Bertrand Bainvel has served as the United Nations Children’s Fund Representative to Myanmar since October 2012. He spoke to The Global New Light of Myanmar about the gains made over the past three years – and the challenges that remain.
“What has been very exciting for us to see is the space created for reforms for children, which include improving education, health and social protection,” Mr Bainvel said.
However he emphasised that such reforms are about generating long term changes and building on ‘quick wins’ that benefit current and future generations.
Alarming child mortality rates prevail
Child mortality rates in Myanmar remain among the highest in the region – only Afghanistan and Pakistan fare worse. When in 2014 Myanmar held its first census in 30 years,the readjusted population figures meant that under-five mortality rates increased further still.
“We don’t believe we saw an actual increase over the last few years, even though the new data increases the previous rate. But in both scenarios, [the under-five mortality rate] is still very high.”
Mr Bainvel said that the biggest killers are neonatal conditions, diarrhoeal diseases, acute respiratory infections and malaria.
“The lack of access to sanitation and clean water needs to be significantly improved. Very often families lack access to health services and the percentage of children born in health facilities is very low. We know that being born in a home is always riskier than a health facility. And without assistance from a trained person, it is even riskier,”he said.
Widespread malnutrition is another major contributing factor to under-five mortality rates.
“We know malnutrition rates are high in Myanmar. However there are plans involving FAO, WFP, WHO and UNICEF to adopt a more systematic approach, so we feel there will be positive results in the coming years.”
Future looks bright
Mr Bainvel expressed hope that the outcome of Myanmar’s historic general election will build on UNICEF’s progress thus far, while acknowledging that “any new government is expected to define its own priorities.”
UNICEF held consultations with 80 political parties ahead of the election with the aim of highlighting the need to prioritise children’s rights, and will soon undertake a follow-up of various campaign manifesto pledges. International Children’s Day on 20 November will be seized as a great opportunity for UNICEF to do so.
Guarding against preventable disease
Mr Bainvel said that one of the greatest successes over the past three years in Myanmar was an immunisation campaign against measles and rubella that began in January.
The campaign aimed to immunise 17.4 million children up to the age of 15. The US$24 million programme took place in all 14 states and regions and was funded by Gavi, the Vaccine Alliance, together with the Ministry of Health, World Health Organisation and UNICEF.
“It was the largest immunisation campaign ever held in Myanmar: it had a 90 percent coverage rate. It involved many grassroots programmes across the country to get children vaccinated – for many it was the first time they saw a nurse arrive at their school carrying a box of vaccines.”
However Mr Bainvel said that UNICEF remains concerned about certain pockets of the country that could not be reached.
In areas where armed conflicts were ongoing, health workers from ethnic groups were put in touch with those from the government to negotiate “some space” for vaccinations. Other areas were simply too remote.
The campaign lasted longer than initially planned, as data indicated that nearly 60,000 children missed out due to lacking a fixed abode: this meant that they were unregistered attownship authorities, nor within the catchment of a local health clinic.
New opportunities present new risks
Mr Bainvel said that Myanmar’s opening up to the world comes with both benefits and risks.
“When new economic opportunities are unevenly distributed, it drives the movement of people,” he said.
In parts of the country where extreme poverty and very few opportunities for work exist, such as in Chin and Rakhine states, many opt to move to the economic hubs of Mandalay and Yangon. Seasonal migration also occurs annually, such as to south-eastern areas duringthe rubber cultivation season.
“When people are on the move it’s very difficult to provide basic services – just as it’s difficult to put a child who has been on the move for three months in a school. This will continue to be a big challenge,” he said.
Mr Bainvel added that some children are moving to poor urban areas on their own, which makes them vulnerable to trafficking and being recruited as child soldiers.
Another risk facing Myanmar’s children is the unprecedented influx of foreign tourists, which are expected to number five million this year.
“When Cambodia opened up, for example, many tourists came and the country possibly didn’t anticipate the problems they would face, such as sexual exploitation and the proliferation of orphanages.”
Mr Bainvel stressed that “orphanage tourism” often arises as a result of tourists’ best intentions.
“Many tourists feel they have a responsibility to not just visit the beaches and temples of Myanmar but to also leave something behind. But if it’s not done in the correct way, it can have very bad consequences.”
He said that families struggling with poverty may feel that foreigners can help lift them out of it. The problem is that it’s often the children that are put on the front line of such efforts – whether it be selling postcards, begging at busy intersections or the proliferation of orphanages, particularly in Yangon’s impoverished Dala Township.
UNICEF is unequivocal in its advice to tourists about visiting orphanages: don’t do it.
Mr Bainvel said that surveys have found that more than 70 percent of children living in Myanmar orphanages are not actually orphans – one of their parents is alive.
“By far, the family is the best place for child. Only in an extreme case such as domestic violence should a child be separated from their family and placed in temporary foster care. So to help a child, you should help their family,” he said.
UNICEF has a campaign underway in collaboration with Myanmar’s tourism and hotels sector. It aims to discourage tour operators from including orphanage visits on their itineraries and to highlight the better options that exist.
Community organisations are being twinned with hotels in tourist hot-spots such as Bagan: guests are provided with information about local NGOs and how they can donate. This may include providing social workers with the necessary funds to make home visits and ensure that children are attending school.
“It’s very much a grassroots campaign. It is about showing the alternatives,” Mr Bainvel said.
UNICEF is also working with the transport industry to issue educational pamphlets when tickets are issued by airlines, and plans to create videos screened by international in-bound flights are in the pipeline.
“We have an opportunity to put things in place before it is too late,” said Mr Bainvel.