Psychosocial Support Myanmar 2017-18
From December 2016-January 2018 I have made several trips to Myanmar-also known as Burma. It is a stunningly beautiful country with more than 135 different languages spoken (Burmese being the official one). It borders India, Bangladesh, China, Thailand and Laos. It is punctuated by stunning golden Pagodas, Stupa’s and Buddhist statues, mountains, lakes, deserts, beaches, forests, and ancient ruins.
It’s got something for any curious traveller. The language is artistic, and the people full of smiles and laughter, particularly as I, at 5ft 9” was considered a semi-giant, trying to negotiate the night markets designed for an average height of 5 foot. At the same time there was a kind of proud defiance to the people, which I couldn’t help but like and respect.
When you first arrive in Yangon (previously Rangoon) you are immediately treated to the friendliness of the people with the extremely helpful and friendly visa processing staff inhabiting a brand new airport terminal. The city itself has similarities to the ever sprawling and odorous Bangkok, and its endless traffic jams. However, it isn’t long before you are treated to the splendid glittering site of Shwedagon Pagoda, a huge gold circular structure, the most revered Buddhist site in Myanmar, and possibly the oldest Buddhist Stupa in the world: A place that would be occupied for over 70 years by the British, and a site of gatherings and civil disobedience preceding key changes in the countries history including protests against British rule, and latterly against the military government.
Thinking about Burma / Myanmar you probably make the link with Aung San Su Kki the Nobel Peace Prize winner (1991) who was put under house arrest for fifteen years, was finally released, and is now State Counsellor of the newly elected Government. (She isn’t the President as might be expected, as her marriage to a British man, an ‘inter-faith’ marriage precludes her from that role.) You may also think about Burma being part of the ‘British Empire’, (1824-1948) or maybe you’ve heard of the infamous death railway, where over 61,000 people perished, whilst the country fell under Japanese rule during the Second World War (1943-5)(The historical episode was recently brought to life in the film: ‘The Railway Man’ starring Colin Firth). You may imagine an exotic country hidden from the world for over forty years, a place of intrigue, ancient kingdoms and monks. You may remember images from 2007 of ‘warrior monks’ in violent clashes with their Muslim neighbours. And more recently you may have been aware of the international outcry of the plight of the Rohingya people in Rakhine state fleeing to Bangladesh to escape military ‘operations’ in the area.
What you may not know is that it was Aung San Su Kki’s father that negotiated the independence of Burma from the British. He had made a settlement with the numerous ethnic groups on the border areas, aiming for a united and peaceful Burma, offering them autonomy and a voice in the new Government. However, months before independence finally took place in 1948, he along with six of his cabinet, were murdered. What has followed has been one of the longest civil wars in history as the ethnic groups who were promised autonomy and a voice in the new Burma by him, were then denied these rights upon successive governments and ultimately military rule.
An issue common to many of the armed struggles within Myanmar, along its borders, has been the generic use of landmines as a tactic of control and terror. Nine of its fourteen states are currently contaminated. Princess Diana raised the profile of the issue and impact of landmines, and her work with the Halo Trust added to one of the most effective advocacy campaigns in history bringing about the Landmine Ban Treaty in 1997. This Treaty requires signatories to:
1. Never use antipersonnel mines, nor to “develop, produce, otherwise acquire, stockpile, retain or transfer” them.
2. Destroy mines in their stockpiles within four years.
3. Clear mined areas in their territory within 10 years.
4. Conduct mine risk education and ensure that mine survivors, their families and communities receive assistance.
5. Offer assistance to other States Parties, for example in providing for survivors or contributing to clearance programs.
6. Adopt national implementation measures in order to ensure that the terms of the treaty are upheld in their territory.
One hundred and sixty two countries are now signed up to the Treaty, with only 35 countries remaining outside of it. Myanmar is one of these countries. It has the third highest casualty rate in the world with over 3745 casualties between 199 and 2014. However, this number is considered to be a drastic underestimate of the reality. Many factors preclude accurate records or injuries, including lack of co-ordinated data management systems, and in Myanmar, those unlucky enough to step on a mine actually become liable to paying for it. As many of the conflicts are occurring in border rural areas, where there is not only limited access to health care, but also where people are particularly likely to be experiencing poverty, paying compensation for a landmine either to the government or to a business (landmines cost only $3 to buy and are used by businesses to protect their sites of operation.) is something that can be ill afforded-let alone the cost of health treatment, recovery, and loss of ability to work. In this way, people are reluctant to report officially injuries received.
There is a considerable amount of work going on in Myanmar to mitigate against the risks of new casualties via emergency education sessions being delivered to villages about the risks of landmines in their area. Education is essential as people are displaced by conflict, and often the whereabouts of mines are not known. Also, there are some particularly heinous tactics adopted by armed groups like making the landmines look like toys, so that they are particularly attractive to children. Education is hampered by the rainy season, which dislodges the mines and alters their location. Also language barriers are a huge problem, as many local ethnic groups only speak their own local language and do not understand some of the key messages if they are delivered in Burmese. Local teams risk their lives to get information out as quickly as possible to their communities and face being stopped and questioned and even kidnapped by armed groups whilst out in remote areas. Whilst in villages, as well as offering education sessions, they also document those affected by landmines and refer them for assistance. This is usually provided by the UN or by various international non-governmental organisations. Support can be for travel to health clinics, healthcare, prosthetic limbs, disability, or livelihood support. Victims and their families are also eligible for psychosocial and mental health support. Although the latter is in poor supply, with only five Clinical Psychologists available in the whole country.
My work in Myanmar was about training the emergency training teams on how to effectively manage the distress of the local population who are facing displacement, violence and injuries, and to provide basic psychosocial support. I also train them to know how to refer effectively for ‘victim’ support services. Collecting data from the landmine victims or their families has to be done in very sensitive ways with high awareness about the use of language, and a sensitivity that answering questions can be distressing, and also frightening. People may be afraid to admit their injuries, especially to international organisations for fear of where information will go, and either being charged for destruction of the landmines or for fear of reprisals from armed groups.
I also work with the team on techniques for self-care and burnout prevention. The work the teams are doing can lead a ‘secondary traumatisation’ and burnout-so learning stress management techniques are very important. I wasn’t able to go deep into the villages to do a psychosocial assessment as re-newed fighting broke out. Armed Helicopters were flying over-head and there were clearly military operations taking place in the area where I was. I will be returning to the area in March to follow up with more training and hopefully will be able to carry out the assessment. Behind the scenes, advocacy is taking place and it is hoped that in due course landmine clearance teams will be allowed in to border areas to begin the task of removing the mines and other remnants of the war. With a new political dawn hopefully there will be progress towards peace between the government and the ethnic groups, and change will come to this truly amazing country.
I personally can’t wait to go back. Of all the countries I have worked around issues of post conflict recovery and peace building in Africa, Middle East and now Asia, this one has well and truly captured both my imagination and my heart.
For more information about what you can do in the on-going campaign to eradicate the world of the blight of landmines forever visit the International Campaign to Ban Landmines: http://www.icbl.org/en-gb/home.aspx