#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Health and Human Rights in Chin State, Western Burma: A Population-Based Assessment Using Multistaged Household Cluster Sampling


Background:
The Chin State of Burma (also known as Myanmar) is an isolated ethnic minority area with poor health outcomes and reports of food insecurity and human rights violations. We report on a population-based assessment of health and human rights in Chin State. We sought to quantify reported human rights violations in Chin State and associations between these reported violations and health status at the household level.

Methods and Findings:
Multistaged household cluster sampling was done. Heads of household were interviewed on demographics, access to health care, health status, food insecurity, forced displacement, forced labor, and other human rights violations during the preceding 12 months. Ratios of the prevalence of household hunger comparing exposed and unexposed to each reported violation were estimated using binomial regression, and 95% confidence intervals (CIs) were constructed. Multivariate models were done to adjust for possible confounders. Overall, 91.9% of households (95% CI 89.7%–94.1%) reported forced labor in the past 12 months. Forty-three percent of households met FANTA-2 (Food and Nutrition Technical Assistance II project) definitions for moderate to severe household hunger. Common violations reported were food theft, livestock theft or killing, forced displacement, beatings and torture, detentions, disappearances, and religious and ethnic persecution. Self reporting of multiple rights abuses was independently associated with household hunger.

Conclusions:
Our findings indicate widespread self-reports of human rights violations. The nature and extent of these violations may warrant investigation by the United Nations or International Criminal Court.

: Please see later in the article for the Editors' Summary


Vyšlo v časopise: Health and Human Rights in Chin State, Western Burma: A Population-Based Assessment Using Multistaged Household Cluster Sampling. PLoS Med 8(2): e32767. doi:10.1371/journal.pmed.1001007
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001007

Souhrn

Background:
The Chin State of Burma (also known as Myanmar) is an isolated ethnic minority area with poor health outcomes and reports of food insecurity and human rights violations. We report on a population-based assessment of health and human rights in Chin State. We sought to quantify reported human rights violations in Chin State and associations between these reported violations and health status at the household level.

Methods and Findings:
Multistaged household cluster sampling was done. Heads of household were interviewed on demographics, access to health care, health status, food insecurity, forced displacement, forced labor, and other human rights violations during the preceding 12 months. Ratios of the prevalence of household hunger comparing exposed and unexposed to each reported violation were estimated using binomial regression, and 95% confidence intervals (CIs) were constructed. Multivariate models were done to adjust for possible confounders. Overall, 91.9% of households (95% CI 89.7%–94.1%) reported forced labor in the past 12 months. Forty-three percent of households met FANTA-2 (Food and Nutrition Technical Assistance II project) definitions for moderate to severe household hunger. Common violations reported were food theft, livestock theft or killing, forced displacement, beatings and torture, detentions, disappearances, and religious and ethnic persecution. Self reporting of multiple rights abuses was independently associated with household hunger.

Conclusions:
Our findings indicate widespread self-reports of human rights violations. The nature and extent of these violations may warrant investigation by the United Nations or International Criminal Court.

: Please see later in the article for the Editors' Summary


Zdroje

1. ThomasORonJ 2007 Public health, conflict and human rights: toward a collaborative research agenda. Confl Health 15 11

2. United Nations General Assembly 1976 International Covenant on Civil and Political Rights, adopted and opened for signature, ratification and accession 16 December1966, United Nations General Assembly Resolution 2200A [XX1]. Entered into force 23 March 1976 Available: http://www2.ohchr.org/english/law/ccpr.htm. Accessed 4 December 2010

3. United Nations General Assembly 1976 International Covenant on Economic, Social and Cultural Rights, adopted and opened for signature, ratification and accession 16 December 1966, United Nations General Assembly Resolution 2200A [XX1]. Entered into force 3 January 1976 Available: http://www2.ohchr.org/english/law/cescr.htm. Accessed 4 December 2010

4. AmowitzLReisCLyonsKVannBMansarayB 2002 Prevalence of war-related sexual violence and other human rights abuses among internally displaced persons in Sierra Leone. JAMA 287 513 521

5. VerwimpP 2004 Death and survival during the 1994 genocide in Rwanda. Population Studies 58 233 245

6. BurnhamGLaftaRDoocySRobertsL 2006 Mortality after the 2003 invasion of Iraq: A cross-sectional cluster sample survey. Lancet 368 1421 1428

7. CoghlanBBrennanRNgoyPDofaraDOttoB 2006 Mortality in the Democratic Republic of Congo: A nationwide survey. Lancet 367 44 51

8. IacopinoVFrankMBauerHKellerAFinkS 2001 A population-based assessment of human rights abuses committed against ethnic Albanian refugees from Kosovo. Am J Public Health 91 2013 2018

9. AmowitzLReisCIacopinoV 2002 Maternal mortality in Herat Province, Afghanistan, in 2002: An indicator of women's human rights. JAMA 288 1284 1291

10. AmowitzLKimGReisCAsherJIacopinoV 2004 Human rights abuses and concerns about women's health and human rights in southern Iraq. JAMA 291 1471 1479

11. ReisCHeislerMAmowitzLMorelandRMafeniJ 2005 Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria. PLoS Med 2 e246 doi:10.1371/journal.pmed.0020246

12. WangSModvigJMontgomeryE 2009 Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences. BMC Int Health Hum Rights 9 29

13. WangSSalihuMRushitiFBalaLModvigJ 2010 Survivors of the war in the Northern Kosovo: Violence exposure, risk factors and public health effects of an ethnic conflict. Confl Health 4 11

14. MullanyLLeeCYoneLPawPOoE 2008 Access to essential maternal health interventions and human rights violations among vulnerable communities in Eastern Burma. PLoS Med 5 e242 doi:10.1371/journal.pmed.0050242

15. MullanyLRichardsALeeCSuwanvanichkijVMaungC 2007 Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma. J Epidemiol Community Health 61 908 914

16. QuintanaTO 2010 Human rights situations that require the Council's attention, Progress report of the Special Rapporteur on the situation of human rights in Myanmar. Geneva UN Commission on Human Rights. UN doc A/HRC/13/48 Available: http://www2.ohchr.org/english/bodies/hrcouncil/docs/13session/A.HRC.13.48_en.pdf. Accessed 20 September 2010

17. WFP 2009 Improving the food security, nutrition status and livelihoods of vulnerable populations - Myanmar. World Food Program Available: http://one.wfp.org/operations/current_operations/project_docs/200032.pdf. Accessed 15 November 2010

18. TurnellS 2010 Burma's Economy 2010: A fresh look at some elemental issues. Burma Partnership Available: http://www.burmapartnership.org/wp-content/uploads/2010/09/Burma-Economy-September-2010.pdf. Accessed 4 December 2010

19. WHO 2008 World Health Observatory, Country Profile: Myanmar. Available: http://www.who.int/countries/mmr/en/. Accessed 4 December 2010

20. UNICEF 2008 The state of the world's children 2008. Available: http://www.unicef.org/sowc08/. Accessed 4 December 2010

21. WHO 2010 Malaria in the Greater Mekong subregion. Available: http://www.wpro.who.int/internet/resources.ashx/MVP/docs/MAL-260.pdf. Accessed 4 December 2010

22. WHO 2000 World Health Report. Available: http://www.who.int/whr/2000/en/. Accessed 4 December 2010

23. Human Rights Watch 2009 “We are like forgotten people” - The Chin people of Burma: unsafe in Burma, unprotected in India. New York Human Rights Watch Available: http://www.hrw.org/en/reports/2009/01/27/we-are-forgotten-people. Accessed 4 December 2010

24. Amnesty International 18 May 2004 Myanmar The Rohingya Minority: Fundamental Rights Denied Available: http://www.amnesty.org/en/library/info/ASA16/005/2004/en. Accessed 26 October 2010

25. Refugees International 2010 Burma. Refugees International. Available: http://refugeesinternational.org/where-we-work/asia/burma. Accessed 16 November 2010

26. IHRC Crimes in Burma. Cambridge International Human Rights Clinic at Harvard Law School Available: http://www.law.harvard.edu/programs/hrp/documents/Crimes-in-Burma.pdf. Accessed 16 November 2010

27. Irish Centre for Human Rights 2010 Crimes against Humanity in Western Burma: The Situation of the Rohingyas. Available: http://www.nuigalway.ie/human_rights/documents/ichr_rohingya_report_2010.pdf. Accessed 4 November 2010

28. CSW 2009 Visit to the Thailand-Burma Border. Christian Solidarity Worldwide Available: http://dynamic.csw.org.uk/article.asp?t=report&id=122&search=. Accessed 4 November 2010

29. ICC 1998 The Rome Statute of the International Criminal Court, opened for signature 17 July 1998. The Hague

30. HinshelwoodC 2009 Swarms of rats plague rural Myanmar. Chiang Mai Asia Times Online Available: http://www.atimes.com/atimes/Southeast_Asia/KJ21Ae01.html. Accessed 16 November 2010

31. Time Staff 2009 Biofuel gone bad: Burma's atrophying jatropha. Time Magazine Available: http://www.time.com/time/world/article/0,8599,1885050,00.html. Accessed 4 December 2010

32. CHRO 2009 On the edge of survival: The continuing rat infestation and food crisis on Chin State, Burma. Chin Human Rights Organization. 23 p Available: http://www.chro.ca/images/stories/files/PDF/special_reports/On_The_Edge_of_Survival.pdf. Accessed 4 November 2010

33. CHRO 2008 Critical Point: Food Scarcity and Hunger in Burma's Chin State. Chin Human Rights Organization. 7 p Available: http://www.burmalibrary.org/docs5/Critical_Point.pdf. Accessed 4 November 2010

34. Images Asia, Karen Human Rights Organization, OSI Burma Project 1998 All quiet on the Western Front? The situation in Chin State and Sagaing Division, Burma Available: http://www.burmalibrary.org/docs/Western_Front.htm. Accessed 4 November 2010

35. International Labour Organization ILO Convention concerning Forced or Compulsory Labour (ILO No. 29). Entered into force 1 May 1932, U.N.T.S. 55. http://treaties.un.org/doc/Publication/UNTS/Volume%2039/volume-39-I-612-English.pdf. Accessed 4 December 2010

36. UN 1984 UN Convention against torture and other cruel, inhuman or degrading treatment or punishment. General assembly res. 39/46. Annex, 39 U.N. GAOR Supp. (No. 51) at 197, UN Doc. A/39/51. Entered into force 26 June 1987 Available: http://www.un.org/millennium/law/iv-9.htm. Accessed 4 December 2010

37. Myanmar Information Management Unit 2009 Chin State planning maps. Chin State: MIMU http://www.themimu.info/HTML/Maps/Chin.html

38. National Geospatial Intelligence Agency 2009 Geonet names server. Washington, D.C. Available: http://earth-info.nga.mil/gns/html/. Accessed 4 December 2010

39. Oak Ridge National Laboratory 2009 LandScan. Geographic Information Science and Technology Oakridge (Tennessee) UT-Battelle for Department of Energy Available: http://www.ornl.gov/sci/gist/. Accessed 4 December 2010

40. Union of Myanmar Ministry of Health 2006 Township health profiles. Yangon http://www.moh.gov.mm/. Accessed 27 October 2009

41. GraisRRoseAGuthmannJ 2007 Don't spin the pen: Two alternative methods for second-stage sampling in urban cluster surveys. Emerg Themes Epidemiol 4 8

42. DeitchlerMBallardTSwindaleACoatesJ 2010 Validation of a measure of household hunger for cross-cultural use: Food and Nutrition Technical Assistance II Project (FANTA-2). Washington, D.C. FANTA-2 Available: http://www.fantaproject.org/downloads/pdfs/HHS_Validation_Report_May2010.pdf. Accessed 4 December 2010

43. MonahanPShachamEReeceMKroenkeKOng'orW 2008 Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in Western Kenya. J Gen Intern Med 24 189 197

44. KroenkeKSpitzerRWilliamsJLoweB 2010 The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review. Gen Hosp Psychiatry 32 345 359

45. StataCorp 2010 Stata 11. StataCorp College Station, TX

46. ICC 2000 Elements of crimes. UN doc PCNICC/2000/1/Add.2 http://www.icc-cpi.int/NR/rdonlyres/9CAEE830-38CF-41D6-AB0B-68E5F9082543/0/Element_of_Crimes_English.pdf Accessed 14 November 2010

Štítky
Interné lekárstvo

Článok vyšiel v časopise

PLOS Medicine


2011 Číslo 2
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#