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“They had long shoots of bamboo and were pushing down on her abdomen,” one of the Young Leaders in the Bush Institute’s Liberty and Leadership Forum recalled.  He spoke emotionally of witnessing untrained medical attendants assisting a woman giving birth in a remote area of Burma, also known as Myanmar.


The other 17 participants from Burma listened attentively.  They had stories, too.


Another recounted the incident that paralyzed his right leg and made him unable to walk for several years.  “The doctor injected my leg with something.  I don’t know what it was.  We tried to sue him, but he destroyed all the documents.”  The young man can now walk with the assistance of a brace after his grandfather treated him using traditional medicine.


After emerging from decades of authoritarian rule by a brutal military junta, the health care system in Burma is broken.  Burma ranks 150 out of 187 countries in the United Nations Human Development Index which measures health, knowledge and standard of living across the world.  With life expectancy at 65, Burma compares globally with countries like Angola, Rwanda, and Cameroon.  The average for East Asia and the Pacific is 74.


Residents in rural areas of Burma lack access to proper medical care.  Care remains elusive even to those living in bustling cities due to its high cost.  Patients who go into a state hospital for a vaccination must pay for the syringe, the alcohol used to sterilize their skin, even the cotton ball and bandage used to cover the wound.  According to the most recent statistics from the World Health Organization (WHO), Burma spends just $19.80 per person on health each year.  France, on the other hand, spends $3,608.70 per capita annually.


The problem is especially acute in Rakhine State, the westernmost province of Burma.  Rakhine is one of the most destitute parts of Burma.  Since 2012, communal violence between the ethnic and religious Rakhine Buddhist majority and the Rohingya Muslim minority has wreaked havoc in the region.  At least 280 have been killed and thousands of homes destroyed due to the violence.  The United Nations estimates that 130,000 Rohingya are trapped in refugee camps that lack access to adequate food and medical care.


In February, the government expelled Doctors Without Borders, also known by its French acronym MSF, from Rakhine State for allegedly favoring the Rohingya minority.  In fact, this is the population that needs the most basic but critical services MSF provides.  Conditions in the Rohingya refugee camps have been documented by many international reporters, with heartbreaking pictures of the suffering widely publicized.


Just days ago Burmese officials announced that MSF would be allowed to resume operations in Rakhine State.  While a welcome move, Burma’s government must make the protection of minority rights a higher priority in its liberalization efforts.  How a nation treats its most marginalized populations is a key indicator of true democracy.


Elizabeth Hoffman is the Program Manager for Human Freedom at the George W. Bush Institute.