SECTION: CAPITOL HILL HEARING TESTIMONY

LENGTH: 3152 words

COMMITTEE: HOUSE INTERNATIONAL RELATIONS

SUBCOMMITTEE: EAST ASIA AND THE PACIFIC

HEADLINE: BURMA DEVELOPMENTS

TESTIMONY-BY: KAREN D. TURNER, DEPUTY ASSISTANT ADMINISTRATOR

AFFILIATION: BUREAU FOR ASIA AND THE NEAR EAST

BODY:
Statement of Karen D. Turner Deputy Assistant Administrator Bureau for Asia and the Near East United States Agency for International Development

Before the

Subcommittee on East Asia and the Pacific Committee on House International Relations

June 19, 2002

Mr. Chairman, Members of the Subcommittee, I am pleased to have this opportunity to appear before you today to speak about the U.S. Government's assistance to the Burmese people.

As my colleague from the Department of State has told you, the people of Burma have suffered a great deal at the hands of a military junta. The repressive policies of this regime have reversed the results of democratic elections; its policies have allowed a serious AIDS epidemic to spread even wider, and have left over three million people displaced within Burma, and others forced to live as refugees along its borders.

Burmese Refugees -- An Overview

The Union of Burma's 1945 independence constitution established the country under a quasi-federal system that recognized the autonomy claims of key minority nationalities (Karen, Shan, Mon, Chin, Karenni, and Kachin). This federal system followed the British practice of treating the ethnic groups as semi-autonomous regions within Burma. The initial union lasted less than two years before the country erupted into civil war. What initially began as a communist insurgency soon spread to include all the principal ethnic groups in fighting against the Burman dominated central government. In the early 1990's, the Burmese government devised a "Four Cuts Policy," cutting off supplies of food, funds, recruits and information in an attempt to suppress ethnic insurgencies smoldering in several outlying states. Entire populations in these states were forced to abandon their villages and communities and move to relocation centers scattered throughout the country. Many chose to flee the country altogether. While cease-fire agreements have been signed with all but three of the ethnic groups, the government's policy of forced relocation has continued to drive tens of thousands of Burmese from their homes.

The first refugees from Burma arrived in Thailand in 1984. Since then, over a million people have fled Burma: 1 million to Thailand, 40,000 to Bangladesh, 50,000 to India, 10,000 to China, and almost 5,000 to Malaysia. About 138,000 refugees live in 10 camps scattered along the Thai-Burma border, while as many as one million survive as illegal migrants working at seasonal agricultural or urban industrial jobs in Thailand.

In 1988 about 10,000 Burmese students and pro-democracy activists fled Burma after the failure of a popular democratic uprising, accounting for the first major outflow of refugees. In 1990 the government cancelled the results of the national election when it became apparent that the regime had lost 80 percent of the vote to Aung San Suu Kyi's National League for Democracy (NLD). The regime's ensuing persecution of NLD leaders, combined with the army's stepped up campaigns against ethnic minority groups who had not signed cease-fire agreements, forced increasing waves of Burmese across the border.

Beginning in FY 1996 in response to a congressional directive, the U.S. Government has provided humanitarian assistance to Burmese in Thailand, along the Thai-Burma border and funded pro- democracy activities both inside Burma and along the Thai-Burma Border. $2.4 million was provided in FY 1996, and has increased incrementally to its present annual level of $6.5 million. Management of this program is closely coordinated between USAID and the State Department, with USAID managing some activities and the State Department managing other elements.

The objectives of U.S. government assistance for Burma and Burmese refugees are to:

- develop the capacity of the Burmese people to manage the eventual transition to a democratic society;

- maintain pressure on the ruling Burmese regime, the State Peace and Development Council (SPDC); and

- encourage the regime's participation in a process leading toward a peaceful transition to a democratically elected government.

Humanitarian Assistance Program ($3 million in FY 2001)

Our humanitarian assistance program is focused on building the capacity of Burmese refugees along the Thai-Burma border to manage and implement their own basic education and health care delivery systems, and to carry these skills with them to Burma when a safe return to their homeland becomes possible. Through grants to the International Rescue Committee and World Education, the program provides formal and on-the-job education and health training to refugees, primarily in Karen and Karenni refugee camps.

International Rescue Committee (IRC) (USAID-managed) - $1.3 million in FY 2001. IRC provides training to refugee community leaders and local NGO's to develop their capacity to manage their own health care delivery programs, with a goal of handing over maximum management responsibility for programs in the camps to camp representatives. IRC trains multi-purpose health workers, traditional midwives, and medics. This training has contributed to maintaining levels of maternal health and child survival in the refugee camps that are on par with surrounding Thai communities.

Thousands of refugees outside of camps are benefiting from USAID support to Dr. Cynthia's Clinic. Herself a refugee, Dr. Cynthia Maung and her medics see hundreds of patients a week, treating injuries including landmine wounds, monitoring infant growth, providing prenatal care, educating families in nutrition, and teaching Burmese women how they can space their children to ensure the best possible health. Dr. Cynthia trains medics, midwives and community health workers who provide basic health services to displaced Burmese inside Burma and on the border.

World Education/ World Learning Consortium (USAID-managed) -- $1.7 million in FY 2001. Since 1999, the Consortium has helped develop a viable education system for 30,000 children within the refugee camps. The goal of the program is to assist the refugee camp leaders to develop an education system that can be transferred to Burma when the refugees return. In six refugee camps where the Consortium works, the project has produced educational materials for use by schools, trained teachers and administrators, and assisted in curriculum development. Half of all school directors and 75 percent of teachers have less than a tenth grade education and so rely heavily on the Consortium's training. Many textbooks used in Karenni camps were based on books dated before 1942 from the British Colonial Period in Burma. Now elementary students and teachers are using a new English, math and geography curriculum.

Democracy Program ( $3.5 million in FY 2001)

The goal of the democracy program is to assist Burmese both inside and outside of Burma to improve their ability to manage an eventual transition to democracy. The program supports activities that promote civic participation, better governance, increased dialog among ethnic groups, and more effective advocacy for human rights. The main components of the program are described below.

National Endowment for Democracy (Department of State-managed) -- $2.3 million in FY 2001. With funds from the Department of State, the National Endowment for Democracy supports a variety of activities to help the Burmese develop the capacity to make the transition to a democratic form of government. These efforts include documenting and publicizing the treatment of political prisoners in Burma, as well as humanitarian assistance to political prisoners and their families. Working with the independent labor movement in exile and in Burma, violations of internationally recognized labor rights have been documented and publicized. Members of the National League for Democracy and ethnic political parties in exile have been trained to support an issues-based political dialog, communicate effectively, and develop an internal democratic organization.

Open Society Institute (OSI) (USAID-managed) -- $0.56 million in FY 2001. OSI assists USAID in administering an important small grants program at the border to support democracy activities. Separately, OSI conducts a highly successful scholarship program, which has helped over 1000 undergraduate, graduate and Ph.D. Burmese students continue their schooling.

Internews (USAID-managed) -- $0.5 million in FY 2001. Since 2000, the Internews program has trained Burmese journalists in Thailand along the Thai-Burma border in four areas: 1) basic journalism (what is newsworthy, how to gather news, who is the audience, and how to write with accuracy, clarity and credibility); 2) management (organizational systems, revenue generation, marketing, fundraising); 3) editorial processes (developing a news agenda, managing a newsroom); and 4) layout and design. Working with seven ethnic newsgroups and five newspapers, Internews training has resulted in wider news coverage, more accurate reporting with a higher frequency of attribution to reliable sources, improved appearance of publications, increased circulation, and an increase in ethnic news stories quoted by other news sources.

Prospect Burma (Department of State-managed) -- $0.14 million in FY 2001. Prospect Burma provides scholarships to Burmese students to study at Thai universities. The program is similar to the OSI scholarship program in its goals and implementation. OSI provides student screening and tracking services for the Prospect Burma.

Additional Assistance

The Department of State's Bureau of Population, Refugees and Migration provides the following assistance to Burmese refugees that is additional to the $6.5 million program described above:

- $1,589,000 in FY 2001 to the American Refugee Committee (ARC) to provide medical care, including reproductive health care, basic sanitation and water supplies to Burmese refugees living in camps on the Thai-Burma Border;

- $3,113,000 in FY 2001 to the International Rescue Committee to provide food, health care and cooking fuel to refugees in camps on the Thai-Burma border, of which $1.5 million is used to purchase basic food commodities (rice, fish paste, salt, mung beans, cooking oil, and nutritional supplements for special nutrition programs) distributed monthly to 42,000 refugees through the Burmese Border Consortium (BBC);

- Approximately $1,360,000 in FY 2001 to the United Nations High Commission for Refugees for programs in Thailand focussing on the regularization and registration of Burmese refugees by Thai authorities, as well as humanitarian assistance to the most vulnerable groups.

- Approximately $2,828,000 in FY 2001 to the United Nations High Commission for Refugees for programs in Bangladesh and Burma to support Rohingas on the Bangladesh-Burma border.

HIV/AIDS in Burma

As the Subcommittee is aware, this year USAID was requested by the managers for the Conference on the Foreign Operations, Export Financing and Related Programs Act 2002 to prepare a report on the extent of the HIV/AIDS epidemic in Burma and to make recommendations for actions that the U.S. Government could take to limit its spread. We want to ensure that these activities are transparent, thoroughly monitored, and like other assistance to Burma, is administered in consultation with the National League for Democracy. We completed our assessment and reported back to Congress in April. I have attached a copy of our report to my testimony.

What Do We Know?

Official HIV surveillance data in Burma, while imperfect, clearly indicate a serious epidemic, that has spread from known high-risk groups into the general population. Data from antenatal clinics record HIV prevalence of 2.8% among the youngest group (15-24 years old) of pregnant women. Data from groups with high-risk behaviors indicate much higher prevalence levels, representing sub-epidemics in specific areas. Overall HIV rates are higher along the Chinese and Thai border areas in the eastern section of the country, and decline to low levels at the western border with Bangladesh. The majority of currently infected persons are male and most infections are transmitted sexually. This is associated with prostitution in which HIV prevalence in different samples of female prostitutes range from 30-50%. Men who have sex with men are not included in the national surveillance, but reports in 1996 showed levels of HIV over 30% among them. Injecting drug users, mostly male, and heavily concentrated in northern opium- producing states, have HIV prevalence levels up to 74% and more, one of the highest levels recorded anywhere in the world.

Most Burmese are not aware how widespread HIV/AIDS is nor how to protect themselves. Condoms were outlawed until 1992 and usage remains very low. A survey in 1996 found that only 20% of women and 62% of men could identify a condom when shown one and it is estimated that less than 5% of the nation's prostitutes are consistent condom users. Public campaigns have stressed morality and have associated HIV/AIDS with criminals and socially less desirable segments of the population. People with HIV infections are now generally stigmatized and do not always access the care and support actually in place. Few support groups exist for people living with HIV/AIDS.

The State Peace and Development Council (SPDC) has recently publicly acknowledged concern about HIV/AIDS and has publicly named the epidemic as one of the top three priority public health issues, along with malaria and tuberculosis. The professional and technical staff in the Ministry of Health understand the HIV/AIDS epidemic and are committed to their work but, overall, Ministry of Health capacity to respond is limited and training and resources are needed.

The future of the Burmese people could be severely affected by the economic consequences of the current epidemic. Further, Burma's epidemic influences the epidemics in northeastern India, Thailand and China and, to some extent, vice versa due to commercial travelers (e.g. truckers), labor migration, tourism, movement of prostitutes and trafficking in persons and drugs.

Why Now?

The time is ripe for investment in reducing the spread of HIV in Burma and mitigating its impact on the population. United Nations agencies are in the process of strengthening their programs, several bilateral donors have now made assessments and are planning to bring in resources, and both the SPDC and the National League for Democracy (NLD) view HIV/AIDS as a major threat to health in Burma. The SPDC appears to be open to assistance from outside. The NLD agrees with the need for increased HIV/AIDS assistance and would support limited work with public health institutions as long as the use of resources is carefully monitored. There is now an opportunity to leverage United States Government assistance by collaborating with the private sector, other bilateral and multi-lateral donors, non- governmental organizations and community-based organizations that are addressing HIV/AIDS in Burma.

What is Being Done?

There are several international non-governmental organizations (INGOs) working in Burma on HIV/AIDS and more are expected. Several are doing important work and making significant contributions, but there are not sufficient resources to mount a truly effective national response and sufficient information is not available to target or evaluate an expanded program. The INGOs working on HIV/AIDS have proceeded cautiously, attempting to maintain independence from government while bringing services to the people. They have been able to develop a range of important projects, most kept relatively small so far, that include the social marketing of condoms, innovative education campaigns using traditional theatre to promote health messages, and the support of community volunteers who provide home care.

There are also many Burmese government-related NGOs (Go-NGOs) and local community-based organizations (CBOs) working on HIV/AIDS in Burma, but their capacity is limited and they need technical assistance and training to increase their effectiveness. Many of the Go-NGOs are at least informally linked to the SPDC through their directors' associations with public officials but it is believed that the majority of them are dedicated to the struggle against HIV/AIDS in Burma.

UN agencies, such as UNICEF, WHO, UNDCP and UNDP, have been playing an essential role in advocacy and in helping Burmese officials understand what is required for an effective response to the epidemic. Recently the UN agencies, with the regime and some international and government-related NGOs, prepared a Joint Plan of Action for the coordination of the activities of the UN system for the period 2001-2002. Very recently several bilateral donors, particularly Australia, Great Britain, Japan and the European Union, are considering new and expanded assistance for HIV/AIDS programs in Burma. Virtually all of the key bilateral donors are currently assessing their HIV/AIDS program options, which will provide a unique opportunity during the next six months to collaborate in a coordinated response.

What Can USAID Do?

U.S. Government sanctions restrict assistance to the Government of Burma because of Burma's position with regard to human rights, trafficking and drugs. However, Congress has provided "notwithstanding" language for HIV/AIDS programs in Section 104 of the Foreign Assistance Act of 1961 (P.L. 87-195), as amended, that permits USAID to provide HIV/AIDS assistance in Burma.

We are proposing a limited-focus program in Burma as part of a larger, regional effort to control HIV/AIDS in Southeast Asia. With a funding level of $1 million in FY 2002, USAID would focus its support on:

- primary prevention programs aimed at most at-risk persons (prostitutes and their clients; men who have sex with men; and injecting drug users) - these programs would include education about HIV/AIDS transmission factors including high-risk sex, and injecting drug use, and prevention strategies including reduced numbers of sexual contacts, the consistent use of condoms and not sharing needles;

-education for the general population to increase awareness and understanding of HIV/AIDS, its transmission and prevention and to reduce stigma against those infected;

-behavioral research;

-training for health care providers;

-improved and expanded social marketing of condoms;

-care and support of people living with HIV/AIDS;

All activities will be closely coordinated with Burma's democratic forces inside and outside of Burma. No assistance will be provided to the military regime. USAID will be carefully monitor the funds provided to assure that they are used for their intended purposes.



LOAD-DATE: June 20, 2002