In an exclusive interview with Karen News, Saw Nay Htoo, director of the Burma Medical Association explains why its important ethnic health organizations should be providers of healthcare services to ethnic communities. He points out that Burma is a country where government healthcare provision is almost non-existence and why ethnic organizations need to be involved in reforming Burma’s ailing healthcare system.
Saw Nay Htoo spoke to Karen News following an ethnic health organizational forum held in the last week of June, 2017.
“This [forum] is related to the HSS (Health System Strengthening) we recognize as the steering committee assembly that it needs strengthening. Therefore, within the steering committee we aim for the work that we have done to show the transparency and improvement among us. We came together to share our views. Secondly, we came to cooperate for the strengthening and improving the health care system.”
“The main issues that we discussed were related to the ACCG’s works such as the meeting with Myanmar Ministry of Health’s to discuss the functioning for the health care system. Secondly, we discussed about how much HSS’ project works have been improving and how much we need to cooperate more. Thirdly, we discussed about the function of the health care system.”
“The cooperation and participation of ethnic health organizations are important and is really essential. In the past 2, 3 or 4 decades as well as during the [armed] conflict period, the ethnic health organizations have been working among their own community or ethnic nationalities [to provide] health care and treatment.”
“Because of the political reforms taking place in Burma, many people say the healthcare system in Burma should be reformed and reorganized. If so, the country needs to have cooperation [with ethnic groups] because it’s not only Burman who live in Burma. There are many ethnic groups who live in Burma. There needs to be an improvement of the national health system as well as services that include the participation of ethnic health organizations – this is really important because ethnics have their own large areas and the Burma government cannot cover all of these areas. Because of the lack of [government] coverage, ethnic health organizations provide health care on their own as much as possible.”
“For us to build up a federal union, it’s important to start to meet and discuss about the health care system development. I think, ethnic health organization’s participation in this is the most important thing.”
“At the meeting with the Myanmar Ministry of Health, meeting we started with only programs like minor health care services. We have started to meet and discuss about the issues, but as I have mentioned, we have not moved to any of the ful discussion on the level of health care system. It is essential for us to meet, discuss and form the uniformity of health care organization and system which is really important. Because of the different views and perspectives, we set up our health care system based on community-based [needs]. Secondly, we set up our health care system based on power sharing – not just the government alone should have all the healthcare related power – but other ethnics have its own organizations and health care organizations so it is really essential [for them] to have some healthcare related power. It means that the centralization of health care approach, the union government should not only hold the power, but it is also essential for the state government to have power related to heath care. Secondly, the health care based on ethnics should obtain their own rights and authority over their own healthcare provision.”
“We can say that there are challenges. For example, we will talk about an example like we, ethnics (Karen) related to treatment of eyes’ mission. Some people may have heard about the case in Karen state where the Ministry of Border Affairs declared an official letter forbidding us. These kind of issues, we have never seen and heard about it in the past. After we started our work, there is a consent permission for travelling as an example and it’s happened one time, two times and three times. It is like an obstacle. In the past, we did not need to get permission, we travelled on our own and supported our community and population.”
“Secondly, I want to say that during this time, we call it [the] transition period. On the side of government during the transition, they should have the discussion about the establishment of the hospitals or clinics with each ethnic group. It seems that the situation at the moment, because they have money, they come and build many hospitals, like many RHC (Rural Health Centers) have increased. We say that just only in the Karen state, there are other states as well, we do not access to all the data and information, so we can not say exactly but within Karen state, there are many RHC. I believe one thing during the transition period, I think, there should be meetings and discussions. It is not right to do what you want, and it is not right to do when you have power and strength. We have to be careful during the peace process, we need to be careful not to hurt the peace process.”
“If there are no equal rights, the same thing could happen. Both sides should understand and be humble to have equality. If not, these kinds of issues will happen again and again. Equality is the most important. For example, you negotiate and [if] you do not have equal rights it is meaningless. I think, both sides should be humble and should understand and respect equal rights.”
“What we try to work for ethnic health system is important for our ethnic groups in order to be able to form [a] federal union and to be able to include the needs of all ethnics in a federal union, we, health organizations, our mission, and our partners would like to form a health system based on a federal union. It is the most important. For forming the system, everyone has a responsibility. One important thing is that the leadership of the ethnic politics needs to be good and it is really important for them to understand and support the health care system based on a federal union. They should understand and support in order for it to be sustain. And one day, we will exist with equality and unity, which is really important.”