Padraig Colman

Rambling ruminations of an Irishman in Sri Lanka

Tag: US

Reconciliation in Burma

What’s in a name?

 
I generally like to call this South East Asian nation “Burma” rather than “Myanmar”. In doing so, I am in line with the US State Department: “Although the State Peace and Development Council (SPDC) changed the name of the country to ‘Myanmar,’ the democratically elected but not convened Parliament of 1990 does not recognize the name change, and the democratic opposition maintains use of the name ‘Burma.’ Due to consistent, unyielding support for the democratically elected leaders, the U.S. Government likewise uses ‘Burma’.”

 
Burmese lessons for Sri Lanka?

 
That “State Peace and Development Council “ is the name the dictatorship gives itself. They have been giving a show recently of relaxing their grip somewhat. On July 30,  US Under Secretary of State Robert Hormats told the Washington International Trade Association: “My baseline scenario is they will continue to move in the direction of reform”.

 

 

President Thein Sein

The “new” government, led by President Thein Sein, a former military general, has started overhauling the country’s economy, easing media censorship, legalizing trade unions and protests and freeing political prisoners. The most prominent of those, Aung San Suu Kyi, the Burmese opposition leader, has been allowed to travel outside the country.

I have seen a  few bizarre  comments in the Sri Lankan media suggesting that the Sri Lankan should look to Burma for lessons on how to conduct itself. These commentators seem determined  to think the worst of Sri Lanka if they think the nation consistently  placed at number 190 in the human rights league of shame could be an exemplar to anyone.

 
“There has been one admirable quality among many Burmese leaders in the past and present, unlike in Sri Lanka. They were modest enough to admit failures. Ne Win himself declared that ‘Burmese socialism’ was a failure and stepped down in 1988. That led to continuous social upheavals asking for democracy.”

 

 

General Ne Win

So says Laksiri Fernando,  author of Human Rights, Politics and States: Burma, Cambodia and Sri Lanka writing in the Asian Tribune. Fernando can even see the bright side of  the ethnic conflicts in Burma: “There are thousands and thousands of internally displaced people in the country due to the ethnic conflict. No one calls the ethnic conflict a myth like in Sri Lanka!” Another great thing was, according to Fernando, that “no insurgency evolved into ruthless terrorism like in Sri Lanka”.

 

 

Colonial background

 
British rule in Burma lasted from 1824 to 1948, from the Anglo-Burmese Wars through the creation of Burma as a province of  British India. The First Anglo-Burmese War arose from friction between Arakan in western Burma and British-held Chittagong to the north. The British navy took Rangoon without a fight in 1824 but the war itself had cost 15,000 European and Indian troops and cost the equivalent of 48 billion US dollars of today. This caused a severe economic crisis for British India. In 1852, the Second Anglo-Burmese War was provoked by the British who wanted the teak forests in Lower Burma as well as a port between Calcutta and Singapore.

 

The Third Anglo-Burmese War in 1885 was because of the British desire to get their hands on the resources of the north. The British government justified their actions by claiming that the last independent king of Myanmar, Thibaw, was a tyrant and that he was conspiring to give France more influence in the country. After 25 years of peace fighting started again and lasted until the British occupied the whole of Lower Burma.

 

 

King Thibaw

The Third Anglo-Burmese War lasted less than two weeks during November 1885. British troops entered Mandalay on 28 November 1885 and Burma was incorporated into the British empire on 1 January 1886. The new colony of Upper Burma was attached to the Burma Province on 26 February 1886. Rangoon, having been the capital of British Lower Burma, became the capital of the province.

 
The British tied  Burmese economy to  global market forces and forced Burma to  become a part of the colonial export economy. Suddenly a large amount of Burmese resources were being exported for Britain’s benefit, thereby extracring the resources needed by the Burmese to continue living their lives as they had before colonisation. Vast tracts of land were converted  for cultivation of rice for export. Burmese farmers were forced to borrow money from Indian moneylenders at high interest rates prepare the new land for cultivation. This often led to the eviction of indigenous farmers and most jobs went to indentured Indian labourers.

 
An account by a British official describing the conditions of the Burmese people’s livelihoods in 1941 describes the Burmese hardships as they must quickly adapt to foreign trade:

 
“The peasant had grown factually poorer and unemployment had increased…. The collapse of the Burmese social system led to a decay of the social conscience which, in the circumstances of poverty and unemployment caused a great increase in crime.”

 
Burmese were excluded from the civil service and the military which were staffed by Indians, Anglo-Burmese and minority groups such as the Karens. The Burmese resented both the British and the Indian migrants, and staged guerrilla warfare, often led by former Burmese army officers, against the British army of occupation.

 
The British rulers imposed a separation of church and state and exiled King Thibaw. This was a way of imposing direct control. The monarchy had supported the sangha and the Buddhist monks were dependent on the monarchy and explained the monarchy to the public. The imperial power introduced a secular education system and encouraged Christian missionaries to found schools Buddhism and traditional Burmese culture were discouraged as part of a plan to deprive the  Burmese people of a cultural unity separate from the British.

 

 

Resistance continued in northern Burma until 1890, with the British systematically destroying villages. Grass-roots control was exercised by burning villages and uprooting established families regarded as disloyal. Dissent was suppressed by  mass executions.

 
Independence

 
An independence movement emerged in the early 20th century, initially led by monks and students. A nationalist movement began to take shape in the form of Young Men’s Buddhist Associations (YMBA). Between 1900 and 1911 the “Irish Buddhist” U Dhammaloka  (a hobo variously known as Laurence Carroll, Laurence O’Rourke and William Colvin or “Captain Daylight”, who was probably born in Dublin in 1850) publicly challenged Christianity and imperial power, leading to two trials for sedition.

 

 

U Dhammaloka

By the 1930s a new radical movement known as the Thakin was formed. Its leading figures included Aung San, U Nu and Ne Win. They began to look to neighbouring powers to help break the yoke of British rule. One student, Ko Aung Kyaw, was beaten to death by British colonial police in the third Rangoon University student boycott in December 1938. Students had been supporting striking oil workers. In Mandalay,  police shot into a crowd of protesters led by Buddhist monks, killing 17 people.

 

 

Aung San

Aung San, Aung San Suu Kyi’s father, sought support for the Burmese independence struggle from Japan. Japan invaded Burma in 1942 but never succeeded in fully conquering the whole country. On 1 August 1943, the Japanese declared Burma to be an independent nation. Aung San was appointed War Minister. He became disillusioned with the Japanese. One of his followers told General Slim:  ‘If the British sucked our blood, the Japanese ground our bones!’ When the British defeated the Japanese Aung San was offered the rank of Deputy Inspector General of the Burma Army, but he declined and became the civilian political leader and the military leader of the People’s Volunteer Organisation (PVO).

 

He was assassinated on 19 July 1947 Former prime minister U Saw was tried and hanged. A number of middle-ranking British army officers were also were tried and imprisoned. There were rumours of higher-level British involvement, and/or involvement by Ne Win Aung San’s long-term rival.

 

U Saw with Lord Halifax

Dictatorship

For most of its existence as an independent nation, Burma has been a military dictatorship. There were sporadic protests against military rule during the Ne Win years and these were almost always violently suppressed. In 1974, the military violently suppressed anti-government protests at the funeral of U Thant, Burmese UN General Secretary. Student protests in 1975, 1976 and 1977 were quickly suppressed by overwhelming force.

 

 

General   Saw Maung

In 1988, unrest over economic mismanagement and political oppression led to  pro-democracy demonstrations throughout the country. Security forces killed thousands of demonstrators.  General   Saw Maung staged a coup and established SLORC – the State Law and Order Restoration council. In May 1990, the government held free elections for the first time in almost 30 years and the NLD – National League for Democracy, Aung San Suu Kyi’s party won 80% of the seats. SLORC  continued to rule until 1997, and then ruled as the SPDC until March 2011.

 
Ethnic conflict

 
Pace Mr Fernando,  analyst Martin Smith believes “Burma has been the scene of some of the most-sustained and diverse ethnic insurgencies in the contemporary world… conflict resolution––with integrated support from the international community––remains a primary need if Burma and its peoples are to achieve peace, democracy, and a stable nation-state.” There are 135 officially recognised ethnic groups in Burma. Martin Smith writes: “In the deep mountains and forests of the borderland periphery, over 20 armed opposition groups controlled, under their own administrations, vast swathes of territory and continued to reflect an often changing alignment of different political or nationality causes.”

 
The Thailand Burma Border Consortium’s (TBBC) annual report on conditions in South East  Burma “found that more people had been forcibly displaced from their homes during the past year than any other since data was first collected in 2002.” Jack Dunford, the TBBC’s Executive Director, said: “A determined and sustained effort to resolve ethnic conflict in Burma is essential to avoid another generation of violence and abuse.” In recent years the TBBC’s and its partner agencies have documented “the destruction, forced relocation or abandonment of more than 3,700 civilian settlements in South East Burma since 1996.” The TBBC statement estimated that during the past year at least 112,000 people were forced to abandon their homes. “While some fled into Thailand as part of an ongoing flow of new refugee arrivals and others returned to former villages or resettled elsewhere in Burma, over 450,000 people currently remain internally displaced in the south eastern region.”

 

Mr Dunford said that while democratic reforms by the “new” government are both vital and welcomed but conflict has increased in ethnic areas.

 
Muslims

 
Even though some wish to be optimistic about Burma, oppression of minorities hits the headlines even today. Burma has a  substantial Muslim population, known as  Rohingyas, of 800,000. Rohingyas have been subjected to persecution for decades. According to Amnesty International, 200,000 of them fled to Bangladesh in 1978 to escape a brutal military operation. Another  250,000 went into exile in 1991-92. The refugees complained of rape, persecution and forced labour by the military. Another 100,000 fled to Thailand, but were forced to leave for camps along the border. Although the Rohingyas have lived in Burma since the eight century they are regarded as illegal immigrants with no rights. A 56-page report released Wednesday by Human rights Watch  group called for strong international reaction to “atrocities” committed during last month’s bloody unrest between Rakhine Buddhists and Rohingyas, which left 78 people dead and about 100,000 homeless.

 
Recently a foreign journalist asked Aung Sang Suu Kyi whether she regarded Rohingyas as citizens of Burma. “I do not know. We have to be very clear about what the laws of citizenship are and who are entitled to them.” This can be translated as “I won’t get any votes by defending a minority group”.

 
US involvement

 

The US had  accepted Burma as one of the original beneficiaries of its Generalized System of Preference (GSP) program in 1976. It also granted Burma Most Favored Nation (MFN, now referred to as Normal Trade Relations, or NTR) status, and supported the provision of developmental assistance by international financial institutions.

 

There were also close military to military relations (including a major International Military Education and Training [IMET] programme) until 1988. The implementing of sanctions on Burma did not begin until after the Tatmadaw (Burmese military) brutally suppressed a peaceful, popular protest that has become known as the 8888 Uprising. Starting in the fall of 1987, popular protests against the military government sprang up throughout Burma, reaching a peak in August 1988.

 

Washington recently lifted some  financial and investment sanctions in response to nascent democratic reforms but has retained the ban on imports — a restriction that a US Senate committee this month said should be extended by three years.

 

Garment industry

 
Prior to the passage of Customs and Trade Act of 1990, the Bush pére Administration had suspended Burma’s eligibility for the Generalized System of Preferences (GSP) program on April 13, 1989. President Bush also designated Burma as a drug-producing and/or drug-trafficking country under the Foreign Assistance Act of 1961 on February 28, 1990, which required the United States to oppose loans to Burma by international financial institutions.

 

Today, optimists on Burma have criticised sanctions as stifling key job-creating areas of the economy such as the garment industry rather than hurting the interests of the corrupt elite it targets. The
International Crisis Group(ICG)  think-tank is well-known to Sri Lankans. Although it has called for sanctions on Sri Lanka it opposes them on the far worse regime in Burma. It says Myanmar’s reform process had challenged “the dominance” of crony businessmen, who flourished under the disbanded junta, and nudged the economy towards greater openness at the expense of some key hardliners.

 

ICG warned that renewing the US import embargo, due to lapse this year, “could have a serious impact on Myanmar’s economic recovery”. ICG believes the  ban is skewing the nation’s economy towards “potentially problematic” extractive industries at the expense of sectors that employ large numbers of ordinary people.

 

Resources

 
Burma is cursed by being a resource-rich country. Burma’s GDP stands at $42.953 billion and grows at an average rate of  only 2.9% ICG believes that current sanctions will skew the economy towards extractive industries such as oil, gas and gem mining which have long been linked with corruption and also raise fears over environmental damage.

 

Human rights

 
The UN and several other organizations have reported consistent and systematic  human rights violations in Burma including child labour and human trafficking. After Hurricane Nargis devastated the country international NGOs feared that the reconstruction effort would depend on forced labour – be it from children or migrant adult workers. The Tatmadaw  routinely forces civilians to work on state infrastructure projects, such as the building of roads, bridges, military bases or even towns.

 

When friends have enthused about the joys of Burma as a tourist destination I have responded that I could  not be comfortable in a hotel that had been built by slaves. A Boycott Burma campaign stated : “As a tourist to Burma you will travel on roads and railroads, see temples and palaces and stay in hotels built or rebuilt since 1988, which will definitely contain the dead bodies of the slave labourers who made them for you… I never met anyone going to Burma since 1988 to help the people there. Only selfish, ignorant people on holiday who want to see for themselves. See what? Burmese used as human landmine detectors? Burmese slave labour camps? Burmese people dead in piles in the no man’s land? If you go to Burma, you pay to murder the people you visit.”
The army has  used  villagers as human minesweepers to clear the way for the safe passage of soldiers. Convicts are used as forced labour. It is estimated that as many as 20 percent of prisoners sentenced to “prison with hard labour” die as a consequence of the conditions of their detention. It has been reported that at least 91 labour camps operate in areas across the country .

 

Human Rights Watch (HRW) estimated that there may be more than 70,000 child soldiers in the SPDC Army. The children are often kidnapped without their parents’ knowledge while on their way home from school. They are then brutalised and physically abused during their induction and basic training before being shipped off to fight in the country’s ethnic states. “Child soldiers are sometimes forced to participate in human rights abuses, such as burning villages and using civilians for forced labour,” said HRW. “Those who attempt to escape or desert are beaten, forcibly re-recruited or imprisoned.”

 


Back in 2009, The Independent reported that Burmese soldiers, who provide security for the Yadana oil pipeline on behalf of the French company, Total, are forcing thousands of people to work portering, carrying wood and repairing roads in the pipeline area. They have also been forced to build police stations and barracks.
Reconciliation

 

After such knowledge, what forgiveness? With poverty, inequality and racism,  there will always be conflict.
In a media statement the TBBC said: “While government figures estimate that a quarter of the nation live in poverty, the survey found that almost two thirds of households in rural areas of the South East are unable to meet their basic needs.” The TBBC statement said poverty severe in the “conflict-affected areas of northern Kayin State and eastern Bago Region.”

 

Jack Dunford said: “As prospects for the voluntary return of refugees and internally displaced persons are directly linked to national reconciliation, the urgency of finding a solution to conflict in Burma has never been greater.”

Sri Lanka Healthcare better than US?

I wrote this for Open Salon back in January 2010. I see that my friend Jonathan Wolfman is posting on Open Salon on a relatd subject.

I can’t join in on OS but come over here and comment Jonathan.

Sri Lanka Healthcare better than US?

Will Obama, or anyone else, succeed in providing as effective a health service to poor and middle- income US citizens as Sri Lanka provides for its citizens?

When I told English friends that I was moving to Sri Lanka one said: “How can you risk leaving behind the National Health Service?” As it turned out, I found the Sri Lankan health service to be excellent whenever, which fortunately was not often, I had to use it. When I had a head injury, I was promptly and effectively dealt with free of charge at Bandarawela general hospital. In similar circumstances in England I have had to wait for hours in Accident and Emergency in the company of violent drunks (patients not doctors) and screaming children, eventually to be dealt with by a condescending junior doctor who had probably not slept for days.

My wife had a brain scan at a top London hospital some years ago when she was suffering severe headaches. Nine years on, she has still not received the scan results. Her civil efforts to get the results caused her to be reprimanded by her London General Practioner (GP) for harassing her staff. Sri Lanka is far superior to England in the matter of diagnostic tests. Here it is easy to get the tests done at a reasonable cost and get the results quickly.

The Sri Lankan authorities responded far more effectively to the 2004 tsunami than did US authorities to Hurricane Katrina. Sri Lanka’s past investments in a broad-based public health system and community awareness of basic sanitary and hygienic practices ensured that there were no disease outbreaks. Essential medical aid, emergency food, and other relief supplies were mobilized within a day. It was possible to feed, clothe, and shelter survivors; provide the injured with medical attention; and ensure that the thousands of bodies were quickly cremated or buried.

Susantha Goonathilake wrote in his book, Recolonization, about the influence of foreign NGOs on Sri Lanka: ‘While NGOs stood wringing their hands or trying to mobilize funds only from international sources, Buddhist temples around the country were the quickest to respond. Those affected by the tsunami rushed into temples where they were received with warmth. These temples along the coast became havens of shelter, not only for Buddhists, but also for Hindus, Muslims and Christians. There are innumerable stories of the incredible generosity of these temples. Monks gave up their robes to bandage victims, looked after their children and babies, fed them from whatever little provisions they had, and comforted them. Illustrative of the genuineness of this response was the remote Eastern province temple of Arantalawa. Here LTTE (Liberation tigers of Tamil Eelam) death squads had once hacked to death young Buddhist monks. Now Arantalawa opened itself to nearly 1,000 refugees, most of whom were from the Tamil community and may well have included the very assassins who had hacked the young Buddhist monks’.

Despite international criticism the health services more recently coped well with the closing stages of the war against the LTTE (Liberation Tigers of Tamil Eelam)and the aftermath of the 300,000 internally displaced persons (IDPs). The extremely dire outbreaks of disease in the IDP camps predicted by foreign NGOs just did not materialize.

Prime Minister Wickramanayaka has claimed that public financing for healthcare began in Sri Lanka more than 2,000 years ago when Buddhist kings established public hospitals and maintained them with royal revenues. Ancient records show that 18 hospitals were established by King Dutugemunu in the second century B.C. This tradition was strongly influenced by Buddhist culture which accords high priority to actively caring for the needy, the poor and the sick, he said.

According to the World Health Organisation, a modern health service can be said to have started in Sri Lanka in 1858 with the creation of the Civil Medical Department under a Principal Civil Medical Officer (PCMO). The department initially concentrated on the establishment of new hospitals in large towns. Primary care facilities at village level were initiated in 1877. Initially, preventive medicine was confined to measures aimed at preventing the spread of major communicable diseases.

Today, management of all healthcare institutions, other than private hospitals, teaching hospitals and field services, is the responsibility of the provincial councils but funding is provided by central government from general taxation. There have been significant increases of manpower in the public sector. The government health service is absorbing all the medical graduates graduating from the medical faculties. In 2006 there were six doctors per 10,000 of population and 14 nurses per 10,000.

A wide disparity in the regional distribution in Sri Lanka of health personnel is evident. The Colombo district has a high concentration of most categories of health personnel except public health staff. In 2001, 35 percent of the specialists were concentrated in the Colombo district. The Districts of Kilinochchi, Mullaitivu and Mannar (these areas were controlled by the LTTE) did not have a single specialist.

Reintroduction of private practice for government doctors, liberalization of drug imports and service provision deficiencies in some government hospitals have resulted in the growth of private hospitals in urban centers. There is a thriving private sector in health in urban areas and particularly in Colombo, which boats a number of modern, well-equipped and well-staffed hospitals such as Apollo, Asiri, Nawaloka and Ninewells Gynecological Hospital.

However excellent Colombo’s private hospitals may be, research by Oxfam shows that scaling up government-provided health services is the only proven route to improving life chances in poor countries. Parts of the US are very third-world. Despite serious problems in many countries, publicly financed and delivered services successfully reduced child deaths by between 40 and 70 per cent in a decade in Botswana, Mauritius, Sri Lanka, South Korea, Malaysia, Barbados, Costa Rica, Cuba, and the Indian state of Kerala.

Recently, I suffered severe pain as a result of an ear infection and a perforated eardrum. I went to my GP, who has a clinic in a small private hospital. He normally charges me about 300 rupees ($2.62) but on this occasion did not charge anything as he referred me to a specialist at a private clinic. He does not charge poorer patients anything. The private clinic charged 460 rupees ($4.02). The clinic was overcrowded, noisy and none  too clean. There was a very long wait but the consultant when seen was sympathetic, approachable and competent. He quickly and correctly diagnosed my condition but suggested that, as he did not have the appropriate technology at his private clinic, I should see him the next morning at the general hospital where I would be seen free of charge.

Most specialist who provide services free at the general hospitals dash around all day from private clinic to private clinic. The patients at these clinics are by no means rich but the charges are not high. A new GP clinic has set up in a private home near our temple. The doctor there also works at the general hospital. In Colombo there is an excellent service where one can pay an annual membership fee to have an ambulance with doctor and paramedic call at one’s home when the need arises. They also call at one’s home to take blood tests and deliver the results. The doctors operating this service also work at the government general hospital.

Badulla general hospital has recently opened a magnificent, huge, new building which is extremely clean with spacious wards, modern lifts and equipment. Unfortunately it was opened to the public before they put up any signs so there are a lot of dazed and confused people wandering about at the mercy of vague security guards. We ended up on the maternity ward looking for our eighty-year-old male friend who was being treated for a broken arm.

The MDGs (Millennium Development Goals) have set the agenda for social development in developing countries for the 21st century. In the health sector, it encompasses reducing maternal mortality, under-five mortality and malnutrition; halting and reversing the HIV/AIDS epidemic; reducing the incidence of malaria and tuberculosis; provision of access to affordable essential drugs; to halve by 2015 the proportion of people without sustainable access to safe drinking water and sanitation. (Sri Lanka’s MDG scorecard can be examined at http://www.mdg.lk/)

An article in the January 2010 issue of Le Monde diplomatique by Allan Popelard and Paul Vannier describes the hell that is Detroit. In the course of the article, the authors discuss the inadequacy of health provision in that city. General Practitioners have not been persuaded to stay in the inner city to tend the poor but have migrated to the suburbs where they can make more money. Although the city has some of the best hospitals in the country, only the rich can afford to use them. Popelard and Vannier say “The health indicators for the local population are equal to those of a developing country: infant mortality is 18 per 1,000 [live births], three times higher than the rest of the US and the same as Sri Lanka.”  It is interesting to note that in 2003-05, the infant mortality rate (IMR) in the US as a whole for African Americans was 13.6; the rate for White Americans was 5.7 per 1000 births. IMR is generally seen as an indicator of a nation’s level of health development and is a component of the physical quality of life index. IMR is generally considered to correlate very strongly with, and is among the best predictors, of state failures.

Popelard and Vannier’s statement jarred with me. Sri Lanka has many problems but to one who has lived in the country for over eight years it does not feel anything like a “failed state”. The World Health Organisation (WHO) has said that Sri Lanka’s health indicators are improving all the time.

True, the CIA Fact Book puts Sri Lanka’s IMR at 19 but perhaps the juxtaposition of “CIA” and “Fact” constitutes an oxymoron.

According to WHO’s website, Sri Lanka’s IMR was 11.2 in 2003, significantly better than Detroit today and somewhat better than the US IMR for black citizens. I checked with WHO on 25 January 2010 and they told me that the provisional IMR figure for Sri Lanka for 2006, based on data from the Registrar General (RG) Department, is 10 per 1,000 live births. IMR for 2005 was 11.2. (The source for that is a statistical abstract published in 2008 by the Department of Census and Statistics using RG data.) WHO regards this as a great success and attributes it to “effective and widely accessible prevention and primary healthcare strategies including treatment of minor infections”.

WHO believes that  Sri Lanka’s “Maternal Mortality Ratio of 2.3/10,000 live births in 2000 is an exceptional achievement for a developing country with an income level of about US $ 800 per capita. The improvement of these indicators is attributed to the maternal and child healthcare programme implemented nationally as an integral component of the state healthcare system.” Not just good luck then, but planning, hard work and dedication by selfless professionals who might make more money in other countries.

Life expectancy in Sri Lanka has risen steadily. In 1946 (when the Brits were still running the show) it was 43.9 for males and 41.6 for females. Life expectancy in 2001 for males was 70.7 years; for females, it was 75.4 years. (Life expectancy for black US males was 70 in 2003; the average life-span of an African-American in New Orleans is 69.3 years, nearly as low as life expectancy in North Korea, according to www.measureofamerica.org September 17, 2009).  Sorry if I seem to be picking on Louisiana here. The state does unfortunately seem to come in at number 50 among US states on many quality of life indicators. I had a serious eye condition when I was in Louisiana and received excellent care at a clinic in Baker. However, going to a clinic on Frenchman’s in New Orleans proved to be a traumatic experience that I do not intend to repeat.

WHO says: “Sri Lanka has achieved extraordinarily good health outcomes compared to the level of spending on health.  … During 2001, the provision of public expenditure on health services was 1.6 percent of the GNP and 4.9 percent of national expenditure. The per capita health expenditure was Rs 1,222 ($13.71) in 2001. Recurrent expenditure amounted for 81 percent of the total expenditure.”

In 2001, patient care services utilized 66 percent of health expenditure, while community health services utilized only 8 percent. While the UK has been, since the early 90s, putting more emphasis on primary care in the community to divert patients away from acute hospital care, Sri Lanka’s state services are characterized by a very busy and overcrowded system of national, provincial, general and (Army) base hospitals and a widely-spread network of district hospitals and healthcare units. Sri Lanka reported 0.2 per capita in-patient admissions in 1997. This heavy demand may be due to a number of factors including patients being admitted to hospital when, with better primary care, they could have been treated as out-patients.

My perhaps superficial impression is that Sri Lankans from all social classes are hypochondriacs. Better-off people are always talking about their bowels and their blood-pressure and everyone knows their sugar-level and lipid count. Poor people seem to get validation by going to hospital for minor ailments like the common cold (which they call “fever”) and judge a doctor’s competence by the number of pills they get. I was recently at the birthday celebration of a 96-year-old friend (a good advertisement for the health service – she has survived many serious ailments) where a catholic priest was telling me that his new doctor was much better than his previous one because he had given him eight different pills for his chesty cough rather than the mere seven he had got before.

This is not to say that there are not harsh critics in Sri Lanka of the way the government runs the health service. The Sri Lankan health service is not perfect. There have been public concerns about the quality of drugs imported from India and China and there have been some deaths of children during immunization programs. There are complaints about broken equipment not being replaced and in any system there will be inefficiencies and sloth and torpor. Always in Sri Lanka there are dark hints about corruption. However, the WHO indicators give encouragement that future problems will be addressed. Black citizens of Detroit or New Orleans might be impressed by the health service offered in Sri Lanka.

Dr. Godfrey Gunatilleke, Chairman Emeritus Marga Institute, a private think tank, warned recently that 20% of the world’s population belongs to the elderly category. Sri Lanka’s birth rate is not meeting replacement requirements and the nation’s population is ageing. A strategy for treatment of non-communicable diseases among the elderly needs to be different to the way maternal and infant communicable diseases are addressed.  Gunatilleke said that primary healthcare for ageing revolves around “treatment for morbidity.”  Mental health is one of the non-communicable diseases that have been on the increase. He said that market economics which treat health as a commodity would have to be reconsidered. “When poverty declines, life expansion increases,” he said.

This echoes the findings of an Oxfam study published in a 2009 report entitled Blind Optimism: Challenging the myths about private health care in poor countries. Anna Marriott, author of the report, says  “Thanks to increased state spending on health in Sri Lanka, for instance, women can now expect to live almost as long as those in Germany, despite an income ten times smaller,” Marriott said. “The World Bank and other donors need to put their blind optimism about the market behind them. To achieve universal and equitable access to health care, the public sector must be made to work as the majority provider.”

Although health services are available free of charge to anyone regardless of ethnicity or religion, the Tamils living in the north and east have not been getting the welfare services that they were entitled to. This was not because they were discriminated against by the central government. Even during the fierce fighting at the end of the war the government was trying to get medicines to civilians but was thwarted by the separatist rebels. Possibly the biggest challenge is to re-integrate into the national health service those areas previously controlled by the LTTE. In spite of the millions of dollars flowing to that organization from the Tamil diaspora, LTTE stewardship did nothing for the infrastructure of the de facto statelet and did nothing but undermine the welfare of its people.

The Milo Minderbinder School of Foreign Policy

No tongues please. I’m British!

I wrote this in April 2011. Things have moved on since.

 

“In a democracy, the government is the people,” Milo explained. “We’re people, aren’t we? So we might just as well keep the money and eliminate the middleman. Frankly, I’d like to see the government get out of war altogether and leave the whole field to private industry.”

Milo Minderbinder, the mess officer  in Catch-22 is the personification of capitalism. He has no allegiance to any country, person or principle unless it pays him. Milo doesn’t see himself as corrupt or evil. He claims to live by a strict moral code. The one country he will not deal with is the Soviet Union (although they are supposed to be allies in the war)  out of respect for private property and disdain for socialism.

Milo organizes the bombing of his own base because he has a contract with the Germans. The Germans may be the enemy but they are good payers.

Milo was a neo-liberal avant la lettre. When markets fail to deliver, the capitalist is quick to turn to the government for help. Milo depends on governments for his riches.

His moral code allows for price inflation and betraying one’s country for the sake of profit. Everyone has a “share” in the Syndicate, a fact which Minderbinder uses to defend his actions- what is good for the company is good for all. He secretly replaces the CO2 cartridges in the emergency life vests with certificates for shares in M & M, on the assumption that the future person who may need that vest will be instantly compensated for its absence. He steals the silk out of parachutes, the morphine out of  first aid kits, all in the name of making a few bucks, honest or otherwise.  His most interesting attributes are his complete immorality without self-awareness, and his circular logicality in running his Syndicate. Minderbinder decides that he can trust Yossarian  because “anyone who would not steal from the country he loved would not steal from anyone.”

This fellow is a bit more cautious on a first date.

Libya and the IRA

During the period 1969–1971, the Provisional IRA was very poorly armed. By 1972, the IRA had large quantities of modern small arms, particularly Armalites, made and bought in the USA. The IRA’s main gun runner in the USA was George Harrison (no relation) an IRA veteran, who had lived in New York since 1938. Harrison bought guns for the IRA from a Corsican arms dealer named George de Meo who had connections with organized crime. Harrison was funded by NORAID -“Irish Northern Aid Committee”.

The IRA used the QE2 to smuggle arms from the USA.

Joe Cahill

Quadaffi first donated arms  to the IRA in 1972–1973, following visits by veteran IRA man Joe Cahill to Libya. In early 1973, the Irish navy seized an arms shipment on the Claudia. Five tonnes of Libyan arms and ammunition were found on board. The weapons seized included 250 Soviet-made small arms, 240 rifles, anti-tank mines and other explosives. Cahill was arrested on board. It is believed  that three shipments of weapons of similar size did get through to the IRA around  the same time. The early Libyan arms shipments provided  the IRA with its first RPG-7 rocket-propelled grenade launchers.  Qaddafi also donated three to five million US dollars to the IRA at this time.

IRA contact with Libya was broken off in 1976 but was restored after the 1981 IRA  hunger strikes. In this period, Libya provided enough arms to equip at least two infantry battalions. Qaddafi is thought to have decided to support the IRA to get back at the British government for its support for Reagan’s bombing of Benghazi and Tripoli in 1986. US planes had been allowed to take off  from British bases. Sixty Libyans died in the attacks, including Qaddafi’s adopted baby daughter Hanna. This second major Libyan contribution to the IRA came in 1986–1987. In 1987, the French navy intercepted the  Eksund in the Bay of Biscay. She was carrying 120 tonnes of weapons, including HMGs, 36 RPGs, 1000 detonators, 20 SAMs, Semtex and 1,000,000 rounds of ammunition from Libya. There were four shipments before the Eksund incident which were not intercepted. There had been a huge intelligence failure of both Irish and British agencies  author Brendan O’Brien described as ‘calamitous’. O’Brien claims that, thanks to Libya, there was an “oversupply” of arms in the hands of the IRA by 1992. It is also estimated that the Libyan government gave the IRA the equivalent of £2 million cash along with the 1980s shipments.

On 31 October 2009, a cross-party delegation of Northern Irish politicians travelled to the Tripoli for the first face-to-face meeting with Libyan government ministers to discuss compensation claims for victims of IRA violence.

Shootout at the Libyan Embassy

On 17 April 1984, there was a demonstration by anti-Quadaffi dissidents outside the Libya embassy in St James’s Square, London . Thirty police officers were sent to control the situation. Shots were fired and eleven people were hit. WPC Yvonne Fletcher died from her wounds. An inquest ruled that she died as a result of a stomach wound caused by bullets from two Sterling sub-machine guns fired from the embassy. Following the shooting, the embassy was surrounded by armed police for eleven days, after which the staff were allowed to leave and then deported. The UK broke off diplomatic relations with Libya.

Joe Vialls, conspiracy theorist or  self-proclaimed private investigator dedicated to “exposing media disinformation,”,  concluded that the fatal shots had come not from within the embassy but from a penthouse flat next-door-but-one to the Libyan embassy, and were fired by CIA/Mossad agents. Vialls may have been a crank but more respectable people were also sceptical about the official line on the shooting. These included George Styles, a top army ballistics expert, Hugh Thomas, expert on bullet wounds from his experiences as consultant surgeon of the Royal Victoria hospital in Belfast, and veteran Home Office pathologist, Professor Bernard Knight.

A report from April 2007 concluded that two men, who were later senior members of the Libyan regime, played an “instrumental role” in the killing. According to a report in the Daily Telegraph in 2009, the Crown Prosecution Service had been told  by an independent prosecutor that there was sufficient evidence to prosecute two Libyans.

The Foreign Office eventually  bowed to Libyan pressure and agreed that Britain would abandon any attempt to try the murderer of WPC  Fletcher. Anthony Layden, Britain’s former ambassador to Libya, said he had signed an agreement with the Libyan government when Jack Straw was foreign secretary. At the time Britain was negotiating trade deals worth hundreds of millions of pounds with Libya. The deal followed a visit by Tony Blair, then prime minister, to meet Colonel Qaddafi in March 2004 after Libya announced that it was ending its nuclear weapons programme. The Foreign Office said the deal had been sealed in an exchange of ambassadors’ letters in 2006: “The Fletcher family know all this and have not considered it to be a big issue.” Queenie Fletcher’s  MP questioned this interpretation.

On Friday, 25 March 2011, Kim Sengupta wrote in The Independent  about a meeting with Omar Ahmed Sodani, the chief suspect in the killing of WPC Fletcher.  Sodani, now 59, was  head of the Al Ejanalghoria, Muammar Qaddafi’s militia in Benghazi. He has been questioned by his captors in the rebel movement, not only about the shooting, but for allegedly providing reports on Libyan students in London which led to their persecution back home, as well as complicity in human rights abuses. “They have interrogated me about the shooting all those years ago,” he said. “I have explained to them that I did not do it.”

Sengupta wrote: “After talking for a little more than an hour, Mr Sodani was led away. As he departed, he made one final pronouncement: ‘I have full confidence in the fairness of the revolution and the revolution’s judges. This country would be a far better place in the future than it was in the past.’ There was no mistaking the fear in his voice.”

Lockerbie

On Wednesday 21 December 1988, Pan Am Flight 103 was destroyed by a bomb, killing all 243 passengers and 16 crew members. Eleven people in Lockerbie, a town in southern Scotland, were killed as large sections of the plane destroyed several houses. Total fatalities were 270. Libya did not formally admit responsibility until 16 August 2003. In a letter to the UN Security Council it “accepted responsibility for the actions of its officials” but expressed no remorse.

The motive that is generally attributed to Libya can be traced back to a series of military confrontations with the US Navy that took place in the 1980s. Libyan planes were shot down and ships sunk. Libya was accused of retaliating by ordering the bombing of the La Belle nightclub in West Berlin in 1986.

Even in February 2004, Libya did  not accept guilt. Prime Minister  Shukri Ghanem told the BBC that his country had paid  compensation as the “price for peace” and to secure the lifting of sanctions. He also denied that Libya was responsible for killing Yvonne Fletcher. Qaddafi later retracted Ghanem’s comments, under pressure from Washington and London.

There are  many conspiracy theories about the Lockerbie case. I will not go into them in detail here but those interested in following this up will be guided by:

http://en.wikipedia.org/wiki/Pan_Am_Flight_103_conspiracy_theories

Campaigning journalists, John Pilger and the late  Paul Foot have written extensively about Lockerbie.

Iran was initially the prime suspect for the Lockerbie bombing and had the most obvious motive. Five months earlier, an Iranian civilian aircraft had been  shot down by the US warship USS Vincennes and Ayatollah Khomeini had called for revenge. The theory is that Iran paid the Syrian-based Popular Front for the Liberation of Palestine General Command (PFLP-GC) to carry out the attack on its behalf. Ahmad Behbahani, a former Iranian intelligence official, later claimed that he personally conveyed the message to the PFLP-GC.

A recurring theory is that the CIA, or rogue elements within it,  it had cleared a drugs smuggling route from Europe to America involving Pan Am flights in return for intelligence about militant groups.

Saif al-Qaddafi said that Libya had admitted responsibility for the Lockerbie bombing simply to get trade sanctions removed. He went on to describe the families of the Lockerbie victims as very greedy: “They were asking for more money and more money and more money”. Several of the victims’ families refused to accept compensation because they did not believe that Libya was responsible. On 23 February 2011,  Mustafa Mohamed Abud Al Jeleil, former Justice Secretary of Libya, claimed to have evidence that Qaddafi personally ordered the bombing.

Indictments for murder were issued on 13 November 1991 against Abdelbaset al-Megrahi, a Libyan intelligence officer and  Lamin Khalifa Fhimah, Libyan airlines station manager in Malta. (Don’t forget that Milo was Mayor of Valetta). UN sanctions against Libya and protracted negotiations with the Libyan leader secured the handover of the accused on 5 April 1999 to Scottish police. Both accused chose not to give evidence in court. On 31 January 2001, Megrahi was convicted of murder by a panel of three Scottish judges in a courtroom in “neutral” Holland. There was no jury. Megrahi was sentenced to life imprisonment but Fhimah was acquitted.

Megrahi served eight and a half  years of his sentence, throughout which time he maintained that he was innocent. Some argue that the governments in England and Scotland in effect blackmailed Megrahi into dropping his appeal as a condition of his immediate release.

He was released from prison on compassionate grounds on 20 August 2009 as he was suffering from cancer. Allegations have been made that the UK government and British Petroleum sought Al-Megrahi’s release as part of a trade deal with Libya. In 2008, the British government “decided to do all it could to help the Libyans get Al-Megrahi home … and explained the legal procedure for compassionate release to the Libyans”.

Some argue that key evidence presented at the trial (for example, timer fragment, parts from a specific radio cassette model, clothing bought in Malta, a suitcase originating at Luqua, could have been fabricated by the U.S. and Britain for the “political” purpose of incriminating Libya. Paul Foot wrote that when Saddam Hussein invaded Kuwait in 1991, Bush Sr needed Iran’s support as he built a “coalition” to expel his wayward client from an American oil colony. The only country that defied Bush and backed Iraq was Libya. “Like lazy and overfed fish,” wrote Foot, “the British media jumped to the bait. In almost unanimous chorus, they engaged in furious vilification and open warmongering against Libya.”

Former CIA officer Robert Baer, who took part in the original investigation, said ” the evidence amassed by [Megrahi’s] appeal is explosive and extremely damning to the system of justice.” A “key secret witness” at the original trial, who claimed to have seen Megrahi, loading the bomb on to the plane at Frankfurt, was bribed by the US authorities holding him as a “protected witness”. The defense exposed him as a CIA informer who stood to collect, on the Libyans’ conviction, up to $4m as a reward. New evidence would have shown that a fragment of a circuit board and bomb timer, “discovered” in the Scottish countryside and said to have been in Megrahi’s suitcase, was probably planted.

Paul Foot, wrote that  the Scottish judges, while admitting a “mass of conflicting evidence” and rejecting the fantasies of the CIA informer, found Megrahi guilty on hearsay. Their 90-page “opinion”, wrote Foot, “is a remarkable document that claims an honored  place in the history of British miscarriages of justice”. (His report, Lockerbie – the Flight from Justice, can be downloaded from http://www.private-eye.co.uk for £5.) Foot reported that most of the staff of the US embassy in Moscow who had reserved seats on Pan Am flights from Frankfurt cancelled their bookings when they were alerted by US intelligence that a terrorist attack was planned.

Britain’s strange constitutional arrangements allowed Gordon Brown, who, although a Scotsman representing a Scottish constituency,  was PM of the UK, to express ersatz outrage at the decision by the Scottish government to allow the release. Not only was this hypocritical because  a release was being negotiated for a long time by the Blair and Brown administrations because of oil and arms sales, but there were doubts about Megrahi’s guilt and the fairness of his trial.

John Pilger was incensed at the hypocrisy of the reaction to Megrahi’s release. “No one in authority has had the guts to state the truth about the bombing of Pan Am Flight 103”.

Tony  Minderbinder Blair

Whether Libya was guilty over Lockerbie or not,  there have, no doubt, been dirty deals. Tony Blair first announced a “new relationship” with Libya in 2004. The Duke of York visited Libya several times, meeting Qaddafi and his son Saif. Minderbinder Blair, now peace envoy in the Middle East, recognized that peace and friendship with  Libya was good for UK plc. British Aerospace could provide employment for British workers by selling arms to Libya. Blair stopped the Serious Fraud Office investigation into BAE bribery charges.

And, of course, there is the oil.

David Cameron is the new Minderbinder in Downing Street. Having sold arms to Quadaffi,  the UK  is now entertaining  the Libyan rats deserting the ship. Speaking at a Downing Street press conference about the defector, Moussa Koussa,  Cameron said: “The decision by the former Libyan minister to come to London to resign his position is a decision by someone at the very top. It tells a compelling story of the desperation and the fear right at the very top of the crumbling and rotten Qaddafi regime.”

However, Lockerbie won’t go away. It was made clear that Koussa’s defection will raise uncomfortable questions about atrocities which happened when he was a senior figure in Libya’s foreign intelligence service. Scottish prosecutors told the Foreign Office they want to interview Koussa about  Pan Am flight 103. He could also face questioning about the murder of Yvonne Fletcher.

Julie MacLusky

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