title: On the frontline of eastern Burma's chronic conflict--listening to the voices of local health workers.
abstract: Globally, attacks on and interferences with health workers and healthcare delivery, including targeted violence towards providers, attacks on hospitals and delays and denial of health care, represent a serious humanitarian and human rights issue. However, gaps in research about these events persist, limiting the evidence base from which to understand and address the problem. This paper focuses on experiences of local health workers in eastern Burma's chronic conflict, including their strategies for addressing security and ensuring access to vulnerable ethnic communities in the region. Face-to-face in-depth interviews were conducted in June and August 2012 with 27 health workers from three health organizations that operate throughout eastern Burma, with their operational head quarters located in Mae Sot, Tak Province, Thailand. Qualitative analysis found that health workers in this setting experience violent and non-violent interferences with their work, and that the Burmese government's military activities in the region have severely impacted access to care, which remains restricted. Data show that innovative security strategies have emerged, including the important role of the community in ensuring securer access to health care. This study underscores health workers' concern for improved data collection to support the rights of health workers to provide health care, and the rights of community members to receive health care in conflict-affected settings. Findings will inform the development of an incident reporting form to improve systematic data collection and documentation of attacks on health in this setting.
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, 615 N. Wolfe Street/E7141, Baltimore, MD 21205, USA. Electronic address: kfooter@jhsph.edu.
authors.forename: Katherine H A
authors.initials: KH
authors.lastname: Footer
authors.affiliation: Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Meyer
authors.affiliation: Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Sherman
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, 615 N. Wolfe Street/E7141, Baltimore, MD 21205, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Rubenstein
mesh_terms: D000328:Adult; D003695:Delivery of Health Care; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D002052:Myanmar; D014857:Warfare; D055815:Young Adult
keywords: Attacks; Burma; Conflict; Ethnic groups; Health worker; Myanmar; Security; Violence