Myanmar (Burma)

Burma, now officially known as the Union of Myanmar, is located on the Andaman Sea in Southeast Asia. It is bordered by China, Laos, Thailand, Bangladesh and India. Once a British colony, Burma has suffered repeated bouts of political upheaval and coup d'etats since winning independence in 1948. The country has been under the control of a military junta since 1988.

The population is 47,400,000 and growing at 0.815 percent annually. The birth rate is 17.48 per 1,000 and the death rate is 9.33 per 1,000. Median age is 27.4 years. Life expectancy is 60.29 years for males and 64.83 years for females. Gross national income is $220 per person, with about a quarter of the population living in poverty. While Myanmar is rich in natural resources, [Page 1155]inefficient governmental policies and political unrest has inhibited growth.

Endemic disease comprises a substantial part of the health burden carried by the Burmese people. Poor water and sanitation and overcrowded living conditions throughout the country leads to frequent outbreaks of cholera, plague, dengue hemorrhagic fever, diarrhea, dysentery, typhoid, viral hepatitis, meningitis, and malaria. The tuberculosis rate is 170 cases per 100,000. While the rate of new AIDS infections may be in decline, at 1.3 percent prevalence, it remains among the most serious AIDS epidemics in Southeast Asia, with an estimated 360,000 Burmese infected.

While there have been some positive trends in improving the health of the people, the progress is fragile. As Myanmar modernizes, the disease burden is shifting to non-communicable disorders stemming from lifestyle changes, including increased tobacco, drug, and alcohol use. Increased urbanization alone is leading to a more traffic accidents, industrial mishaps, and violence. Health education is poor, particularly in rural areas, where people tend to rely on local cures and miracle injections from unlicensed sources.

Child mortality has declined slightly since 1990, with 75 deaths per 1,000 for infants and 105 deaths per 1,000 for children aged 1–5. Acute respiratory infections and diarrhea are the leading causes of under-5 deaths. About 32 percent of children are underweight and stunted. While school enrollment is up, less than 50 percent of children finish primary school. Children go to work in factories or teashops, where they are easily abused or underpaid. An unknown number are trafficked into sex slavery in the region's many red-light districts.

Women in Myanmar have stood at the forefront of the pro-democracy movement, and many have paid the price with imprisonment, torture, rape, forced labor, and relocation. As with children, women are easily exploited as workers or forced into prostitution. The fertility rate is low at 1.95 children per woman, despite a 34 percent contraception prevalence. Three quarters of pregnant women receive prenatal care, and 57 percent have a trained attendant at birth. The maternal mortality rate is 360 deaths per 100,000 live births.

The military government has worked to improve healthcare, increasing medical personnel and the number of hospitals and rural clinics. It has also improved epidemiological surveillance and emergency response to natural disasters.

There are 17,800 physicians, 9,900 nurses and 39,400 midwives working in Myanmar today. Government expenditures on healthcare is $0.60 per capita, with most healthcare costs borne by the patients themselves.

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