#WhatWENeed in Myanmar
Full CRPD Compliance on the inclusion of persons with psychosocial disabilities
Myanmar obtained Independence from Britain in 1948. Even though a former British colony, Myanmar haschosen 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.
#What Myanmar Needs:
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.
[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