Health and Human Rights:

Medicine is Politics

In 1847 Rudolf Virchow was only 26 years of age, but he was already one of Germany's greatest scientists. In that year, the Berlin City Council asked Virchow to investigate an epidemic of typhus which had broken out in upper Silesia (currently located in Poland). Virchow concluded that the cause of the epidemic was "mismanagement of the region by the Berlin government". Virchow's recommendations included full democracy for Silesia, allowing Polish as the official language of the region, the separation of church and state, shifting the burden of taxation from the poor to the rich, a program for road construction, the improvement of agriculture, and the establishment of farming cooperatives. The Berlin Council was very unhappy with Virchow's report. The Council criticized Virchow for producing a political document rather than the scientific report which they thought they had commissioned. Virchow then made his famous statement which still resonates 155 years later:

Medicine is a social science and politics is nothing but medicine writ large!

Virchow further claimed that if medicine were to be successful then it must enter political and social life because diseases were caused by defects in society. He claimed that,

If disease is an expression of individual life under unfavourable circumstances, then epidemics must be indicative of mass disturbances.

It is now well accepted in public health circles that the Burmese HIV epidemic is one of the world's fastest growing and most pervasive. According to Dr Peter Piot, UNAIDS's Executive Director, Burma currently has at least 500,000 to 700,000 people with HIV/AIDS — the second worst AIDS epidemic in Asia after Cambodia. The Southeast Asian Information Network and other non-governmental organisations have confirmed Piot's estimate. The Burmese junta, however, claims that there are only 21503 confirmed cases of HIV infection and 2854 cases of AIDS in Burma. (Dr Chris Beyrer)

The junta's refusal to recognize the epidemics clearly indicated that this political and humanitarian crisis is caused by their massive mismanagement, corruption and policy failure.

Pro-military people who visited Burma would come back and say ... now Burma is progressing ... with how many hundreds of new hotels, how many lanes of highways ... etc. Are the number of hotels and night clubs, the criteria for measuring the progress of one country?

Thirteen years ago when we were working at Rangoon General Hospital, the blood test for electrolytes (which is a basic and essential test for management of renal diseases, strokes, snake bites, malaria, etc.) could be done in the hospital lab and results could be obtained quickly for a seriously ill patient. Nowadays, this test is done at an outside clinic, which is located just across the road from the hospital, and it costs 3000 kyats per test.

While health is understood to include physical, mental and social well-being, it is concluded that the violation or neglect of any human right will impact adversely on health. In every nation in the world, government is a key player in the health sector. Human rights regarding health require that the state provide health care that individuals are not able to obtain or provide on their own. The failure of the SPDC to acknowledge the HIV and other health problems in Burma is proof that the SPDC is not acting like an elected/official government. Because they are not the government, it is not surprising that they do not realize the duty of the government. Unless democracy is restored in Burma by replacing the illegal regime with an elected government, the HIV/AIDS epidemic in Burma is likely to spiral ever more out of control.

As Virchow so eloquently described 155 years ago,

Medicine is Politics

Dr. Khin Saw Win

This commentary is based on a posting Dr. Khin Saw Win made in the soc.culture.burma newsgroup and the FreeBurma Yahoo! Group on 2001-11-02. The posting has been edited for inclusion on the Burma Watch International Web site. The original posting was translated into Japanese and published in the Japanese Human Rights Magazine.