Myanmarese (Burmese): Karen, Chin and Rohingya women

Cultural Profile

Migration History

Burma is one of the most ethnically diverse nations in the world. Out of Burma’s population of approximately 45 million, around one-third come from ethnic minority groups, principally the Mon, Kachins, Chins, Shans, Rohingyas and Karen, each of whom have traditionally dominated a particular area of the country (UNHCR, 2011). When Burma regained independence from Britain in 1947, the Burmese Government ignored many of the promises made by the British to ethnic minority groups. As a consequence, many ethnic groups formed armed resistance movements in opposition to the Burman dominated-government.

Since a military coup in 1962, a repressive military regime, the State Peace and Development Council (SPDC) resisted a return to democracy, resulting in years of armed opposition to the Government and a dismal record of human rights violations (UNHCR, 2011). In 1988, a student uprising ended in a massacre, with thousands of mainly Karen people fleeing to the Thai border. In 1990, a national election resulted in a democratic victory, but the military regime refused to cede power (UNHCR, 2011). Fighting intensified, with continued human rights violations and the flow of refugees to Thai border camps.

Since the SPDC began forcibly relocating minority ethnic groups, they have destroyed nearly 3000 villages, particularly in areas of active ethnic insurgency and areas targeted for economic development. Abuses by the Burmese military against civilians include the widespread use of anti-personnel landmines, sexual violence against women and girls, extrajudicial killings, forced labour, torture, beatings, targeting of food production and means of civilian livelihood, and confiscation of land and property (UNHCR, 2011).

From 2011–2015, a series of political, economic and administrative reforms were undertaken in Myanmar by the military-backed government. These reforms include the release of pro-democracy leader Aung San Suu Kyi from house arrest, the establishment of the National Human Rights Commission, general amnesties of more than 200 political prisoners, the introduction of new labour laws allowing labour unions and strikes, the relaxation of press censorship, and the regulation of currency practices (Wikipedia, 2015). However, uncertainties exist as some other political prisoners have not been released and clashes between Myanmar troops and local insurgent groups continue. Human rights violations continue.

There are an estimated one million internally displaced persons in Burma, and several hundred thousand Burmese refugees in Bangladesh, India, Malaysia and especially neighbouring Thailand (Ministry of Health, 2012). In recent years, there has been a significant rise in the number of ethnic minority Burmese refugees arriving in New Zealand.

Many refugees from Myanmar have spent years in dangerous refugee camps with minimal health care and education opportunities. Many suffer the impact of the psychological trauma of their refugee experiences, and the extensive loss of family and community members. Adjusting to life in New Zealand is challenging. Many families arrive with little or no English language skills and have difficulty finding employment.

Burmese women and girls may have a history of sexual assault and abuse. Gynaecological examinations may evoke strong emotional and psychological responses. Same gender health providers are vital for these examinations. Whilst women traditionally have ante and postnatal support from traditional midwives, women in refugee camps will not have had access to this support. Women are likely to be isolated from the family and community networks which would traditionally provide childrearing and emotional support (Waitemata DHB, eCALD® Services, 2015). Women may continue traditional health practices while utilising western medicine.

Main language and dialects

The main language spoken in Burma is Burmese. The other languages/dialects spoken by Burmese include: Mon, Kachin, Chin, Shan, Rohingya and Karen languages. Many ethnic minorities do not speak Burmese.

Religious beliefs and practices

• Buddhism, predominantly the Theravada tradition is practiced by 90% of Burmese. Practitioners are mostly among the dominant ethnic groups in Burma: Burmese, Shan, Rakhine, Mon, Karen, and Chinese, who are well integrated into Burmese society. The culture and world view of the people of Burma is very influenced by Buddhism, and although some ethnic minorities practice other religions, it is often in conjunction with Buddhist principles.
• Nat worship is practised usually in conjunction with Buddhism mostly by ethnic Burmese and more so in rural areas. Nats are a collection of deities including spirits of trees, rivers, ancestors, snakes and the spirits of people who are believed to have met violent or tragic deaths, and wreak destructive vengeance on people who annoy them. Many houses contain a nat sin or nat ein, which essentially serve as altars to nats. Villages often have a patron Nat.
• Some Burmese ethnic groups are Christian including Catholics and Protestants, and followers of the Wa church (an ethnic minority from China) which is Baptist in character.
• Hinduism and Islam are also represented in smaller numbers.
• Rohingya peoples are Muslims (Waitemata DHB, eCALD® Services, 2015).

Traditional family values

Years of repression have had a negative impact on the traditional Burmese and Burmese ethnic minority cultures. However, Burmese groups remain family and religious-oriented with the following features. Amongst most ethnicities:

• Families are usually extended, although due to the refugee experience and migration many families in New Zealand are nuclear families.
• Social class lines are strong and so there is little social mobility.
• Initiation into adulthood begins at nine and for boys with the shin-pyu ceremony which is traditionally followed by several weeks in a monastery as a novice (this is often not possible after resettlement).
• The nahtwin ceremony for girls is followed by having the ears pierced.
• Thanaka, a pale yellow paste applied to the cheeks and forehead is still used and some refugees may arrive in New Zealand wearing this application (more often girls and women).

Health care beliefs and practices

Traditionally, health is thought to be related to harmony in and between the body, mind, soul and the universe. Imbalances amongst these elements (eg the "hot" and "cold" states within the body) can cause illness. As in most other Southeast Asian cultures treatment would then be with medicines or foods, and practices that have the opposite quality to restore balance

• Supernatural factors such as spirit possession by a Nat or an ancestor can cause ill health.
• Spiritual factors such as bad karma or non-observance of a religious ethic are seen as a possible causative factor.
• Traditional beliefs:
  • A culture bound illness referred to as Koro in which there is a fear that the genitalia will recede into the body and that if they recede completely, death will occur.
  • Among women, menstrual flow is thought to be critical to health and, depending on the flow, an indication of good or poor physical and mental health.
• Western medicine and the concept that illness can be the result of external factors such as accidents and infectious diseases is accepted by many, especially those who have lived in refugee camps or come from urban areas. As with many resettled peoples, the degree to which traditional practices are Adapted and modified varies enormously.

Traditional treatments and practices

• Dietary changes are commonly used to treat illness. Depending on the illness, an increase in or reduction of one or more of the six Burmese tastes (sweet, sour, hot, cold, salty, bitter) may be indicated.
• Herbal medicines are used by many Burmese, particularly for minor ailments (eg Yesah which is a herbal cure-all substance, lotions for aches and pains, pastes applied to wounds and abscesses).
• Western medicine has been integrated into much of the urban Burmese culture. Many Burmese refugees will have had some experience of western medical care in refugee camps.
• Integrated practices are common and many clients may integrate herbal and other traditional practices with western interventions. Practitioners may need to assess what herbal remedies are being taken for potential drug interactions.