Tuesday, July 25, 2017

Black ribbons fail to deter militarisation of health ministry

Just three weeks ago, the black ribbon movement – targeting what organisers described as the “militarisation” of the Ministry of Health – seemed to have forced an embarrassing government backdown.

An orthopaedic surgeon wears a ribbon in support of the black ribbon movement at Yangon General Hospital in Yangon on August 11. (Lynn Bo Bo/EPA)An orthopaedic surgeon wears a ribbon in support of the black ribbon movement at Yangon General Hospital in Yangon on August 11. (Lynn Bo Bo/EPA)

The concession from the ministry – that no more military personnel would be appointed to senior positions – took the momentum out of the campaign. Nothing has been posted on the black ribbon movement Facebook page since August 14, and the number of “likes” has risen only slightly since August 11, when it stood at 39,000, to almost 43,000 yesterday.

But what has the campaign really achieved? Staff within the ministry and the broader public health community have told The Myanmar Times that despite the recent promises, they expect the trend to continue.

For years, military officials have been transferred into the ministry. But under the current health minister, Dr Than Aung, a former deputy minister who was appointed to the top post in August 2014, military personnel have been placed into more important positions. Dr Than Aung is also from the military; a former major general, he retired in 2011 after serving as director of the Myanmar Military Medical Corps from 2003 to 2011.

Some senior positions now held by ex-military officers are responsible for managing recruitment, promotions, transfers, demotions and dismissals. In some departments, these former officers are next in line to take over from civilian officials coming up for retirement. According to critics, this serves to reinforce the militarisation trend, as these officials then give military officers priority over civilians.

While the ministry’s permanent secretary, Dr Thet Khine Win, is from a civilian background, both the second permanent secretary, U Sein Win, and the third permanent secretary have military connections.

But ex-military officials also hold a range of other positions in the ministry. This includes the deputy director general of the Medical Care Department Dr Myawanna Soe, who is close to the current minister and expected to take over when director general Dr Myint Hun comes up for mandatory retirement.

In July, a military officer, Colonel Khine Maung Than, was appointed deputy director in the department, replacing Dr San Myint, who was transferred to a less important position in the Public Health Department.

The current acting director general of the Department of Food and Drug Administration, Dr Than Htut, also comes from the military.

Meanwhile, on July 21, another military officer, Lieutenant Colonel Phyi Hein, was appointed deputy director in the Department of Health Professional Resources Development and Management.

These and earlier appointments have lowered morale among career civil servants, who feel overlooked when military personnel, sometimes with no medical experience, are appointed above them, limiting opportunities for progression.

“We have worked a long time in the medical field, but feel like we are not properly recognised,” said a director in the FDA, who asked not to be named. “This campaign was a way of showing our feelings to the minister.”

Against this backdrop the campaign was launched on August 10. The spark was the leaking online of appointment notices for four military officials who had been given deputy director roles or, in some cases more senior positions, despite having no medical experience. They were appointed in July together with nine military personnel with a background in medicine.

Within hours the campaign had gained momentum. Dr Kyaw Kyaw, a former medical superintendant at Yangon General Hospital, recalls hearing his phone receive a flood of Facebook notifications late on August 9, alerting him to the launch.

The campaign’s Facebook page described the appointments constitute an attempt “to progressively infiltrate the Ministry of Health with military officers at different ranks including several key positions”.

Damagingly for the ministry, many working doctors joined the campaign, posting photos of themselves wearing a black ribbon to social media. Comments on the photos have been mostly supportive, with many also complaining about militarisation of other areas of the public service.

In response, the minister’s office announced to its departments on August 11 that it would stop appointing military officials to positions within the ministry.

Second permanent secretary U Sein Win said at the time that it was impossible to transfer the officials back to the Ministry of Defence because they had already resigned from the military. However, he said the ministry was reviewing their appointments in light of the “huge criticism”.

Asked on August 26 about that review, U Sein Win said there had been no changes.

Another ministry spokesperson, U Win Naing, said there was no plan to issue a formal statement confirming that there would be no more military appointees.

The ministry’s lack of action has managed to bring a swift halt to the campaign without making any concrete committments to address its aims.

Within the ministry, however, the same frustrations remain. Dr Kyaw Kyaw says the appointments have split the ministry even further along civilian-military lines. Few believe that the current leadership have any desire to change.

“We can see the government is not following the wishes of the people. They have not taken seriously the concerns raised,” he said.

He added that the July appointments were far from unusual. In 2006, more than 40 officers were shifted to the ministry, but under strict military rule the information was suppressed and there few ways to express discontent.

Dr Chit Soe, a consultant physician and professor at the University of Medicine 2 in North Okkalapa, said he was disappointed by the outcome.

“I joined [the ribbon campaign] because I wanted the military officers who were recently appointed to be sent back,” he said. “But now we can see people are less interested in our movement so the government doesn’t really care about it anymore. We don’t have much hope that they’ll do what we demand.”

Ministry of Health’s structure

Six departments:

  • Medical Care
  • Public Health
  • Medical Research
  • Traditional Medicine
  • Health Professional Resources Development and Management
  • Food and Drug Administration

One director general for each department
One to three deputy director generals under each director general
Up to 15 directors in each department
One to seven deputy directors under each director
One to several assistant directors under each director