Health and Human Rights:
Medicine is Politics
In 1847 Rudolf Virchow was only 26 years of age, but he was already one
of Germany's greatest scientists. In that year, the Berlin City Council
asked Virchow to investigate an epidemic of typhus which had broken out
in upper Silesia (currently located in Poland). Virchow concluded that the
cause of the epidemic was "mismanagement of the region by the Berlin
government". Virchow's recommendations included full democracy for
Silesia, allowing Polish as the official language of the region, the
separation of church and state, shifting the burden of taxation from
the poor to the rich, a program for road construction, the improvement
of agriculture, and the establishment of farming cooperatives. The Berlin
Council was very unhappy with Virchow's report. The Council criticized
Virchow for producing a political document rather than the scientific
report which they thought they had commissioned. Virchow then made his
famous statement which still resonates 155 years later:
Medicine is a social science and politics is nothing
but medicine writ large!
Virchow further claimed that if medicine were to be successful then it
must enter political and social life because diseases were caused by
defects in society. He claimed that,
If disease is an expression of individual life under
unfavourable circumstances, then epidemics must be indicative of mass
It is now well accepted in public health circles that the Burmese HIV
epidemic is one of the world's fastest growing and most pervasive.
According to Dr Peter Piot, UNAIDS's Executive Director, Burma currently
has at least 500,000 to 700,000 people with HIV/AIDS the second
worst AIDS epidemic in Asia after Cambodia. The Southeast Asian
Information Network and other non-governmental organisations have
confirmed Piot's estimate. The Burmese junta, however, claims that there
are only 21503 confirmed cases of HIV infection and 2854 cases of AIDS in
Burma. (Dr Chris Beyrer)
The junta's refusal to recognize the epidemics clearly indicated that
this political and humanitarian crisis is caused by their massive
mismanagement, corruption and policy failure.
Pro-military people who visited Burma would come back and say
... now Burma is progressing ... with how many
hundreds of new hotels, how many lanes of highways ... etc.
Are the number of hotels and night clubs, the criteria for measuring the
progress of one country?
Thirteen years ago when we were working at Rangoon General Hospital,
the blood test for electrolytes (which is a basic and essential test for
management of renal diseases, strokes, snake bites, malaria, etc.) could
be done in the hospital lab and results could be obtained quickly for a seriously ill patient. Nowadays, this test is done at an outside clinic,
which is located just across the road from the hospital, and it costs
3000 kyats per test.
While health is understood to include physical, mental and social
well-being, it is concluded that the violation or neglect of any human
right will impact adversely on health. In every nation in the world,
government is a key player in the health sector. Human rights regarding
health require that the state provide health care that individuals are
not able to obtain or provide on their own. The failure of the SPDC to
acknowledge the HIV and other health problems in Burma is proof that the
SPDC is not acting like an elected/official government. Because they are
not the government, it is not surprising that they do not realize the
duty of the government. Unless democracy is restored in Burma by
replacing the illegal regime with an elected government, the
HIV/AIDS epidemic in Burma is likely to spiral ever more out of control.
As Virchow so eloquently described 155 years ago,
Medicine is Politics
Dr. Khin Saw Win
This commentary is based on a posting Dr. Khin Saw Win
made in the soc.culture.burma newsgroup and the FreeBurma Yahoo! Group on 2001-11-02. The posting has been edited for inclusion on the Burma Watch
International Web site.
The original posting was translated into Japanese and published in the Japanese Human Rights Magazine.