#WhatWENeed Myanmar

#WhatWENeed in MyanmarFull CRPD Compliance on the inclusion of persons with psychosocial disabilities

Myanmar obtained Independence from Britain in 1948. Even though a former British colony, Myanmar has chosen not to be a part of the Commonwealth nations. There are strong feelings about having been colonized, that foreign rule has isolated the country for 50 years from international contact and growth, and left it desolate of self determination and resources. Myanmar, geographically, is divided by its 3 rivers.

Administratively, like other Commonwealth nations, it has retained its administrative structure on central and federal basis. Years of the peace struggles, the \’divide and rule\’ policies of the British, and complex political alliances before and after the War towards independence, has impacted the nation; and its continuing internal strife, especially impacting ethnic peoples. The United Nations (UN) describes the situation in Myanmar as ‘a complex combination of vulnerability to natural disasters, food and nutrition insecurity, armed conflict, inter-communal tensions, statelessness, displacement, trafficking and migration’. This is yet another country of the erstwhile British colonies, that faces serious post colonial aftermath.

#WhatMyanmarNeeds:

1.  Our full and effective inclusion in national laws and policies.

Disability legislation for people in need is still an ongoing process of advocacy, rights and provisions.  Implementation of signed and ratified (UNCRPD) is still a challenge.  No  policy or legislation exists, that is in compliance  with  UNCRPD.Mental health is not fully integrated into Development services, or disability inclusion.

2.  Our right to live independently and be included in communities.

Myanmar, as expected from an erstwhile British colony, has the Lunacy Act of 1912. As expected, also, it has 2 old mental asylums warehousing people by the hundreds, in the traditional colonial way. Especially, more than 300 people  with  Psychosocial  disabilities in the mental  hospital  in  Yangon are institutionalized life-long.  Due to historical, legal, social and other barriers, they don\’t get  the right  support  through  de-institutionalization, psychosocial  services and processes adapted to life in communities. Recent events of human rights violations   in Myanmar has been seen by globalizing mental health as an \”opportunity\” for expansion [1] of mental health services, especially, psychiatric and psychotherapeutic services.

3.  Full CRPD Compliance in  policy and legislation.

Current legal frameworks for persons with psychosocial disabilities is not in compliance with CRPD. It focuses on involuntary institutionalization and the medical model.The Lunacy Act is a colonial legislation, with provisions of deprivation of liberty of someone who is a \’lunatic\’ or an \’idiot\’. There is a view that this law must be made more contemporary.[2] In other British postcolonial societies, this has meant changing the legal concepts, but not the penal framework.

Guardianship

Guardianship law exists under the Lunacy legislation. Currently, according to the Lunacy act (1912) , the  mental  hospital (psychiatric  Board) has  the  guardianship  to  keep  more than 300   person with psychosocial  disability  as being  institutionalized  life-long. Currently, old  existing laws and  policies, as found in all erstwhile British colonies, discriminate the persons with psycho-social  disabilities on grounds of legal incapacity and put them under guardianship.

4. Community support systems

There is no provision for living independently or for community living:Families continue to take care of their loved ones in need.  The communities also engage in socialisation especially through traditional practices. Gaps include:

(1) lack of accessible community based  mental  health  support systems especially in remote, poor  areas

(2)  lack of the right  support  systems in terms of psychosocial  recovery and  rehabilitation, which is favoured by traditional society like Myanmar

(3) lack of trainings and skilled resources in psychosocial services

(4) lack of law and policy which safeguards the person centered  approach, and  finally

(5) rights and provisions in compliance with legislation on CRPD.

5. Public financing for Inclusion:

The state  doesn\’t allocate  separate  budget  for persons with psychosocial    disabilities although  it provides  the (health)  budget for the 2 mental  hospitals. Some programs are  being operated  on some  extent of  psychosocial  part. But  persons of high support need with psychosocial disabilities are still outcast. The state does not allocate budget for independent living and inclusion. There is a lack of awareness and gaps in the implementation of psychosocial recovery and inclusion within the current system.

6. To foster community empowerment for care sharing

The huge gap in psychosocial  services  and the structure to  support  the needy  population  is necessary  to  build up the  community. Civil society groups are working and advocating for reform. There needs to be  more awareness about recovery and inclusion cross sectorally. We need more allies and persons for advocacy. CRPD must guide law, policy, trainings, especially knowledge resources and implementation manuals. 

(1)  mental health awareness and the importance  of psychosocial  wellbeing.

(2)  Community  based, trauma informed, psychotherapeutic  care  system across the country

(3)  Legal  and policy safeguards for the rights of person with psychosocial disabilities

(4) Disability inclusive community  and social  inclusion(5) Integrated multi-sectoral approach   in  psychosocial  support.   

7. To continue traditional healing practices that are CRPD compliant and serving communities:

Myanmar  is  one  of  South East Asian countries, has  traditional  ways  of  healing.  The first is  going  to  astrologers, taking their  advice and  doing  some  treatments  to feel safe and  combat  the  impending misfortunes. The second  is  Buddhist  traditional meditations,  which  is  provided  by  the  monasteries.  The sense of \”collectiveness\”  at the  meditation  center is  helpful   practice for  people to engage in  their cultural practices of healing and finding peace. Being  in the traditional space, is also an inspiration  for the  group to feel together.  Being  isolated  from  modernization  is  related  with the  still  strong  traditions of doing religious ritual practices, and a regularity of visits at the religious sites, pagoda, church, mosque. It is considered a good deed to adopt such practices. The ethical setting of different religions help  people  to  bring spiritual  confidence  and  esteem .  There  are  specific rituals  of  Burmese  and  Ethnic  people  across  the  country, related with  cultural and  belief systems (eg. Belief  in  full moon ,water festival, faith in the supernatural) play  in  healing path too. There  are  some games , dances of  the Burmese  and  Ethnics, and also folk  dance and  music  are  associated   with  individual autonomy, pursuit  of  happiness of   individual  and  feelings of collectiveness.

(Prepared for TCI Asia Pacific, Bali Plenary August 2018)Myanmar Christian Blind Federation  

We are working for sustainable psychosocial support, care, networking  for persons with psychosocial disabilities; Community based mental health and holistic care; Advocacy for progressive mental health care in community; Advocacy for implementation of UNCRPD elements in mental health care; policy development; de-institutionalization; and, Decentralization.   Our advocacy is for independent living and inclusion in communities, for persons with psychosocial disabilities.              

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[1] A. J. Nguyen, C. Lee, M. Schojan, and P. Bolton  (2018). \”Mental health interventions in Myanmar: a review of the academic and gray literature\”. Global mental health, 5e-8, February 19. doi:  10.1017/gmh.2017.30 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827419/

[2] https://www.mmtimes.com/news/government-urged-draft-mental-health-care-policy.html