What are the consequences of militarism on health?

Militarism in Burma

The word "militarism" can mean any of the following:

1. the leadership of society by a military class
2. the tendency to use military strategy in dealing with problems
3. the tendency to aggressively prepare for war

It seems like the Burmese military regime has fulfilled all of the above three meanings. To be a militarist is to be a villain and nobody in the world is going to admit to the epithet. Studying and preparing for war is always justified as a prudent precaution against the belligerence of others.

What are the consequences of militarism upon health in Burma?

The foremost effect, of course, is the outright killing, maiming, refugeeism and destruction of livelihood caused by atrocity, brutality and war. There is no doubt that this cost very much more in civilian lives than in military lives. In militaristic countries, health care is a scarce resource and the control of it is seen as a crucial element of power. Accordingly, in many militarized nations, health workers and health facilities are primary targets of military operation.

In Mozambique, between 1982 and 1988, the South African backed Renamo guerrillas killed an estimated 100,000 civilians and destroyed 484 health centers serving 2 million people. According to political scientist George Lopez, there is throughout the Third World a "unified national security doctrine" that targets health and human rights workers, and a direct correlation between the degree of militarization of a government and its level of human rights violations.

The rise of the military class has shifted money and resources into the hands of a few so that many more Burmese can not afford health care and health conditions for the poor have become worse. In militarized poor countries, especially in Burma, it is very difficult for a poor family to reach middle class security and comfort by legal means. A military career may be one of the few avenues of upward mobility, since it can give one the raw power needed for extra legal operations. In Burma, military officers do get rich through extortion, bribery and graft, eventually forming an elite class in their own right. This has the effect of further siphoning off scarce resources, such as land and precious stones, into the hands of the military. Lopez continues: "What is unique in current Third World conflicts is that military leaders are becoming extremely wealthy." This is exactly true for Burma.

Militarism has created an unhealthy physical environment for the Burmese people to live in. The military have contributed directly through weapons production and by supplying and training an army. Political and war-related refugeeism has had major impacts on the environment as displaced populations lack the resources and facilities to feed and house themselves, or to dispose of their wastes. Mining companies and industries in Burma, needed by the military for financial support, have polluted the environment by releasing large quantities of hazardous wastes, toxic chemicals and metals.

Finally, it is needless to speak about the way in which militarism contributes to crime and terrorism. As in the case of Burmese military regime, which is involved in drug trafficking evidenced by the full protection offered to the World's famous drug dealer.

What can Health Professionals do?

A recent World Bank policy study on financing health services in militarized developing countries lists three main barriers to effective health care delivery in those countries. The barriers are:

1. insufficient spending on cost-effective activities like immunization and contraception
2. internal inefficiencies of public programs
3. inequality in the distribution of benefits

This same World Bank report points out that health care expenditures in militarized countries have been shrinking as a percentage of national budgets.

Given the strong militarism in Burma, it is the work of health professionals to document the specific effects of militarism on health, to disseminate this information to clients and the international community, to search for countermeasures against it, and to promote prophylactic measures that will reduce the prevalence of militarism in the health environment. This is obviously a strong undertaking, and it will take lots of time and courage.

But it is more practical and realistic to take those measures, rather than calling upon governments to make economic sanctions less harmful to the health of the people in targeted nations (ACP-ASIM's journal Annals of Internal Medicine, 2000, 132:158-61) because sanctions have no harmful effect on ordinary people and the health of the people of Burma.

Dr Khin Saw Win

This commentary is based on a paper Dr. Khin Saw Win presented at the First Burma Medical Association (BMA) Conference held in July 2001. She also posted it in the soc.culture.burma newsgroup and the FreeBurma Yahoo! Group on 2001-05-20. The posting has been edited for inclusion on the Burma Watch International Web site.