Reproductive Health/Gynaecology, Obstetrics
Websites/Multiple Documents
| Title: | | Burma Children Medical Fund |
| Description/subject: | | "The Burma Children Medical Fund (BCMF) is a program dedicated to raising money for children from Burma with serious medical problems who are disadvantaged as a result of the political turmoil in Burma. On this website you will find a brief introduction to the situation along the Thai-Burma border and at the Mae Tao Clinic; see pictures of children you can help; read about the medical conditions that BCMF funds treatment for and see how donations are managed and used.
BCMF is currently expanding its program to include special adult and women’s cases. Please see Burma Adult Medical Fund (BAMF) and Women’s Gynaecological Surgery Fund (WGSF) for more information. |
| Language: | | English |
| Source/publisher: | | Burma Children Medical Fund |
| Format/size: | | html |
| Alternate URLs: | | http://www.burmachildren.net/our-cases/women/ |
| Date of entry/update: | | 26 December 2012 |
|
Individual Documents
| Title: | | Separated by Borders: United By Need, An Assessment of Reproductive Health on the Thai-Burma Border (English) |
| Date of publication: | | 06 February 2012 |
| Description/subject: | | A needs assessment of reproductive health on the Thailand-Burma border...According to Dr. Angel Foster, DPhil, MD, of Ibis Reproductive Health and the University of Ottawa, “Our report finds that millions of Burmese and ethnic minorities both inside Burma and along the Thai border have limited or no access to family planning, safe abortion, and general reproductive health care. The toll on women has been particularly severe. Negative effects include high numbers of unplanned pregnancies — and, consequently, high rates of maternal mortality and unsafe abortions. In fact, post-partum hemorrhage and unsafe abortion are the leading causes of maternal death and injury.”
The absence of health care infrastructure inside eastern Burma, as well as for those Burmese living illegally as migrants in Thailand, has produced a kind of reproductive health “perfect storm.” Notes Foster, “Since denial of health care has been an official policy of the Burmese military in ethnic areas, women and men, especially adolescents, know little about family planning practices and voluntary sterilization.”
Other key findings: Despite the fact that rape and sexual violence are extensive problems within both the conflict zones of eastern Burma and in migrant communities in Thailand, the few health workers that do exist generally lack the knowledge and supplies to dispense critical medicines like emergency contraceptive pills (ECPs), which can prevent pregnancy after sexual assault. Even within refugee camps inside Thailand, leaders and organizations working there often adopt policies that prevent unmarried people from accessing family planning information or supplies. Finally, abortion is illegal in Burma unless a woman’s life is at risk and restricted in Thailand. Lack of legal access combined with a lack of trained providers are fundamental causes of morbidity and mortality from abortion.
“Our hope is that the new Burmese government will someday make it possible for more organizations to provide aid and resources to the people in eastern Burma where outside groups are currently banned,” said Cari Sietstra, JD, a consultant at Ibis. “The time has come to rebuild the health and human rights of the millions of men, women, and children affected by this conflict.”...
Due to an ongoing sixty-year civil war that has subjected civilian populations to forced labor, extrajudicial killings, rape, displacement, imprisonment, denial of health care and education, and destruction of food supplies, the reproductive health of Burmese populations on both sides of the Thai-Burma border is marked by high levels of unmet needs. Reproductive health indicators throughout the region demonstrate a lack of access to family planning resources, including sexual and reproductive health information, low levels of contraceptive access, and high rates of unplanned pregnancy, maternal mortality, and harm from unsafe abortion. Unsafe abortion is a leading cause of maternal mortality for Burmese populations on both sides the Thailand-Burma border. |
| Language: | | English (full text); Karen, Burmese, Thai (summary and findings) |
| Source/publisher: | | Ibis Reproductive Health (Ibis), Global Health Access Program (GHAP) |
| Format/size: | | pdf (2.8MB - OBL version; 4.15MB - original) |
| Alternate URLs: | | http://ibisreproductivehealth.org/work/other/thaiburmaborder.cfm (Summary and findings in Thai, Burmese, Karen and English) |
| Date of entry/update: | | 15 February 2012 |
|
| Title: | | Forced Migration and Adolescent Reproductive Health |
| Date of publication: | | December 2011 |
| Description/subject: | | "This article combines findings from a study on reproductive health in three
populations along the Thailand-Burma border and research conducted on
adolescent pregnancy in camps for Burmese refugees in Thailand. The data
show that adolescents in three populations—communities in eastern Burma
(isolated rural villages, conflict-affected areas, and internally displaced person
(IDP) areas in eastern Burma), migrant communities and refugee camps
in Thailand—face difficulties in gaining access to reproductive health information
and services. One key reason for gaps in service is community attitudes
towards adolescent sexual health and reproduction. The impact of
community attitudes on access to care is most striking in refugee camps,
where populations may access camp-based clinics for reproductive health
services, and arguably face the fewest structural barriers to access (for example,
barriers to access that exist as part of one’s external environment,
such as security and freedom of movement)..." |
| Author/creator: | | SU-ANN OH AND MARGARET HOBSTETTER |
| Language: | | English |
| Source/publisher: | | "Gender Perspectives" (Vol. 3, Issue 2, December 2011) INSTITUTE OF SOUTHEAST ASIAN STUDIES (ISEAS) |
| Format/size: | | pdf (596K) |
| Date of entry/update: | | 23 February 2012 |
|
| Title: | | Against the Odds: Helping Mothers and Babies Survive in Eastern Burma |
| Date of publication: | | November 2011 |
| Description/subject: | | Technical support provided by the Global Health Access Program (the health branch of
Community Partners International), and the Center for Public Health and Human Rights,
Johns Hopkins Bloomberg School of Public Health....."Over
the
last
decade,
militarization
and
the
destruction
of
community
infrastructure
have
escalated
in
eastern
Burma.
The
government
does
not
provide
health
care
for
the
displaced
population,
which
is
targeted
for
abuse,
with
food
and
health
facilities,
documents
and
supplies
destroyed.
We
have
a
high
prevalence
of
malaria
in
eastern
Burma,
which
causes
low
birth
weight,
and
sometimes
miscarriage.
If
not
properly
cared
for,
pregnant
women
suffer
high
maternal,
and
high
neo-‐natal
death.
There
is
high
mortality
in
children
under
age
five.
And
there
is
a
lack
of
family
planning
services.
Before
the
Mobile
Obstetric
Maternal
Health
Workers
(MOM)
Project,
our
community-‐based
organizations
utilized
every
opportunity
to
improve
access
to
maternal
and
child
health
care
and
education
for
these
vulnerable
displaced
populations.
There
were
many
successes,
but
it
was
far
from
enough.
We
needed
to
increase
health
worker
capacity,
improve
access
and
the
referral
system,
and
most
of
all,
to
address
the
shortage
in
life-‐saving
emergency
care.
What
the
MOM
Project
brought
was
a
focus
on
mobile
health
care,
a
way
to
address
obstetric
emergencies
and
training
of
local
health
workers,
even
in
displaced
populations.
Through
the
MOM
Project,
we
helped
empower
individuals
and
the
community.
The
MOM
Project
could
not
get
rid
of
maternal,
or
neonatal
and
infant
death.
But
by
equipping
people
and
communities
with
knowledge
and
skills,
it
has
saved
countless
lives.
Significantly,
the
MOM
Project
played
a
role
in
fulfilling
the
basic
right
to
reproductive
health
and
building
a
human
rights-‐based
approach
to
health
in
eastern
Burma.
Health
and
human
rights
cannot
be
separated.
People
have
the
right
to
access
health
information
and
essential
health
services.
Families
have
the
right
to
stay
together
and
organize
as
a
community.
A
rights-‐based
approach
encourages
looking
at
the
bigger
picture,
at
integrating
health
into
the
broader
system
of
civil
society.
This
is
the
critical
issue
—
strengthening
our
civic
foundation
to
save
the
lives
of
mothers
and
children,
and
build
healthy
families
and
communities." - Dr.
Cynthia
Maung |
| Language: | | English |
| Source/publisher: | | The Mobile Obstetric Maternal Health Workers (MOM) |
| Format/size: | | pdf (2.5MB) 32 pages |
| Alternate URLs: | | http://cpintl.org/sites/default/files/bookPdf/CPI%20RH%20report%20web_0.pdf |
| Date of entry/update: | | 15 February 2012 |
|
| Title: | | A ‘climate of fear’ at the Thai-Burma border |
| Date of publication: | | 03 February 2010 |
| Description/subject: | | The oppressive regime running Burma has both forced many Burmese into displaced person camps in Thailand. Young Burmese people are particularly vulnerable, especially due to issues such as sexual health education and trafficking.
By any account, Burma is a beautiful, naturally rich country with a diverse ethnic history. It is also run by one of the most oppressive regimes in the world, the State Peace and Development Council, an 11-member group of military commanders. This junta, in power under different names since 1988, has been cited for countless human rights abuses. The SPDC also oversees a corrupt, inefficient economy. In spite of the country’s natural wealth, social-economic conditions continue to deteriorate, along with Burma’s schools and hospitals. |
| Language: | | English |
| Source/publisher: | | Conversation for A Better World |
| Format/size: | | html |
| Date of entry/update: | | 02 November 2010 |
|
| Title: | | Accessing Maternal Health Services in Eastern Burma |
| Date of publication: | | 23 December 2008 |
| Description/subject: | | This Perspective discusses the following new study published in PLoS Medicine:
Mullany LC, Lee CI, Yone L, Paw P, Oo EKS, et al. (2008) "Access to essential maternal health interventions and human rights violations among vulnerable communities in eastern Burma". PLoS Med 5(12): e242. doi:10.1371/journal.pmed.0050242
Luke Mullany and colleagues examine access to essential maternal health interventions and human rights violations within vulnerable communities in eastern Burma. |
| Author/creator: | | Macaya Douoguih |
| Language: | | English |
| Source/publisher: | | PLoS Med 5(12) |
| Format/size: | | html |
| Date of entry/update: | | 03 February 2009 |
|
| Title: | | Access To Essential Maternal Health Interventions and Human Rights Violations among Vulnerable Communities in Eastern Burma |
| Date of publication: | | December 2008 |
| Description/subject: | | Background:
Health indicators are poor and human rights violations are widespread in eastern Burma.
Reproductive and maternal health indicators have not been measured in this setting but are
necessary as part of an evaluation of a multi-ethnic pilot project exploring strategies to increase
access to essential maternal health interventions. The goal of this study is to estimate coverage
of maternal health services prior to this project and associations between exposure to human
rights violations and access to such services...
Methods and Findings:
Selected communities in the Shan, Mon, Karen, and Karenni regions of eastern Burma that
were accessible to community-based organizations operating from Thailand were surveyed to
estimate coverage of reproductive, maternal, and family planning services, and to assess
exposure to household-level human rights violations within the pilot-project target population.
Two-stage cluster sampling surveys among ever-married women of reproductive age (15–45 y)
documented access to essential antenatal care interventions, skilled attendance at birth,
postnatal care, and family planning services. Mid-upper arm circumference, hemoglobin by
color scale, and Plasmodium falciparum parasitemia by rapid diagnostic dipstick were
measured. Exposure to human rights violations in the prior 12 mo was recorded. Between
September 2006 and January 2007, 2,914 surveys were conducted. Eighty-eight percent of
women reported a home delivery for their last pregnancy (within previous 5 y). Skilled
attendance at birth (5.1%), any (39.3%) or 4 (16.7%) antenatal visits, use of an insecticidetreated
bed net (21.6%), and receipt of iron supplements (11.8%) were low. At the time of the
survey, more than 60% of women had hemoglobin level estimates 11.0 g/dl and 7.2% were
Pf positive. Unmet need for contraceptives exceeded 60%. Violations of rights were widely
reported: 32.1% of Karenni households reported forced labor and 10% of Karen households had
been forced to move. Among Karen households, odds of anemia were 1.51 (95% confidence
interval [CI] 0.95–2.40) times higher among women reporting forced displacement, and 7.47
(95% CI 2.21–25.3) higher among those exposed to food security violations. The odds of
receiving no antenatal care services were 5.94 (95% CI 2.23–15.8) times higher among those
forcibly displaced...
Conclusions:
Coverage of basic maternal health interventions is woefully inadequate in these selected
populations and substantially lower than even the national estimates for Burma, among the
lowest in the region. Considerable political, financial, and human resources are necessary to
improve access to maternal health care in these communities. |
| Author/creator: | | Luke C. Mullany, Catherine I. Lee, Lin Yone, Palae Paw, Eh Kalu Shwe Oo, Cynthia Maung, Thomas J. Lee, Chris Beyrer |
| Language: | | English |
| Source/publisher: | | PLoS Medicine, December 2008 | Volume 5 | Issue 12 | e242 |
| Format/size: | | pdf (186K) |
| Alternate URLs: | | http://www.burmalibrary.org/docs6/Access_To_Essential_Maternal_Health.pdf |
| Date of entry/update: | | 03 February 2009 |
|
| Title: | | Increasing access to reproductive health services in eastern Burma |
| Date of publication: | | May 2008 |
| Description/subject: | | EXECUTIVE SUMMARY:
Alternative strategies to increase access to reproductive health services among internally displaced
populations are urgently needed. In eastern Burma continuing conflict and lack of functioning health
systems render the emphasis on facility-based delivery with skilled attendants unfeasible. Along the
Thailand/Burma border, local organizations are implementing a unique pilot, the "Mobile Obstetric
Maternal Health Workers (MOM) Project", which establishes a three-tiered collaborative network of
community-based reproductive health workers. Health workers from local organizations receive
practical training in basic emergency obstetric care plus blood transfusion, focused antenatal care,
and family planning at a central facility. Returning to their target communities inside Burma, these
first-tier “Maternal Health Workers ” (MHWs) train a second tier of local health workers (HWs) and a
third tier of traditional birth attendants (TBAs) to provide a limited subset of these interventions
depending on their level of training. Close communication between health workers and TBAs
promotes acceptance and coverage of reproductive health services throughout the community. We
describe the rationale, the design and implementation of the project and the parallel monitoring plan
for evaluation of the MOM Project. This unique model of health care delivery may serve as a model
for new strategies for increasing access to care in other conflict settings....
Keywords:
Emergency obstetric care, reproductive health, misoprostol, internally displaced populations, Burma |
| Language: | | English |
| Source/publisher: | | The Mobile Obstetrics Maternal Health Worker Project (MOM) |
| Format/size: | | pdf (2.89MB) |
| Date of entry/update: | | 20 December 2008 |
|
| Title: | | The MOM Project: Delivering Maternal Health Services among Internally Displaced Populations in Eastern Burma |
| Date of publication: | | May 2008 |
| Description/subject: | | Abstract: Alternative strategies to increase access to reproductive health services among internally
displaced populations are urgently needed. In eastern Burma, continuing conflict and lack of
functioning health systems render the emphasis on facility-based delivery with skilled attendants
unfeasible. Along the Thailand–Burma border, local organisations have implemented an innovative
pilot, the Mobile Obstetric Maternal Health Workers (MOM) Project, establishing a three-tiered
collaborative network of community-based reproductive health workers. Health workers from local
organisations received practical training in basic emergency obstetric care plus blood transfusion,
antenatal care and family planning at a central facility. After returning to their target communities
inside Burma, these first-tier maternal health workers trained a second tier of local health workers
and a third tier of traditional birth attendants (TBAs) to provide a limited subset of these
interventions, depending on their level of training. In this ongoing project, close communication
between health workers and TBAs promotes acceptance and coverage of maternity services
throughout the community. We describe the rationale, design and implementation of the project
and a parallel monitoring plan for evaluation of the project. This innovative obstetric health
care delivery strategy may serve as a model for the delivery of other essential health services in
this population and for increasing access to care in other conflict settings."...Keywords: antenatal care, childbirth, emergency obstetric care, misoprostol, internally displaced
populations, Burma |
| Author/creator: | | Luke C Mullany, Catherine I Lee, Palae Paw, Eh Kalu Shwe Oo, Cynthia Maung, Heather Kuiper, Nicole Mansenior, Chris Beyrer, Thomas J Lee |
| Language: | | English |
| Source/publisher: | | "Reproductive Health Matters" |
| Format/size: | | pdf (544K) |
| Date of entry/update: | | 20 December 2008 |
|
| Title: | | Reproductive health in Burma: a priority for action |
| Date of publication: | | 30 April 2008 |
| Description/subject: | | There is an urgent need for improved
reproductive health services in
Burma. At 360 per 100,000 live births
the estimated maternal mortality
ratio is lower than for a number of
other countries in the region but
there is widespread belief that this
number is not a true representation
of the maternal deaths in the
country. Contraceptive use is also
low, with large regional variations;
women in those areas most affected
by conflict are less likely to use a
modern contraceptive than those
living in the central plains region.
In Arakan (Rakhine) State, where
many people are displaced from
their homes or are returnees from
refugee camps in Bangladesh, the
contraceptive prevalence rate among
married women is particularly low. |
| Author/creator: | | John Bercow |
| Language: | | English, Burmese |
| Source/publisher: | | "Forced Migration Review" No. 30 |
| Format/size: | | pdf (English, 275K; Burmese, 190K) |
| Alternate URLs: | | http://www.fmreview.org/FMRpdfs/FMR30Burmese/22-23.pdf |
| Date of entry/update: | | 30 November 2008 |
|
| Title: | | Borderline Health |
| Date of publication: | | 2008 |
| Description/subject: | | As a "slow-motion genocide" envelops ethnic minorities in eastern Burma, health workers rely on innovative strategies and raw courage to save the lives of mothers and infants. |
| Author/creator: | | Cathy Shufro |
| Language: | | English |
| Source/publisher: | | "Johns Hopkins Public Health" Online Edition, FAll 2008 |
| Format/size: | | html |
| Date of entry/update: | | 21 December 2008 |
|
| Title: | | "Health Messenger" Magazine No. 37 -- special issue on maternal health |
| Date of publication: | | September 2007 |
| Description/subject: | | I. Health:-
1. Female reproductive system
(HM);
2. Lifestyle consideration during antenatal and postnatal period - Erika Garrity Pied (TBBC);
3. Breast-feeding
- Erika Garrity Pied (TBBC);
4. Family planning
(HM)...
II. Medical:-
5. Pregnancy changes and management of symptoms -
Dr. Htwe (AMI);
6. Antenatal care
(SMRU);
7. Genital Haemorrhage: Differential Diagnosis and Treatment
- Dr. Bertrand Martinez-Aussel (AMI);
8. Vaginal Discharge -
Dr. Bertrand Martinez-Aussel (AMI);
9. Intra-natal and Post-natal care
(SMRU)...
Focus: "I don't have enough breast-milk!";
10. Interview with ARC staff in Umpiem;
Quiz. |
| Language: | | Burmese, English |
| Source/publisher: | | Aide Medicale Internationale (AMI) |
| Format/size: | | pdf (3.2MB) |
| Date of entry/update: | | 19 November 2007 |
|
| Title: | | Myanmar Adolescent Health Fact Sheet |
| Date of publication: | | January 2007 |
| Description/subject: | | Myanmar’s population is estimated
at 50.52 million1 with a growth
rate of 1%. Nearly 70% of the
population is rural. The sex ratio
was estimated to be 989 males
per 1000 females in 20022. According
to the Fertility and Reproductive
Health Survey (FRHS) in 2001, the total fertility rate has decreased
from 4.0 in 1990 to 2.4 in 20012.
In 2001, the crude birth rate was
23.9 and crude death rate
11.23. The infant mortality rate
has declined from 79 per 1000
live births in 1997 to 49 in 2001
(48.3 in urban and 50 in rural areas). In the year 2000 the maternal
mortality ratio of the country was
360 per 100,000 live births. The
adult literacy rate improved from
83.1% in 1995 to 96.5% in 2001
and the Human Development
Index of Myanmar for 2003
was 0.5784. |
| Language: | | English |
| Source/publisher: | | World Health Organization_SEARO |
| Format/size: | | pdf (236.42 K) |
| Date of entry/update: | | 12 November 2010 |
|
| Title: | | Fertility Regulation through Traditional Midwives along the Thai-Burma Border |
| Date of publication: | | 21 July 2006 |
| Description/subject: | | Reproductive Health in Developing Countries...SUMMARY:
"Multiple confounders with important interaction make a cause & effect analysis
difficult when discussing factors contributing to decrease reproductive mortality.
Every sector taken up to be improved is a step towards the objective of
improving women’s well-being.
Findings of this literature review are: traditional midwives (TMs) as
contraceptive distributors are not significant in reducing reproductive deaths.
The main killer among mothers in Burma and along the Thai-Burma border is
unsafe, septic, induced abortion.
Even if TMs cannot provide emergency obstetric care, as distributors of
modern contraception they could affect the maternal mortality in four ways.
1: Reducing number of pregnancies, which decreases the number of times
women face risk of maternal death.
2: High-risk pregnancies at higher parities can be avoided.
3: Women can avoid unwanted pregnancy, which may end in unsafe
abortion or in not seeking care or in abandoning a baby.
4: Involving TMs in contraceptive services may replace their practice of
inducing unsafe abortions.
As long as most of the deliveries are still at home with indigenous midwives
maternal mortality can not be reduced below 100/100,000, even if there is
functioning emergency obstetric care (EmOC) available. Examples from Brazil
and China have shown this It is still realistic that the present high mortality from over 600/100,000 in
Burma’s internally displaced people (IDP) areas can be significantly reduced.
Fertility regulation is not a substitute for obstetric care in a limited budget
country, but they should work together.
TMs have been utilized in some countries by integrating them successfully into
existing health systems. Even in countries with political stability the reduction of
maternal mortality took decades. In an unstable population disrupted by civil
war additional factors delay the process.
To overcome the feminization of poverty girls schooling is to be promoted. The
number of girls in secondary schools needs to be increased, so that the coming
generation has a better understanding of health issues.
No RH prospective intervention studies about postemergency settings with TM
programmes for fertility regulation have been found in the literature.
There cannot be one monopolized concept for healthcare or for safe
motherhood, or for population stabilization. We need measured tailored
projects for every ethnic group in its circumstances reaching each needy
individual. If one way does not bring the expected results, the strategy must be
changed. With motivated skilled midwives from the Backpack Health Worker
Team (BPHWT) and additional trained EmOC-staff, who can form a link in a
transition period until there are enough literate skilled midwives, as many lay
midwives as possible should be offered training on a voluntary basis with as
many skills as they can take in.
Disarmament of rebel groups and peace negotiations are essential." |
| Author/creator: | | Inge Sterk |
| Language: | | English |
| Source/publisher: | | Liverpool School of Tropical Medicine |
| Format/size: | | pdf (855K - low resolution; 1.53MB - original, high resolution ) |
| Alternate URLs: | | http://www.mitwelt-netzwerk.de/documents/thesis_2006-07.pdf |
| Date of entry/update: | | 22 February 2007 |
|
| Title: | | Frauen in Bildung und Gesundheit |
| Date of publication: | | 29 December 2005 |
| Description/subject: | | Armutsreduzierung und die Stärkung der Position von Frauen hängen in vielerlei Hinsicht zusammen. In Burma, so heißt es im Allgemeinen, nehmen die Frauen eine angesehene und respektierte Rolle in der Gesellschaft ein. In der Kombination mit Armut, Gewalt oder kulturellen Werten werden jedoch Diskriminierungen und Ungleichheiten sichtbar. Die meisten Gesundheitsprobleme, denen sich Frauen ausgesetzt sehen, sind auf schlechte Lebensbedingungen zurückzuführen.
keywords: women, health, education, prostitution, HIV/AIDS, family planning |
| Author/creator: | | Ulrike Bey |
| Language: | | German, Deutsch |
| Source/publisher: | | Asienhaus Focus Asien Nr. 26, S. 37-43 |
| Format/size: | | pdf |
| Date of entry/update: | | 20 March 2006 |
|
| Title: | | Working Our Way Back Home - Fertility and pregancy loss on the Thai-Burmese border |
| Date of publication: | | December 2005 |
| Description/subject: | | Findings:-
Key findings from the research show that:
While unplanned pregnancy and abortion are a large problem, they
can be prevented.
* Post abortion care at Thai and Burmese health facilities takes
large amounts of health resources.
* At least a third of women with post abortion complications have
self-induced abortions.
* Men and women have low levels of knowledge about modern
methods of contraception.
* Temporary contraceptive information or methods are not offered
to women during post abortion care in the Mae Sot Hospital but
are offered 6 weeks after discharge.
Many women are affected by unplanned pregnancies ~
* The vast majority of women are married and two thirds have
children.
* A third of women have five or more pregnancies, which is a health
risk in itself.
The way the pregnancy ends can negatively affect women's health
and wellbeing ~
* Unqualified abortionists and home remedies are the only recourse
women have to end an unwanted pregnancy.
* Women know of and use a wide variety of methods to end their
pregnancy including self-medication with multinational and
Burmese medicines, drinking ginger and whisky, vigorous pelvic
pummelling and insertion of objects into the sex organs.
* Post abortion treatment in hospital can be expensive if a woman
does not have a work permit or is not referred by Mae Tao Clinic
and can leave her with debts.
Women are pressured by social and political circumstances to end
their pregnancies~
* Women are often pressured by employers, husbands and the
fear of unemployment to end their pregnancies.
* Some women report domestic violence as influencing their
decision to abort.
Women were attempting to limit their fertility in many different ways ~
* Most women and lay midwives classified menstrual regulation
and abortion as traditional methods of fertility control.
* Most women accepted a diverse range of temporary and
permanent contraceptive methods from the Mae Tao Clinic staff
while they were still in-patients.
The nature of forced displacement and lack of human rights directly
effects reproductive health ~
* Having a work permit does not necessarily offer protection to
women, as there is scrutiny to ensure a woman is not pregnant
when a permit is issued.
As workers without work permits can be arrested and
deported by Thai police, women are reluctant to travel
to any type of health service and often wait until they
are very unwell.
Burmese women as non-citizens are not included in Thai
death statistics at a national level so the deaths of
Burmese women go unnoticed, by both Thai and Union
of Myanmar authorities. |
| Author/creator: | | Cynthia Maung, Suzanne Belton |
| Language: | | English |
| Source/publisher: | | Mao Tao Clinic |
| Format/size: | | pdf (2.2MB) |
| Date of entry/update: | | 23 December 2005 |
|
| Title: | | A Pregnant Problem |
| Date of publication: | | November 2005 |
| Description/subject: | | Young women trapped by dogma and the generation gap...
"It’s only a couple of years ago that young people living in and around the Karenni refugee camp at Ban Tractor in Thailand’s Mae Hong Son Province were able to help themselves to free condoms from boxes attached to trees and wayside posts. It was the idea of the camp health department director, Say Reh, who had been growing increasingly concerned about the rising numbers of young unmarried women becoming pregnant and also about the risk of HIV/AIDS in the community.
But it was a short-lived idea. Say Reh had to abandon his solo birth-control effort after three months because of strong opposition from many of the camp residents and Catholic and Protestant church ministers. “Older people here believe that distributing condoms and organizing sex education encourages young people to indulge in sex,” says Say Reh.
Although he’s abandoned his free condoms initiative, Say Reh and some of his co-workers still hold occasional sex education classes for the young people of Ban Tractor, under the watchful eye of disapproving elder members of the community. “The problem is that parents are sensitive on sex issues and many are illiterate, so they don’t know how to educate their children and guard them from unwanted pregnancies,” he says..." |
| Author/creator: | | Louis Reh |
| Language: | | English |
| Source/publisher: | | "The Irrawaddy" Vol. 13, No. 11 |
| Format/size: | | html |
| Date of entry/update: | | 01 May 2006 |
|
| Title: | | Borders of fertility: Unwanted pregnancy and fertility management by Burmese women in Thailand |
| Date of publication: | | May 2005 |
| Description/subject: | | Submitted in total fulfilment
of the requirements of the degree of
Doctor of Philosophy...Faculty of Medicine, Dentistry and Health Sciences,
School of Population Health,
Key Centre for Womenâ�â¢s Health in Society
The University of Melbourne...This thesis, describes how women who are forced to migrate from Burma into
Thailand manage their fertility, unwanted pregnancy and pregnancy loss. Unsafe
abortion is a common problem and much time and resources are taken with the care of
women suffering haemorrhage, infection and pain after self-induced abortion in both
Thai and Burmese-led health facilities.
The thesis examines the characteristics of 43 Burmese women admitted to health
facilities with post-abortion complications and their chosen methods of self-induced
abortion. There is no commonly agreed definition of abortion between formal,
informal health workers or women. Most people considered it morally proscribed and
in some cases knew it was illegal, but still felt it was necessary. Some aspects of
post-abortion care are performed better by informally than formally trained health
workers. Post-abortion family planning was poorly performed by Thai health
workers. Lay midwives play a central role in fertility management and some are
abortionists. Burmese womenâ�â¢s partners are not well informed about fertility
management and frequently decline vasectomy. Within a relm of limited traditional
and modern reproductive choices, women manage their fertility outcomes.
The Burmese women in this study are generally married with children. Considered
illegal migrants, they are employed and work in Thailand without work permits.
Many women have a history of escaping human rights abuses and entrenched poverty
in Burma. At least a third of women admitted into care with post-abortion
complications have induced their abortion with oral herbal preparations, pummelling
manipulations or stick abortions. Most of the abortion services are provided by
Burmese lay midwives. Reasons for terminating the pregnancy include: poverty,
gender-based violence and the local illness of �weaknessâ�â¢. In addition, incomplete
sexual health knowledge, and difficult access to reproductive health services play a
part in mistimed pregnancy.
I argue that a lack of rights increases womenâ�â¢s risk of unsafe abortion. The rights
to work and earn a fair wage and to move without fear influence reproductive health choices and access to health services. A lack of sexual health information for men
and women and the ability to safely control fertility causes unwanted pregnancies.
Furthermore, violence perpetrated at the individual and state level contributes to
unsafe abortion. Burmese womenâ�â¢s mortality and morbidity associated with unsafe
abortion in Thailand is largely unrecorded and unknown to the Burmese military
government.
Unwanted and mistimed pregnancy can be avoided through reproductive
technologies, education programmes, and access to modern contraceptives. To safely
terminate unwanted pregnancies and to treat the complications of pregnancy loss is a
womanâ�â¢s right. Burma and Thailand are signatories to Convention on the Elimination
of all Forms of Descrimination Against Women, yet Burmese women continue to
suffer, become sterile, socially vilified, unemployed or repatriated to Burma due to
their reproductive status. Their sickness and deaths are secondary to the economic
imperatives of Burma and Thailand. |
| Author/creator: | | Dr. Suzanne Belton |
| Language: | | English |
| Format/size: | | pdf (3.8MB) |
| Date of entry/update: | | 23 December 2005 |
|
| Title: | | Fertility and abortion: Burmese women's health on the Thai-Burma border |
| Date of publication: | | January 2004 |
| Description/subject: | | "In Thailand's Tak province there
are 60,520 registered migrant
workers and an estimated 150,000
unregistered migrant workers from
Burma. Fleeing the social and political
problems engulfing Burma, they are
mostly employed in farming, garment
making, domestic service, sex and
construction industries. There is also
a significant number of Burmese
living in camps. Despite Thailandâ�â¢s
developed public health system and
infrastructure, Burmese women face
language and cultural barriers and
marginal legal status as refugees in
Thailand, as well as a lack of access to
culturally appropriate and qualified
reproductive health information and
services..." |
| Author/creator: | | Suzanne Belton and Cynthia Maung |
| Language: | | English |
| Source/publisher: | | Forced Migration Review No. 19 |
| Format/size: | | pdf (110K) |
| Date of entry/update: | | 08 June 2004 |
|
| Title: | | Myanmar Fertility and Reproductive Health Survey 2001 |
| Date of publication: | | December 2002 |
| Description/subject: | | Preliminary Report:
The 2001 Fertility and Reproductive Health Survey (FRHS) is the third survey to obtain detailed information on demography and reproductive health in Myanmar. The first survey was 1991 Population Changes and Fertility Survey (PCFS) and the second was the 1997 FRHS.
This Preliminary Report is the first report of 2001 FRHS to provide policymakers, programme managers, international organizations, NGOs and scholars timely and reliable detailed but brief information on fertility, contraception, maternal and child health, infant and child mortality, knowledge of STDs and HIV/AIDS and internal migration in Myanmar. Two more detailed reports are planned to supplement this one: comprehensive Country Report (main survey report) and Report on Detailed Analysis of Trends and Patterns on selected topics. |
| Language: | | English |
| Source/publisher: | | Myanmar Department of Population |
| Format/size: | | pdf (2.21 MB) |
| Alternate URLs: | | http://countryoffice.unfpa.org/myanmar/?publications=1472 |
| Date of entry/update: | | 22 October 2010 |
|
| Title: | | Post Abortion Care: Who Cares? |
| Date of publication: | | September 2002 |
| Description/subject: | | "This article is intended to give health workers an introduction into the individual implications of pregnancy loss as well as local issues on the Thai-Burma border and broader South-east Asian regional issues. I want to focus on the gender and social features rather than pure biomedical information, although this is of course highly important but is covered in other parts of this magazine. I will talk about some womenâ�â¢s stories that were collected in 2002 to outline typical cases, the reasons why the woman chose to end the pregnancy and impact on womenâ�â¢s lives. I will also present some findings from a medical records review conducted with the Mae Tao Clinic and discuss some findings from research in the international arena. So should we care about post abortion care? I hope to show that we should, as not only can it be a life threatening event for the woman but it reflects certain aspects about the communities we live in, social conditions, legal and religious norms, how we value human rights and the status of women..." |
| Author/creator: | | Suzanne Belton |
| Language: | | English |
| Source/publisher: | | Health Messenger |
| Format/size: | | html (60K) |
| Date of entry/update: | | 15 June 2004 |
|
| Title: | | Lady's Love Powder |
| Date of publication: | | June 2002 |
| Description/subject: | | This article appeared in Burma - Women's Voices for Change, Thanakha Team, Bangkok, published by ALTSEAN in 2002... "...Unplanned pregnancies and sexually transmitted diseases are problems that many Burmese women face with little support and a poverty of health resources. Of course it is difficult to quantify such statements in light of the limited sharing of information that occurs between the Burman military government and the rest of the world. One informed source, Dr Ba Thike (1997), a doctor working in Burma, reported that in the 1980s abortion complications accounted for twenty percent of total hospital admissions and that for every three women admitted to give birth, one was admitted for abortion complications...The records at the Mae Tao Clinic in Thailand, a health service that offers reproductive health services to women coming from Burma as day visitors or as longer-term migrant workers, reflects a crisis in womenâ�â¢s health. In 2001, the Mae Tao Clinic documented 185 abortion complication cases (Out Patients Department) and 231 cases that needed to be admitted into the In-patients Department with complications such as sepsis, dehydration, haemorrhage and shock from abortions and miscarriage..." |
| Author/creator: | | Suzanne Belton (Ma Suu San) |
| Language: | | English |
| Source/publisher: | | Burma - Women's Voices for Change (publ. ALTSEAN) |
| Format/size: | | html (24K) |
| Date of entry/update: | | 15 June 2004 |
|
| Title: | | WOMEN'S HEALTH (Chapter from "Gathering Strength") |
| Date of publication: | | January 2002 |
| Description/subject: | | OVERVIEW;
GOVERNMENT HEALTH SPENDING;
POLICY, LAW & ENVIRONMENTAL FACTORS RELATING TO WOMEN'S HEALTH;
EDUCATION ABOUT WOMEN'S HEALTH ISSUES;
ACCESS TO HEALTH CARE;
REPRODUCTIVE HEALTH;
MATERNAL HEALTH;
WOMEN & HIV/AIDS;
FINDINGS & RECOMMENDATIONS. |
| Author/creator: | | Brenda Belak |
| Language: | | English |
| Source/publisher: | | Images Asia |
| Format/size: | | PDF (954K) |
| Date of entry/update: | | 03 June 2003 |
|
| Title: | | "Escape From the Bear and Run Into the Tiger": The Impact of Violence and Fear on Migrants' Reproductive Health |
| Date of publication: | | December 2000 |
| Description/subject: | | "The massive influx of migrants from Burma into Thailand is one of the largest migrant populations in Asia. Over one million migrants from Burma are currently residing in Thailand. An ethnically diverse group coming from all over Burma and speaking many different languages, these migrants often lack a common language even among themselves. What they do share are encounters of fear and violence, that affect most facets of their lives.
During 1998, an Assessment of Reproductive and Sexual Health Perspectives, Concerns and Realities of Migrant Workers
from Burma in Thailand was conducted under the guidance of Mahidol University's Institute of Population and Social Research (IPSR). The recently published results of the study reveal that a fear of violence and a preoccupation with staying safe determines almost every aspect of the migrants' lives, including their health care options and decisions.
The study highlights the extremely limited health services that exist in Burma as well as the problems encountered by migrants in
Thailand such as the ready availability of medicines without access to health services or education. Consequently, people from
Burma suffer from easily treatable conditions, presenting a health care crisis on both sides of the border. Most migrants from
Burma in Thailand reside illegally and are generally unable to communicate in Thai. They are often in situations which leave them
vulnerable to violence and abuse by employers, authorities and even each other. These experiences, coupled with fears of
violence and exploitation, create a vacuum in which the migrants have few or no options for health services. This reality is further
compounded by cultural mores and the lack of basic and reproductive health education, which lead to high maternal mortality and
morbidity rates, unwanted pregnancies, unsafe abortions and sexually transmitted diseases (including HIV/ AIDS)..." |
| Author/creator: | | Therese Caouette |
| Language: | | English |
| Source/publisher: | | "Burma Debate" VOL. VII, NO. 4 WINTER 2000 |
| Format/size: | | pdf (329K - article; 1.22MB - full magazine) |
| Alternate URLs: | | http://www.burmalibrary.org/docs11/BD2000-V07-N04.pdf |
| Date of entry/update: | | 03 June 2003 |
|
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