Wednesday, January 18, 2012

Health status of Burmese refugees in India

Burmese refugees in India are of poor families living in substandard condition with insufficient health care system in a foreign developing country which also ranks low. Many of them come from the remote areas of Burma which are underdeveloped and neglected by the governments for decades. The level of education and economy as well as health status are extremely low and all asylum seekers are prone to infectious diseases. When arrived in Delhi there are new facilities available but it is awfully insufficient.

As per mandate the UNHCR provides health assistance to the recognized ones. There are hundreds of unrecognized. Burmese refugees do not know how the government of India helps for their in health. There are a couple of NGOs which are partners of the UNHCR to assist Burmese refugees. However, recently there have been noisy complaints against those NGOs for corruption, discrimination, inefficiency and etc. The complaints by Burmese refugees could not be wrong because previously one health NGO of such had been disallowed.

Burmese refugees are encouraged to seek medical treatment from government hospitals and dispensaries. However they don’t get what they deserve. Professionally speaking apart from long queue, difficulties in communication, discrimination, the quality of health care is questionable. Recently a Burmese pregnant mother who is hepatitis B positive had unexplained and unfortunate labor process at a government hospital. It is learnt that unprofessional persons pushed with force the pregnant abdomen and the patient had to be transfused with 10 units of blood after labor and followed by post-delivery emergency laparotomy.

To promote health, Burmese community tried to set up own clinics. One of them is the Yamuna clinic opened since 2002. The data collected by Yamuna clinic reveals the actual health status of Burmese refugees taking shelter in Delhi.

The clinic is free for all Burmese refugees. It is run by a Burmese physician cum politician who request for donations and contribution from friends and sympathizers because most of the NGOs are not interested in running a clinic for refugees residing in a capital city. In the Q and A from a Burmese language radio, Daw Aung San Suu Kyi promised to support the clinic.

Nationality question is a matter of interest because Burma is country of many different ethnic nationalities. The doctor belongs to mainstream Burmese and the majority of refugees come from Chin, Kachin and Arakan States and also from Kuki area and Naga Hills. Among Chin refugees there are at least three different dialects. Therefore the doctor needs assistants who can speak different Chin languages.

The clinic assistants deserve appreciation because they are like all other refugees who have to manage for their living. But they volunteer for free service. Some of them have to spend from their pocket for local travel to come to the clinic. The clinic assistants have to come to clinic at any time if there is labor case. They are well-trained and good for community. They are the right ones who can provide health education among the community.

In 2010 there were total of 8,607 patients among them 62.3% was female patients and 37.7% was male patients. Majority of refugees suffer from infectious and communicable diseases. It is due to poor socio-economic living condition. Many girls, women and even men have anemia and vitamin deficiencies. Many of them have big families and sometimes the entire family members got infected. Seasonal illnesses such as flu, diarrhea, allergies, shin infections, viral hepatitis A, Dengue fever, and etc. are common.

Among the patients ante-natal care (ANC) is significantly common. Seeing that government hospitals are crowded and private clinic are expensive, Yamuna clinic opens for all labor cases. Since 2006 November, total of 207 babies have been delivered at the clinic. Vaccinations (BCG, Hepatitis B, DPT, OPV and ATT) for all newborn babies are also provided. But refugee women can’t get HPV vaccine for cervical cancer. The children have to pay for MMR, Typhoid and Measles vaccines from private centers. All are expensive.

Tuberculosis (TB) is not uncommon among Burmese refugees and the morbidity is rising. Refugees have to pay for laboratory tests and X-ray from outside and regular treatment is provided free by Yamuna clinic. Hepatitis B and C as well as HIV are also positive among the refugees. The extremely costly tests and treatments for those serious life threatening diseases are challenging. Some of them have no choice and let the disease take their course.

Burmese refugees have to work mostly in informal sector where there is no health insurance, no care for occupational health hazards and no compensation. There are accidental death reports.

Health education is not practically feasible for Burmese refugees because they have to work for many hours and have no time for education or political events. NGOs love workshops that do not fit for refugees. Though addiction and depression are common among the refugees psychological counseling is what Burmese refugees can’t get at all.

Most of Burmese refugees residing in Delhi have dream of third country resettlement. For that they have to undergo medical check-up before leaving. So for them healthy body is more important than English skill. For refugee children health is more important than education. There are a few outstanding refugees who have resettled in the third countries and send donations to the clinic. It can be translated that working and contribution for health is community based, different nationalities work for a common good, and a good practice of politics.

Dr. Tint Swe
Medical officer
Yamuna Clinic for Burmese community in India
13-9-2011

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