An Imprisoned Doctor Describes Medical Conditions in a Burmese Prison

This is the seventh of seven blog posts from Dina Fine Maron and M. Francesca Monn, writing from Mae Sot, Thailand, a town on the border with Burma. Maron and Monn are PHR interns who are collecting information about medical conditions and human rights abuses inside Burma’s prisons. This research is being completed with the help of Assistance Association for Political Prisoners-Burma (AAPP-B), a Thailand-based advocacy group consisting of former Burmese political prisoners.

In an interview, Myo Win, a former political prisoner and medical doctor, provided insights into the health conditions in Mandalay prison where he was jailed from 1999 until 2004.

Since Win [whose name was changed to protect his identity] knew the head prison doctor from medical school, he was allowed to live and work in the prison hospital instead of the general prison. His good rapport with the prison warden also gave him some autonomy in treating patients. 

Although the International Committee of the Red Cross (ICRC) paid quarterly visits to Burmese prisons during the years of Win’s imprisonment—a service which vastly improved prison conditions—his stories of the diseases present in the prison, and the conflict experienced by many forced to work for the regime, echo those of other prisoners at the time. Infectious diseases, mental health concerns, and torture were constant concerns in this prison.

Infectious Diseases and Outbreaks
The most common conditions in Mandalay prison were malaria, tuberculosis, and malnutrition, Win said. Two severe cholera outbreaks occurred in Mandalay prison between 1999 and 2004. During that time the prison did not have enough IV fluids and antibiotics to treat the cases, and it took days for the government to respond with supplies. According to the doctor, during the more lethal of the two outbreaks 36 prisoners died. 

Mental health
Most prisoners also experienced some degree of depression, anxiety, extreme stress, or psychosis. Between 1999 and 2004, there were around 20 successful suicides and many more attempts at the prison.

Interrogation and Torture
Prisoners were frequently sent to the clinic bearing signs of torture. According to Win, prison officials marked May 27, 2000, the tenth anniversary of the NLD winning the last free and open election in Burma, by doling out physical punishment to the political prisoners. Loud music was blared over the prison loudspeakers, seemingly to muffle the shrieks from the prison blocks, and shortly after the music began the clinic began receiving a steady stream of prisoners with head trauma and broken bones. Many appeared to have been brutally beaten. The caseload grew so heavy that the physician begged prison authorities to send an orthopedic surgeon to help address the numerous severe fractures.

Dual Loyalty: A Duty to Oneself and One’s Employer
Torture also forced Win to struggle with his own medical ethics. During Win’s prison term one of his jobs was to perform autopsies. Injuries that he believed were the result of torture,  like ruptured spleens and bruised brains, were frequently the cause of death, he said. But to preserve his position in the hospital he wrote alternative causes of death on the death certificates such as “complication of hypertension” or “chronic lung disease.” Win struggled with his decisions but said that it was more important to continue to provide crucial services to living prisoners than write real causes of death on certificates and lose his position.

In 2012, Burma’s new regime has released hundreds of political prisoners in response to international pressure, but hundreds more remain behind bars. Releasing dissidents is an important step toward national reconciliation and legitimizing the government, however, more must be done. Political prisoners have suffered torture, denial of medical care, and loss of dignity at the hands of the state. They are entitled to reparations, an official apology, and a promise that Burma will never again see such injustices.

The government of Burma needs to do more: just releasing prisoners is not enough.

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