its humanitarian mandate and working methods, and to assess the living and security conditions of civilians caught in the cross-fire.
The extension of ICRC activities in these sensitive areas has been welcomed at all levels: “The authorities and armed groups have accepted the presence of the ICRC , and a dialogue about the protection of the civilian population and the lawful conduct of hostilities is gradually bring established,” says Ducraux.
Detention activities: a link to the outside world
The ICRC began visiting people detained in connection with conflict in May 1999; as with its visits anywhere, its concerns are to ensure that prisoners are treated humanely and that they benefit from decent conditions.
Up to the end of February 2003 almost 200 visits had been made to 76 detention facilities, including prisons, labour camps and so-called “guesthouses”. Out of some 5,500 detainees registered by the ICRC since 1999, about 3,000 are still detained.
In line with its standard practice worldwide, the ICRC’s findings are reported confidentially to the authorities concerned, in this case the Ministry of Home Affairs. If recommendations for improvements are made, the results are closely monitored on subsequent visits. An ICRC health specialist takes part in the visits, to check on medical care for the detainees.
The process also enables prisoners to keep in touch with their families, both through the Red Cross Message service (some 6,300 of these have been exchanged) and through family visits organized and paid for by ICRC – about 550 each month.
In the dangerous border areas between Myanmar and Thailand, emergency care is not easy to come by. The ICRC provides financial support to enable the wounded to get the necessary treatment. In the first three months of 2003, 17 people were helped under this programme.
The ICRC also provides basic equipment to hospitals that have been renovated by its engineers, and can furnish emergency supplies to facilities receiving wounded patients, if needed.
Safe water, healthy environment
Health becomes an especially critical issue in remote areas affected by conflict. The ICRC intervenes in Kayin, Mon and Shan States to help ensure safe water supplies and construct latrines. One aspect of this work is in support of the government’s school-building programme; another is to provide villagers with the hardware to enable them to build latrines.
The Myanmar Red Cross is also involved in the health programme, and provides public health education for local people.
By February 2003, more than 13,000 people in 27 villages had benefited directly from the ICRC’s water and sanitation programmes, which included: creating stream catchments, constructing wells, protecting water sources, building block latrines for schools and health centres and distributing basic kits for the construction of private latrines.
Investing in local partners
The Myanmar Red Cross is already the ICRC’s main partner in the country for assistance programmes. It supports the work of the International Federation of Red Cross and Red Crescent Societies to further strengthen the national society's operational capacity, particularly in the fields of restoring family links, promotion of international humanitarian law and conflict preparedness.