Impact of Armed Conflict on Health and Human Rights in Burma: A Population-Based Assessment Using Multi-Staged Household Cluster Sampling

Background:  The Chin State of Burma is an isolated ethnic minority area with poor health outcomes, and high levels of food insecurity and human rights violations. We report on the first population-based assessment of health and rights in Chin State.

Methods:  Three-staged randomized household sampling was done. Heads of households were interviewed on demographics, access to health care, health status, food insecurity, forced displacement, forced labor, and other human rights violations over the preceding 12 months (2009). Ratios of the prevalence of household hunger comparing exposed and unexposed to each violation was estimated using binomial regression, and 95% confidence intervals constructed. Multivariate models were done to adjust for possible confounders.

Findings:  Overall, 91.7 % of households (95% CI=  89.5 - 94.0%) reported forced labor in the past 12 months. 43% of households met FANTA-3 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. Multiple rights abuses were independently associated with household hunger.

Conclusions:  The widespread and systematic nature of rights abuses in Chin State may amount to crimes against humanity and should be investigated by the International Criminal Court.