Advertisement
Review| Volume 389, ISSUE 10081, P1841-1850, May 06, 2017

Download started.

Ok

The Rohingya people of Myanmar: health, human rights, and identity

  • Syed S Mahmood
    Correspondence
    Correspondence to: Dr Syed S Mahmood, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
    Affiliations
    Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Cardiology Division, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
    Search for articles by this author
  • Emily Wroe
    Affiliations
    Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Division of Global Health Equity, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA

    Partners In Health, Boston, MA, USA
    Search for articles by this author
  • Arlan Fuller
    Affiliations
    FXB Center for Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
    Search for articles by this author
  • Jennifer Leaning
    Affiliations
    FXB Center for Health and Human Rights, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA

    Physicians for Human Rights, Boston, MA, USA
    Search for articles by this author
Published:December 01, 2016DOI:https://doi.org/10.1016/S0140-6736(16)00646-2

      Summary

      The Rohingya people of Myanmar (known as Burma before 1989) were stripped of citizenship in 1982, because they could not meet the requirement of proving their forefathers settled in Burma before 1823, and now account for one in seven of the global population of stateless people. Of the total 1·5 million Rohingya people living in Myanmar and across southeast Asia, only 82 000 have any legal protection obtained through UN-designated refugee status. Since 2012, more than 159 000 people, most of whom are Rohingya, have fled Myanmar in poorly constructed boats for journeys lasting several weeks to neighbouring nations, causing hundreds of deaths. We outline historical events preceding this complex emergency in health and human rights. The Rohingya people face a cycle of poor infant and child health, malnutrition, waterborne illness, and lack of obstetric care. In December, 2014, a UN resolution called for an end to the crisis. We discuss the Myanmar Government's ongoing treatment of Rohingya through the lens of international law, and the steps that the newly elected parliament must pursue for a durable solution.
      This article is available free of charge.
      Simply log in to access the full article, or register for free if you do not yet have a username and password.
      Already registered?
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'
      Not yet registered?
      Register for free

      References

      1. 1.
        • Clark J
        UN implores South East Asian nations to help starving migrants stranded at sea.
        BMJ. 2015; (published online May 19.)https://doi.org/10.1136/bmj.h2728
      2. 2.
        • Salama P
        • Spiegel P
        • Talley L
        • Waldman R
        Lessons learned from complex emergencies over past decade.
        Lancet. 2004; 364: 1801-1813
      3. 3.
        • Nieburg P
        • Waldman RJ
        • Krumm DM
        Evacuated populations—lessons from foreign refugee crises.
        N Engl J Med. 2005; 53: 1547-1549
      4. 4.
        • United Nations High Commissionier on Refugees
        UN refugee agency launches campaign to eliminate statelessness within 10 years. United Nations News Centre, Geneva, Switzerland2014
      5. 5.
        • Myanmar
        Population and Housing Census of Myanmar, 2014 (Vol I). Government of Myanmar, Nay Pyi Taw2014
      6. 6.
        • United Nations High Commissioner on Regufees
        War's human cost: UNHCR—global trends 2013. United Nations High Commissioner on Refugees, Geneva, Switzerland2013
      7. 7.
        • Agency CI
        The World Factbook: Burma. Central Intelligence Agency, 2016 (accessed Oct 13, 2016).
      8. 8.
        • Buchanan F
        A comparative vocabulary of some of the languages spoke in the Burma Empire.
        Asiatic Researches. 1799; 5: 219-240
      9. 9.
        • UN
        Situation of human rights in Myanmar: resolution adopted by the General Assembly on 29 December 2014. A/RES/69/248. United Nations, Geneva, Switzerland2014
      10. 10.
        • McGovern J
        H. RES. 418, urging the Government of Burma to end the persecution of the Rohingya people and respect internationally recognized human rights for all ethnic and religious minority groups within Burma.
        (accessed June 29, 2016).
      11. 11.
        • Sollom R
        • Parmar P
        Stateless and starving: persecuted Rohingya flee Burma and starve in Bangladesh. Physicians for Human Rights, Washington, DC2010
      12. 12.
        • European Parliament
        Resolution 2013/2669(RSP) of 13 June 2013 on the situation of Rohingya Muslims. European Parliament, Strasbourg2013
      13. 13.
        • Adams B
        Letter to President Thein Sein. Re: amending the 1982 Citizenship Law. Human Rights Watch, New York, NY2015
      14. 14.
        • Myo M
        Final report of inquiry commission on sectarian violence in Rakhine State. Republic of the Union of Myanmar, Myanmar2013
      15. 15.
        • Chan A
        The development of a Muslim enclave in Arakan (Rakhine) State of Burma (Myanmar).
        SOAS Bull Burma Res. 2005; 3: 396-420
      16. 16.
        • Lee Y
        Report of the Special Rapporteur on situation of human rights in Myanmar (A/69/398, dt Sep 23, 2014). United Nations General Assembly, Geneva, Switzerland2014
      17. 17.
        • Bennison JJ
        Census of India, 1931. Office of Superintendent, Government Printing and Stationery, Burma, Rangoon1933
      18. 18.
        • Transnational Institute
        Ethnicity without meaning, data without context: the 2014 census, identity and citizenship in Burma/Myanmar. Transnational Institute, Amsterdam2014
      19. 19.
        • Fortify Rights
        Policies of persecution: ending abusive state policies against Rohingya Muslims in Myanmar. Fortify Rights, Aurora, CO2014
      20. 20.
        • Government of Burma
        Pyithu Hluttaw Law No 4 of 1982 (Burma Citizenship Law). Government of Burma, Rangoon1982
      21. 21.
        • Wijnroks M
        • Bloem MW
        • Islam N
        • et al.
        Surveillance of the health and nutritional status of Rohingya refugees in Bangladesh.
        Disasters. 1993; 17: 348-356
      22. 22.
        • Lindblom A
        • Marsh E
        • Motala T
        • Munyan K
        Persecuation of the Rohingya muslims: is genocide occuring in Myanmar's Rakhine State? Yale Law School & Fortify Rights, New Haven, CT2015
      23. 23.
        • Physicians for Human Rights
        Patterns of anti-Muslim violence in Burma: a call for accountability and prevention. Physicians for human rights.
        (accessed Oct 13, 2016).
      24. 24.
        • Human Rights Watch
        Burma: new violence in Arakan State. Oct 25, 2012. Human Rights Watch, New York, NY2012
      25. 25.
        • Simpson I
        Dalai Lama Decries Buddhist Attacks On Muslims In Myanmar. Huffington Post. United States ed. Huffington Post.
        (accessed Aug 18, 2016).
      26. 26.
        • OCHA
        Humanitarian bulletin: Myanmar. United Nations Office for the Coordination of Humanitarian Affairs, Geneva, Switzerland2013
      27. 27.
        • Shwe Man TR
        Development of Rakhine State. In: (Parliament) HoR, editor. Soe, Kyaw ed. Nay Pyi Taw, Myanmar: Republic of the Union of Myanmar, 2013: 30.
        (accessed Aug 16, 2016).
      28. 28.
        Burma: Foreigners Act, 1864. 12 February 1864.
        (accessed Aug 23, 2016).
      29. 29.
        • European Commission's Humanitarian Aid and Civil Protection Department
        The Rohingya crisis. European Commission, Brussels2014
      30. 30.
        • United Nations High Commissioner on Refugees
        South-East Asia: irregular maritime movements (Jan–Nov 2014). United Nations, Geneva, Switzerland2014: 1-8
      31. 31.
        • United Nations High Commissioner on Refugees
        Rohingya refugees and asylum-seekers in India: a situational analysis. United Nations, New Delhi2014: 1-11
      32. 32.
        • Médicins Sans Frontières
        Myanmar: restrictions severely impacting access to health care. May 27, 2013. Médecins Sans Frontières, Amsterdam2013
      33. 33.2014 UNHCR country operations profile—Bangladesh. United Nations High Commissioner on Refugees, Geneva, Switzerland2014
      34. 34.
        • UN General Assembly
        Convention relating to the status of refugees, 28 July 1951. United Nations, Geneva, Switzerland1951
      35. 35.
        • United Nations High Commissioner on Refugees
        States parties to the 1951 convention relating to the status of refugees and the 1967 Protocol. United Nations, Geneva, Switzerland2015
      36. 36.
        • Akhter S
        • Kusakabe K
        Gender-based violence among documented Rohingya refugees in Bangladesh.
        Indian J Gender Studies. 2014; 21: 225-246
      37. 37.
        • Myanmar: GDP per capita
        • PPP
        World Bank, 2010.
        (accessed Oct 12, 2016).
      38. 38.
        • UNICEF
        Rakhine State: a snapshot of child wellbeing. UNICEF, New York, NY2012
      39. 39.
        • UN
        Non-discrimination in economic, social and cultural rights: UN Committee on Economic, Social and Cultural Rights. United Nations, Geneva, Switzerland2009
      40. 40.
        • Sen A
        Violence, identity and poverty.
        J Peace Res. 2008; 45: 5-15
      41. 41.
        • Médecins Sans Frontières
        The ongoing humanitarian emergency in Myanmar's Rakhine State. Feb 6, 2013. Médecins Sans Frontières, Amsterdam2013
      42. 42.
        • Hickox K
        Myanmar: delivering care to isolated Rohingya. July 23, 2009. Médecins Sans Frontières, Amsterdam2009
      43. 43.
        • Philippines Go
        Comparative Wages in Selected Countries: July 29, 2016.
        in: Employment DoLa Government of Philippines, Manila, Philippines2016: 2 (accessed Oct 16, 2016).
      44. 44.
        • Myo M
        Final report of Inquiry Commission on Sectarian Violence in Rakhine State. Republic of the Union of Myanmar, Myanmar2013 (accessed Aug 6, 2016).
      45. 45.
        • Médecins Sans Frontières
        Myanmar: violence and intimidation leave tens of thousands without medical care. Médecins Sans Frontières, Amsterdam2013
      46. 46.
        • Médecins Sans Frontières
        Myanmar: encouraging dialogue on rakhine, but clinics remain closed. Médecins Sans Frontières, Amsterdam2014
      47. 47.
        • United Nations High Commissioner on Refugees
        South-East Asia: irregular maritime movements (April–June 2015). United Nations, Geneva, Switzerland2015: 1-8
      48. 48.
        • United Nations High Commissioner on Refugees
        South-East Asia: irregular maritime movements (Jan–March 2015). United Nations, Geneva, Switzerland2015: 1-6
      49. 49.
        • Human Rights Watch
        Southeast Asia: end Rohingya boat pushbacks. Human Rights Watch, Bangkok2015
      50. 50.
        • Office to Monitor and Combat Trafficking in Persons
        Thailand: 2014 trafficking in persons report. US Department of State, Washington, DC2014
      51. 51.
        • Teng TS
        • Mohd Shariff Z
        Nutritional status of Rohingya children in Kuala Lumpur.
        Malay J Med Health Sci. 2011; 7: 41-49
      52. 52.
        • Fuller T
        Myanmar to bar Rohingya from fleeing, but won't address their plight. NY Times, New York, NY2016 (accessed Aug 8, 2016).
      53. 53.
        • UNICEF
        Malaysia: maternal, newborn & child survival. UNICEF, New York, NY2012
      54. 54.
        • WHO
        Child growth standards and the identification of severe acute malnutrition in infants and children: a joint statement. World Health Organization, Geneva, Switzerland2009: 11
      55. 55.
        • UNICEF
        Child and maternal nutrition in bangladesh. UNICEF, New York, NY2009
      56. 56.
        • United Nations High Commissioner on Refugees
        Workshop on operational guidance on the use of special nutritional products to reduce micronutrient deficiencies and malnutrition in refugee population. UNHCR and WFP Presentation from Bangladesh. United Nations, Geneva, Switzerland2012: 35
      57. 57.
        • Médecins Sans Frontières
        10 year of the Rohingya refugees in Bangladesh: past, present and future. Médecins Sans Frontières, Amsterdam2002
      58. 58.
        • Khan M
        • Munshi M
        Clinical illnesses and causes of death in a Burmese refugee camp in Bangladesh.
        Int J Epidemiol. 1983; 12: 460-464
      59. 59.
        • Aall C
        Disasterous international relief failure: a report on Burmese refugees in Bangladesh from May to December 1978.
        Disasters. 1979; 3: 429-434
      60. 60.
        • The Sphere Project
        Humanitarian charter and minimum standards in humanitarian response. The Sphere Project, Hampshire2011
      61. 61.
        • UNICEF
        Bangladesh: neonatal and child health country profile. UNICEF, New York, NY2013
      62. 62.
        • Gurpreet K
        • Tee GH
        • Amal NM
        • Paramesarvathy R
        • Karuthan C
        Incidence and determinants of acute diarrhoea in Malaysia: a population-based study.
        J Health Popul Nutr. 2011; 29: 103-112
      63. 63.
        • WHO
        Mortality and burden of disease: malaria. World Health Organization, Geneva, Switzerland2013
      64. 64.
        • WHO
        Use of high burden country lists for TB by WHO in the post-2015 era. World Health Organization, Geneva, Switzerland2015
      65. 65.
        • United Nations
        Millenium development goals indicators.
        (accessed July 17, 2015).
      66. 66.
        • Regional Order 1/2005—Addendum
        Drawing maps, making a record of buildings, and reviewing household registrations. Letter No: 3/24-1/U 6 (1057). Township Peace and Development Council, Rakhine Government of Myanmar, Maungdaw2005
      67. 67.
        • International Court of Justice
        Declarations and reservations to the convention on the prevention and punishment of the crime of genocide. International Court of Justice, The Hague1989
      68. 68.
        • Prosecutor vs Jelisic
        Case No IT-95-10-T, Judgment, 82 (Dec 14, 1999). Citing Report of the International Law Commission on the work of its forty-eighth session, 6 May–26 July 1996, GAOR, 51st session, Supp No 10 (A/51/10) (1996). International Court of Justice, The Hague1999
      69. 69.
        • Ramzy A
        After Myanmar election, few signs of a better life for muslims.
        New York Times. Nov 18, 2015;
      70. 70.
        • Paddock RC
        Aung San Suu Kyi asks U.S. not to refer to ‘Rohingya’.
        New York Times. 2016; (accessed Aug 16, 2016).
      71. 71.
        • Office SC
        Establishment of the advisory commision on Rakhine state. Government of Myanmar, Nay Pyi Taw, Myanmar2016 (accessed Nov 17, 2016).
      72. 72.
        • Board E
        Ending the horror of Myanmar's abuse of Muslims.
        The New York Times (New York, NY). Nov 18, 2015; (accessed June 29, 2016).

      Linked Articles

      • Department of Error
        • Mahmood S S, Wroe E, Fuller A, Leaning J. The Rohingya people of Myanmar: health, human rights, and identity. Lancet 2016; 389: 1841–50—On page 7 of this Review, the text should have read “The maternal mortality ratio in the Rohingya-predominant northern region of Rakhine State is 380 per 100 000 livebirths, compared with 178 per 100 000 livebirths across Myanmar”. This correction has been made to the online version as of Dec 12, 2016, and the printed Review is correct.
        • Full-Text
        • PDF
      • Department of Error
        • Mahmood S S, Wroe E, Fuller A, Leaning J. The Rohingya people of Myanmar: health, human rights, and identity. Lancet 2016; 389: 1841–50—On page 5 of this Review, the text should have read “A Myanmar Government report 44 noted that, in the Rohingya-predominant northern region of Rakhine State, both Maungdaw and Butheetaung townships have only one physician each (serving 158 000 people combined)…” This correction has been made in the online version as of May 4, 2017, and the printed Review is correct.
        • Full-Text
        • PDF
      • WHO and the health crisis among the Rohingya people of Myanmar
        • Syed Mahmood and colleagues1 (Dec 1) barely mention WHO in their analysis of how the Myanmar Government's persecution of the Rohingya people has created a health crisis. WHO categorises the situation in Rakhine State as a protracted humanitarian emergency in its 2016 Humanitarian Response Plans.2 The 2013 Emergency Response Framework states that WHO should have a leading role in responding to the health aspects of such crises and pay “special attention to vulnerable and marginalised groups”.3 However, in practice WHO is doing little to resolve the health crisis and does not specifically refer to the Rohingya—a term not recognised by the Myanmar Government—in its latest Humanitarian Response Plans or Country Cooperation Strategy.
        • Full-Text
        • PDF
      View full text