Chin State, known locally as the ‘Chin Hills’, due to its mountainous geography, is the second smallest State in the Union of Myanmar, with approximately 479,000 inhabitants living mainly in small to medium rural communities. Chin State is widely recognised as the most impoverished State in Myanmar, with an estimated 73% of inhabitants unable to meet basic food and non-food needs, compared to the national average of 32%. The mountainous terrain creates major problems for road construction and transportation, and provides little land for food production. The rugged geography and scattered population also make it difficult to provide adequate education and health services.
Decades of military rule and oppression in Myanmar officially ended in 2011 with the introduction of a nominally civilian government. Despite ongoing conflict between the country’s diverse ethnic groups and the Myanmar Army in many regions, a cease-fire agreement was signed between the Chin State National Front and the Government on the 9th December 2012. This provides an opportunity to address long-standing political, military, ethnic, cultural, religious and human rights issues in the State. However, the widespread nature of prior abuses, their ongoing legacy and the multi-dimensional issues of poverty facing the Chin people, make for an extremely challenging environment.
Poor health and lack of access to medical care is a major concern in Chin State, with residents among the least healthy in the whole of Myanmar. Chin State has the highest incidence of malaria and diseases of the digestive system. The primary causes of death are from preventable and curable diseases such as pneumonia, diarrhoea and malaria. However, medicines are scarce and expensive, there is no fully functioning hospital in the region and less than one fifth of the necessary medical doctor positions are filled.
It is estimated that nearly 7% of children in Chin State die before their 5th birthday, more than twice the national average. The principle causes of death are treatable, such as diarrhoea, acute lung infections and malaria, exacerbated by underlying malnutrition. Only half of all pregnant women in the State receive anti-natal care by a trained professional and less than 6% give birth in a healthy facility, with many women giving birth alone or with only untrained assistance.
Pre-school coverage in Chin State is severely limited and the levels of supervision and teaching quality diverse, with 3 to 5-year-olds often receiving no training in their own ethnic language. These problems continue on into primary school and, combined with high levels of household poverty, contribute to a school drop out rate of 18% by 11 years of age.
The drop out rate is highest among the poorest, who rely on children to perform domestic and farming duties, collect fuel and water and care for younger siblings while parents work. Poor households are also less likely to be able to cope with economic shocks resulting from loss of employment, illness or death. In rural areas, these factors, combined with lack of access to educational services, and exams often set in non-ethnic languages, contribute to only 8% of children passing their final exams at age 15, compared to 17.8% in urban areas.
Traditional livelihoods in Chin State are rooted in agriculture; usually paddy rice, mobile fowl and livestock farms and slash and burn crop-planting techniques. However, deforestation and changes in rainfall and climate are reducing farmer’s yields. Cash crops cannot compete with lowland products or those arriving from other countries, and falling levels of rice and maize, the local staple diet, are being produced. In addition, safe water supplies for drinking and crop irrigation are insufficient for local demand. As such, since 2000, food consumption has declined and food insecurity and hunger are common in rural areas for several months each year. This has resulted in widespread malnutrition and the stunted growth of 58% of children in Chin State, the highest in Myanmar.
It is in this context of desperate poverty and oppression, in an isolated ethnic group, that Health and Hope aim to bring light to a broken world, through the provision of basic healthcare, education and community development projects.