Page last updated at 23:41 GMT, Thursday, 15 June 2006 00:41 UK

Burma's public service suffering

Government hospital in Rangoon
Government-run hospitals are usually closed to outsiders

In the third article of a special series from inside Burma, the BBC's Kate McGeown looks at the military government's record of caring for the health and education of its citizens.

Burma's hospitals and schools are secretive places.

Much of what goes on inside these tightly controlled buildings remains a mystery to the outside world.

But indications from the few people prepared to risk speaking out paint a disturbing picture.

One doctor described long queues of patients, many with the classic diseases of poverty such as TB, malaria and water-borne illnesses.


She said she was often unable to give people the treatment they needed, because the drugs were either too expensive or impossible to obtain.

"I get upset sometimes, but then I'm also used to it - every day's the same," she said.

Burma's military junta has been ruling the country for four decades, during which time many other South East Asian nations have seen dramatic improvements in their economies, government services and standards of living.

But many analysts believe that since it came to power, the Burmese government has done little to improve basic services, preferring to spend money on the military and expensive projects like building a new capital.

Water sanitation project in Ayeyawady Division ( image by Penny Tweedie)
NGOs often concentrate on basic needs, such as a clean water supply
The World Health Organization estimates that Burma spends $10 per person per year on healthcare, compared with its neighbours Thailand and Malaysia, which spend $160 and $218 respectively.

One NGO estimated that the actual Burmese figure was even lower - more like $0.50.

The results of such policies are obvious. An estimated 150,000 Burmese children under the age of five die every year of malaria, acute respiratory infections and diarrhoea.

"There is no question that the government is not caring adequately for its people," one aid worker said.

Fight against HIV

Not all the news is bad, though. In the past few years, the authorities have increased their co-operation with local and foreign NGOs to tackle the spread of HIV/Aids - and according to UNAids, there have been some concrete results.

Condom use has tripled since 1999, needle exchange programmes are far more prevalent than a few years ago, and more people are both seeking and obtaining treatment.

But Burma still has one of the most serious HIV/Aids epidemics in South East Asia. UNAids estimates that 360,000 Burmese people are currently living with the disease - and other organisations put the figure as high as 600,000.

Despite these successes, there is evidently a long way to go in raising awareness, judging from one man who was brave enough to talk to me about his experiences.

Aids awareness poster in downtown Rangoon
There has been some positive news in the fight against HIV/Aids
Not only did he risk the wrath of the authorities - like everyone else I spoke to - he also risked exposing himself to the discrimination that comes from having a disease which is still seen as a taboo subject.

"There is a lot of discrimination," he admitted. "I used to share a flat with a friend, but when he found out I had HIV, he made me leave.

"Another man I know used to own a business, but when people found out, no one would buy anything from him anymore."

The man I spoke to is somewhat unusual, in that he is being given free anti-retroviral drugs - a rare luxury in Burma.

"I am one of the lucky ones," he admitted, adding that many Burmese died of Aids without ever knowing there was an alternative.

Education and propaganda

If little is known about healthcare, even less is known about Burma's schooling system.

Because of past student uprisings, the government sees schools and universities as potential hotbeds of dissent, and is therefore especially vigilant at keeping them free from prying eyes.

In fact, according to most of the teachers who were prepared to speak, the government seems to put more energy into stopping outsiders getting into schools than it does on educating the children inside them.

"I have about 80 children in my class," said one woman. "I have to shout so everyone can hear.

Much of a teacher's time is taken up with fulfilling government requests.

Schoolchildren in Rangoon
Teachers say education is not a high priority in Burma
"I spent a lot of time being involved in government propaganda," said a woman who left the teaching profession last year in frustration.

"I kept being told to take the children outside to wait for hours at a time, so they could wave flags when important people came past."

The result is that many children leave school without an adequate education.

There are glimmers of hope, though, for even the poorest students.

A few charitable schools operate around the country. One in Mandalay provides free education to nearly 6,000 children.

Passing tourists are welcome to visit, and foreign volunteers are actively sought to help teach English.

It is a refreshing change from the majority of Burmese schools, where the doors remain firmly shut - not only to outsiders, but also to the hopes of Burmese children who want to improve their lives.

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