Acronym Required

The Myanmar Effect

"'A Catastrophe Within A Catastrophe'". That's how French Foreign Minister Bernard Kouchner described the "junta's uncooperativeness", after Cyclone Nargis devastated the Burmese city of Rangoon and the Irrawaddy Delta a week ago. The political struggles between the obstinate Myanmar military junta and international aid groups and governments trying to help Burma dominate the news. The German paper Spiegel shows a map of areas submerged in the storm earlier this week. The Guardian spoke to Mark Canning, ambassador to Britain, who warned that "authoritative estimates of the numbers of dead and missing ranged between 63,000 and 100,000, and up to 1.9 million were now vulnerable to water-borne disease, hunger and lack of drinkable water. 'So you can do the maths and you will see how quickly this thing can get larger'".

The International Red Cross and other agencies report that there aid is getting through to people that need it --a statement that will encourage donors -- but if that is so, that aid is stretched thin. The junta has confiscated food and equipment from the UN World Food Programme, refused to grant visas to aid workers, and said it will accept cash and material aid but not labor. The Guardian quoted the US ambassador to Thailand, Eric John, who noted in a somewhat awkward analogy that food without distribution capabilities would be like "dropping a lot of orchestral instruments on the ground and expecting a symphony to come out of it."

Let Them Eat Rotting Rice

In Burma equipment and tools are forever scarce, as are all other resources. The military junta takes food from villagers on "good" days, that is, when the government is merely tyrannical, incompetent and brutal but not faced with the aftermath of a massive cyclone that has ripped through a mangrove stripped delta of rice paddies, leaving in its path face down floating bodies and families desperately looking through the rubble for their kin. Given the everyday actions of the junta, it should be no surprise that the government confiscates international food sent for Nargis victims -- that's just what they do. Nor should it surprise us that the government isn't ashamed to dole out supplies with the names of generals written on boxes before news cameras, in some twisted "propaganda exercise", as the International Herald Tribune called it.

The military junta's political shenanigans are to be expected.The rulers are by all accounts paranoid as well as brutal, tenaciously controlling the population via the only methods they know, violence and manipulation. The Free Burma Rangers ¹, a group profiled by here by The Economist, lists the junta's habitual human violations, offenses that often target minority groups like the Karen. The military is accused of everything from stealing supplies to burning villagers out of their villages, to forcing unpaid villagers to clear land, build roads, and walk in front of bulldozers clearing land-mined areas.

Always wrangling to increase its power, the Myanmar military relentlessly pursues its goals, even as citizens are left struggling in the wake of the cyclone without water, food or medicine. The government insisted on holding a referendum to increase its power yesterday, and the military spent considerable effort coercing, forcing and bribing people to vote "yes". With mind blowing cynicism, the leaders had their pictures snapped with their fancy-dressed wives, casting their votes for what all outsiders call a "sham" election, while hundreds of thousands of "people with almost no clothes battl[e] it out to survive" -- as one Indian pilot reported after delivering an aid sortie and traveling through the Irrawaddy Delta.

China, Thailand and India have the most potential for nudging the junta towards accepting responsibility but it's unclear how much sway these governments hold. < !--1a--> China has the closest economic ties to Burma apparently, and it's not clear what incentive it has to mediate, what with it's own abuse of Tibetans and minorities and its interest in Burma's resources. India reports sporadically on its stance on the situation. Burma's neighbor Thailand, for its part, is sending a diplomatic team to Myanmar, and was obviously disturbed to see media films showing Thailand's aid boxes plastered over with labels indicating they were gifts from the junta's generals.

What the junta is actually giving in aid, the Associated Press reports is "minuscule rations of rice and oil", in some places one cup of rice per day per family. AP says many people are simply "clustered on roadsides hoping for handouts," and that desperate pleas -- "[t]he words "'Help us!'" [written] in chalk on the side of one home", are evidence of the level of despair.

Aid First?

Disasters such as Cyclone Nargis exaggerate and bring into stark relief dysfunctional politics, and also present a quandary for international communities. A few years ago, Acronym Required wrote about the Global Fund withdrawing its AIDS program in Burma due to difficulties working with the junta. At the time we commented on the conflicted ideas about providing aid to the repressed citizens of brutal regimes. The AIDS crisis in Burma is serious and any country's bad governance will make a public health or natural disaster recovery infinitely more dire. As we've often documented, politics can worsen the death toll of AIDS or avian flu pandemic, an earthquake, cyclone or tsunami.

The international community is forever torn because there is no good answer. Try to support the citizens in spite of the government? Or condemn and punish the government, which further increases the suffering of the people? The current situation in Burma intensifies this dilemma for the international community.

The world has experienced enough natural disasters in the past couple of years to know the difficulty of getting help to stricken populations. In the U.S., the government was challenged to evacuate survivors swiftly enough, and to deliver aid and essentials in a timely way after Hurricane Katrina. Rescue and supply delivery is increasingly daunting in remote locations of the world, like SE Asia where the tsunami victims were hard to reach, and during the Kashmir earthquake. And in these situations the affected countries welcomed aid. ²

Given the Myanmar junta's treatment of the country's people, its hard not to advocate political change. But that's problematic, since governments around the world acknowledge that the Burmese in the stricken areas are in dire need of the most basic necessities now, not "democracy".

Barbara Bush, who back in 2007 advised that the US would impose sanctions on the Myanmar military government if it did not moving toward democracy "within the next couple of days", used the publicity of last weeks' cyclone to reiterate her displeasure with the military junta. The move was widely criticized by 'those in the aid community who know better', since it could only increase the paranoia of the highly paranoid holed-up-in-the-middle-of-the-jungle junta. This doesn't seem like an challenging notion available only to those in the aid community. You'd think the emerging White House diplomat would carry some insight to deliver a more nuanced diplomatic entreaty from her second grade teacher experience, her recognition of the reasons why the US denied aid from Cuba during Hurricane Katrina, or even because her diplomatic threats to Myanmar never caused the junta to budge before. Now Mrs. Bush seems to have backed off and Secretary Rice insists that Burma Aid Is About Saving Lives, Not About Politics.

Of course, the White House always sends mixed messages. While Mrs. Bush lectured Myanmar from the podium and the Bush administration imposed sanctions, for instance by cutting off the bank accounts of the junta, companies like Chevron provide a lifeline to the regime . Chevron runs a gas line through the country that is aggressively guarded by the junta.

"Tear Down the Bamboo Curtain"

So wrote the Financial Times last fall, and The Australian today. As if the western nations could just summon some erstwhile off-duty troops to parachute into Myanmar, China's neighbor and ally, to take care of things. The press loves to chant a rallying cry for "freedom", and "democracy", and could no doubt not contain itself from referencing what is now relived in popular dream-talk as Reagan's great coup; tearing the wall. It's the business of news to engage fantasies and so these headlines are relentlessly fantastic.

Reporters ask questions like: "Could there be a silver lining to the cyclone's clouds?", as Time magazine and hopefully -- "for decades, outsiders have searched for a way to pry open Burma's secretive regime". As if this is some natural evolution of government, when actually China, Russia and a host of other countries prove that power may be more instinctively and securely amassed via non-democratic and brutish means. And so spooked, but with aid pouring in, Myanmar hunkers down after 40 years to present to the world more of the same. Tons of high-energy biscuits energy bars can go a long way in a junta that was days ago to stealing rice from villagers.

The Myanmar junta is of course defiant in the face of the international democracy criers, defending its own deadly actions by saying that the US government's response to Katrina was also slow. Seeing the same shaky parallel, a dean from the University of Vermont, in an editorial for the Daily Times of Pakistan, wrote offered: "This may also be a time for alerting the world to the grave inequalities in the country, just as Katrina was a wake-up call for the world to see the plight of impoverished African-Americans in Louisiana."

It's hard to imagine that there would be "sides" in the midst of such a disaster, or that politicians would take the opportunity to push political points of view, but of course they do, even in the enlightened western democracies. In the Financial Times yesterday, Christopher Caldwell from the Weekly Standard took the opportunity to reconstruct the events of the Katrina aftermath altogether with the truth defying statement: "that the US failed in part because it was too constitutional, too deferential to the prerogatives of the state of Louisiana, is not something anyone remembers or cares about any more." ("Disasters and Dictatorships").

While countries like the US and France are now trying to muffle their instinctive calls for democracy, other countries will take a different lesson from the cyclone and in the US commentators will frame the disaster for their own ends. If nothing else, attempts to shape and rewrite history are universal.

Hopefully, the Myanmar military junta, weakened to the point that is convinced that it will lose control by letting aid workers in, will come to its senses and realize that in it's own best interests to save some of its people.

In the meantime, to help with aid efforts, various groups are accepting donations for Burma, including Google's matching aid pledge, Doctors Without Borders, Unicef , and many others.

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¹This group, lists itself as a "multi-ethnic humanitarian service movement". It may not be non-denominational since it seems to have some Christian missionary zeal behind its efforts.

²With the exception of India which initially rejected international help after the tsunami.

Acronym Required has published several articles on Hurricane Katrina and FEMA and AIDS and Burma.

For many years, the defense ministries in allied states like the US, Canada and the UK have denied that exposure to depleted uranium (DU) could produce negative health effects. Depleted uranium is a byproduct of uranium 238 (U238) enrichment, and contains a higher percentage of U235, a more fissile isotope that makes DU useful in the production of nuclear weapons and energy. This depleted byproduct is 1.7 times the density of lead, and because of its durability, has been used extensively by militaries for things like armor piercing projectiles and anti-tank weapons. During the Iraq and Balkans wars, when vehicles and weapons clashed together, dust from depleted uranium was released. Bullets made with the depleted uranium were scattered in battle, and shrapnel was strewn about and embedded in wounds. Depleted uranium ordnance now lays scattered throughout previous war zones where children play and civilians attempt to carry on their lives.

Civilians and other species are exposed to depleted uranium not only during war, but via dust in the air around weapons factories and groundwater near firing test ranges like in Solway, Scotland, where scientists find worms that carry uranium isotopes. All of this exposure could prove toxic to animals and humans.

Depleted uranium is not as radioactive as U235 but it is suspected of causing a host of illnesses, from cancer to birth defects in offspring born of soldiers who inhale or ingest it. Research shows that in lab animals, depleted uranium is an immunotoxin, neurotoxin, and teratogen and carcinogen. It is suspected in the host of immune disorders and other conditions like Gulf War Syndrome. Although the deteriorations in the health of some soldiers seems to show the the dangers of DU, there's limited government recognition of these dangers, from military, medical, and science establishments. Even in the face of accumulating evidence and significant public outcry about depleted uranium, militaries give mixed messages about DU safety. The US Department of Defense says:

• "The health effects of uranium have been studied extensively for over 50 years."
• "The Department of Defense has comprehensively studied the environmental fate of depleted uranium both before and after the Gulf War."
• "Fortunately, DU is only mildly radioactive emitting alpha and beta particles, and gamma rays.....The risk of chemical toxicity is also minimal because there is little likelihood that sufficient quantities of DU could be inhaled or ingested to cause a heavy metal concern."
• "Since the Gulf War, the DoD has dramatically stepped up its emphasis on increasing soldier and leader awareness of the hazards associated with the battlefield use of depleted uranium..." through training, handbooks and "support materials".
• "...there is no reason to believe that other exposed Service members have any elevated risk to their health due to their DU exposures."

Similarly, the Ministry of Defense (MOD) for the UK has repeatedly asserted minimal health effects from exposure to depleted uranium, but the MOD also gave warning cards to all UK servicemen deployed to Iraq stating possible health effects of DU. The Ministry of Defense suggests that it's reducing use of DU, noting cryptically of all the accounting of the depleted uranium used by the military: "In 2003, during the recent Iraq conflict, UK tanks expended 1.9 tonnes of DU ammunition and none has been fired since the official ending of the conflict." The MOD urged soldiers to get monitored for depleted uranium, but after testing the urine of returning servicemen the Ministry of Defense told papers in 2006 that "no evidence of DU was found in their urine". Critics question the sensitivity of their tests.

Clearly, the effects of depleted uranium are still disputed and perhaps not a problem, but new research suggests a potential solution. Scientists have discovered a fungus that will break down depleted uranium to a less toxic mineral, research sponsored in part by the Ministry of Defense, produced by scientists at the University of Dundee in Scotland and published in the recent issue of Current Biology. They describe how a plant symbiotic fungus can be grown on the surface of depleted uranium, where it will transform the depleted uranium into uranyl phosphate minerals, a more stable form of the metal that is less likely to be absorbed into plants, animals and water. The mycorrhizal fungi usually lives in the roots of plants, where it transforms carbon into nutrients that plants use. When colonizing uranium, moisture in the air helps the fungi cover the surface of the metal, where the fungi helps accelerate the corrosion process of the uranium into products that can be take up by the fungi or broken down to less toxic uranium holding minerals. The fungi could be used for various bioremediation projects in uranium polluted soils.

Public health requires perseverance. A mutation in a virus responsible for avian flu or in the parasite that causes malaria can instantly change the course of a disease -- who gets infected, where, and how. Many other changes, in politics, economics, leadership, geopolitical stability, funding, even weather can impact progress treating and preventing diseases. Technology also changes the course of disease, although promises of technology advances sometimes provide more sustained satisfaction than the actual technology fulfillments. In the fight against AIDS, for instance, [romises vaccines one-upped promises of retroviral treatment for all, which in turn supplanted promises of prevention through education and condoms. Ths means that progress on the ever devastating HIV/AIDS pandemics takes even more perseverance than many less lethal threats. It's morbid to think there may never be a silver bullet for the HIV/AIDS crisis, but at the least, many more strategies will be tested en route to stanching the devastation of the virus.

Despite global discouragement, there are always optimistic moments, like ten years ago when education and prevention through condom use and social marketing was the crux of HIV/AIDS fight. In September, 1998 Washington Post reported on the "remarkable success" of the new strategies.

Across the world, the paper said, HIV infection rates were decreasing. In places like the Dominican Republic, Brazil, and Uganda, and the Ivory Coast, and in Tanzania,, where a three year trial aimed at decreasing sexually transmitted diseases had "reduced HIV transmission by 40 percent". An administrator from the AIDS Control and Prevention (AIDSCAP), Brian Atwood, told the paper: "this agency has made a global contribution....over the years, we've learned so much about this..."

Learning about the risk of AIDS doesn't necessarily change sexual practices or result in long term success. The AIDSCAP program ran through the 1990's and despite the successes, suffered many obstacles. Any program can be derailed by staff turnover, stigma around disease, misunderstanding of disease etiology, uneven programming, funding shortages, interruptions, and politics.

Today in Tanzania infection rates are lower than places like South Africa, averaging at about 8%, but overall life expectancy has decreased by 8 years due to AIDS. While HIV infection in urban areas declined by 16.65% from 2000 to 2005, in rural areas infection rates have markedly increased. Other critical economic development measures have also regressed in Tanzania, for instance literacy rates dropped from 80% in 1980, to 60% today. In one survey of adults, 52% of women and 62.5% of men believed that a teacher who has "the AIDS virus but is not sick should be allowed to continue teaching."

Now, an experimental trial in Tanzania will attempt to attack this complex knot of problems underlying the HIV/AIDS epidemic with a market solution. The Financial Times wrote last weekend about a project in Tanzania that would pay people who practiced safe sex. The trial participants would take regular tests for sexually transmitted diseases like gonorrhea, and be paid about $45 if they remained disease free. The control arm of the trial would not be paid. All would be treated for any infections. Sexually transmitted diseases increase the risk of becoming HIV infected and Tanzania has long focused on this connection.

The project is sponsored by the World Bank, William and Flora Hewlett Foundation, the Population Reference Bureau and the Spanish Impact Evaluation Fund (affiliated with the World Bank). The Financial Times quoted Carol Medlin, a researcher on the project from the University of California, San Francisco, who said: "We hope this 'reverse prostitution' will make people think hard about the long-term consequences of their short-term behaviour."

The move is controversial -- can paying people for intrinsic choices motivate them? Can the complex set of problems underlying AIDS epidemics, involving everything from public health infrastructure, to politics, social norms, economics, and leadership, be resolved by motivating personal choices with money? In an accompanying editorial ("Cash for safe sex; Bribing Africans to be careful is bizarre - and worth a try"), the Financial Times suggested that the scope of the problem warrants such an attempt: "In the face of an appalling Aids epidemic, we should overcome our unease." Should we?