BACKGROUND: Case reports of human rights violations have focused on individuals' experiences. Population-based quantification of associations between rights indicators and health outcomes is rare and has not been documented in eastern Burma. OBJECTIVE: We describe the association between mortality and morbidity and the household-level experience of human rights violations among internally displaced persons in eastern Burma. METHODS: Mobile health workers in conflict zones of eastern Burma conducted 1834 retrospective household surveys in 2004. Workers recorded data on vital events, mid-upper arm circumference of young children, malaria parasitaemia status of respondents and household experience of various human rights violations during the previous 12 months. RESULTS: Under-5 mortality was 218 (95% confidence interval 135 to 301) per 1000 live births. Almost one-third of households reported forced labour (32.6%). Forced displacement (8.9% of households) was associated with increased child mortality (odds ratio = 2.80), child malnutrition (odds ratio = 3.22) and landmine injury (odds ratio = 3.89). Theft or destruction of the food supply (reported by 25.2% of households) was associated with increased crude mortality (odds ratio = 1.58), malaria parasitaemia (odds ratio = 1.82), child malnutrition (odds ratio = 1.94) and landmine injury (odds ratio = 4.55). Multiple rights violations (14.4% of households) increased the risk of child (incidence rate ratio = 2.18) and crude (incidence rate ratio = 1.75) mortality and the odds of landmine injury (odds ratio = 19.8). Child mortality risk was increased more than fivefold (incidence rate ratio = 5.23) among families reporting three or more rights violations. CONCLUSIONS: Widespread human rights violations in conflict zones in eastern Burma are associated with significantly increased morbidity and mortality. Population-level associations can be quantified using standard epidemiological methods. This approach requires further validation and refinement elsewhere.
BACKGROUND: Case reports of human rights violations have focused on individuals' experiences. Population-based quantification of associations between rights indicators and health outcomes is rare and has not been documented in eastern Burma. OBJECTIVE: We describe the association between mortality and morbidity and the household-level experience of human rights violations among internally displaced persons in eastern Burma. METHODS: Mobile health workers in conflict zones of eastern Burma conducted 1834 retrospective household surveys in 2004. Workers recorded data on vital events, mid-upper arm circumference of young children, malaria parasitaemia status of respondents and household experience of various human rights violations during the previous 12 months. RESULTS: Under-5 mortality was 218 (95% confidence interval 135 to 301) per 1000 live births. Almost one-third of households reported forced labour (32.6%). Forced displacement (8.9% of households) was associated with increased child mortality (odds ratio = 2.80), child malnutrition (odds ratio = 3.22) and landmine injury (odds ratio = 3.89). Theft or destruction of the food supply (reported by 25.2% of households) was associated with increased crude mortality (odds ratio = 1.58), malaria parasitaemia (odds ratio = 1.82), child malnutrition (odds ratio = 1.94) and landmine injury (odds ratio = 4.55). Multiple rights violations (14.4% of households) increased the risk of child (incidence rate ratio = 2.18) and crude (incidence rate ratio = 1.75) mortality and the odds of landmine injury (odds ratio = 19.8). Child mortality risk was increased more than fivefold (incidence rate ratio = 5.23) among families reporting three or more rights violations. CONCLUSIONS: Widespread human rights violations in conflict zones in eastern Burma are associated with significantly increased morbidity and mortality. Population-level associations can be quantified using standard epidemiological methods. This approach requires further validation and refinement elsewhere.
Authors: V Iacopino; M W Frank; H M Bauer; A S Keller; S L Fink; D Ford; D J Pallin; R Waldman Journal: Am J Public Health Date: 2001-12 Impact factor: 9.308
Authors: Lynn L Amowitz; Chen Reis; Kristina Hare Lyons; Beth Vann; Binta Mansaray; Adyinka M Akinsulure-Smith; Louise Taylor; Vincent Iacopino Journal: JAMA Date: 2002 Jan 23-30 Impact factor: 56.272
Authors: Russell E Coleman; Nongnuj Maneechai; Nattawan Rachaphaew; Chalermpol Kumpitak; R Scott Miller; Virat Soyseng; Krongthong Thimasarn; Jetsumon Sattabongkot Journal: Am J Trop Med Hyg Date: 2002-08 Impact factor: 2.345
Authors: Luke C Mullany; Thomas J Lee; Lin Yone; Catherine I Lee; Katherine C Teela; Palae Paw; Eh Kalu Shwe Oo; Cynthia Maung; Heather Kuiper; Nicole F Masenior; Chris Beyrer Journal: PLoS Med Date: 2010-08-03 Impact factor: 11.069
Authors: Tyler Brown; Linda S Smith; Eh Kalu Shwe Oo; Kum Shawng; Thomas J Lee; David Sullivan; Chris Beyrer; Adam K Richards Journal: Malar J Date: 2012-09-19 Impact factor: 2.979
Authors: Rose McGready; Marcus J Rijken; Claudia Turner; Hla Hla Than; Nay Win Tun; Aung Myat Min; Sophia Hla; Nan San Wai; Kieran Proux; Thaw Htway Min; Mary Ellen Gilder; Anne Sneddon Journal: Wellcome Open Res Date: 2021-06-28