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Myanmar: Health Workers

Volume 828: debated on Tuesday 7 March 2023


Asked by

To ask His Majesty’s Government what support they are providing for health workers in Myanmar who are caring for patients outside the areas controlled by the military government of that country.

I beg leave to ask the Question standing in my name on the Order Paper and, in doing so, I declare an interest as patron of THET, the Tropical Health and Education Trust.

My Lords, Myanmar’s public healthcare system has been in crisis since the coup. We are concerned about Myanmar’s level of basic healthcare services and childhood immunisation rates. The UK is a leading donor on supporting healthcare needs in that country. This financial year, the UK has provided £13.95 million for healthcare in Myanmar, which is being delivered by the UN, by civil society and by ethnic healthcare organisations. This support is saving the lives of vulnerable women and children.

I thank the Minister for that response. I agree that the situation in Myanmar two years after the coup is truly appalling. I pay tribute to the UK Government’s efforts, including their efforts at the Security Council to keep up pressure on the country. There are many courageous health workers in the parts of the country that are not controlled by the military who are providing health services where and how they can from makeshift facilities, and they are being targeted by the military as a result. They are being excellently supported by UK and UK-based Burmese clinicians with education, training, advice, some supplies and more, largely over the internet. However, this is problematic because it is very largely controlled by the Government.

I have two immediate questions. I understand that Professor Zaw Wai Soe, the Health Minister of the National Unity Government, has asked the noble Lord, Lord Ahmad, if the UK can help by providing access to satellites. Can the Minister tell the House what progress is being made with this and when a response can be expected? Would he be willing to meet representatives of the UK and the UK-based Burmese clinicians in this country to discuss the situation, and what further practical action can be taken?

My Lords, for obvious reasons, humanitarian access is extremely challenging, with many areas cut off completely to the UN and international NGOs. That is why our approach has been targeted at using and working with domestic organisations of the sort that the noble Lord has cited. The problem with that, as he knows, is that healthcare workers affiliated in any way with the civil disobedience movement are targeted. According to the World Health Organization, at least 51 healthcare workers have been killed and 352 attacked since the coup, and the Tropical Health and Education Trust, which the noble Lord is part of, reports that 624 healthcare workers remain in arbitrary detention. I am afraid I do not know the answer about progress on satellites, but I will ask my noble friend Lord Ahmad, in whose portfolio this sits, and if he is not able to meet representatives then I will certainly happily do so.

My Lords, since Security Council Resolution 2669, we have seen 2 million children in need of a targeted immunisation catch-up programme and 3,000 people having died at the hands of the military coup. Does the Minister agree with the UN High Commissioner for Human Rights, Volker Türk, that the crisis will not end until those responsible are held to account? Will the Minister ensure that we pursue that strongly at the United Nations?

I absolutely agree with the noble Lord and with the UN. He will know that in December last year the UN Security Council passed the first ever resolution on the situation in Myanmar, and that was led by the UK. The resolution demands an end to violence and urges immediate action by the military regime to fully implement the ASEAN five-point consensus and release everyone who has been arbitrarily detained. However, we are not going to see change until we see change at the very top. The noble Lord is right to make that point, and it is of course a priority for the UK.

My Lords, I declare my interests as vice-chair of the all-party parliamentary groups on Burma and the Rohingya. I want to take the Minister back to what he has just said about levels of access and the request from my noble friend Lord Crisp about meeting some of those who are involved in these issues, specifically in this case Burma Campaign UK, in order to address their concerns about the level of reporting that is required for the receipt of international humanitarian aid, which they say is wholly unrealistic and simply not feasible in a conflict zone. They say that people are dying because of the red tape. Can we look again at how to utilise local civil society organisations, as referred to by the Minister a moment ago, which are indeed best placed to get aid to those who need it? They say that, among Burma’s ethnic minorities and the 2 million displaced since the military coup, a humanitarian catastrophe is unfolding.

My Lords, it is without doubt a humanitarian catastrophe. Myanmar is the Indo-Pacific’s most desperate humanitarian crisis. Some 17.6 million people are in need of humanitarian assistance and over 1.6 million have been displaced, including over 500,000 children. Some 15 million people are considered moderately or severely food insecure, and 7.8 million children remain out of school. So the noble Lord is right. The difficulty, as I mentioned earlier, is access. When dealing with a regime of the sort that runs that country, access to the grass roots is very difficult. So we have a twin approach: first, we work through channels such as the UN and ASEAN to push for greater humanitarian access and, secondly, we increasingly support local civil society networks with access to vulnerable communities to be the first responders to the crisis. That has ensured that UK aid is reaching the most remote and hard-to-reach areas, but it is difficult.

My Lords, the Burmese diaspora are working closely with NHS colleagues in delivering clinical education and training. Their time and expertise are gifted free of charge and supported by modest FCDO funds, which allow organisations such as the Tropical Health and Education Trust to organise and structure this support in a professional way. Could the Minister comment on whether he sees any scope for increasing those funds for UK health communities in their response to Myanmar?

I will reiterate the point I made. We applaud the Myanmar health professionals who are risking their lives to continue treating patients. We commend the NHS volunteers who are sharing their skills and knowledge with colleagues and friends in Myanmar, taking huge risks in doing so. I absolutely pay tribute to them. Since the coup, we have provided around £100 million to support those in need of humanitarian assistance, to deliver healthcare and education for the most vulnerable and to protect civic space. In 2021-22, we provided nearly £50 million in aid to Myanmar, including £24 million of life-saving assistance for 600,000 people. I am not in a position to comment on future expenditure, but I think it is very clear from our recent track record that this remains a priority focus for the FCDO.

My Lords, as I started to say earlier, the attack on health workers and health support workers is deeply reprehensible and I support the Government’s actions, including the sanctions. The operation of a parallel health system by health workers to provide much-needed support for children could be a model in other countries, such as Syria and Afghanistan, where we do not recognise the regimes. When the Minister is considering the right reverend Prelate’s question regarding UK government support, can that support include those seeking to offer vital health support in Syria and Afghanistan, where we do not recognise the regime?

The noble Lord makes an important point, and I will make sure that that suggestion is conveyed to relevant Ministers and officials. I will add that, according to the World Health Organization, one-third of all attacks on health workers around the world have occurred in Myanmar. This is a real problem. I think the approach adopted in that country by the international community has worked and, like the noble Lord, I do not see any reason why it would not in other areas where we do not recognise the regime.

My Lords, I declare an interest as a trustee of Burma Campaign UK. The Minister will know that, since the coup in 2021, the military has brutally suppressed its critics and unlawfully attacked civilians on the ground and from the air, including many health workers working in the ethnic areas. While the UK and EU-imposed sanctions on aviation fuel are welcome, will the Minister give assurances that he will keep those sanctions under urgent review as companies change names to avoid sanctions, and look into whether British companies are involved in the provision of third-party services to vessels involved in the shipment of aviation fuel to Myanmar, such as insurance, shipping or financial services? Stopping the military’s relentless bombing campaign on innocent civilians will help those providing humanitarian aid.

The Government always keep their sanctions policy under review. We are considering a range of further targets and other measures to hold the suppressive, brutal regime to account. It is vital that any sanctions imposed have the desired effect of denying the regime credibility and reducing its access to finance, arms and equipment. Part of that is to tackle the problem identified by the noble Baroness—the use of aviation fuel to facilitate bombing campaigns. That is a focus of the FCDO when it comes to looking at the appropriate sanctions.