Humanitarian and medical aid

The first of these broader factors are the forms of emergency medical, humanitarian and health-development programs provided by international and national NGOs and UN agencies in-country. The first NGOs to begin work in Burma, Médecins sans Frontières and World Vision International, began operations in 1992. Aid provision within Burma has been scaled up significantly in the past five years, despite international economic sanctions against the regime and the limited mandates of organisations such as the International Labour Organisation (ILO), the UN Development Program (UNDP) and the UN Office on Drugs and Crime (UNODC). The politicised nature of aid and the restrictions on international aid workers have meant that community-based and local NGOs have become channels for aid. It also means that many aid agencies have aligned themselves with government organisations in quasi-partnerships that have significant ethical dimensions. Transparency and impartiality have thus been key to the continuing effort to expand aid and monitoring by UN agencies in recent years.

A recent rapid appraisal of the humanitarian situation in Burma has noted that the humanitarian situation needs to be reconceptualised from one of human security to one of social security, emphasising the need for and partial success in recent years of the UN agencies and other organisations in pushing back or at least containing the Burmese state’s continuing attempt to penetrate all aspects of the civil sphere (Duffield 2008). Duffield (2008:41) argues for a rationalisation of international aid architecture in Burma to ‘increase the range and depth of social welfare support’. This suggestion is all the more cogent given the State Peace and Development Council’s (SPDC) increasing view of many forms of international humanitarian aid as either potentially or actively subversive of the military’s continuing rule.

Duffield’s report highlights the fragile, broken and often non-existent public welfare and health system in Burma and the significant role that international aid is playing in propping up, extending and establishing basic health services in the absence of a public welfare system.