Introduction and Background
Numerous violent expulsions and panicked flights of the Rohingya, a minority population mainly from Rakhine state in Myanmar, have been documented since the 18th century, but their incidence and scale have increased since 1978. Of a population estimated at 1-1.3 million, over 700,000 Rohingya fled Rakhine in late 2017, joining hundreds of thousands of Rohingya already living in exile in squalid refugee camps in Bangladesh. (1) The 2017 expulsion of and flight by Rohingya is the largest yet. Although Rohingya-led violence is well-documented (2) many argue that the response of the Myanmar state is grossly disproportionate. The adverse health effects of this violence and exile are immense, profound, diverse and multi-generational. (1,3) They may arise from social responses to deteriorating physical ecology.
Rakhine is fertile, but growing tension over resource distribution, (4) combined with weak institutions and population growth, have been identified as likely to contribute to human insecurity in Myanmar. The 1994 Rwandan genocide has been postulated as an “eco-social” phenomenon, arising from growing resource scarcity interacting with social ecology, expressed as fear of the other, racism, and entrenched beliefs and behaviors, expressed by both victim and perpetrator groups. (5) It is here theorized that many subtle changes, as yet poorly studied, in the physical ecology of Rakhine have contributed to the plight of the Rohingya. As in Rwanda, a dynamic of competing social ecologies has generated violence, on a background of real and perceived resource scarcity.
Many vested interests inhibit resolution, and even diagnosis of this chronic health emergency. The most obvious obstacle is the hostility of the dominant Buddhist population in Rakhine, supported by an aggressive central government and military. United Nations Security Council action is inhibited by China, which shares with Myanmar anti-democratic impulses and practices. (4)
Diagnosis and remedy of the Rohingya crisis is also inhibited by dominant neoliberal academic discourse, which for decades has suppressed and failed to integrate the multi-disciplinary evidence that underpin and explain the growing planetary heath emergency. (5) Two particularly important strands are approaching limits to growth (6) and the once widely accepted view that rapid population growth generates and entraps impoverished populations. (7)
In response to the most recent crisis, the United Nations High Commission for Refugees has helped to fund Rohingya camps, supported by many aid groups, such as Médecins Sans Frontières. (1) There has been much criticism of Myanmar authorities, especially from Western sources. Inevitably, however, these criticisms and attempts to assist, even if noble, can do little to solve the really deep causes.
Although aggression, fear, violence and hatred have deep evolutionary roots, a future can still be created in which populations, even if culturally diverse, such as in Rakhine, live in partial harmony, or at least co-exist. Implementation of these solutions has several pre-conditions. These include a global re-awakening, both high-level and distributed, that the scale of human co-operation needs to be widened to the planetary level, and an evolution of technology which allows the worst physical manifestations of adverse environmental change to be kept within tolerable levels.
It will be interesting to see if the Planetary Health conference includes any papers on the Rohingya, and for that matter, any of the many other cases of what I have called "regional overload". I am rather doubtful. In 2016 I was invited to submit a longer version of these arguments for the first issue of the new journal Lancet Planetary Health - but only if accompanied by US$5,000 (for a research paper, not a commentary). In a world of intensifying market forces, where publishing is corrupted by money and power, this is not surprising.
1. White K. (2017) Rohingya in Bangladesh: an unfolding public health emergency. Lancet 390:1947.
2. International Crisis Group. Myanmar: A new Muslim insurgency in Rakhine State (2016) https://www.crisisgroup.org/asia/south-east-asia/myanmar/283-myanmar-new-muslim-insurgency-rakhine-state
3. Riley A, Varner A, Ventevogel P, Hasan MMT, Welton-Mitchell C. (2017) Daily stressors, trauma exposure, and mental health among stateless Rohingya refugees in Bangladesh. Transcult Psychiatry 54(3).
4. Kattelus M, Rahaman MM, Varis O. (2014) Myanmar under reform: Emerging pressures on water, energy and food security. Nat Resources Forum 38(2):85-98.
5. Andre, C., Platteau, J-P. (1998) Land relations under unbearable stress:Rwanda caught in the Malthusian trap. J Econ Behav Organizn 34, 1-47; 75. Butler C.D. (2000): Entrapment: global ecological and/or local demographic?Reflections upon reading the BMJ's "six billion day" special issue. Ecosyst Hlth 6, 171-180.
6. Bolopion P. (2017) How long will UN Security Council be missing in actionon Burma? New resolution opportunity for Council to address crisis. Human Rights Watch.
7. Butler C.D. (2017) Limits to growth, planetary boundaries and planetary health. Current Opinion Envtl Sustainability 25: 59-65; Butler C.D. (2017) Regional overload, and the consequences it has for health. BMJ http://blogs.bmj.com/bmj/2017/01/20/colin-d-butler-regionaloverload-and-the-consequences-it-has-on-public-health/; Butler C.D. (2016) Planetary Overload, Limits to Growth and Health. Curr Envtl Hlth Reports 3(4): 360-369; Butler C.D. (2016) Sounding the alarm: Health in the Anthropocene. Int J Envtl Res Pub Hlth 13, 665
8. Butler, C.D., Higgs, K. McFarlane, RA. Environmental health, planetary boundaries and four futures. In Bachmann, T. (editor) Encyclopaedia of Environmental Health, Elsevier (submitted).