In the remote mountains of Karen state, eastern Myanmar, a man named Saw Htoo* was following a fellow medic along a dense jungle trail, returning from a medical mission in an isolated village. They took extra precaution along this route -- a riverbank where skirmishes had been common between government troops and ethnic Karen rebels.
A sudden explosion rang out in the trail ahead. Running to catch up, Saw Htoo found his friend doubled over in agony beneath a cloud of acrid smoke. His right foot was charred black and mangled beyond recognition as blood pooled beneath him. Saw Htoo acted immediately to control the bleeding. While he concentrated on packing the wound, he kept a wary eye on the forest around him. The landmine blast would be heard for miles and government forces could arrive at any moment.
In the past few months, Myanmar (also known as Burma) has made unprecedented appeals to the Western democratic world. It freed Nobel Laureate Aung San Suu Kyi from house arrest, released hundreds of political prisoners, suspended a major hydroelectric development project backed by China, and welcomed the first United States Secretary of State in over 50 years.
On Jan. 12, Myanmar signed a cease-fire agreement with the Karen National Union, the ethnic resistance group that has been involved in a half-century long civil war with the national military. Nevertheless, life is unlikely to change for Saw Htoo and the communities he serves. Even if both sides of the conflict respect the peace agreement, villagers will continue to suffer due to long-forgotten landmines placed near their fields and meager to non-existent national health services. Furthermore, Myanmar's military regime has made and broken numerous ceasefire accords with various ethnic groups over the course of their decades-long struggle, and it remains to be seen if the new agreement with the Karen will be any different.
Since 1970, Myanmar's military has enforced a 'four-cuts policy' against ethnic groups in areas controlled by liberation forces, in which they intended to strike at their civilian support -- access to food, funds, information and recruitment. To this end, government soldiers have perpetrated widespread human rights violations against civilians, including the systematic use of landmines, rape, torture, forced labor, and the burning of over 3,000 villages in eastern areas. As such, the region suffers from high rates of infectious disease (a quarter of children in displaced areas will die before their fifth birthday from preventable causes#) and conflict-related traumatic injuries. With scarce resources and medical supplies, community health organizations employ backpack medics to provide basic health services to over 350,000 war-affected villagers, despite the constant threat of military attacks.
Saw Htoo's story is only one example of what backpack medics must endure when serving villages in the conflict zones of eastern Myanmar. Though they are non-combatants and serve civilian villagers, medics and their clinics have been targeted, captured, and in some cases executed by government troops.
With the rapid reestablishment of diplomatic ties between Myanmar and the United States, it will be more crucial than ever to ensure that international humanitarian laws are respected in active and post-conflict areas. Security, access to healthcare, and human rights for people in the ethnic border areas must be prioritized in future negotiations between the two nations.
This is a critical moment to press for further changes in the way that Myanmar's government deals with its ethnic minorities. Despite the positive headlines, war rages on in ethnic states with tragic consequences for civilian bystanders. In Kachin state, violent exchanges are now increasing between the government and Kachin Liberation armies.
International organizations such as the International Committee for the Red Cross must be given access to document rights abuses committed in conflict regions. The UN should set up a commission to investigate potential war crimes. The U.S. and other nations must apply diplomatic pressure to ensure that Myanmar provides healthcare, education, sanitation, and other social services for all its civilians, equally -- regardless of ethnicity.
Even if the ceasefire holds, the neglect of national health services and the innumerable forgotten landmines laid around villages will remain. Until these provisions are met, villagers in these areas will continue to perish from easily preventable and treatable causes, and medics like Saw Htoo will continue to risk life and limb to treat them. We cannot turn a blind eye to their struggle.