Myanmar: Health System

Baroness Northover Excerpts

Thursday 29th February 2024 Grand Committee

[Baroness Northover (LD)]

My Lords, I too thank the noble Lord, Lord Crisp, for securing this debate and pay tribute to him for all his work on global health. I am a former trustee of THET and am very glad to hear that it is playing a major part.

As we have heard, the situation in Myanmar is very worrying. Various noble Lords, including my noble friend Lord Bruce, the noble Lord, Lord Alton, the noble Baroness, Lady Bennett, and the noble Earl, Lord Sandwich, have demonstrated their personal knowledge of that country. Health workers should be protected under international law. We have seen that in the debates on Gaza. Certainly in Myanmar, health workers and health facilities, far from being protected, have become a particular target. As the noble Lord, Lord Crisp, said, many health workers resisted military rule, but most have sought to assist those who have been wounded by the military. Burma Campaign UK notes that they faced beatings, arrest, torture and death.

It is therefore not surprising that many health workers have sought to escape to areas beyond the control of ethnic armed organisations. We hear that, once there, some health workers have joined existing health networks, some have established new clinics and others may have joined new armed forces set up by the resistance. We have heard today how the military has targeted clinics and hospitals in areas not under their control with deliberate and repeated attacks. We just heard from the noble Baroness, Lady Finlay, about the effects of this.

The health service was not strong before the military action, although I know that the noble Lord, Lord Darzi, had been working to strengthen it over a period of years. Having been asked to set up a hospital, he recognised the need for a whole health service, which he worked on delivering. My noble friend Lord Bruce spoke of those who returned to Myanmar to help rebuild the country. It is desperately sad that this has come to absolutely nothing.

As in other countries, the pandemic affected medical and allied health professional universities and training schools in Myanmar. This resulted in the closure of all training institutions in 2020, with no graduation of the health workforce. Since the coup, Myanmar’s health provision has been further severely damaged. The BMA and the Royal College of Paediatrics and Child Health—we have heard about their efforts—are working in Myanmar and note that, since the military coup in February 2021, the health service has largely collapsed, as the right reverend Prelate the Bishop of Chelmsford said. The number of skilled birth attendants has fallen, infant mortality has risen, and acute malnutrition has shot up. As the noble Lord, Lord Crisp, and others have said, vaccination rates have fallen dramatically—below 50% of the relevant population in 2021—leaving Myanmar open to large-scale disease outbreaks and unprotected against potential new pandemic diseases. Does the Minister see this as undermining global health security? How might it be tackled? I note the warning that the noble Baroness, Lady Bennett, just issued.

There has been an increase in violence, including against women and girls. Is the FCDO monitoring this, and what is being done to ensure that women and girls have access to family planning? Noble Lords detailed the kinds of attacks, and I see that 385 attacks were recorded against healthcare infrastructure or personnel, in direct contravention of international humanitarian law. The WHO said that the number of people in need of humanitarian health assistance was estimated at 10 million in 2023. The noble Lord, Lord Alton, has updated this to 12 million this year—four times the previous rate.

Routine disease surveillance systems have become dilapidated, raising the risk of Myanmar becoming an ungoverned source of potential new pandemic emergence, threatening economic recovery in the region and globally. But the UK’s long engagement in Myanmar has been hit by a 70% decrease in funding. Could the Minister say whether this will be reversed?

Civil society organisations have proposed bans on aviation fuel, as the noble Baroness, Lady Bennett, just mentioned, which would hinder the military’s campaign. Could the Minister comment? It is difficult to get aid into conflict areas; it is always a problem. Could the Minister comment on how this is being tackled? I look forward to his replies.