Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Mullany, LC; Richards, AK; Lee, CI; Suwanvanichkij, V; Maung, C; Mahn, M; Beyrer, C; Lee, TJ

Published Date

  • October 2007

Published In

Volume / Issue

  • 61 / 10

Start / End Page

  • 908 - 914

PubMed ID

  • 17873229

Pubmed Central ID

  • PMC2652972

International Standard Serial Number (ISSN)

  • 0143-005X

Digital Object Identifier (DOI)

  • 10.1136/jech.2006.055087

Language

  • eng

Conference Location

  • England