Executive Summary: "This report reveals that the health of populations in conflict-affected areas of eastern Burma, particularly women and children, is amongst the worst in the world, a result of official disinvestment in health, protracted conflict and the abuse of civilians..."Diagnosis: Critical" demonstrates that a vast area of eastern Burma remains in a chronic health emergency, a continuing legacy of longstanding official disinvestment in health, coupled with protracted civil war and the abuse of civilians. This has left ethnic rural populations in the east with 41.2% of children under five acutely malnourished. 60.0% of deaths in children under the age of 5 are from preventable and treatable diseases, including acute respiratory infection, malaria, and diarrhea. These losses of life would be even greater if it were not for local community-based health organizations, which provide the only available preventive and curative care in these conflict-affected areas. The report summarizes the results of a large scale population-based health and human rights survey which covered 21 townships and 5,754 households in conflict-affected zones of eastern Burma. The survey was jointly conducted by the Burma Medical Association, National Health and Education Committee, Back Pack Health Worker Team and ethnic health organizations serving the Karen, Karenni, Mon, Shan, and Palaung communities. These areas have been burdened by decades of civil conflict and attendant human rights abuses against the indigenous populations. Eastern Burma demographics are characterized by high birth rates, high death rates and the significant absence of men under the age of 45, patterns more comparable to recent war zones such as Sierra Leone than to Burma?s national demographics. Health indicators for these communities, particularly for women and children, are worse than Burma?s official national figures, which are already amongst the worst in the world. Child mortality rates are nearly twice as high in eastern Burma and the maternal mortality ratio is triple the official national figure. While violence is endemic in these conflict zones, direct losses of life from violence account for only 2.3% of deaths. The indirect health impacts of the conflict are much graver, with preventable losses of life accounting for 59.1% of all deaths and malaria alone accounting for 24.7%. At the time of the survey, one in 14 women was infected with Pf malaria, amongst the highest rates of infection in the world. This reality casts serious doubts over official claims of progress towards reaching the country?s Millennium Development Goals related to the health of women, children, and infectious diseases, particularly malaria. The survey findings also reveal widespread human rights abuses against ethnic civilians. Among surveyed households, 30.6% had experienced human rights violations in the prior year, including forced labor, forced displacement, and the destruction and seizure of food. The frequency and pattern with which these abuses occur against indigenous peoples provide further evidence of the need for a Commission of Inquiry into Crimes against Humanity. The upcoming election will do little to alleviate the situation, as the military forces responsible for these abuses will continue to operate outside civilian control according to the new constitution. The findings also indicate that these abuses are linked to adverse population-level health outcomes, particularly for the most vulnerable members of the community—mothers and children. Survey results reveal that members of households who suffer from human rights violations have worse health outcomes, as summarized in the table above. Children in households that were internally displaced in the prior year were 3.3 times more likely to suffer from moderate or severe acute malnutrition. The odds of dying before age one was increased 2.5 times among infants from households in which at least one person was forced to provide labor. The ongoing widespread human rights abuses committed against ethnic civilians and the blockade of international humanitarian access to rural conflict-affected areas of eastern Burma by the ruling State Peace and Development Council (SPDC), mean that premature death and disability, particularly as a result of treatable and preventable diseases like malaria, diarrhea, and respiratory infections, will continue. This will not only further devastate the health of communities of eastern Burma but also poses a direct health security threat to Burma?s neighbors, especially Thailand, where the highest rates of malaria occur on the Burma border. Multi-drug resistant malaria, extensively drug-resistant tuberculosis and other infectious diseases are growing concerns. The spread of malaria resistant to artemisinin, the most important anti-malarial drug, would be a regional and global disaster. In the absence of state-supported health infrastructure, local community-based organizations are working to improve access to health services in their own communities. These programs currently have a target population of over 376,000 people in eastern Burma and in 2009 treated nearly 40,000 cases of malaria and have vastly increased access to key maternal and child health interventions. However, they continue to be constrained by a lack of resources and ongoing human rights abuses by the Burmese military regime against civilians. In order to fully address the urgent health needs of eastern Burma, the underlying abuses fueling the health crisis need to end."