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Myanmar: Leprosy: Myanmar struggles with ancient scourge

20 August 2014 - 11:19pm
Source: Agence France-Presse Country: Myanmar

08/21/2014 03:03 GMT

by Kelly MACNAMARA

MAWLAMYAING, August 21, 2014 (AFP) - High in the hills of Myanmar's war-torn borderlands, a clutch of new leprosy cases among communities virtually cut off from medical help is a sign that the country's battle with the ancient disease is far from over.

It took six days by plane, boat, motorcycle, bus -- and an arduous mountain trek -- for a group of medical workers to treat two leprosy patients in a remote corner of the country, where conflict and neglect are the legacy of decades of military rule and even access to basic medicines is a distant dream.

But the charity-funded medics were also on the lookout for evidence that the disease had spread.

They soon found three more leprosy sufferers, including one man who had such a severe case he required hospital care.

"I promised him that I would come back for him or I would send someone to pick him up," said Doctor Saw Hsar Mu Lar, after the May expedition, as he returned to his hospital in Mawlamyaing, Mon state -- one of only two specialising in leprosy in Myanmar.

Weeks later the patient was still waiting to travel as tensions between the Myanmar army and local rebels closed transportation routes.

Myanmar reached so-called 'elimination' status for leprosy in 2003 -- meaning less than one person per 10,000 has the illness.

But there are still around 3,000 new cases found each year and medical workers warn that the debilitating disease could be on the rise once more as the country's creaking healthcare system fails to reach those at risk.

Decades of civil war in ethnic regions have also left vast swathes of its border areas cut off from all but the most basic medical help, meaning the disease could be passing undetected.

"There can be pocket areas, hidden areas," Saw Hsar Mu Lar told AFP.

"We have to tell the world that it's not finished yet."

A curable curse

Leprosy is one of the world's oldest -- and most feared -- diseases.

The bacteria affects the skin and deadens the nerves, meaning sufferers are prone to injure themselves, which results in ulcers and can lead to limb loss. Symptoms can take as long as 20 years to appear.

It is not particularly infectious, passing only through close contact over long periods, and modern medicine is able to cure patients relatively quickly.

But Myanmar has one of the world's least developed medical systems, with government funding consistently among the lowest of any country, even with recent increases under a post-junta semi-civilian government.

State health workers are technically in charge of outreach and aid groups are banned from conducting leprosy awareness campaigns or looking for new patients -- although they can treat people they find through dermatology clinics and during follow-up field trips.

The respected local aid group that organised the border expedition asked AFP not to give specific details of their work fearing that it could jeopardise future missions.

Saw Hsar Mu Lar's Mawlamyaing Christian Leprosy Hospital, with its bright, simple wards, trained staff and plentiful supply of drugs, is a medical haven -- funded mainly by international donations.

Most of the patients AFP met were farmers or had turned to begging to make ends meet.

"We had no medicine at our village even though we had a clinic," said 40-year-old Mu Hai, who had travelled from western Rakhine state for treatment.

The hospital's matron, Ni Ni Thein, is worried. In 2011 they saw 58 new leprosy cases, but that rose to 62 in 2012 and 68 last year.

"Now cases are increasing... the complication rate is increasing," she said, adding that the age range for the disease had also appeared to have widened, with one four-year-old treated this year.

The fight to stop leprosy has been a major international success, with around 16 million people cured by multi-drug therapy (MDT) medicine in the last two decades.

But experts warn against complacency.

Myanmar is one of 18 countries that together account for almost all new cases of the disease.

The number of new cases it finds annually is dwarfed by its populous neighbour India, where there were some 127,000 new patients identified in 2011 according to World Health Organisation figures.

But while India managed an over 50 percent reduction between 2004 and 2011, Myanmar struggled to reduce its new incidences by 18 percent.

The WHO's goodwill ambassador on leprosy, Yohei Sasakawa, said stagnation in Myanmar's new case numbers over several years could indicate authorities are not doing enough to root out the disease.

One problem is that the numbers affected seem small compared to other health challenges like HIV, tuberculosis and malaria.

"It is quite easy to be brought down the priority list," he told AFP during a recent mission to the country.

'He shall dwell alone'

Even if patients are cured, many around the world still fall victim to the stigma that clings to the disease, ending up living in segregated colonies.

Public vilification dates back over two thousand years.

The Bible says of leprosy sufferers: "he is unclean: he shall dwell alone".

Saw Roger was chased out of his village when he started to show signs of leprosy aged 18 in the 1950s.

"I lived only with the animals in the jungle and I was frightened. I used to go into my village under the moonlight and I took rice and fish paste before going back into the dark forest," the 76-year-old told AFP.

After two years sleeping in the woods, Roger was found by missionaries and taken to the Mawlamyaing hospital.

Roger, whose legs, left hand and eye have been ravaged by the disease, has found sanctuary there ever since.

Passing the time reading and leading the church choir, he said he has found happiness despite a lifetime of travails caused by the illness.

"I can continue to look forward," he added.

klm/apj/dwa

© 1994-2014 Agence France-Presse

New Zealand: Helping Burmese Refugees Start New Lives in New Zealand

20 August 2014 - 9:51pm
Source: Irrawaddy Country: Myanmar, New Zealand

By KYAW HSU MON / THE IRRAWADDY

Sparsely populated New Zealand could be said to be punching above its wait in terms of Burmese refugee intake. About 2,000 Burmese, largely coming from refugee camps on the Thai-Burma border, now live in the island nation of 4.4 million people.

Annie Coates, an ethnic Karen woman who has lived in the capital Wellington for more than 30 years, is helping those transplants adjust to life in the southern hemisphere, working with the refugee community on health, education and other social issues. In 2009, she received the Prime Minister’s Social Hero Award in recognition of her work.

Formerly with the ChangeMakers Refugee Forum, Coates now works independently, volunteering her time to teach English, assist with job hunting and even babysitting for refugees. The Irrawaddy spoke with Coates in Wellington about her role in supporting the Burmese refugee community in New Zealand.

Question: How do you help Burmese refugees in New Zealand?

Answer: I was working many jobs in the past, when Burmese refugees began coming to New Zealand in the 2000s. At that time, I took leave to help them. I was what’s called a cross-cultural worker. I helped them to rent houses and with health issues, because at that time, there was a language barrier in communicating with Kiwis [New Zealand citizens]. For social support, I helped them by, for example, staying overnight to babysit. I am not actually a qualified social worker, but just serve in a supporting role.

Most of them are young people and they do not have any relatives in New Zealand, so I become automatically their mother or grandmother. There are 38 children I have been taking care of here. And also I’m helping to recommend some Burmese who apply for visas to come here who are the wives or husbands of people here.

Q: How many Burmese are there living in New Zealand? Are they all refugees from the Thai-Burma border camps?

A: Almost 2,000 Burmese are living here. Mostly they are living in the biggest city, Auckland. More than half the total Burmese are living there. About 200 live in Wellington, and also Nelson. Most of them grew up on the Thai-Burma border, ethnic Karen and Kayah [Karenni] from Burma. But ethnic Chinese and Rakhine [Arakanese] are coming from Malaysia.

They might be economic refugees who are here to seek jobs. But they come here without a visa as there is a lot of corruption in Malaysia. There are many Burmese who queue in front of the UNHCR [UN High Commissioner for Refugees] office in Malaysia to get here. If someone is arrested by Malaysian police, the UNHCR issues refugee cards for them, so some are intentionally paying bribes to police to arrest them, so they can easily get refugee cards and come here. There are no official refugee camps in Malaysia, but there are detention facilities holding some Burmese people.

Q: Are you supporting all of them or do you have to be selective, given the number of Burmese refugees coming to New Zealand?

A: I am helping them through social humanitarian activities; there is not a political agenda. I support whoever needs support. I help them using my own money. While I was working in cross-cultural support in refugee services, there were barriers to helping them, like forbidding emotional attachment [to refugees]. That’s why after my contract ended, I decided to independently support Burmese refugees myself.

Q: Can these refugees become New Zealand citizens?

A: They have been granted permanent resident status. After five years, they can apply for citizenship here. After they have been granted citizenship, some people take a chance and move to Australia.

Q: What about job opportunities for Burmese refugees here? Is it easy for them to find employment?

A: There are a lot of job-seeking agencies for them here. After they get to New Zealand, they receive an orientation; they are taught the English language and also undergo a skills assessment. If they provide some information about their background [such as education and work histories] in Malaysia or Thailand, it’s easy to access jobs. But some people still have difficulties getting a job here. The problem is the language barrier, though there are many job vacancies here. Some people get a chance to study here while working at the same time. As long as they’re trying hard, staying here is good for them.

Q: Is it true that some Rohingya refugees are also coming to New Zealand?

A: I have heard about that, but no one here in Wellington. Some have lived on the Thai-Burma border for a long time as refugees. They are registered in the UN list as Karen, but the names on their ID cards are Muslim names. However they can speak the Karen language very well.

Myanmar: ‘Nationwide Ceasefire Will Happen This Year’

20 August 2014 - 9:45pm
Source: Irrawaddy Country: Myanmar

By MAY KHA/ THE IRRAWADDY

The Burmese government’s Union Peacemaking Working Committee (UWPC) and ethnic rebel groups’ Nationwide Ceasefire Coordination Team (NCCT) met to discuss the signing of a nationwide ceasefire agreement in Rangoon last week.

The two sides have since announced that they will convene again next month to continue efforts to draft a single-text ceasefire accord that would bring Burma one step closer to national reconciliation after decades of civil war. Following the meeting, The Irrawaddy spoke to Nai Hong Sar, the head of the NCCT, to discuss the current state of peace negotiations and future prospects for a nationwide end to hostilities between government troops and armed ethnic rebel groups.

Question: Some say the peace process has bogged down in recent months. Can you tell me what difficulties negotiators are facing and why progress appears to have slowed?

Answer: Every chapter from the single-text [ceasefire] requires a thorough discussion. It wasn’t very easy to get this far either. I know what the people are saying and I understand why. I want to ask them to be patient. At this point, we don’t have many difficulties left in the process.

Q: What do you think of the government’s peace efforts?

A: It has been great, but the ethnic people have identical points of view, and the government side doesn’t have the same opinions. It is formed of the military, Hluttaw [Parliament] and the government, so yes, I understand there could be different views. However, I have found that the recent meetings have been much improved.

Q:What were some of those differing opinions?

A: For example, the military didn’t want to approve use of the word ‘federal,’ just as they were not fond of wording like ‘equal rights’ and ‘self-determination.’ They didn’t seem to feel like amending these things.

Q: But now the UWPC has accepted the federal framework. Do you mean to say the military is not fully in support of this?

A: We will only know whether they accept this or not at the upcoming meetings.

Q: I’ve heard that some are worrying that the ethnic rebels will declare a revolution once the military has stopped firing. What can you say of such speculation?

A: If we don’t discuss, the shots will continue to be fired. If the meeting goes well, we do not have to fight anymore. It’s already been over 60 years [of conflict]. We are negotiating to cease the fire. We can ensure our word, and the government also needs to give us some guarantee [that it will honor a nationwide ceasefire].

Q: The government says everything is on the table, except anything that might compromise the integrity of the Union. How do ethnic minority groups view the issue?

A: Our ethnic rebel forces haven’t asked for secession, but rather federalism and equality. If we can’t have them, we will need to remain as armed rebel forces. If needed, we will secede. None of the ethnic rebel forces are looking to secede if they can get what they ask for. That’s the truth.

Q: Among the government, military and Hluttaw, which party has been most difficult to negotiate with?

A: Of course, it’s the military. All of them [military representatives] come here along with orders from their commander in chief. Things are a little bit more difficult since they have those orders from their superiors.

Q: Do you think a ceasefire would be durable, given that you’ve just now said it has been hard to negotiate with the military?

A: The Army is one of the three parties discussing it, along with the government and Hluttaw. Because they can’t be divided, I think they will accept this in a very short time.

Q: Then why is there still no response from the military?

A: It’s because they need time. We have a lot of things to go through precisely and thoroughly. What we have discussed so far has been very general.

Q:Do you honestly think that a genuine ceasefire can be achieved?

A: I can say that it will happen this year. But still, we haven’t decided who will join and be the witnesses yet.

Myanmar: Shan IDPs Petition for Army to Vacate Occupied Village

20 August 2014 - 3:28pm
Source: Irrawaddy Country: Myanmar

RANGOON— About 300 internally displaced persons (IDPs) in northern Shan State’s Kyaythee Township plan to submit a petition asking the Burmese Army to withdraw from their village, which troops have occupied since clashes with Shan rebels broke out more than one month ago.

Hla Shwe Thein, who is a committee member for the ethnic Shan IDPs in Tar Pha Saung village, told The Irrawaddy that all of those displaced wanted to go back to their homes, but were afraid to return because the military had set up a base there. The signature campaign is urging the Union and state governments to order the army to completely vacate the village.

“We collected around 300 signatures from the refugees. … We will send it to the Shan State government and Union government, and President Thein Sein, and [military commander-in-chief] Min Aung Hlaing,” Hla Shwe Thein told The Irrawaddy on Wednesday.

He said the villagers did not dare return with the army presence, which now includes defensive bunkers dug since the villagers fled. Troops have taken up residence in the villagers’ homes, he added.

The 300 IDPs have been staying at a Buddhist monastery since shortly after the fighting between the Burmese Army and Shan State Army-North broke out in late June.

Another clash between government troops and the SSA-North rebels took place on Aug. 8, according to local sources, forcing another 40 IDPs to seek refuge at the monastery. Since then conditions in the area have become more stable, leading the villagers to consider returning to their homes—but not while the military remains.

“The Burmese Army told them [the displaced villagers] to come back, but they do not dare to stay together with the army, and therefore they have not returned to their houses,” said Sai Hlaing Khan, who is chairman of the Shan National League for Democracy’s Kyaythee Township branch.

Exacerbating the anxieties of the homeless villagers are concerns that they may not have enough food to eat in the future because their displacement prevented them from planting crops during this year’s rainy season. The villagers hope to return to their homes in time to plant, but the window of opportunity to do so is shrinking.

The Burmese Army and SSA-North have occasionally clashed despite the two sides having signed a ceasefire agreement in January 2012. SSA-North leaders have claimed that the fighting has been due to Burmese Army encroachment in the rebel armed group’s area of control.

Viet Nam: Vietnam, Myanmar test patients for Ebola

20 August 2014 - 2:53am
Source: Agence France-Presse Country: Myanmar, Nigeria, Viet Nam

08/20/2014 09:46 GMT

HANOI, August 20, 2014 (AFP) - Vietnam and Myanmar are testing three patients for the deadly Ebola virus after they arrived in the Southeast Asian nations from Africa while suffering from fever, health officials said.

Two Nigerians were sent to Ho Chi Minh City's Tropical Diseases Hospital for isolation after they arrived in the city by plane, Vietnam's health ministry said, adding that they did not have symptoms other than fever.

Airline passengers sitting next to the pair -- who travelled to Vietnam on Monday from Nigeria via Qatar -- have been advised to monitor their own health.

In Myanmar a 22-year-old local man was taken to hospital in Yangon after arriving at the city's main airport on Tuesday, the Myanmar Centre for Disease Control and Prevention said in a statement on its official Facebook page late Tuesday.

It said he is believed to have returned from Guinea, having also travelled to Liberia, two of the countries worst hit by the Ebola outbreak.

Four people who accompanied the man to hospital were also being kept under observation, although they have not shown signs of illness.

"We have to send the samples to India for laboratory testing to see whether it is Ebola or not. The process will take three to four days," Tun Tin, deputy director of the ministry of health, told AFP.

He added that authorities were working closely with the World Health Organisation.

Myanmar, which began emerging from harsh junta rule in 2011, has one of the world's worst funded and poorly equipped healthcare systems, with many people cut off from even basic medical help.

The global death toll from Ebola stands at 1,229, with the bulk of cases in Liberia, Guinea and Sierra Leone.

The medical charity MSF has said the outbreak is moving faster than aid organisations can handle, while the World Health Organisation said the scale of the epidemic had been vastly underestimated.

Vietnam has introduced mandatory temperature checks at its two major international airports in Hanoi and Ho Chi Minh City to try to prevent passengers bringing the deadly virus into the country.

bur/klm/dr/sm

Thailand: New Rules to Help Burmese Migrants Apply for Passports

20 August 2014 - 2:16am
Source: Irrawaddy Country: Myanmar, Thailand

By NYEIN NYEIN

CHIANG MAI, Thailand — The Burmese Embassy in Thailand is revising procedures for Burmese migrants to receive regular passports, the Burmese government says.

The revision comes after many Burmese migrants were not able to apply for passports because they did not have a valid Burmese ID.

After seizing power in a May coup, the Thai junta launched a crackdown on illegal migrant workers, putting pressure on people to apply for proper documentation.

The Burmese Ministry of Labor announced on Monday that a 10-member committee of embassy officials and labor rights specialists would soon begin a “national verification process” to check the IDs of Burmese migrants in Thailand. Any migrant with a valid ID and household registration can apply for a regular passport, labor attaché Thein Naing told The Irrawaddy.

But many migrants did not bring their IDs or household registration with them when they left Burma. And in the aftermath of the coup, they have been reluctant to return home to retrieve this paperwork, fearing they might be stopped from coming back to Thailand.

Under the revised procedures for passport applications, migrants without IDs will need to return to Burma to acquire one. With a temporary stay permit issued from the Thai junta, they can make the trip and come back to Thailand without any trouble from law enforcement. The temporary stay permits were initially valid for only two months but were extended recently to March 2015 due to a backlog of applicants at one-stop service centers along the border.

According to the ministry’s statement, passports can be picked up at the embassy in Bangkok or at offices in three border towns: Tachileik, Myawaddy and Kawthaung.

Kyaw Thaung, a member of the national verification committee, as well as a director of the Myanmar Association Thailand, said he believed it would be ineffective to check for Burmese ID cards in Thailand because so many migrants lacked official documents. “I recommend continuing to implement the current temporary passport process,” he said.

Thein Naing, the labor attaché, urged Burmese migrants to apply whenever possible for an MoU passport, available to those who have already agreed to a contract with an employer in Thailand. “It is the most effective way to solve labor dispute problems,” he said.

According to official figures last year, there were 1.7 million Burmese migrants legally registered in Thailand, while migrant rights activists estimated another 1.3 million migrants were unregistered. The Thai government says 190,000 Burmese workers have now registered for temporary stay permits, while another 150,000 are expected to register soon.

Myanmar: Myanmar Staff Complete HALO Management Course

20 August 2014 - 1:45am
Source: HALO Trust Country: Cambodia, Myanmar

Eight men and women from Mon, Karen and Kayah ethnic groups in Myanmar have completed an extensive six-month training course in Cambodia. The newly trained staff then quickly went to work on an inaugural pilot survey project in Mon state

These are significant steps forward for mine action in Myanmar where, despite being one of the most heavily mine-impacted countries in the world, no clearance to international standards has taken place.

The future mine action managers recruited by HALO and Norwegian People’s Aid were trained, tested and qualified in mine risk education, minefield survey, mineclearance, Explosive Ordnance Disposal, para-medicine and project management with HALO’s experienced training team in Cambodia.

The recruits were selected on account of their educational qualifications, language abilities and aptitude for the task ahead as well as their area of origin, as HALO recruits from within the mine impacted communities. Between them they speak five ethnic minority languages (Mon, Karenni and three flavors of Karen) as well as Burmese and English.

Concurrently, our management continued its work with the Myanmar Peace Centre, within which the Myanmar Mine Action Center is being established, to draft national mine action standards and pave the way forward for a full survey and mineclearance programme.

Landmines are concentrated in the States around Myanmar’s borders with Thailand after decades of war between the government and ethnic minority armed groups. Their presence hinders the safe return of refugees and Internally Displaced Persons and restricts livelihood opportunities. Mine action will be vital to peace-building efforts by facilitating the return to displaced people, improving economic opportunities in affected ethnic minority areas and increasing physical security.

HALO would like to extend its thanks to Actiefonds Mijnen Ruimen for funding this project. As HALO’s programme in Myanmar continues to expand, these staff will no doubt play an ever more prominent role over the coming years in steering their country towards the ultimate goal; a peaceful and mine-free Myanmar.

World: Global Emergency Overview Snapshot 13 - 19 August

19 August 2014 - 10:54am
Source: Assessment Capacities Project Country: Afghanistan, Angola, Bangladesh, Burundi, Cameroon, Central African Republic, Chad, Côte d'Ivoire, Democratic People's Republic of Korea, Democratic Republic of the Congo, Djibouti, Dominican Republic, Eritrea, Ethiopia, Gambia, Guatemala, Guinea, Haiti, Honduras, Iraq, Jordan, Kenya, Lebanon, Lesotho, Liberia, Malawi, Mali, Mauritania, Myanmar, Namibia, Niger, Nigeria, occupied Palestinian territory, Pakistan, Paraguay, Philippines, Rwanda, Senegal, Sierra Leone, Somalia, Sri Lanka, Sudan, Syrian Arab Republic, Uganda, Ukraine, World, Yemen, South Sudan preview

Snapshot 13-19 August

Yemen: The 9 August Al Jawf ceasefire has been broken. Access to people affected by the conflict in Al Jawf is extremely limited due to persistent insecurity, and it is very difficult to obtain information. Almost 3,000 people have died in violence since the National Dialogue Conference took place on 25 January.

Syria: Government air strikes hit Islamic State positions in Ar-Raqqa, as well as Deir-ez-Zor and Aleppo, while IS advanced west towards the Turkish border, taking several villages from rival opposition groups. IS killed some 700 Sunni Sheitat tribe members, while an estimated 15,000 Yazidis fleeing IS in Iraq are seeking refuge in Al Hasakeh governorate.

Iraq: A Level 3 emergency was declared by the Inter-Agency Standing Committee. 17 million people, more than half the population, are affected by the ongoing violence, and 1.5 million need assistance. 200,000 people were displaced in the week of 4–11 August.

Updated: 19/08/2014. Next update: 26/08/2014

Global Emergency Overview Web Interface