Page 100 - Journal of Special Operations Medicine - Fall 2017

governments. The key issues are related to the non-Burman The BPHWT strives to provide assistance based on commu-
(i.e., ethnic) people’s social, economic, and political aspirations nity needs. Providing assistance in this manner requires re-
for the self-autonomy and ethnic equality promised to them specting the traditions and culture of each community, using
when they joined with the Burmans to establish the Union of local resources, collecting data in order to assess the unique
Burma. Consequently, over the subsequent 70 years, many needs of each community, seeking community feedback, and
non-Burman groups formed political/armed groups to initially partnering with other local organizations that provide health-
fight for independence and later for self-autonomy as mani- related services in Burma.
fested in some equitable form of political and resource power
sharing. A number of early ethnic insurgent soldiers had served Health workers, TTBAs, and VHWs are from and work in
with U.S. and British Special Operations units such as the OSS villages in local village tracks and therefore speak the local
101/Kachin Rangers, V Force, and Force 136. language and are familiar with the health issues and the secu-
rity situation particular to their area. When a Back Pack team
In 2016, the new National League for Democracy (NLD) gov- is not present in a given village, there are embedded TTBAs
ernment of Aung San Suu Kyi came to power in Burma and and VHWs in the village who continue to provide basic care.
continued with the peace negotiations of the previous civilian This local network ensures constant access to basic services
government. However, there has been no meaningful politi- in between visits from the Back Pack teams, helping to pro-
cal dialogue toward the self-autonomy and ethnic equality de- vide service continuity in the event of a sudden change such
manded by the EAOs. Also, despite the ceasefire agreements, as displacements from fighting, land confiscations, or natural
the approximately 20 EAOs, with about 70,000 soldiers, re- disasters. Should their communities be forced to flee because
tain their arms and territory. Moreover, there is active fighting of fighting or forced displacement, these TTBAs, and VHWs
between the Burma military and various EAOs in Northern move with them and provide the vital link with the local mo-
Shan State, Kachin State, Arakan State, and Southern Chin bile Back Pack team. Also, they provide a frontline to identi-
State. Thus, sustainable peace in the country still seems to be fying emerging public health issues, especially the spread of
distant even with the new NLD government. infectious diseases.

For security, logistics, funding, administrative, and training
Back Pack Health Worker Team
purposes, the BPHWT oversees and administers its programs
In respect to the humanitarian struggle against the Burma from Thailand but implements all program activities inside
military, ethnic health organizations (EHOs) and community- Burma. A 15-person multiethnic Leading Committee gov-
based health organizations (CBHOs) were initially established erns the BPHWT and is elected by the BPHWT field staff
under the authority of the EAOs in response to the health and head office leadership every 3 years. The Leading Com-
needs of ethnic people in areas controlled by them. The EHOs mittee appoints the eleven members of the executive board,
are the health departments of the EAOs, whereas the CBHOs which meets monthly to make operational decisions about
are organizations formed by members of communities to pro- the implementation and coordination of the BPHWT’s pro-
vide health services to their people. grams. The members of the Executive Board constitute the
day-to-day administrative and program management of the
The BPHWT, a CBHO, was established to provide primary BPHWT:
healthcare services to unserved/underserved populations in con-
flict-affected areas of Burma. In 1996, responding to increas- • Director
ing Burma military attacks in eastern Burma and a worsening • Deputy Director
humanitarian crisis, mobile medical teams began to be sent to • Medical Care Program Coordinator
provide primary health care in Karen, Karenni, and Mon States • Maternal & Child Healthcare Program Coordinator
in eastern Burma. Later in 1998, mobile health workers from • Community and Health Education And Promotion Pro-
the Mon, Karen, and Karenni areas of eastern Burma estab- gram Coordinator
lished the BPHWT. The BPHWT was initially made up of 32 • Capacity Building Program Coordinator
teams and 120 health workers serving a target population of • Health Information and Documentation Program
66,000 people in Mon, Karen, and Karenni States. Coordinator
• Finance Manager
Today, the BPHWT provides curative and preventative health • Office Manager
care to vulnerable people living in remote, conflict, and inter- • Logistics Manager
nally displaced areas, controlled by EAOs, in Karen, Karenni, • Monitoring and Evaluation Manager
Mon, Shan, Kachin, Chin, and Arakan States and portions
of Pegu, Tenasserim, and Sagaing Divisions of Burma. These The BPHWT works with local partners and international or-
populations, affected by decades of civil war, otherwise have ganizations to receive technical support for health information
no access to health care. systems, epidemiology, monitoring and evaluation, financial
management, and survey design. However, the BPHWT does
There are currently 1,425 health personnel living and work- not use foreigners in its delivery of health services because it is
ing in the BPHWT target areas inside Burma. This healthcare sufficiently equipped to provide health care and does not want
system is composed of 400 health workers on 113 Back Pack to endanger their teams or served populations.
teams linked to a network of 775 trained traditional birth at-
tendants (TTBAs) and 250 village health workers (VHWs) The BPHWT has three main programs: Medical Care Program
embedded in their respective villages. These Back Pack teams (MCP), Maternal and Child Healthcare Program (MCHP),
presently serve a target population of more than 280,000 con- and Community Health Education and Prevention Program
flict-affected people in 21 field areas (CHEPP).

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